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Alcoholism a Risk Factor for S. pneumoniae

Almost one-third of current and former alcoholics will develop community-acquired pneumonia

WEDNESDAY, May 10 (HealthDay News) -- Alcoholism is an independent risk factor for contracting community-acquired pneumonia (CAP), according to a study published in the May issue of Chest.

Andres de Roux, M.D., Ph.D., of the University of Barcelona in Spain, and colleagues analyzed clinical, microbiological, radiographic and laboratory data as well as follow-up variables for patients hospitalized with CAP from 1997 to 2001, of whom 128 were alcoholics, 54 were former alcoholics and 1,165 were non-alcoholics.

Among patients who misused alcohol, S. pneumoniae was significantly more prevalent. A total of 27 percent of current alcoholics, 30 percent of former alcoholics and 16 percent of nonalcoholics developed S. pneumoniae infections. However, there were no differences in terms of antibiotic resistance, invasive pneumococcal disease and other microorganisms. Although current alcoholics had more severe symptoms, there were no significant differences in mortality rates.

The authors hypothesize that sustained risk of developing CAP even after abstinence from alcohol for one year may be due to alterations of the proinflammatory cytokine response in the lung and decreased local neutrophil recruitment that remain even after cessation of alcohol intake.

"The association of S. pneumoniae and alcoholism strongly supports the need to promote pneumococcal vaccination in this risk group of patients. In addition, as the course of the disease is more severe, the decision to admit such a patient to an intensive care unit should be considered seriously," the authors conclude.

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