Major Adverse Cardiovascular Events During Invasive Pneumococcal Disease Are Serotype Dependent
| Autor: | Hernan Vargas, Alejandro Rodriguez, Ingrid G Bustos, Alirio Bastidas, Luis F. Reyes, Hector F Africano, Sandra Gomez, Carlos J. Orihuela, Paula C. Ramirez-Valbuena, Cristian C. Serrano-Mayorga |
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| Rok vydání: | 2020 |
| Předmět: |
Microbiology (medical)
Serotype medicine.medical_specialty Colombia Serogroup medicine.disease_cause Pneumococcal Infections Pneumococcal Vaccines 03 medical and health sciences 0302 clinical medicine Internal medicine Streptococcus pneumoniae medicine Humans cardiovascular diseases 030212 general & internal medicine Serotyping Online Only Articles Retrospective Studies Heart Failure business.industry Infant Retrospective cohort study Odds ratio Pneumonia Pneumococcal medicine.disease Infectious Diseases 030228 respiratory system Bacteremia Cohort Quellung reaction business Mace |
| Zdroj: | Clin Infect Dis |
| ISSN: | 1537-6591 1058-4838 |
| DOI: | 10.1093/cid/ciaa1427 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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