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Şenol E, Çilli A, Günen H, Şener A, Dumlu R, Ödemiş A, Topçu AF, Yıldız Y, Güner R, Özhasenekler A, Mutlu B, Köktürk N, Sevimli N, Baykam N, Yapar D, Ekin S, Polatlı M, Gök ŞE, Kılınç O, Sayıner A, Karaşahin Ö, Çuhadaroğlu Ç, Sesin Kocagöz A, Togan T, Arpağ H, Katı H, Köksal İ, Aksoy F, Hasanoğlu C. The Role of Pneumococcal Pneumonia among Community-Acquired Pneumonia in Adult Turkish Population: TurkCAP Study. Turk Thorac J 2022; 22:339-345. [PMID: 35110252 DOI: 10.5152/turkthoracj.2021.20223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate the rate of pneumococcal pneumonia (PP) among patients with community-acquired pneumonia (CAP) in Turkey and to investigate and compare features of PP and non-PP CAP patients. MATERIAL AND METHODS This multicenter, non-interventional, prospective, observational study included adult CAP patients (age ≥ 18 years). Diagnosis of PP was based on the presence of at least 1 positive laboratory test result for Streptococcus pneumoniae (blood culture or sputum culture or urinary antigen test [UAT]) in patients with radiographic findings of pneumonia. RESULTS Four hundred sixty-five patients were diagnosed with CAP, of whom 59 (12.7%) had PP. The most common comorbidity was chronic obstructive pulmonary disease (30.1%). The mean age, smoking history, presence of chronic neurological disease, and CURB-65 score were significantly higher in PP patients, when compared to non-PP patients. In PP patients, 84.8% were diagnosed based ony on the UAT. The overall rate of PP patients among CAP was calculated as 22.8% considering the UAT sensitivity ratio of 63% (95% confidence interval: 45-81). The rate of intensive care treatment was higher in PP patients (P = .007). While no PP patients were vaccinated for pneumococcus, 3.8% of the non-PP patients were vaccinated (P = .235). Antibiotic use in the preceding 48 hours was higher in the non-PP group than in the PP group (31.8% vs. 11.1%, P = .002). The CURB-65 score and the rate of patients requiring inpatient treatment according to this score were higher in the PP group. CONCLUSION The facts that PP patients were older and required intensive care treatment more frequently as compared to non-PP patients underline the burden of PP.
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Affiliation(s)
- Esin Şenol
- Department of Infectious Diseases, Gazi University, Faculty of Medicine, Ankara, Turkey
| | - Aykut Çilli
- Department of Pulmonary Diseases, Akdeniz University, Faculty of Medicine, Antalya, Turkey
| | - Hakan Günen
- Department of Pulmonary Diseases, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Alper Şener
- Department of Infectious Diseases and Clinical Microbiology, 18 Mart University, Faculty of Medicine, Çanakkale, Turkey
| | - Rıdvan Dumlu
- Department of Infectious Diseases and Clinical Microbiology, 18 Mart University, Faculty of Medicine, Çanakkale, Turkey
| | - Ayşe Ödemiş
- Department of Pulmonary Diseases, Akdeniz University, Faculty of Medicine, Antalya, Turkey
| | - Ayşe Füsun Topçu
- Department of Pulmonary Diseases, Dicle University, Faculty of Medicine, Diyarbakır, Turkey
| | - Yeşim Yıldız
- Department of Infectious Diseases and Clinical Microbiology, Mardin State Hospital, Mardin, Turkey
| | - Rahmet Güner
- Department of Infectious Diseases and Clinical Microbiology, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
| | - Ayhan Özhasenekler
- Department of Emergency Medicine, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
| | - Birsen Mutlu
- Department of Infectious Diseases, Kocaeli University, Faculty of Medicine, Kocaeli, Turkey
| | - Nurdan Köktürk
- Department of Pulmonary Diseases, Gazi University, Faculty of Medicine, Ankara, Turkey
| | - Nurgül Sevimli
- Department of Pulmonary Diseases, Gazi University, Faculty of Medicine, Ankara, Turkey
| | - Nurcan Baykam
- Department of Infectious Diseases and Clinical Microbiology, Hitit University, Faculty of Medicine, Çorum, Turkey
| | - Derya Yapar
- Department of Infectious Diseases and Clinical Microbiology, Hitit University, Faculty of Medicine, Çorum, Turkey
| | - Selami Ekin
- Department of Pulmonary Diseases, Yüzüncü Yıl University, Faculty of Medicine, Van, Turkey
| | - Mehmet Polatlı
- Department of Pulmonary Diseases, Adnan Menderes University, Faculty of Medicine, Aydın, Turkey
| | - Şebnem Eren Gök
- Department of Infectious Diseases and Clinical Microbiology, Bozok University, Faculty of Medicine, Yozgat, Turkey
| | - Oğuz Kılınç
- Department of Pulmonary Diseases, Dokuz Eylül University, Faculty of Medicine, Izmir, Turkey
| | - Abdullah Sayıner
- Department of Pulmonary Diseases, Ege University, Faculty of Medicine, Izmir, Turkey
| | - Ömer Karaşahin
- Department of Infectious Diseases and Clinical Microbiology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Çağlar Çuhadaroğlu
- Department of Pulmonary Diseases and Sleep Disorder, Acıbadem Health Group Maslak Hospital, Istanbul, Turkey
| | - Ayşe Sesin Kocagöz
- Department of Infectious Diseases and Clinical Microbiology, Acıbadem Health Group Maslak Hospital, Istanbul, Turkey
| | - Turhan Togan
- Department of Infectious Diseases and Clinical Microbiology, Başkent University Konya Hospital, Konya, Turkey
| | - Hüseyin Arpağ
- Department of Pulmonary Diseases, Sutcu Imam University, Faculty of Medicine, Kahramanmaraş, Turkey
| | - Hakan Katı
- Department of Infectious Diseases, Gazi University, Faculty of Medicine, Ankara, Turkey
| | - İftihar Köksal
- Department of Infectious Diseases, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey
| | - Firdevs Aksoy
- Department of Infectious Diseases, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey
| | - Canan Hasanoğlu
- Department of Pulmonary Diseases, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
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Dokuzoguz B, Celikbas AK, Gök ŞE, Baykam N, Eroglu MN, Ergönül Ö. Severity scoring index for Crimean-Congo hemorrhagic fever and the impact of ribavirin and corticosteroids on fatality. Clin Infect Dis 2013; 57:1270-4. [PMID: 23946218 DOI: 10.1093/cid/cit527] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patients infected with Crimean-Congo hemorrhagic fever (CCHF) virus present with a wide clinical spectrum. In observational studies, the effects of therapeutic agents are confounded by severity. We describe use of a clinical severity scoring index (SSI) for CCHF patients and assess the effect of ribavirin and corticosteroid therapy on the case-fatality rate, stratified by SSI. METHODS The study group included hospitalized patients who received a diagnosis of CCHF at the Infectious Diseases and Clinical Microbiology Clinic of Ankara Numune Education and Research Hospital between 2004 and 2011. The SSI included platelet count, bleeding, fibrinogen level, activated partial thromboplastin time, and somnolence. The effects of ribavirin and corticosteroid on the case-fatality rate were studied by univariate and multivariate analysis, stratified by SSI. RESULTS Two hundred eighty-one confirmed cases of CCHF were included in the study. Of 281 patients, 23 (8%) died. The mean age (±SD) of the patients was 47 ± 16 years. Forty-nine percent were female. The mean duration of stay at our clinic after onset of symptoms was 4.4 days, with a range of 1-14 days. In multivariate analysis of factors for the prediction of death, the SSI (odds ratio [OR], 3.27; 95% confidence interval [CI], 2.09-5.13) and ribavirin use (OR, 0.04; 95% CI, .004-.48) were found to be statistically significant factors. CONCLUSION The SSI is an accurate predictor of death and will therefore be a useful tool for case management and for drug-assessment studies. After stratification of cases by SSI, ribavirin was found to be effective in reducing the case-fatality rate, especially among moderately ill patients, whereas steroids were found to be beneficial particularly among patients with severe disease.
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Affiliation(s)
- Basak Dokuzoguz
- Clinical Microbiology and Infectious Diseases Clinic, Ankara Numune Education and Research Hospital, Ankara
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