{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T06:33:36Z","timestamp":1792564416297,"version":"4.5.0"},"reference-count":42,"publisher":"Elsevier BV","issue":"1","license":[{"start":{"date-parts":[[2021,10,24]],"date-time":"2021-10-24T00:00:00Z","timestamp":1635033600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,10,24]],"date-time":"2021-10-24T00:00:00Z","timestamp":1635033600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann. Intensive Care"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The presence of bacteraemia in pneumococcal pneumonia in critically ill patients does not appear to be a strong independent prognostic factor in the existing literature. However, there may be a specific pattern of factors associated with mortality for ICU patients with bacteraemic pneumococcal community-acquired pneumonia (CAP). We aimed to compare the factors associated with mortality, according to the presence of bacteraemia or not on admission, for patients hospitalised in intensive care for severe pneumococcal CAP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This was a post hoc analysis of data from the prospective, observational, multicentre STREPTOGENE study in immunocompetent Caucasian adults admitted to intensive care in France between 2008 and 2012 for pneumococcal CAP. Patients were divided into two groups based on initial blood culture (positive vs. negative) for\n                      <jats:italic>Streptococcus pneumoniae<\/jats:italic>\n                      . The primary outcome was hospital mortality, which was compared between the two groups using odds ratios according to predefined variables to search for a prognostic interaction present in bacterial patients but not non-bacteraemic patients. Potential differences in the distribution of serotypes between the two groups were assessed. The prognostic consequences of the presence or not of initial bi-antibiotic therapy were assessed, specifically in bacteraemic patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 614 included patients, 274 had a blood culture positive for\n                      <jats:italic>S. pneumoniae<\/jats:italic>\n                      at admission and 340 did not. The baseline difference between the groups was more frequent leukopaenia (26% vs. 14%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0002) and less frequent pre-hospital antibiotic therapy (10% vs. 16.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.024) for the bacteraemic patients. Hospital mortality was not significantly different between the two groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.11). We did not observe any prognostic factors specific to the bacteraemic patient population, as the statistical comparison of the odds ratios, as an indication of the association between the predefined prognostic parameters and mortality, showed them to be similar for the two groups. Bacteraemic patients more often had invasive serotypes but less often serotypes associated with high case fatality rates (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). The antibiotic regimens were similar for the two groups. There was no difference in mortality for patients in either group given a beta-lactam alone vs. a beta-lactam combined with a macrolide or fluoroquinolone.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Bacteraemia had no influence on the mortality of immunocompetent Caucasian adults admitted to intensive care for severe pneumococcal CAP, regardless of the profile of the associated prognostic factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13613-021-00936-z","type":"journal-article","created":{"date-parts":[[2021,10,24]],"date-time":"2021-10-24T09:02:38Z","timestamp":1635066158000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Comparison of prognostic factors between bacteraemic and non-bacteraemic critically ill immunocompetent patients in community-acquired severe pneumococcal pneumonia: a STREPTOGENE sub-study"],"prefix":"10.1016","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9479-5507","authenticated-orcid":false,"given":"Hugo","family":"Bellut","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael","family":"Porcher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuelle","family":"Varon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Asfar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yves","family":"Le Tulzo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Megarbane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armelle","family":"Mathonnet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Dugard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Veinstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kader","family":"Ouchenir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shidasp","family":"Siami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Reignier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaud","family":"Galbois","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00ebl","family":"Cousson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9bastien","family":"Preau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Baldesi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2011Philippe","family":"Rigaud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertrand","family":"Souweine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benoit","family":"Misset","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederic","family":"Jacobs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florent","family":"Dewavrin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2011Paul","family":"Mira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2011Pierre","family":"Bedos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","published-online":{"date-parts":[[2021,10,24]]},"reference":[{"key":"936_CR1","doi-asserted-by":"publisher","first-page":"R58","DOI":"10.1186\/cc13812","volume":"18","author":"AP Walden","year":"2014","unstructured":"Walden AP, Clarke GM, McKechnie S, Hutton P, Gordon AC, Rello J, et al. Patients with community acquired pneumonia admitted to European intensive care units: an epidemiological survey of the GenOSept cohort. Crit Care. 2014;18:R58.","journal-title":"Crit Care"},{"key":"936_CR2","doi-asserted-by":"publisher","first-page":"2162","DOI":"10.1007\/s00134-018-5444-x","volume":"44","author":"J-P Bedos","year":"2018","unstructured":"Bedos J-P, Varon E, Porcher R, Asfar P, Le Tulzo Y, Megarbane B, et al. Host\u2013pathogen interactions and prognosis of critically ill immunocompetent patients with pneumococcal pneumonia: the nationwide prospective observational STREPTOGENE study. Intensive Care Med. 2018;44:2162\u201373.","journal-title":"Intensive Care Med"},{"key":"936_CR3","doi-asserted-by":"publisher","first-page":"R155","DOI":"10.1186\/cc11471","volume":"16","author":"N Mongardon","year":"2012","unstructured":"Mongardon N, Max A, Bougl\u00e9 A, P\u00e8ne F, Lemiale V, Charpentier J, et al. Epidemiology and outcome of severe pneumococcal pneumonia admitted to intensive care unit: a multicenter study. Crit Care. 2012;16:R155.","journal-title":"Crit Care"},{"key":"936_CR4","doi-asserted-by":"publisher","first-page":"729","DOI":"10.1007\/s15010-015-0837-z","volume":"43","author":"JM Bordon","year":"2015","unstructured":"Bordon JM, Fernandez-Botran R, Wiemken TL, Peyrani P, Uriarte SM, Arnold FW, et al. Bacteremic pneumococcal pneumonia: clinical outcomes and preliminary results of inflammatory response. Infection. 2015;43:729\u201338.","journal-title":"Infection"},{"key":"936_CR5","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1093\/clinids\/21.2.345","volume":"21","author":"B Afessa","year":"1995","unstructured":"Afessa B, Greaves WL, Frederick WR. Pneumococcal bacteremia in adults: a 14-year experience in an inner-city university hospital. Clin Infect Dis. 1995;21:345\u201351.","journal-title":"Clin Infect Dis"},{"key":"936_CR6","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1007\/s00134-008-1363-6","volume":"35","author":"A Rodriguez","year":"2009","unstructured":"Community-Acquired Pneumonia Intensive Care Units (CAPUCI) Study Investigators, Rodriguez A, Lisboa T, Blot S, Martin-Loeches I, Sol\u00e9-Violan J, et al. Mortality in ICU patients with bacterial community-acquired pneumonia: when antibiotics are not enough. Intensive Care Med. 2009;35:430\u20138.","journal-title":"Intensive Care Med"},{"key":"936_CR7","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/j.bjid.2013.06.001","volume":"18","author":"A Fica","year":"2014","unstructured":"Fica A, Bunster N, Aliaga F, Olivares F, Porte L, Braun S, et al. Bacteremic pneumococcal pneumonia: serotype distribution, antimicrobial susceptibility, severity scores, risk factors, and mortality in a single center in Chile. Braz J Infect Dis. 2014;18:115\u201323.","journal-title":"Braz J Infect Dis"},{"key":"936_CR8","doi-asserted-by":"publisher","first-page":"1307","DOI":"10.1007\/BF01709543","volume":"22","author":"O Leroy","year":"1996","unstructured":"Leroy O, Georges H, Beuscart C, Guery B, Coffinier C, Vandenbussche C, et al. Severe community-acquired pneumonia in ICUs: prospective validation of a prognostic score. Intensive Care Med. 1996;22:1307\u201314.","journal-title":"Intensive Care Med"},{"key":"936_CR9","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1097\/00005792-200007000-00002","volume":"79","author":"DM Musher","year":"2000","unstructured":"Musher DM, Alexandraki I, Graviss EA, Yanbeiy N, Eid A, Inderias LA, et al. Bacteremic and nonbacteremic pneumococcal pneumonia. A prospective study. Medicine. 2000;79:210\u201321.","journal-title":"Medicine"},{"key":"936_CR10","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1155\/2003\/862856","volume":"10","author":"TJ Marrie","year":"2003","unstructured":"Marrie TJ, Low DE, de Carolis E, The Canadian Community-Acquired Pneumonia Investigators. A comparison of bacteremic pneumococcal pneumonia with nonbacteremic community-acquired pneumonia of any etiology\u2014results from a Canadian multicenter study. Can Respir J. 2003;10:368\u201374.","journal-title":"Can Respir J"},{"key":"936_CR11","doi-asserted-by":"publisher","first-page":"618","DOI":"10.1378\/chest.07-1322","volume":"133","author":"J Bord\u00f3n","year":"2008","unstructured":"Bord\u00f3n J, Peyrani P, Brock GN, Blasi F, Rello J, File T, et al. The presence of pneumococcal bacteremia does not influence clinical outcomes in patients with community-acquired pneumonia. Chest. 2008;133:618\u201324.","journal-title":"Chest"},{"key":"936_CR12","doi-asserted-by":"publisher","first-page":"940","DOI":"10.1378\/chest.128.2.940","volume":"128","author":"K Weiss","year":"2005","unstructured":"Weiss K, Tillotson GS. The controversy of combination vs monotherapy in the treatment of hospitalized community-acquired pneumonia. Chest. 2005;128:940\u20136.","journal-title":"Chest"},{"key":"936_CR13","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1086\/367541","volume":"36","author":"JA Martinez","year":"2003","unstructured":"Martinez JA, Horcajada JP, Almela M, Marco F, Soriano A, Garcia E, et al. Addition of a macrolide to a \u03b2-lactam-based empirical antibiotic regimen is associated with lower in-hospital mortality for patients with bacteremic pneumococcal pneumonia. Clin Infect Dis. 2003;36:389\u201395.","journal-title":"Clin Infect Dis"},{"key":"936_CR14","doi-asserted-by":"publisher","first-page":"1837","DOI":"10.1001\/archinte.161.15.1837","volume":"161","author":"GW Waterer","year":"2001","unstructured":"Waterer GW, Somes GW, Wunderink RG. Monotherapy may be suboptimal for severe bacteremic pneumococcal pneumonia. Arch Intern Med. 2001;161:1837\u201342.","journal-title":"Arch Intern Med"},{"key":"936_CR15","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1164\/rccm.200311-1578OC","volume":"170","author":"LM Baddour","year":"2004","unstructured":"Baddour LM, Yu VL, Klugman KP, Feldman C, Ortqvist A, Rello J, et al. Combination antibiotic therapy lowers mortality among severely ill patients with pneumococcal bacteremia. Am J Respir Crit Care Med. 2004;170:440\u20134.","journal-title":"Am J Respir Crit Care Med"},{"key":"936_CR16","doi-asserted-by":"publisher","DOI":"10.1186\/2110-5820-1-48","author":"J Caballero","year":"2011","unstructured":"Caballero J, Rello J. Combination antibiotic therapy for community-acquired pneumonia. Ann Intensive Care. 2011. https:\/\/doi.org\/10.1186\/2110-5820-1-48.","journal-title":"Ann Intensive Care"},{"key":"936_CR17","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1093\/cid\/cis414","volume":"55","author":"L Asadi","year":"2012","unstructured":"Asadi L, Sligl WI, Eurich DT, Colmers IN, Tjosvold L, Marrie TJ, et al. Macrolide-based regimens and mortality in hospitalized patients with community-acquired pneumonia: a systematic review and meta-analysis. Clin Infect Dis. 2012;55:371\u201380.","journal-title":"Clin Infect Dis"},{"key":"936_CR18","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1086\/315760","volume":"182","author":"M Kalin","year":"2000","unstructured":"Kalin M, \u00d6rtqvist \u00c5, Almela M, Aufwerber E, Dwyer R, Henriques B, et al. Prospective study of prognostic factors in community-acquired bacteremic pneumococcal disease in 5 countries. J Infect Dis. 2000;182:840\u20137.","journal-title":"J Infect Dis"},{"key":"936_CR19","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1136\/thoraxjnl-2012-203106","volume":"68","author":"P Naucler","year":"2013","unstructured":"Naucler P, Darenberg J, Morfeldt E, \u00d6rtqvist \u00c5, Henriques NB. Contribution of host, bacterial factors and antibiotic treatment to mortality in adult patients with bacteraemic pneumococcal pneumonia. Thorax. 2013;68:571\u20139.","journal-title":"Thorax"},{"key":"936_CR20","doi-asserted-by":"publisher","first-page":"2758","DOI":"10.1097\/01.CCM.0000239434.26669.65","volume":"34","author":"M Auburtin","year":"2006","unstructured":"Auburtin M, Wolff M, Charpentier J, Varon E, Le Tulzo Y, Girault C, et al. Detrimental role of delayed antibiotic administration and penicillin-nonsusceptible strains in adult intensive care unit patients with pneumococcal meningitis: the PNEUMOREA prospective multicenter study. Crit Care Med. 2006;34:2758\u201365.","journal-title":"Crit Care Med"},{"key":"936_CR21","doi-asserted-by":"publisher","first-page":"6178","DOI":"10.1016\/j.vaccine.2015.10.015","volume":"33","author":"E Varon","year":"2015","unstructured":"Varon E, Cohen R, B\u00e9chet S, Doit C, Levy C. Invasive disease potential of pneumococci before and after the 13-valent pneumococcal conjugate vaccine implementation in children. Vaccine. 2015;33:6178\u201385.","journal-title":"Vaccine"},{"key":"936_CR22","doi-asserted-by":"publisher","first-page":"1424","DOI":"10.1086\/374624","volume":"187","author":"AB Brueggemann","year":"2003","unstructured":"Brueggemann AB, Griffiths DT, Meats E, Peto T, Crook DW, Spratt BG. Clonal relationships between invasive and carriage Streptococcus pneumoniae and serotype- and clone-specific differences in invasive disease potential. J Infect Dis. 2003;187:1424\u201332.","journal-title":"J Infect Dis"},{"key":"936_CR23","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1128\/IAI.73.1.431-435.2005","volume":"73","author":"WP Hanage","year":"2005","unstructured":"Hanage WP, Kaijalainen TH, Syrjanen RK, Auranen K, Leinonen M, Makela PH, et al. Invasiveness of serotypes and clones of streptococcus pneumoniae among children in Finland. Infect Immun. 2005;73:431\u20135.","journal-title":"Infect Immun"},{"key":"936_CR24","doi-asserted-by":"publisher","first-page":"1369","DOI":"10.1128\/JCM.01763-10","volume":"49","author":"R Sa-Leao","year":"2011","unstructured":"Sa-Leao R, Pinto F, Aguiar S, Nunes S, Carrico JA, Frazao N, et al. Analysis of invasiveness of pneumococcal serotypes and clones circulating in Portugal before widespread use of conjugate vaccines reveals heterogeneous behavior of clones expressing the same serotype. J Clin Microbiol. 2011;49:1369\u201375.","journal-title":"J Clin Microbiol"},{"key":"936_CR25","doi-asserted-by":"publisher","first-page":"e1000081","DOI":"10.1371\/journal.pmed.1000081","volume":"6","author":"ZB Harboe","year":"2009","unstructured":"Harboe ZB, Thomsen RW, Riis A, Valentiner-Branth P, Christensen JJ, Lambertsen L, et al. Pneumococcal serotypes and mortality following invasive pneumococcal disease: a population-based cohort study. PLoS Med. 2009;6:e1000081.","journal-title":"PLoS Med"},{"key":"936_CR26","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1086\/655828","volume":"51","author":"DM Weinberger","year":"2010","unstructured":"Weinberger DM, Harboe ZB, Sanders EAM, Ndiritu M, Klugman KP, R\u00fcckinger S, et al. Association of serotype with risk of death due to pneumococcal pneumonia: a meta-analysis. Clin Infect Dis. 2010;51:692\u20139.","journal-title":"Clin Infect Dis"},{"key":"936_CR27","unstructured":"The European Committe on Antimicrobial Susceptibility Testing. Breakpoints tables for interpretation of MICs and zone diameters. Version 5.0, 2015. http:\/\/www.eucast.org. Accessed Jan 1 2019."},{"key":"936_CR28","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1128\/AAC.50.2.572-579.2006","volume":"50","author":"E Varon","year":"2006","unstructured":"Varon E, Houssaye S, Grondin S, Gutmann L, The Groupe des Observatoires de la Resistance du Pneumocoque. Nonmolecular test for detection of low-level resistance to fluoroquinolones in Streptococcus pneumoniae. Antimicrob Agents Chemother. 2006;50:572\u20139.","journal-title":"Antimicrob Agents Chemother"},{"key":"936_CR29","doi-asserted-by":"publisher","DOI":"10.1002\/9781118032985","volume-title":"The statistical analysis of failure time data: Kalbfleisch\/the statistical","author":"JD Kalbfleisch","year":"2002","unstructured":"Kalbfleisch JD, Prentice RL. The statistical analysis of failure time data: Kalbfleisch\/the statistical. Hoboken: Wiley; 2002. https:\/\/doi.org\/10.1002\/9781118032985."},{"key":"936_CR30","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1183\/13993003.00039-2016","volume":"48","author":"R Amaro","year":"2016","unstructured":"Amaro R, Liapikou A, Cilloniz C, Gabarrus A, Marco F, Sellares J, et al. Predictive and prognostic factors in patients with blood-culture-positive community-acquired pneumococcal pneumonia. Eur Respir J. 2016;48:797\u2013807.","journal-title":"Eur Respir J"},{"key":"936_CR31","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2466-14-128","author":"A Capelastegui","year":"2014","unstructured":"Capelastegui A, Zalacain R, Bilbao A, Egurrola M, Iturriaga LAR, Quintana JM, et al. Pneumococcal pneumonia: differences according to blood culture results. BMC Pulm Med. 2014. https:\/\/doi.org\/10.1186\/1471-2466-14-128.","journal-title":"BMC Pulm Med"},{"key":"936_CR32","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1097\/CCM.0b013e318194b021","volume":"37","author":"J Rello","year":"2009","unstructured":"Rello J, Rodriguez A, Lisboa T, Gallego M, Lujan M, Wunderink R. PIRO score for community-acquired pneumonia: a new prediction rule for assessment of severity in intensive care unit patients with community-acquired pneumonia. Crit Care Med. 2009;37:456\u201362.","journal-title":"Crit Care Med"},{"key":"936_CR33","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1086\/499242","volume":"42","author":"K Sjostrom","year":"2006","unstructured":"Sjostrom K, Spindler C, Ortqvist A, Kalin M, Sandgren A, Kuhlmann-Berenzon S, et al. Clonal and capsular types decide whether pneumococci will act as a primary or opportunistic pathogen. Clin Infect Dis. 2006;42:451\u20139.","journal-title":"Clin Infect Dis"},{"key":"936_CR34","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1086\/518538","volume":"45","author":"SRJ Alanee","year":"2007","unstructured":"Alanee SRJ, McGee L, Jackson D, Chiou CC, Feldman C, Morris AJ, et al. Association of serotypes of streptococcus pneumoniae with disease severity and outcome in adults: an international study. Clin Infect Dis. 2007;45:46\u201351.","journal-title":"Clin Infect Dis"},{"key":"936_CR35","doi-asserted-by":"publisher","first-page":"1575","DOI":"10.1128\/AAC.44.6.1575-1577.2000","volume":"44","author":"E Azoulay-Dupuis","year":"2000","unstructured":"Azoulay-Dupuis E, Rieux V, Muffat-Joly M, B\u00e9dos JP, Vall\u00e9e E, Rivier C, et al. Relationship between capsular type, penicillin susceptibility, and virulence of human streptococcus pneumoniae isolates in mice. Antimicrob Agents Chemother. 2000;44:1575\u20137.","journal-title":"Antimicrob Agents Chemother"},{"key":"936_CR36","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/j.1574-6968.2001.tb10917.x","volume":"205","author":"JC Hoyt","year":"2001","unstructured":"Hoyt JC, Robbins RA. Macrolide antibiotics and pulmonary inflammation. FEMS Microbiol Lett. 2001;205:1\u20137.","journal-title":"FEMS Microbiol Lett"},{"key":"936_CR37","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2018.00302\/full","author":"P Zimmermann","year":"2018","unstructured":"Zimmermann P, Ziesenitz VC, Curtis N, Ritz N. The immunomodulatory effects of macrolides\u2014a systematic review of the underlying mechanisms. Front Immunol. 2018. https:\/\/doi.org\/10.3389\/fimmu.2018.00302\/full.","journal-title":"Front Immunol"},{"key":"936_CR38","doi-asserted-by":"publisher","first-page":"609","DOI":"10.4187\/respcare.05943","volume":"63","author":"AW Huckle","year":"2018","unstructured":"Huckle AW, Fairclough LC, Todd I. Prophylactic antibiotic use in COPD and the potential anti-inflammatory activities of antibiotics. Respir Care. 2018;63:609\u201319.","journal-title":"Respir Care"},{"key":"936_CR39","doi-asserted-by":"publisher","first-page":"1202","DOI":"10.1378\/chest.10-0196","volume":"138","author":"AL Friedlander","year":"2010","unstructured":"Friedlander AL, Albert RK. Chronic macrolide therapy in inflammatory airways diseases. Chest. 2010;138:1202\u201312.","journal-title":"Chest"},{"key":"936_CR40","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1001\/jama.2016.0115","volume":"315","author":"JS Lee","year":"2016","unstructured":"Lee JS, Giesler DL, Gellad WF, Fine MJ. Antibiotic therapy for adults hospitalized with community-acquired pneumonia: a systematic review. JAMA. 2016;315:593.","journal-title":"JAMA"},{"key":"936_CR41","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1007\/s00134-009-1730-y","volume":"36","author":"I Martin-Loeches","year":"2010","unstructured":"Martin-Loeches I, Lisboa T, Rodriguez A, Putensen C, Annane D, Garnacho-Montero J, et al. Combination antibiotic therapy with macrolides improves survival in intubated patients with community-acquired pneumonia. Intensive Care Med. 2010;36:612\u201320.","journal-title":"Intensive Care Med"},{"key":"936_CR42","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1097\/CCM.0b013e3182a66b9b","volume":"42","author":"WI Sligl","year":"2014","unstructured":"Sligl WI, Asadi L, Eurich DT, Tjosvold L, Marrie TJ, Majumdar SR. Macrolides and mortality in critically ill patients with community-acquired pneumonia: a systematic review and meta-analysis. Crit Care Med. 2014;42:420\u201332.","journal-title":"Crit Care Med"}],"container-title":["Annals of Intensive Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13613-021-00936-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13613-021-00936-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13613-021-00936-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T06:39:03Z","timestamp":1767767943000},"score":1,"resource":{"primary":{"URL":"https:\/\/annalsofintensivecare.springeropen.com\/articles\/10.1186\/s13613-021-00936-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,24]]},"references-count":42,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["936"],"URL":"https:\/\/doi.org\/10.1186\/s13613-021-00936-z","relation":{},"ISSN":["2110-5820"],"issn-type":[{"value":"2110-5820","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,24]]},"assertion":[{"value":"15 July 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 October 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 October 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study project was approved by the appropriate ethics committee (Comit\u00e9 de Protection des Personnes d\u2019Ile de France, September 9, 2008, #2008\/36NICB).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All the authors read and approved the final version of the manuscript and its submission for possible publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"None of the authors have any conflicts of interest to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"148"}}