Nausea Predicts Bacteremia in Immunocompetent Patients with Pneumococcal Community-Acquired Pneumonia: Secondary Data Analysis from a Prospective Cohort
Background: In pneumococcal community-acquired pneumonia (CAP), bacteremia is associated with increased mortality, but initial clinical severity scores frequently fail to identify bacteremic patients at risk. We have previously shown that gastrointestinal symptoms are common among patients admitted...
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| Format: | Article |
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MDPI AG
2023-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/12/3924 |
| _version_ | 1797594140660203520 |
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| author | Hans Kristian Floeystad Jan Cato Holter Einar Husebye William Ward Siljan Dag Berild Are Martin Holm Lars Heggelund |
| author_facet | Hans Kristian Floeystad Jan Cato Holter Einar Husebye William Ward Siljan Dag Berild Are Martin Holm Lars Heggelund |
| author_sort | Hans Kristian Floeystad |
| collection | DOAJ |
| description | Background: In pneumococcal community-acquired pneumonia (CAP), bacteremia is associated with increased mortality, but initial clinical severity scores frequently fail to identify bacteremic patients at risk. We have previously shown that gastrointestinal symptoms are common among patients admitted to the hospital with pneumococcal bacteremia. The aim of this study was to examine gastrointestinal symptoms and inflammatory responses in bacteremic and non-bacteremic pneumococcal CAP in a prospective cohort of immunocompromised and immunocompetent patients hospitalized with CAP. Methods: Logistic regression analysis was used to estimate the predictive value of gastrointestinal symptoms for pneumococcal bacteremia in patients with CAP. The Mann–Whitney test was used to compare inflammatory responses in patients with bacteremic vs. non-bacteremic pneumococcal CAP. Results: Eighty-one patients with pneumococcal CAP were included, of whom 21 (26%) had bacteremia. Immunocompetent patients with pneumococcal CAP had an odds ratio of 16.5 (95% CI 3.0–90.9, <i>p</i> = 0.001) for bacteremia if nausea was present, whereas no such association was found in the immunocompromised patients (OR 0.22, 95% CI 0.02–2.05, <i>p</i> = 0.18). The serum levels of C-reactive protein, procalcitonin and interleukin 6 were significantly higher in the patients with bacteremic pneumococcal CAP compared to non-bacteremic pneumococcal CAP patients (<i>p</i> < 0.001, <i>p</i> = 0.005, and <i>p</i> = 0.019, respectively). Conclusions: In immunocompetent patients hospitalized with pneumococcal CAP, nausea may be a predictor of bacteremia. Bacteremic pneumococcal CAP patients display an increased inflammatory response compared to non-bacteremic pneumococcal CAP patients. |
| first_indexed | 2024-03-11T02:19:21Z |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T02:19:21Z |
| publishDate | 2023-06-01 |
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| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-5bd4cff031d7407ab25aad48e5270d422023-11-18T10:58:33ZengMDPI AGJournal of Clinical Medicine2077-03832023-06-011212392410.3390/jcm12123924Nausea Predicts Bacteremia in Immunocompetent Patients with Pneumococcal Community-Acquired Pneumonia: Secondary Data Analysis from a Prospective CohortHans Kristian Floeystad0Jan Cato Holter1Einar Husebye2William Ward Siljan3Dag Berild4Are Martin Holm5Lars Heggelund6Department of Internal Medicine, Sorlandet Hospital, 4615 Kristiansand, NorwayDepartment of Microbiology, Oslo University Hospital, 0424 Oslo, NorwayDepartment of Internal Medicine, Drammen Hospital, Vestre Viken Hospital Trust, 3004 Drammen, NorwayDepartment of Pulmonary Medicine, Division of Medicine, Akershus University Hospital, 1478 Lørenskog, NorwayInstitute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0450 Oslo, NorwayInstitute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0450 Oslo, NorwayDepartment of Internal Medicine, Drammen Hospital, Vestre Viken Hospital Trust, 3004 Drammen, NorwayBackground: In pneumococcal community-acquired pneumonia (CAP), bacteremia is associated with increased mortality, but initial clinical severity scores frequently fail to identify bacteremic patients at risk. We have previously shown that gastrointestinal symptoms are common among patients admitted to the hospital with pneumococcal bacteremia. The aim of this study was to examine gastrointestinal symptoms and inflammatory responses in bacteremic and non-bacteremic pneumococcal CAP in a prospective cohort of immunocompromised and immunocompetent patients hospitalized with CAP. Methods: Logistic regression analysis was used to estimate the predictive value of gastrointestinal symptoms for pneumococcal bacteremia in patients with CAP. The Mann–Whitney test was used to compare inflammatory responses in patients with bacteremic vs. non-bacteremic pneumococcal CAP. Results: Eighty-one patients with pneumococcal CAP were included, of whom 21 (26%) had bacteremia. Immunocompetent patients with pneumococcal CAP had an odds ratio of 16.5 (95% CI 3.0–90.9, <i>p</i> = 0.001) for bacteremia if nausea was present, whereas no such association was found in the immunocompromised patients (OR 0.22, 95% CI 0.02–2.05, <i>p</i> = 0.18). The serum levels of C-reactive protein, procalcitonin and interleukin 6 were significantly higher in the patients with bacteremic pneumococcal CAP compared to non-bacteremic pneumococcal CAP patients (<i>p</i> < 0.001, <i>p</i> = 0.005, and <i>p</i> = 0.019, respectively). Conclusions: In immunocompetent patients hospitalized with pneumococcal CAP, nausea may be a predictor of bacteremia. Bacteremic pneumococcal CAP patients display an increased inflammatory response compared to non-bacteremic pneumococcal CAP patients.https://www.mdpi.com/2077-0383/12/12/3924nauseapneumoniapneumococcalbacteremiainflammatory response |
| spellingShingle | Hans Kristian Floeystad Jan Cato Holter Einar Husebye William Ward Siljan Dag Berild Are Martin Holm Lars Heggelund Nausea Predicts Bacteremia in Immunocompetent Patients with Pneumococcal Community-Acquired Pneumonia: Secondary Data Analysis from a Prospective Cohort Journal of Clinical Medicine nausea pneumonia pneumococcal bacteremia inflammatory response |
| title | Nausea Predicts Bacteremia in Immunocompetent Patients with Pneumococcal Community-Acquired Pneumonia: Secondary Data Analysis from a Prospective Cohort |
| title_full | Nausea Predicts Bacteremia in Immunocompetent Patients with Pneumococcal Community-Acquired Pneumonia: Secondary Data Analysis from a Prospective Cohort |
| title_fullStr | Nausea Predicts Bacteremia in Immunocompetent Patients with Pneumococcal Community-Acquired Pneumonia: Secondary Data Analysis from a Prospective Cohort |
| title_full_unstemmed | Nausea Predicts Bacteremia in Immunocompetent Patients with Pneumococcal Community-Acquired Pneumonia: Secondary Data Analysis from a Prospective Cohort |
| title_short | Nausea Predicts Bacteremia in Immunocompetent Patients with Pneumococcal Community-Acquired Pneumonia: Secondary Data Analysis from a Prospective Cohort |
| title_sort | nausea predicts bacteremia in immunocompetent patients with pneumococcal community acquired pneumonia secondary data analysis from a prospective cohort |
| topic | nausea pneumonia pneumococcal bacteremia inflammatory response |
| url | https://www.mdpi.com/2077-0383/12/12/3924 |
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