Bacterial aetiology and mortality in COPD patients with CAP: results from the German Competence Network, CAPNETZ.
Int J Tuberc Lung Dis
; 21(2): 236-243, 2017 02 01.
Article
in En
| MEDLINE
| ID: mdl-28234091
ABSTRACT
BACKGROUND:
Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality, and chronic obstructive pulmonary disease (COPD) is a frequent comorbidity. The bacterial aetiology of CAP-COPD and its possible associations with serum markers and mortality are incompletely understood.OBJECTIVES:
1) To assess the bacterial aetiology of CAP only and CAP-COPD, and 2) to study the association between bacterial aetiology, empirical antibiotic treatment, serum markers and mortality.METHODS:
Of 1288 patients with CAP (57.0% males, age 59.0 years ± 18.5), 262 (20.3%) fulfilled the diagnostic criteria for COPD. Differences between subgroups were investigated using univariate analyses and corrected for multiple comparisons.RESULTS:
Streptococcus pneumoniae was the most common pathogen (30.8% CAP only vs. 26.0% CAP-COPD, not significant). Haemophilus influenzae was significantly more frequent in CAP-COPD (5.6% CAP only vs. 26.0% CAP-COPD, P < 0.001). The number given adequate empirical antibiotic treatment was comparable (83.3% CAP only vs. 83.6% CAP-COPD, P > 0.05). The CAP-COPD group had worse CURB-65 and partial pressure of arterial oxygen levels than the CAP only group (P < 0.001). Partial pressure of arterial carbon dioxide levels were increased in CAP-COPD patients without pathogen detection (P < 0.001). Short- (P = 0.011) and long-term mortality (P = 0.006) were highest in CAP-COPD without pathogen detection.CONCLUSION:
It is important to identify COPD patients with CAP. In particular, those without bacterial pathogen detection have more severe CAP and are at higher risk of dying. Better understanding of the aetiology could contribute to improved management and treatment of CAP in COPD patients.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Community-Acquired Infections
/
Pneumonia, Bacterial
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Pulmonary Disease, Chronic Obstructive
/
Anti-Bacterial Agents
Type of study:
Clinical_trials
/
Observational_studies
/
Prognostic_studies
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
En
Journal:
Int J Tuberc Lung Dis
Year:
2017
Document type:
Article
Affiliation country:
Países Bajos