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Major Adverse Cardiovascular Events During Invasive Pneumococcal Disease Are Serotype Dependent.
Africano, Hector F; Serrano-Mayorga, Cristian C; Ramirez-Valbuena, Paula C; Bustos, Ingrid G; Bastidas, Alirio; Vargas, Hernan A; Gómez, Sandra; Rodriguez, Alejandro; Orihuela, Carlos J; Reyes, Luis F.
Afiliação
  • Africano HF; Universidad de la Sabana, Chía, Colombia.
  • Serrano-Mayorga CC; Universidad de la Sabana, Chía, Colombia.
  • Ramirez-Valbuena PC; Universidad de la Sabana, Chía, Colombia.
  • Bustos IG; Universidad de la Sabana, Chía, Colombia.
  • Bastidas A; Universidad de la Sabana, Chía, Colombia.
  • Vargas HA; Grupo Laboratorio de Salud Pública de Bogotá; Secretaría de Salud de Bogotá, Colombia.
  • Gómez S; Laboratorio de salud pública del Tolima, Secretaria de salud del Tolima, Gobernación del Tolima.
  • Rodriguez A; Grupo Laboratorio de Salud Pública de Bogotá; Secretaría de Salud de Bogotá, Colombia.
  • Orihuela CJ; Hospital Universitari Joan XXIII, Critical Care Medicine, Rovira and Virgili University and CIBERES (Biomedical Research Network of Respiratory Disease), Tarragona, Spain.
  • Reyes LF; The University of Alabama at Birmingham, Birmingham, Alabama, USA.
Clin Infect Dis ; 72(11): e711-e719, 2021 06 01.
Article em En | MEDLINE | ID: mdl-32964223
ABSTRACT

BACKGROUND:

Up to 30% of patients admitted to hospitals with invasive pneumococcal disease (IPD) experience major adverse cardiovascular event (MACE) including new/worsening heart failure, new/worsening arrhythmia, and/or myocardial infarction. Streptococcus pneumoniae (Spn) is the most frequently isolated bacterial pathogen among community-acquired pneumonia (CAP) patients and the only etiological agent linked independently to MACE. Nevertheless, no clinical data exist identifying which serotypes of Spn are principally responsible for MACE.

METHODS:

This was an observational multicenter retrospective study conducted through the Public Health Secretary of Bogotá, Colombia. We included patients with a confirmed clinical diagnosis of IPD with record of pneumococcal serotyping and clinical information between 2012 and 2019. Spn were serotyped using the quellung method by the National Center of Microbiology. MACE were determined by a retrospective chart review.

RESULTS:

The prevalence of MACE was 23% (71/310) in IPD patients and 28% (53/181) in patients admitted for CAP. The most prevalent S. pneumoniae serotype identified in our study was the 19A, responsible for the 13% (42/310) of IPD in our cohort, of which 21% (9/42) presented MACE. Serotypes independently associated with MACE in IPD patients were serotype 3 (odds ratio [OR] 1, 48; 95% confidence interval [CI] [1.21-2.27]; P = .013) and serotype 9n (OR 1.29; 95% CI [1.08-2.24]; P = .020). Bacteremia occurred in 87% of patients with MACE. Moreover, serum concentrations of C-reactive protein were elevated in patients with MACE versus in non-MACE patients (mean [standard deviation], 138 [145] vs 73 [106], P = .01).

CONCLUSIONS:

MACE are common during IPD with serotype 3 and 9n independently of frequency.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Infecções Pneumocócicas / Insuficiência Cardíaca Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans / Infant País como assunto: America do sul / Colombia Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Infecções Pneumocócicas / Insuficiência Cardíaca Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans / Infant País como assunto: America do sul / Colombia Idioma: En Ano de publicação: 2021 Tipo de documento: Article