Table 1.
Characteristics of adults hospitalized with ALRI with and without pneumococcal pneumonia based on blood culture or UAT in rural Thailand, 2006–2011
| Laboratory-confirmed pneumococcal pneumonia* (N = 481) | All UAT+ (N = 396) | All UAT− (N = 9,660) | P value† | |
|---|---|---|---|---|
| Age (years), n (%) | ||||
| 18–29 | 24 (5.0) | 19 (4.8) | 735 (7.6) | 0.004 |
| 30–39 | 39 (8.1) | 37 (9.3) | 922 (9.5) | |
| 40–49 | 61 (12.6) | 43 (10.9) | 1,206 (12.5) | |
| 50–59 | 65 (13.5) | 50 (12.6) | 1,655 (17.1) | |
| 60–69 | 99 (20.6) | 84 (21.2) | 1,977 (20.5) | |
| ≥ 70 | 193 (40.1) | 163 (41.2) | 3,165 (32.8) | |
| Male sex, n (%) | 249 (51.8) | 202 (51.0) | 5,031 (52.1) | 0.68 |
| Clinical characteristics, n (%) | ||||
| Fever (> 38.2°C or reported) | 429 (89.2) | 355 (89.7) | 8,088 (83.7) | 0.002 |
| Abnormal WBC (> 11,000/mL or < 3,000/mL) | 277 (62.5) | 221 (61.2) | 3,826 (43.8) | < 0.0001 |
| Cough | 439 (91.3) | 372 (93.9) | 8,692 (90.0) | 0.001 |
| Sputum production | 294 (61.1) | 249 (62.9) | 5,232 (54.2) | 0.001 |
| Hemoptysis | 19 (4.0) | 18 (4.6) | 426 (4.4) | 0.90 |
| Chest pain | 70 (14.6) | 62 (15.8) | 938 (9.7) | < 0.0001 |
| Dyspnea | 338 (70.3) | 276 (69.7) | 5,306 (55.0) | < 0.0001 |
| Abnormal breath sounds | 337 (70.1) | 280 (70.7) | 5,456 (56.5) | < 0.0001 |
| Tachypnea (based on clinical assessment) | 215 (44.7) | 164 (41.4) | 3,396 (35.2) | 0.01 |
| Rales/crepitation‡ | 246 (73.0) | 199 (71.1) | 2,972 (54.4) | < 0.0001 |
| Rhonchi‡ | 105 (31.2) | 88 (31.4) | 1,524 (27.9) | 0.20 |
| Viral infections, n (%)‡ | ||||
| Adenovirus‡ | 3/409 (0.8) | 2/394 (0.5) | 91/9,648 (0.9) | 0.38 |
| Respiratory syncytial virus‡ | 11/405 (2.7) | 11/402 (2.8) | 274/9,930 (2.9) | 0.95 |
| Influenza A/B viruses‡ | 30/405 (7.4) | 30/390 (7.7) | 971/9,518 (10.2) | 0.11 |
| Radiographic pneumonia, n (%)‡ | 282/380 (74.2) | 228/318 (71.7) | 3,654/6,855 (53.3) | < 0.0001 |
| Medical history, n (%) | ||||
| Any comorbid condition | 128 (26.6) | 101 (25.5) | 2,375 (24.6) | 0.68 |
| Cancer | 10 (2.1) | 7 (1.8) | 152 (1.6) | 0.76 |
| Liver disease | 16 (3.3) | 6 (1.5) | 114 (1.2) | 0.55 |
| Renal disease | 32 (6.7) | 27 (6.8) | 510 (5.3) | 0.18 |
| Heart disease | 47 (9.8) | 38 (9.6) | 1,283 (13.3) | 0.03 |
| HIV | 34 (7.1) | 29 (7.3) | 537 (5.6) | 0.14 |
| Smoking | 133 (27.7) | 101 (25.5) | 2,056 (21.3) | 0.04 |
| Severity, n (%) | ||||
| O2 requirement§ | 447 (92.9) | 363 (91.7) | 8,775 (90.8) | 0.57 |
| Mechanical ventilation | 80 (16.6) | 39 (9.9) | 591 (6.1) | 0.003 |
| Outcomes, n (%) | ||||
| Death | 52 (10.8) | 25 (6.3) | 261 (2.7) | 0.0002 |
| Transferred/referred | 39 (8.1) | 29 (7.3) | 792 (8.2) | |
| Discharge | 368 (76.5) | 329 (83.1) | 8,402 (87.0) | |
| Self-discharge | 22 (4.6) | 13 (3.3) | 197 (2.0) | |
| Discharge diagnoses, n (%) | ||||
| Consistent with any pneumonia | 235 (48.9) | 189 (47.7) | 2,397 (24.8) | < 0.0001 |
| Bacterial pneumonia, unspecified | 40 (8.3) | 34 (8.6) | 481 (5.0) | 0.001 |
| Pneumonia due to Streptococcus pneumoniae | 23 (4.8) | 8 (2.0) | 20 (0.2) | < 0.0001 |
| Viral pneumonia, unspecified | 1 (0.2) | 1 (0.3) | 29 (0.3) | 0.86 |
| Other pneumonia diagnoses∥ | 171 (35.6) | 146 (36.9) | 1,867 (19.4) | < 0.0001 |
| Septicemia | 32 (6.7) | 15 (3.8) | 371 (3.8) | 0.96 |
ALRI = acute lower respiratory infection; HIV = human immunodeficiency virus; UAT = urine antigen test; WBC = white blood cell.
Among 481 pneumococcal pneumonia cases, 105 were confirmed by blood culture and 376 were confirmed by UAT only.
Categorical variables tested by χ2 tests and continuous variables tested by F tests between UAT+ and UAT−. Bold font denotes statistical significance (P < 0.05).
Among those tested.
Oxygen saturation < 92% or received oxygen supplementation.
Other pneumonia diagnoses included: pneumonia due to other infectious organisms, pneumonia due to Haemophilus influenzae, pneumonia unspecified, and pneumonia in diseases classified elsewhere.