title: Impact of alcohol abuse in the etiology and severity of community-acquired pneumonia.
abstract: OBJECTIVE
  Alcohol consumption is known to affect both systemic and pulmonary immunity, predisposing the patient to pulmonary infections. The aim of this study was to compare the etiology of disease, the antibiotic resistance of Streptococcus pneumoniae, the severity of disease, and the outcome of patients with alcohol abuse to those of nonalcoholic (NA) patients who have been hospitalized for community-acquired pneumonia (CAP).
  
  
  METHODS
  From 1997 to 2001, clinical, microbiological, radiographic, and laboratory data, and follow-up variables of all consecutive patients who had been hospitalized with CAP were recorded. Patients were classified as alcoholic (A) [n = 128] or ex-alcoholic (EA) patients (n = 54) and were compared to NA patients (n = 1,165).
  
  
  RESULTS
  S pneumoniae was found significantly more frequently in all patients with alcohol misuse. As regards the rates of antibiotic resistance, invasive pneumococcal disease, and other microorganisms, no differences were found. The severity criteria for CAP according to the American Thoracic Society were more frequent in A patients, but mortality did not differ significantly. Multivariate analysis showed an independent association between pneumococcal CAP and alcoholism (A patients: odds ratio [OR], 1.6; p = 0.033; EA patients: OR, 2.1; p = 0.016).
  
  
  CONCLUSIONS
  We found an independent association between pneumococcal infection and alcoholism. Current alcohol abuse was associated with severe CAP. No significant differences were found in mortality, antibiotic resistance of S pneumoniae, and other etiologies.
authors: Servei de Pneumologia, Hospital Clinic, Villarroel 170, 08036 Barcelona, Spain.
authors: Andrés
authors: A
authors: de Roux
authors: Manuela
authors: M
authors: Cavalcanti
authors: Maria Angeles
authors: MA
authors: Marcos
authors: Elisa
authors: E
authors: Garcia
authors: Santiago
authors: S
authors: Ewig
authors: José
authors: J
authors: Mensa
authors: Antoni
authors: A
authors: Torres