Impact of Preceding Flu-Like Illness on the Serotype Distribution of Pneumococcal PneumoniaReport as inadecuate




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Background

Even though the pathogenicity and invasiveness of pneumococcus largely depend on capsular types, the impact of serotypes on post-viral pneumococcal pneumonia is unknown.

Methods and Findings

This study was performed to evaluate the impact of capsular serotypes on the development of pneumococcal pneumonia after preceding respiratory viral infections. Patients with a diagnosis of pneumococcal pneumonia were identified. Pneumonia patients were divided into two groups post-viral pneumococcal pneumonia versus primary pneumococcal pneumonia, and then their pneumococcal serotypes were compared. Nine hundred and nineteen patients with pneumococcal pneumonia were identified during the study period, including 327 35.6% cases with post-viral pneumococcal pneumonia and 592 64.4% cases with primary pneumococcal pneumonia. Overall, serotypes 3 and 19A were the most prevalent, followed by serotypes 19F, 6A, and 11A-11E. Although relatively uncommon 33 cases, 3.6%, infrequently colonizing invasive serotypes 4, 5, 7F-7A, 8, 9V-9A, 12F, and 18C were significantly associated with preceding respiratory viral infections 69.7%, P<0.01. Multivariate analysis revealed several statistically significant risk factors for post-viral pneumococcal pneumonia: immunodeficiency OR 1.66; 95% CI, 1.10–2.53, chronic lung diseases OR 1.43; 95% CI, 1.09–1.93 and ICI serotypes OR 4.66; 95% CI, 2.07–10.47.

Conclusions

Infrequently colonizing invasive serotypes would be more likely to cause pneumococcal pneumonia after preceding respiratory viral illness, particularly in patients with immunodeficiency or chronic lung diseases.



Author: Joon Young Song , Moon H. Nahm, Hee Jin Cheong, Woo Joo Kim

Source: http://plos.srce.hr/



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