{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T18:25:54Z","timestamp":1780338354136,"version":"3.54.1"},"reference-count":30,"publisher":"FapUNIFESP (SciELO)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. bras. pneumol."],"published-print":{"date-parts":[[2012,8]]},"abstract":"<jats:p>OBJETIVO: Bacteriemia es la forma invasiva m\u00e1s com\u00fan de neumon\u00eda adquirida en la comunidad (NAC) por Streptococcus pneumoniae. Investigamos si la bacteriemia en NAC neumoc\u00f3cica empeora los resultados y si ella guarda relaci\u00f3n con la vacunaci\u00f3n antineumoc\u00f3cica (VAN). M\u00c9TODOS: An\u00e1lisis secundario de una cohorte de pacientes con NAC neumoc\u00f3cica confirmada por cultivo de sangre o esputo o ant\u00edgeno urinario. Se registraron datos demogr\u00e1ficos, cl\u00ednicos, radiogr\u00e1ficos y de laboratorio, escores Acute Physiology and Chronic Health Evaluation II (APACHE II) y pneumonia severity index (PSI), comorbilidades y antecedente de VAN. Se compararon pacientes con NAC neumoc\u00f3cica bacteri\u00e9mica (NNB) vs. no bacteri\u00e9mica (NNNB). RESULTADOS: Cuarenta y siete pacientes ten\u00edan NNB y 71 NNNB (45 por cultivo de esputo y 26 por ant\u00edgeno urinario); 107 ten\u00edan alguna indicaci\u00f3n de VAN. Ning\u00fan paciente con NNB, pero 9 con NNNB, hab\u00edan recibido VAN (p = 0,043). Los pacientes con NNB eran mayores (76,4 \u00b1 11,5 vs. 67,5 \u00b1 20,9 a\u00f1os), ten\u00edan mayor APACHE II (16,4 \u00b1 4,6 vs. 14,1 \u00b1 6,5) y PSI (129,5 \u00b1 36 vs. 105,2 \u00b1 45), m\u00e1s frecuentemente cardiopat\u00eda e insuficiencia renal cr\u00f3nica e internaci\u00f3n en UTI (42,5% vs. 22,5%) y menor hematocrito (35,7 \u00b1 5,8 vs. 38,6 \u00b1 6,7%) y sodio plasm\u00e1tico (133,9 \u00b1 6,0 vs. 137,1 \u00b1 5,5 mEq\/L). La mortalidad fue similar (29,8% vs. 28,2%). CONCLUSIONES: Los niveles de VAN (8,4%) en esta poblaci\u00f3n con alto riesgo de NAC por S. pneumoniae fueron extremadamente bajos. Los pacientes con NNB estaban m\u00e1s graves, pero la mortalidad fue similar entre los dos grupos. La VAN reduce la incidencia de NNB y es razonable incrementar el nivel de vacunaci\u00f3n de la poblaci\u00f3n en riesgo.<\/jats:p>","DOI":"10.1590\/s1806-37132012000400003","type":"journal-article","created":{"date-parts":[[2012,9,5]],"date-time":"2012-09-05T05:58:29Z","timestamp":1346824709000},"page":"422-430","source":"Crossref","is-referenced-by-count":11,"title":["Impacto de la bacteriemia en una cohorte de pacientes con neumon\u00eda neumoc\u00f3cica"],"prefix":"10.1590","volume":"38","author":[{"given":"Ileana","family":"Palma","sequence":"first","affiliation":[{"name":"Universidad de Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Mosquera","sequence":"additional","affiliation":[{"name":"Universidad de Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Demier","sequence":"additional","affiliation":[{"name":"Universidad de Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Vay","sequence":"additional","affiliation":[{"name":"Universidad de Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Famiglietti","sequence":"additional","affiliation":[{"name":"Universidad de Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos M","family":"Luna","sequence":"additional","affiliation":[{"name":"Universidad de Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","reference":[{"key":"ref1","series-title":"Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases","first-page":"2623","volume-title":"Streptococcus pneumoniae","author":"Musher DM","year":"2005"},{"issue":"3","key":"ref2","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1001\/jama.1996.03530270034028","article-title":"Bacteremia with Streptococcus pneumoniae: Implications for therapy and prevention. Franklin County Pneumonia Study Group","volume":"275","author":"Plouffe JF","year":"1996","journal-title":"JAMA","ISSN":"https:\/\/id.crossref.org\/issn\/0098-7484","issn-type":"print"},{"issue":"3","key":"ref3","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1053\/jinf.2000.0653","article-title":"Early predictors of mortality in pneumococcal bacteraemia","volume":"40","author":"Balakrishnan I","year":"2000","journal-title":"J Infect","ISSN":"https:\/\/id.crossref.org\/issn\/0163-4453","issn-type":"print"},{"issue":"2","key":"ref4","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1093\/clinids\/21.2.345","article-title":"Pneumococcal bacteremia in adults: a 14-year experience in an inner-city university hospital","volume":"21","author":"Afessa B","year":"1995","journal-title":"Clin Infect Dis","ISSN":"https:\/\/id.crossref.org\/issn\/1058-4838","issn-type":"print"},{"issue":"13","key":"ref5","doi-asserted-by":"crossref","first-page":"2398","DOI":"10.1016\/j.vaccine.2006.09.008","article-title":"The preventable burden of pneumococcal disease in the developing world","volume":"25","author":"Scott JA","year":"2007","journal-title":"Vaccine","ISSN":"https:\/\/id.crossref.org\/issn\/0264-410X","issn-type":"print"},{"issue":"4","key":"ref6","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1001\/archinte.1937.00170200044004","article-title":"Clinical significance of bacteremia in pneumococcic pneumonia","volume":"59","author":"Tilghman RC","year":"1937","journal-title":"Arch Intern Med,"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"759","DOI":"10.7326\/0003-4819-60-5-759","article-title":"Pneumococcal bacteremia with especial reference to bacteremic pneumococcal pneumonia","volume":"60","author":"Austrian R","year":"1964","journal-title":"Ann Intern Med","ISSN":"https:\/\/id.crossref.org\/issn\/0003-4819","issn-type":"print"},{"issue":"5","key":"ref8","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1097\/00005792-199009000-00004","article-title":"New and emerging etiologies for community-acquired pneumonia with implications for therapy: A prospective multicenter study of 359 cases","volume":"69","author":"Fang GD","year":"1990","journal-title":"Medicine (Baltimore)","ISSN":"https:\/\/id.crossref.org\/issn\/0025-7974","issn-type":"print"},{"issue":"10","key":"ref9","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1097\/00003246-198510000-00009","article-title":"APACHE II: a severity of disease classification system","volume":"13","author":"Knaus WA","year":"1985","journal-title":"Crit Care Med","ISSN":"https:\/\/id.crossref.org\/issn\/0090-3493","issn-type":"print"},{"issue":"5","key":"ref10","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1136\/thorax.58.5.377","article-title":"Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study","volume":"58","author":"Lim WS","year":"2003","journal-title":"Thorax","ISSN":"https:\/\/id.crossref.org\/issn\/0040-6376","issn-type":"print"},{"issue":"4","key":"ref11","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1056\/NEJM199701233360402","article-title":"A prediction rule to identify low-risk patients with community-acquired pneumonia","volume":"336","author":"Fine MJ","year":"1997","journal-title":"N Engl J Med","ISSN":"https:\/\/id.crossref.org\/issn\/0028-4793","issn-type":"print"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1001\/jama.285.13.1729","article-title":"Epidemiology of invasive Streptococcus pneumoniae infections in the United States, 1995-1998: Opportunities for prevention in the conjugate vaccine era","volume":"285","author":"Robinson KA","year":"2001","journal-title":"JAMA","ISSN":"https:\/\/id.crossref.org\/issn\/0098-7484","issn-type":"print"},{"issue":"1","key":"ref13","first-page":"9","article-title":"Adult bacteremic pneumococcal pneumonia acquired in the community: A prospective study on 101 patients","volume":"63","author":"Gentile JH","year":"2003","journal-title":"Medicina (B Aires)","ISSN":"https:\/\/id.crossref.org\/issn\/0025-7680","issn-type":"print"},{"issue":"18","key":"ref14","doi-asserted-by":"crossref","first-page":"1737","DOI":"10.1056\/NEJMoa022823","article-title":"Decline in invasive pneumococcal disease after the introduction of protein-polysaccharide conjugate vaccine","volume":"348","author":"Whitney CG","year":"2003","journal-title":"N Engl J Med","ISSN":"https:\/\/id.crossref.org\/issn\/0028-4793","issn-type":"print"},{"issue":"7","key":"ref15","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1155\/2003\/862856","article-title":"A comparison of bacteremic pneumococcal pneumonia with nonbacteremic community-acquired pneumonia of any etiology: results from a Canadian multicentre study","volume":"10","author":"Marrie TJ","year":"2003","journal-title":"Can Respir J","ISSN":"https:\/\/id.crossref.org\/issn\/1198-2241","issn-type":"print"},{"issue":"8","key":"ref16","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1086\/507699","article-title":"Effect of pneumococcal vaccination: a comparison of vaccination rates in patients with bacteremic and nonbacteremic pneumococcal pneumonia","volume":"43","author":"Musher DM","year":"2006","journal-title":"Clin Infect Dis","ISSN":"https:\/\/id.crossref.org\/issn\/1058-4838","issn-type":"print"},{"issue":"11","key":"ref17","doi-asserted-by":"crossref","first-page":"2179","DOI":"10.1001\/archinte.1986.00360230105016","article-title":"Risk factors for acquiring pneumococcal infections","volume":"146","author":"Lipsky BA","year":"1986","journal-title":"Arch Intern Med","ISSN":"https:\/\/id.crossref.org\/issn\/0003-9926","issn-type":"print"},{"issue":"13","key":"ref18","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1001\/archinte.1997.00440340089009","article-title":"Influence of age on symptoms at presentation in patients with community-acquired pneumonia","volume":"157","author":"Metlay JP","year":"1997","journal-title":"Arch Intern Med","ISSN":"https:\/\/id.crossref.org\/issn\/0003-9926","issn-type":"print"},{"issue":"4","key":"ref19","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1097\/00005792-200007000-00002","article-title":"Bacteremic and nonbacteremic pneumococcal pneumonia: A prospective study","volume":"79","author":"Musher DM","year":"2000","journal-title":"Medicine (Baltimore)","ISSN":"https:\/\/id.crossref.org\/issn\/0025-7974","issn-type":"print"},{"issue":"1","key":"ref20","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.ejim.2007.03.015","article-title":"A comparative study of bacteremic and 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Dis","ISSN":"https:\/\/id.crossref.org\/issn\/1058-4838","issn-type":"print"},{"issue":"6","key":"ref26","first-page":"574","article-title":"Brazilian guidelines for community-acquired pneumonia in immunocompetent adults - 2009","volume":"35","author":"Corr\u00eaa Rde A","year":"2009","journal-title":"J Bras Pneumol"},{"issue":"4","key":"ref27","first-page":"319","article-title":"Pneumonia acquired in the community: Practical guide elaborated by a committee intersocieties","volume":"63","author":"Luna CM","year":"2003","journal-title":"Medicina (B Aires)","ISSN":"https:\/\/id.crossref.org\/issn\/0025-7680","issn-type":"print"},{"issue":"1","key":"ref28","first-page":"51","article-title":"Adverse events after pneumococcal vaccination","volume":"33","author":"Donalisio MR","year":"2007","journal-title":"J Bras Pneumol"},{"issue":"4","key":"ref29","first-page":"353","article-title":"The 23-valent pneumococcal polysaccharide vaccine: Part I. 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