Clinical and epidemiological features of pneumonia in young men in a closed community
https://doi.org/10.18093/0869-0189-2016-26-1-29-37
Abstract
Streptococcus pneumoniae is the leading pathogen of community-acquired pneumonia (CAP) in adults. Therefore, vaccination is an important preventive measure against CAP. Methods. Clinical and epidemiological features of CAP were studied in young conscript soldiers (n = 114) aged 18 to 26 years who had been vaccinated using the 23-valent polysaccharide pneumococcal vaccine PPV23 (Sanofi Pasteur, France) in previous 30 days and in unvaccinated patients (n = 151). Clinical examination, laboratory blood tests, sputum microbiological examination, quantitative C-reactive protein (CRP) measurement, molecular examination of nasopharyngeal smears using polymerase chain reaction (PCR), chest X-ray and pulse oximetry were used. Pneumococcal antigen was determined in urine using immunochromatography (Binax NOW S. pneumoniae test, USA). Results. Established risk factors of CAP in men were low anthropometric parameters (weight, body mass index, chest circumference), chronic upper airway diseases, history of repeated pneumonias, and being unvaccinated against pneumococcus. In first 100 days of military conscript, the risk of CAP was 6.96 (95%CI: 3.39–14.58; p < 0.001) in unvaccinated men; clinical course was more severe. Vaccination against S.pneumoniae shortened the disease by 2.2 days in average. S. pneumoniae was found in nasopharyngeal smears of 48.8% of CAP patients. Leading pathogens of CAP in vaccinated and unvaccinated patients were Haemophilus influenzae (24.1% vs 20.0%, respectively; p > 0.05), Streptococcus spp. (19.0% vs 36.0%, respectively; р = 0.48), and S. pneumoniae (10.3% vs 4.1%, respectively; p > 0.05) according to sputum microbiological results. The urine pneumococcal antigen test was positive in 2.9% of vaccinated and in 1.4% of unvaccinated CAP patients. Conclusion. Vaccination with PPV23 could reduce the rate of pneumococcal CAP in high-risk patient groups.
About the Authors
M. V. Raycheva
State Central Army Clinical Hospital of Internal Security Forces, Ministry of Home Affairs of Russia: build. 101, Vishnyakovskoe road, Nikol'sko-Arkhangel'skiy urban district, Balashikha, Moscow region, 143915, Russia
Russian Federation
Russian Federation
Senior Therapeutist, Head of Bronchological unit, Pulmonology Department, State Central Army Clinical Hospital of Internal Security Forces, Ministry of Home Affairs of Russia; tel.: (495) 524-89-89;
T. N. Bilichenko
Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; 32, build. 4, 11th Parkovaya str., Moscow, 105077, Russia
Russian Federation
Russian Federation
MD, Head of Laboratory of Clinical Epidemiology, Federal Institution "Pulmonology Research Institute", Federal Medical and Biological Agency of Russia; tel.: (495) 965-11-15, факс: (495) 465-52-64
A. G. Chuchalin
Federal Pulmonology Research Institute, Federal Medical and Biological Agency of Russia; 32, build. 4, 11th Parkovaya str., Moscow, 105077, Russia
Russian Federation
Russian Federation
MD, Professor, Academician of Russian Science Academy, Director of Federal Institution "Pulmonology Research Institute", Federal Medical and Biological Agency of Russia; tel. / fax: (495) 465-52-64
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For citations:
Raycheva M.V., Bilichenko T.N., Chuchalin A.G. Clinical and epidemiological features of pneumonia in young men in a closed community. PULMONOLOGIYA. 2016;26(1):29-37. (In Russ.) https://doi.org/10.18093/0869-0189-2016-26-1-29-37
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