Influence of comorbidities in the clinical presentation of invasive pneumococcal disease (IPD) in adults in Spain, 2010-2013. The ODIN study

Objectives: To explore comorbidities associated with the different clinical presentations of IPD in adults in Spain. Methods: A prospective, active, hospital-based surveillance of culture-confirmed IPD episodes in adults (≥18years) was performed in 9 Spanish hospitals (August 2010-June 2013). IPD was considered as isolation of S. pneumoniae from normally sterile fluids. Comorbidities, risk habits, clinical presentation [complicated pneumonia -CP-(presence of pleural effusion/empyema and/or multilobar infiltration), non-complicated pneumonia -N-CP-, meningitis -M-, primary bacteremia -PB-, peritonitis -P- and others -O-], and outcome were recorded. Comorbidities known to increase the risk of IPD were compared between the different clinical presentations. Results: Among the 637 IPD cases identified, up to 90.3% of the patients had ≥1 comorbidity and/or risk habits. Table shows comorbidities with significant association with any of the IPD clinical presentations. Severe sepsis/septic shock occurred in 22% of the patients. Overall mortality was 14.8%, being the highest in PB (21.2%) and CP (20%). Mortality in patients developing severe sepsis/septic shock was 35%. ![Figure][1] Conclusions: This is the first study that clearly demonstrates that some underlying conditions influence the clinical presentation of IPD and thus the mortality rate. [1]: pending:yes