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Clinical Characteristics of Community-Acquired Viridans Streptococcal Pneumonia.

Choi SH, Cha SI, Choi KJ, Lim JK, Seo H, Yoo SS, Lee J, Lee SY, Kim CH, Park JY - Tuberc Respir Dis (Seoul) (2015)

Bottom Line: We compared various clinical parameters between the VS group and the control group.It is characterized by less frequent productive cough, more frequent bed-ridden status, and less common CT pulmonary parenchymal lesions.However, its treatment outcome and clinical course are similar to those of pneumococcal pneumonia.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.

ABSTRACT

Background: Viridans streptococci (VS) are a large group of streptococcal bacteria that are causative agents of community-acquired respiratory tract infection. However, data regarding their clinical characteristics are limited. The purpose of the present study was to investigate the clinical and radiologic features of community-acquired pneumonia (CAP) with or without parapneumonic effusion caused by VS.

Methods: Of 455 consecutive CAP patients with or without parapneumonic effusion, VS were isolated from the blood or pleural fluid in 27 (VS group, 5.9%) patients. Streptococcus pneumoniae was identified as a single etiologic agent in 70 (control group) patients. We compared various clinical parameters between the VS group and the control group.

Results: In univariate analysis, the VS group was characterized by more frequent complicated parapneumonic effusion or empyema and bed-ridden status, lower incidences of productive cough, elevated procalcitonin (>0.5 ng/mL), lower age-adjusted Charlson comorbidity index score, and more frequent ground glass opacity (GGO) or consolidation on computed tomography (CT) scans. Multivariate analysis demonstrated that complicated parapneumonic effusion or empyema, productive cough, bed-ridden status, and GGO or consolidation on CT scans were independent predictors of community-acquired respiratory tract infection caused by VS.

Conclusion: CAP caused by VS commonly presents as complicated parapneumonic effusion or empyema. It is characterized by less frequent productive cough, more frequent bed-ridden status, and less common CT pulmonary parenchymal lesions. However, its treatment outcome and clinical course are similar to those of pneumococcal pneumonia.

No MeSH data available.


Related in: MedlinePlus

Antibiotic regimens for community-acquired pneumonia. Each regimen includes the following antibiotics: cefotaxime+macrolide: cefotaxime (or ceftriaxone) plus macrolide (or fluoroquinolone); ampicillin+sulbactam: ampicillin+sulbactam with or without macrolide; piperacillin+tazobactam: piperacillin+tazobactam (piperacillin+sulbactam, ticarcillin+clavulanic acid, or maxipime) with or without fluoroquinolone (or macrolide); cefotaxime+clindamycin: cefotaxime plus clindamycin; meropenem+teicoplanin: meropenem plus teicoplanin (or vancomycin); levofloxacin: levofloxacin (or moxifloxacin).
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Figure 2: Antibiotic regimens for community-acquired pneumonia. Each regimen includes the following antibiotics: cefotaxime+macrolide: cefotaxime (or ceftriaxone) plus macrolide (or fluoroquinolone); ampicillin+sulbactam: ampicillin+sulbactam with or without macrolide; piperacillin+tazobactam: piperacillin+tazobactam (piperacillin+sulbactam, ticarcillin+clavulanic acid, or maxipime) with or without fluoroquinolone (or macrolide); cefotaxime+clindamycin: cefotaxime plus clindamycin; meropenem+teicoplanin: meropenem plus teicoplanin (or vancomycin); levofloxacin: levofloxacin (or moxifloxacin).

Mentions: Productive cough was significantly less common in the VS group than in the control group. Complicated parapneumonic effusion or empyema occurred more frequently in the VS group than in the control group. The PSI and CURB-65 scores did not significantly differ between the two groups. No differences were observed in clinical course parameters between the two groups, including hospital stay, success rate, and inhospital mortality. Overall, the median duration of follow-up was 46 days (IQR, 12-113 days). The most commonly used antibiotic regimen in the two groups was cefotaxime or ceftriaxone plus macrolide or fluoroquinolone (Figure 2).


Clinical Characteristics of Community-Acquired Viridans Streptococcal Pneumonia.

Choi SH, Cha SI, Choi KJ, Lim JK, Seo H, Yoo SS, Lee J, Lee SY, Kim CH, Park JY - Tuberc Respir Dis (Seoul) (2015)

Antibiotic regimens for community-acquired pneumonia. Each regimen includes the following antibiotics: cefotaxime+macrolide: cefotaxime (or ceftriaxone) plus macrolide (or fluoroquinolone); ampicillin+sulbactam: ampicillin+sulbactam with or without macrolide; piperacillin+tazobactam: piperacillin+tazobactam (piperacillin+sulbactam, ticarcillin+clavulanic acid, or maxipime) with or without fluoroquinolone (or macrolide); cefotaxime+clindamycin: cefotaxime plus clindamycin; meropenem+teicoplanin: meropenem plus teicoplanin (or vancomycin); levofloxacin: levofloxacin (or moxifloxacin).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4499586&req=5

Figure 2: Antibiotic regimens for community-acquired pneumonia. Each regimen includes the following antibiotics: cefotaxime+macrolide: cefotaxime (or ceftriaxone) plus macrolide (or fluoroquinolone); ampicillin+sulbactam: ampicillin+sulbactam with or without macrolide; piperacillin+tazobactam: piperacillin+tazobactam (piperacillin+sulbactam, ticarcillin+clavulanic acid, or maxipime) with or without fluoroquinolone (or macrolide); cefotaxime+clindamycin: cefotaxime plus clindamycin; meropenem+teicoplanin: meropenem plus teicoplanin (or vancomycin); levofloxacin: levofloxacin (or moxifloxacin).
Mentions: Productive cough was significantly less common in the VS group than in the control group. Complicated parapneumonic effusion or empyema occurred more frequently in the VS group than in the control group. The PSI and CURB-65 scores did not significantly differ between the two groups. No differences were observed in clinical course parameters between the two groups, including hospital stay, success rate, and inhospital mortality. Overall, the median duration of follow-up was 46 days (IQR, 12-113 days). The most commonly used antibiotic regimen in the two groups was cefotaxime or ceftriaxone plus macrolide or fluoroquinolone (Figure 2).

Bottom Line: We compared various clinical parameters between the VS group and the control group.It is characterized by less frequent productive cough, more frequent bed-ridden status, and less common CT pulmonary parenchymal lesions.However, its treatment outcome and clinical course are similar to those of pneumococcal pneumonia.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.

ABSTRACT

Background: Viridans streptococci (VS) are a large group of streptococcal bacteria that are causative agents of community-acquired respiratory tract infection. However, data regarding their clinical characteristics are limited. The purpose of the present study was to investigate the clinical and radiologic features of community-acquired pneumonia (CAP) with or without parapneumonic effusion caused by VS.

Methods: Of 455 consecutive CAP patients with or without parapneumonic effusion, VS were isolated from the blood or pleural fluid in 27 (VS group, 5.9%) patients. Streptococcus pneumoniae was identified as a single etiologic agent in 70 (control group) patients. We compared various clinical parameters between the VS group and the control group.

Results: In univariate analysis, the VS group was characterized by more frequent complicated parapneumonic effusion or empyema and bed-ridden status, lower incidences of productive cough, elevated procalcitonin (>0.5 ng/mL), lower age-adjusted Charlson comorbidity index score, and more frequent ground glass opacity (GGO) or consolidation on computed tomography (CT) scans. Multivariate analysis demonstrated that complicated parapneumonic effusion or empyema, productive cough, bed-ridden status, and GGO or consolidation on CT scans were independent predictors of community-acquired respiratory tract infection caused by VS.

Conclusion: CAP caused by VS commonly presents as complicated parapneumonic effusion or empyema. It is characterized by less frequent productive cough, more frequent bed-ridden status, and less common CT pulmonary parenchymal lesions. However, its treatment outcome and clinical course are similar to those of pneumococcal pneumonia.

No MeSH data available.


Related in: MedlinePlus