The Effect of Macrolide-Resistance on the Presentation and Outcome of Patients Hospitalized for Streptococcus pneumoniae Pneumonia.
Am J Respir Crit Care Med. 2015 Mar 25;
Authors: Cilloniz C, Albert RK, Liapikou A, Gabarrus A, Rangel E, Bello S, Marco F, Mensa J, Torres A
BACKGROUND: There are conflicting reports describing the effect of macrolide resistance on the presentation and outcomes of patients with Streptococcus pneumoniae pneumonia.
METHODS: We conducted a retrospective, observational study in the Hospital Clinic of Barcelona of all adult patients hospitalized with pneumonia who had positive cultures for S. pneumoniae from January 1, 2000 to December 31, 2013. Outcomes examined included bacteremia, pulmonary complications, acute renal failure, shock, intensive care unit admission, need for mechanical ventilation, length of hospital stay and 30-day mortality.
RESULTS: Of 643 patients hospitalized for S. pneumoniae pneumonia, 139 (22%) were macrolide-resistant. Patients with macrolide-resistant organisms were less likely to have bacteremia, pulmonary complications and shock, and were less likely to require non-invasive mechanical ventilation. We found no increase in the incidence of acute renal failure, the frequency of ICU admission, the need for invasive ventilatory support, the length hospital stay or the 30-day mortality in patients with (invasive or non-invasive) macrolide-resistant S. pneumoniae pneumonia, and no effect on outcomes as a function of whether treatment regimens did or did not comply with current guidelines.
CONCLUSIONS: We found no evidence suggesting that patients hospitalized for macrolide-resistant S. pneumoniae pneumonia had worse clinical outcomes.
PMID: 25807239 [PubMed - as supplied by publisher]