Clinical Outcomes of CAP Are Similar for Immunocompromised, Non-Immunocompromised

The results of a study by MDPI, a publisher of open-access scientific journals, show that the the clinical outcomes of hospitalized patients with community-acquired pneumonia due to Streptococcus pneumoniae do not differ between individuals who are immunocompromised and those who are not.

In the study, all patients were treated at the onset of their time in the hospital with appropriate antibiotic therapy, and because of that, the killing of Streptococcus pneumoniae was dependent on local antibiotic levels and not the local immune system.

Of 93 immunocompromised individuals and 186 non-immunocompromised individuals, there were 50 and 95 available vaccination records, respectively. Eleven immunocompromised and 20 non-immunocompromised individuals received either the conjugate or polysaccharide vaccine.

The most common symptoms were a cough and/or shortness of breath, and 91% of the immunocompromised and 96% of the non-immunocompromised individuals experienced at least 1 of these. Co-infections of another microorganism were present within 15% of each group.

The most frequent drugs administered within 24 hours of hospitalization were azithromycin and ceftriaxone, levofloxacin, and levofloxacin and piperacillin-tazobactam. Regimens of vancomycin were also prescribed to some.

Twenty-six percent and 23% of immunocompromised and non-immunocompromised individuals, respectively, were admitted to the intensive care unit during hospitalization, and 6% immunocompromised and 3% non-immunocompromised individuals needed invasive mechanical ventilation.

The median time for clinical stability for each group was 2 days, and the median length of hospitalization was 5 days, also for each group.

Clinical failure was 4% and 6%, while cardiovascular events was 10% and 6%, and the mortality rate was 5% and 3% for the immunocompromised and non-immunocompromised individuals, respectively.

The study was approved by the Institutional Review Board at the University of Louisville Human Subjects Research Protection Program Office and research offices at the hospitals.

Reference

Clinical outcomes of immunocompromised adults hospitalized with pneumococcal pneumonia: a case-control study. MDPI. August 16, 2021. Accessed September 2, 2021. https://www.mdpi.com/2076-2607/9/8/1746/htm