Document Detail


Cigarette smoking and invasive pneumococcal disease. Active Bacterial Core Surveillance Team.
MedLine Citation:
PMID:  10706897     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Approximately half of otherwise healthy adults with invasive pneumococcal disease are cigarette smokers. We conducted a population-based case-control study to assess the importance of cigarette smoking and other factors as risk factors for pneumococcal infections. METHODS: We identified immunocompetent patients who were 18 to 64 years old and who had invasive pneumococcal disease (as defined by the isolation of Streptococcus pneumoniae from a normally sterile site) by active surveillance of laboratories in metropolitan Atlanta, Baltimore, and Toronto. Telephone interviews were conducted with 228 patients and 301 control subjects who were reached by random-digit dialing. RESULTS: Fifty-eight percent of the patients and 24 percent of the control subjects were current smokers. Invasive pneumococcal disease was associated with cigarette smoking (odds ratio, 4.1; 95 percent confidence interval, 2.4 to 7.3) and with passive smoking among nonsmokers (odds ratio, 2.5; 95 percent confidence interval, 1.2 to 5.1) after adjustment by logistic-regression analysis for age, study site, and independent risk factors such as male sex, black race, chronic illness, low level of education, and living with young children who were in day care. There were dose-response relations for the current number of cigarettes smoked per day, pack-years of smoking, and time since quitting. The adjusted population attributable risk was 51 percent for cigarette smoking, 17 percent for passive smoking, and 14 percent for chronic illness. CONCLUSIONS: Cigarette smoking is the strongest independent risk factor for invasive pneumococcal disease among immunocompetent, nonelderly adults. Because of the high prevalence of smoking and the large population attributable risk, programs to reduce both smoking and exposure to environmental tobacco smoke have the potential to reduce the incidence of pneumococcal disease.
Authors:
J P Nuorti; J C Butler; M M Farley; L H Harrison; A McGeer; M S Kolczak; R F Breiman
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The New England journal of medicine     Volume:  342     ISSN:  0028-4793     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  2000 Mar 
Date Detail:
Created Date:  2000-03-09     Completed Date:  2000-03-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  681-9     Citation Subset:  AIM; IM    
Affiliation:
Respiratory Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
African Continental Ancestry Group
Case-Control Studies
Child Day Care Centers
Chronic Disease
Educational Status
Female
Humans
Logistic Models
Male
Middle Aged
Multivariate Analysis
Pneumococcal Infections / epidemiology,  etiology*,  microbiology
Risk Factors
Sex Factors
Smoking / adverse effects*
Streptococcus pneumoniae / isolation & purification
Tobacco Smoke Pollution / adverse effects*
Chemical
Reg. No./Substance:
0/Tobacco Smoke Pollution
Comments/Corrections
Comment In:
N Engl J Med. 2000 Mar 9;342(10):732-4   [PMID:  10706905 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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