{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:44:42Z","timestamp":1787013882201,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2012,10,3]],"date-time":"2012-10-03T00:00:00Z","timestamp":1349222400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2012,11]]},"abstract":"Summary<\/jats:title>\n \n Background<\/jats:title>\n \n The pathophysiological mechanisms which contribute to an increased risk of community\u2010acquired pneumonia (\n CAP<\/jats:styled-content>\n ) in patients using proton pump inhibitors are not well established.\n <\/jats:p>\n <\/jats:sec>\n \n Aim<\/jats:title>\n \n To examine differences in microbial etiology in patients with\n CAP<\/jats:styled-content>\n between patients with and without proton pump inhibitor (\n PPI<\/jats:styled-content>\n ) therapy and its possible impact on disease severity.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n All individuals consulting the emergency care unit were prospectively registered and underwent chest radiography. Sputum, urine, nose\u2010throat swabs and blood samples were obtained for microbial evaluation. We evaluated the association between use of proton pump inhibitors, etiology of\n CAP<\/jats:styled-content>\n and severity of illness with multivariate regression analysis.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The final cohort comprised 463 patients, 29% using proton pump inhibitors (\n PPI<\/jats:styled-content>\n s). Pathogens regarded as oropharyngeal flora were more common in\n CAP<\/jats:styled-content>\n patients using\n PPI<\/jats:styled-content>\n therapy compared to those who did not (adjusted\n OR<\/jats:styled-content>\n : 2.0; 95%\n CI<\/jats:styled-content>\n : 1.22\u20133.72). Patients using proton pump inhibitors more frequently had an infection with\n \n S<\/jats:styled-content>\n treptococcus pneumoniae\n <\/jats:italic>\n (28% vs. 14%) and less frequently with\n \n C<\/jats:styled-content>\n oxiella burnetii\n <\/jats:italic>\n (8% vs. 19%) compared to nonuser of\n PPI<\/jats:styled-content>\n . Adjusted for baseline differences, the risk of\n PPI<\/jats:styled-content>\n users being infected with\n \n S<\/jats:styled-content>\n . pneumonia\n <\/jats:italic>\n was 2.23 times (95%\n CI<\/jats:styled-content>\n : 1.28\u20133.75) higher compared to patients without\n PPI<\/jats:styled-content>\n 's. No risk between\n PPI<\/jats:styled-content>\n use and any other microbial pathogen was found. There was no difference in severity of\n CAP<\/jats:styled-content>\n between patients with and without using\n PPI<\/jats:styled-content>\n therapy.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Proton pump inhibitor therapy was associated with an approximately 2\u2010fold increased risk to develop community\u2010acquired pneumonia possibly as a result of\n \n S<\/jats:styled-content>\n . pneumoniae\n <\/jats:italic>\n infection.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/apt.12069","type":"journal-article","created":{"date-parts":[[2012,10,3]],"date-time":"2012-10-03T21:27:12Z","timestamp":1349299632000},"page":"941-949","source":"Crossref","is-referenced-by-count":66,"title":["Proton pump inhibitor therapy predisposes to community\u2010acquired\n \n S<\/scp>\n treptococcus pneumoniae\n <\/i>\n pneumonia"],"prefix":"10.1111","volume":"36","author":[{"given":"C. P. C.","family":"de Jager","sequence":"first","affiliation":[{"name":"Departments of Intensive Care and Emergency Medicine \u2018s\u2010Hertogenbosch The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. C.","family":"Wever","sequence":"additional","affiliation":[{"name":"Medical Microbiology and Infection Control Jeroen Bosch Hospital \u2018s\u2010Hertogenbosch The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. F. A.","family":"Gemen","sequence":"additional","affiliation":[{"name":"Clinical Chemistry \u2018s\u2010Hertogenbosch The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. G. H.","family":"van Oijen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. B.","family":"van Gageldonk\u2010Lafeber","sequence":"additional","affiliation":[{"name":"National Institute for Public Health and the Environment (RIVM) Centre for Infectious Disease Control Bilthoven The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. D.","family":"Siersema","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. C. M.","family":"Kusters","sequence":"additional","affiliation":[{"name":"Clinical Chemistry \u2018s\u2010Hertogenbosch The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. J. F.","family":"Laheij","sequence":"additional","affiliation":[{"name":"Departments of Intensive Care and Emergency Medicine \u2018s\u2010Hertogenbosch The Netherlands"},{"name":"Department of Gastroenterology and Hepatology University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,10,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1086\/511159"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e31824b228f"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.292.16.1955"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2010.04284.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-200831070-00008"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.51.2.179"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2011.04874.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.46"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOG.0b013e32833ea9d9"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.39.1.54"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2006.02707.x"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1053\/bega.2001.0191"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200703-456SO"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(93)91208-4"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.321.7269.1103"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-120-8-199404150-00005"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00020811"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2001.00888.x"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.58.5.377"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2003.01744.x"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.722"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1026604203237"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2000.014s1074.x"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200205000-00026"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.3109\/08923970009016425"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2008.03900.x"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2006.02982.x"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-3003.2000.15d21.x"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.56.2.109"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.160.2.9808045"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.13.1729"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2009.02918.x"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2011.04890.x"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2012-302371"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.032912"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(92)90173-9"},{"key":"e_1_2_6_38_1","first-page":"382","article-title":"Q fever in the Netherlands from 2007 to 2010","volume":"68","author":"Delsing CE","year":"2010","journal-title":"Neth J Med"}],"container-title":["Alimentary Pharmacology & Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fapt.12069","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.12069","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T15:52:15Z","timestamp":1695484335000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.12069"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,10,3]]},"references-count":37,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2012,11]]}},"alternative-id":["10.1111\/apt.12069"],"URL":"https:\/\/doi.org\/10.1111\/apt.12069","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,10,3]]}}}