Q Fever Pneumonia in French Guiana: Prevalence, Risk Factors, and Prognostic Score
| Autor: | Anne-Sophie Drogoul, Cédric B Chesnais, Aba Mahamat, Félix Djossou, Didier Raoult, Charlotte Boullé, Loïc Epelboin |
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| Přispěvatelé: | Unité des Maladies Infectieuses et Tropicales (UMIT), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Université de Guyane (UG), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), Institut Pasteur de la Guyane, Réseau International des Instituts Pasteur (RIIP), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Service de médecine interne et maladies tropicales, CHU Bordeaux [Bordeaux]-Groupe hospitalier Saint-André, Équipe opérationnelle d’hygiène hospitalière, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Université Montpellier 1 (UM1)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS) |
| Rok vydání: | 2012 |
| Předmět: |
Male
[SDV]Life Sciences [q-bio] 0302 clinical medicine Risk Factors [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases Prevalence Cluster Analysis 030212 general & internal medicine Aged 80 and over biology Middle Aged Prognosis French Guiana 3. Good health Community-Acquired Infections Infectious Diseases Predictive value of tests Female Q Fever medicine.drug Adult MESH: Pneumonia Bacterial/epidemiology Microbiology (medical) medicine.medical_specialty Adolescent 030231 tropical medicine Q fever 03 medical and health sciences Predictive Value of Tests Internal medicine Pneumonia Bacterial medicine Humans Risk factor Intensive care medicine Aged Retrospective Studies business.industry Retrospective cohort study Amoxicillin MESH: Community-Acquired Infections/epidemiology medicine.disease Coxiella burnetii biology.organism_classification Confidence interval respiratory tract diseases Pneumonia Logistic Models Multivariate Analysis MESH: Q Fever/epidemiology business [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology |
| Zdroj: | Clinical Infectious Diseases Clinical Infectious Diseases, Oxford University Press (OUP), 2012, 55 (1), pp.67-74. ⟨10.1093/cid/cis288⟩ Clinical Infectious Diseases, 2012, 55 (1), pp.67-74. ⟨10.1093/cid/cis288⟩ |
| ISSN: | 1537-6591 1058-4838 |
| DOI: | 10.1093/cid/cis288 |
| Popis: | Background Community-acquired pneumonia (CAP) is the major manifestation of Q fever, an emerging disease in French Guiana. Consequently, the empirical antibiotherapy used for the treatment of CAP combines doxycycline and the recommended amoxicillin. Our objectives were to estimate the prevalence of Q fever pneumonia and to build a prediction rule to identify patients with Q fever pneumonia for empirical antibiotic guidance. Methods A retrospective case-control study was conducted on inpatients admitted with CAP in the Department of Infectious Diseases of Cayenne Hospital from 2004 to 2007. Serodiagnosis for Coxiella burnetii was performed for all patients. Risk factor analysis was performed using multivariate logistic regression, and a prognostic score was computed using bootstrap procedures. The score performance characteristics were used to choose the best prediction rule to identify patients with Q fever pneumonia. Results One hundred thirty-one patients with CAP were included and the Q fever pneumonia prevalence was 24.4% (95% confidence interval [CI], 17.1-31.9). In multivariate analysis, male sex, middle age (age, 30-60 years), headache, leukocyte count 185 mg/L were independently associated with Q fever pneumonia. Patients with a predictive score ≤3 had a low risk of Q fever pneumonia with a negative predictive value of 0.97 (95% CI, .90-1) and a sensitivity of 0.97 (95% CI, .89-1). Conclusions The prediction rule described here accurately identifies patients with low risk of Q fever pneumonia and may help physicians to make more rational decisions about the empirical use of antibiotherapy. Further prospective studies should be performed to validate this score. |
| Databáze: | OpenAIRE |
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