title: The Fcγ receptor IIA-H/H131 genotype is associated with bacteremia in pneumococcal community-acquired pneumonia.
abstract: OBJECTIVE
  To assess the potential association of the functional polymorphism rs1801274 in the receptor IIa for the Fc portion of immunoglobin G (FcγRIIa) gene (FCGR2A-H131R) with the susceptibility to and the severity of community-acquired pneumonia (CAP).
  
  
  METHODS
  Multicenter prospective and observational study.
  
  
  METHODS
  Four university hospitals in Spain.
  
  
  METHODS
  FCGR2A-H131R polymorphism was determined in 1,262 patients with CAP and in 1,224 in the subject control group.
  
  
  RESULTS
  Severe sepsis was recorded in 366 patients. No significant differences in genotype or allele frequencies were seen among patients with CAP or pneumococcal CAP (PCAP) and controls. Patients with bacteremic PCAP (B-PCAP) had significantly higher frequencies of FCGR2A-H/H131 genotypes than those with nonbacteremic PCAP (p = .00016, odds ratio = 2.9, 95% confidence interval 1.58-5.3). The differences remained significant when adjusting for pneumonia severity index, hospital of origin, and intensive care unit admission (p = .0012, odds ratio = 2.83, 95% confidence interval 1.51-5.32). B-PCAP was associated with a significantly higher severity of the disease, evaluated as sepsis severity (p = .000007, odds ratio = 4.40, 95% confidence interval 2.31-8.39), multiorgan dysfunction syndrome (0.00048, odds ratio = 3.29, 95% confidence interval 1.69-6.41), intensive care unit admission, acute renal failure, and acute respiratory distress syndrome.
  
  
  CONCLUSIONS
  Our results do not support a role of FCGR2A-H131R polymorphism in susceptibility to CAP or PCAP. However, we provide the insight that homozygosity for FCGR2A-H131 predisposes B-PCAP, which was associated with higher severity in our study.
authors.affiliation: Intensive Care Unit, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Solé-Violán
authors.forename: M Isabel
authors.initials: MI
authors.lastname: García-Laorden
authors.forename: José Alberto
authors.initials: JA
authors.lastname: Marcos-Ramos
authors.forename: Felipe Rodríguez
authors.initials: FR
authors.lastname: de Castro
authors.forename: Olga
authors.initials: O
authors.lastname: Rajas
authors.forename: Luis
authors.initials: L
authors.lastname: Borderías
authors.forename: M Luisa
authors.initials: ML
authors.lastname: Briones
authors.forename: Estefanía
authors.initials: E
authors.lastname: Herrera-Ramos
authors.forename: José
authors.initials: J
authors.lastname: Blanquer
authors.forename: Javier
authors.initials: J
authors.lastname: Aspa
authors.forename: Yanira
authors.initials: Y
authors.lastname: Florido
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: García-Bello
authors.forename: José María
authors.initials: JM
authors.lastname: Ferrer-Agüero
authors.forename: Ithaisa
authors.initials: I
authors.lastname: Sologuren
authors.forename: Carlos
authors.initials: C
authors.lastname: Rodriguez-Gallego
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000235:genetics*; D016022:Case-Control Studies; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D011018:Pneumonia, Pneumococcal / Q000235:genetics*; D020641:Polymorphism, Single Nucleotide / Q000235:genetics*; D017452:Receptors, IgG / Q000235:genetics*
chemical_list: C080568:Fc gamma receptor IIA; D017452:Receptors, IgG