Bacterial aetiology and mortality in COPD patients with CAP: results from the German Competence Network, CAPNETZ

D. C. W. Braeken*, F. M. E. Franssen, H. von Baum, H. Schuette, M. W. Pletz, J. Rupp, F. Stassen, M. J. Mooij, G. G. U. Rohde, CAPNETZ Study Grp

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

9 Citations (Web of Science)

Abstract

BACKGROUND: Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality, and chronic obstructive pulmonary disease (COPD) is a frequent comorbidity. The bacterial aetiology of CAPCOPD and its possible associations with serum markers and mortality are incompletely understood.

OBJECTIVES: 1) To assess the bacterial aetiology of CAP only and CAP-COPD, and 2) to study the association between bacterial aetiology, empirical antibiotic treatment, serum markers and mortality.

METHODS: Of 1288 patients with CAP (57.0% males, age 59.0 years +/- 18.5), 262 (20.3%) fulfilled the diagnostic criteria for COPD. Differences between subgroups were investigated using univariate analyses and corrected for multiple comparisons.

RESULTS: Streptococcus pneumoniae was the most common pathogen (30.8% CAP only vs. 26.0% CAPCOPD, not significant). Haemophilus influenzae was significantly more frequent in CAP-COPD (5.6% CAP-SUMMARY only vs. 26.0% CAP-COPD, P <0.001). The number given adequate empirical antibiotic treatment was comparable (83.3% CAP only vs. 83.6% CAP-COPD, P > 0.05). The CAP-COPD group had worse CURB-65 and partial pressure of arterial oxygen levels than the CAP only group (P <0.001). Partial pressure of arterial carbon dioxide levels were increased in CAP-COPD patients without pathogen detection (P <0.001). Short (P = 0.011) and long-term mortality (P = 0.006) were highest in CAP-COPD without pathogen detection.

CONCLUSION: It is important to identify COPD patients with CAP. In particular, those without bacterial pathogen detection have more severe CAP and are at higher risk of dying. Better understanding of the aetiology could contribute to improved management and treatment of CAP in COPD patients.

Original languageEnglish
Pages (from-to)236-243
Number of pages8
JournalInternational Journal of Tuberculosis and Lung Disease
Volume21
Issue number2
DOIs
Publication statusPublished - Feb 2017

Keywords

  • chronic lung disease
  • microbiology
  • pathogen detection
  • respiratory infections
  • survival
  • COMMUNITY-ACQUIRED PNEUMONIA
  • OBSTRUCTIVE PULMONARY-DISEASE
  • INHALED CORTICOSTEROIDS
  • DIAGNOSIS
  • SEVERITY
  • OUTCOMES

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