Risk Factors For Community-acquired Pneumonia Research Articles

Factors associated with hospitalization for community-acquired pneumonia in home health care patients in Taiwan

BackgroundPneumonia is a leading cause of hospitalization and death worldwide. However, studies focusing on risk factors of community-acquired pneumonia (CAP) in the home health care (HHC) population remain scarce.AimsThis study aimed to evaluate risk factors associated with hospitalization for CAP among HHC patients in Taiwan.MethodsThis retrospective cross-sectional study extracted data from patients’ electronic medical records between 1 January 2017 and 31 December 2017. Multiple logistic regression analyses were performed to explore factors associated with hospitalization for CAP.ResultsIn total, 598 patients (men/women: 236/362) were included. One hundred ninety-nine patients (33.28%) were hospitalized for pneumonia. Inpatients showed a higher proportion of the following: male sex, functional impairment, hypoalbuminemia, anemia, nasogastric tube use, excessive polypharmacy, stroke, dementia, heart failure, chronic respiratory disease, and chronic liver disease. Furthermore, nasogastric tube use (odds ratio [OR] 3.01, 95% confidence interval [CI] 1.88–4.82), anemia (OR 2.37, 95% CI 1.48–3.80), male sex (OR 2.14, 95% CI 1.43–3.20), chronic respiratory disease (OR 2.09, 95% CI 1.33–3.30), dementia (OR 1.94, 95% CI 1.27–2.97), heart failure (OR 1.69, 95% CI 1.11–2.56), and hypoalbuminemia (OR 1.57, 95% CI 1.03–2.40) significantly increased the risk of hospitalization for CAP.ConclusionsOur results revealed risk factors associated with hospitalization for CAP in HHC patients. In addition to chronic diseases, malnutrition is an important risk factor. Caregivers should make prompt assessments and take preventive measures for such patients.

Modifiable risk factors for community-acquired pneumonia in children under 5years of age in resource-poor settings: a case-control study.

Despite the availability of vaccines and antibiotics, pneumonia remains the leading cause of mortality among children under 5years of age. The objective of this study was to identify modifiable risk factors for community-acquired pneumonia (CAP) in children under 5years of age in a vaccinated population. A case-control study was conducted between January and December 2017. The cases included children aged 2-59months with X-ray-confirmed pneumonia, whereas the controls were children from the community with no history of respiratory infection. A multivariable logistic regression model was used to determine the modifiable risk factors for CAP. A total of 113 children with X-ray-confirmed pneumonia and 350 healthy children were enrolled in this study. The median ages for the cases and controls were 13.7 (IQR=7.2-25.3) and 13.4 (IQR=6.0-24.8)months respectively. One (0.9%) child died after the enrolment. The independent predictors of CAP included a lack of exclusive breastfeeding for 6months (aOR=1.7, 95% CI=1.0-2.9), underweight (aOR=2.1, 95% CI=1.0-4.5), unclean cooking fuel (aOR=1.8, 95% CI=1.0-3.3) and low income (aOR=2.9, 95% CI=1.6-5.4). No association was found between vaccination status and CAP. In addition to a lack of exclusive breastfeeding, children from families of low-economic status were at risk of contracting CAP. Since the risk factors are complex, the study results call for more concerted efforts by and collaboration among the health, agriculture and development sectors to address mortality caused by CAP.

Lifestyle and comorbid conditions as risk factors for community-acquired pneumonia in outpatient adults (NEUMO-ES-RISK project)

IntroductionInformation about community-acquired pneumonia (CAP) risk in primary care is limited. We assess different lifestyle and comorbid conditions as risk factors (RF) for CAP in adults in primary care.MethodsA retrospective-observational-controlled...

Risk of community-acquired pneumonia in older adults with sarcopenia of a hospital from Callao, Peru 2010–2015

IntroductionSarcopenia is a geriatric syndrome characterized by loss of muscle mass and strength. The prevalence in people between 60–70 years is about 5–13% and in adults over 80 years, between 11–50% in the USA. Sarcopenia increases the risk of mortality and nosocomial infections.Community-acquired pneumonia is the first infectious-related cause of death in elderly people. However, there is lack of evidence about the association between sarcopenia and pneumonia. The aim of our study was to determine the incidence and risk factors of community-acquired pneumonia in older adults with sarcopenia in a Peruvian hospital. MethodsA retrospective cohort study was conducted in the geriatrics service of Centro Medico Naval “Cirujano Mayor Santiago Tavara”. Sarcopenia was defined by “European Consensus of Sarcopenia” criteria. MultivariatePoisson regression model was conducted to estimate the effect of the independent association between sarcopenia and pneumonia. ResultsA total of 1598 subjects were enrolled, 59.0% were male; with a mean age of 78.3 ± 8.6 years. The prevalence of sarcopenia was 15.1% (95% CI: 13.3–16.8) and the incidence of community-acquired pneumonia was 15.14% (95%CI 13.4–16.9). In the multivariate model, we found a higher incidence of pneumonia in sarcopenic compared to non-sarcopenic, RR(a) 3.88 (95% CI: 2.82–5.33). DiscussionOur study showed a higher incidence of community-acquired pneumonia in sarcopenic subject. Results provide information on the importance of detecting this syndrome because it gives us scientific evidence of the interest of a correct comprehensive geriatric assessment in older patients with a high risk of pneumonia.

Risk Factors for Community-acquired Pneumonia in Malaysian Pilgrims Attending the Hajj, 2012

Community-acquired pneumonia (CAP) is an important cause of morbidity and mortality in Malaysian pilgrims attending the Hajj every year. This study aimed to determine risk factors associated with CAP in Malaysians attending the Hajj. We conducted an unmatched case-control study at a Malaysian hospital in Mecca from September 2012 to January 2013, during the Hajj season. Individuals who met the definition of CAP were selected as cases. Controls were randomly selected among Malaysian pilgrims staying in the same accommodation as the cases, and followed up two weeks after returning to Malaysia. Information on risk factors was gathered using a structured questionnaire, and the strength of association was assessed using adjusted odds ratios (AOR) and 95% confidence intervals (CI) through a multiple logistic regression model. The study identified 108 cases and 673 unmatched controls. Among cases, 57.4% were males and 98.1% were aged more than 50 years. CAP was significantly associated with drinking over three liters of water daily (AOR = 0.2, 95% CI = 0.9-0.4), taking multivitamins (AOR = 0.2, 95% CI = 0.9-0.5), age 60 years or more (AOR = 20.2, 95% CI = 10.6-38.3), asthma/chronic obstructive airway disease (AOR = 5.9, 95% CI = 2.4-14.7) and congestive cardiac failure (AOR = 5.4, 95% CI = 2.0-14.7). Determining potentially preventable risk factors for CAP could help to inform public health programs for future Hajj pilgrims and might potentially reduce the associated morbidity and mortality.

Risk factors for community-acquired pneumonia among adults in Kenya: a case\u2013control study

BackgroundPneumonia is a leading cause of morbidity and mortality among adults worldwide; however, the risk factors for community-acquired pneumonia in Africa are not well characterized.MethodsThe authors recruited 281 cases of community-acquired pneumonia and 1202 hospital controls among patients aged ≥15 years who attended Kilifi District Hospital/Coast Provincial General Hospital in Kenya between 1994 and 6. Cases were admissions with an acute illness with ≥2 respiratory signs and evidence of consolidation on a chest radiograph. Controls were patients without signs of pneumonia, frequency matched by age, sex and hospital. Risk factors related to socio-demographic factors, drug use, clinical history, contact patterns and exposures to indoor air pollution were investigated by questionnaire, anthropometric measurements and laboratory assays. Associations were evaluated using a hierarchical logistic regression model.ResultsPneumonia was associated with human immunodeficiency virus (HIV) infection (Odds Ratio [OR] 2.06, 95% CI 1.44–3.08), anemia (OR 1.91, 1.31–2.74), splenomegaly (OR 2.04, 95% CI 1.14–3.41), recent history of pneumonia (OR 4.65, 95% CI 1.66–12.5), history of pneumonia >2 years previously (OR 17.13, 95% CI 5.01–60.26), coryza in the 2 weeks preceding hospitalization (OR 2.09, 95% CI 1.44–3.03), current smoking (2.19, 95% CI 1.39–3.70), use of khat (OR 3.44, 95% CI 1.72–7.15), use of snuff (OR 2.67, 95% CI 1.35–5.49) and contact with several animal species. Presence of a Bacillus Calmette-Guerin (BCG) scar was associated with protection (OR 0.51, 95% CI 0.32–0.82). The risk factors varied significantly by sex.ConclusionPneumonia in Kenyan adults was associated with global risk factors, such as HIV and smoking, but also with specific local factors like drug use and contact with animals. Intervention strategies should account for sex-specific differences in risk factors.

Undiagnosed Diabetes Mellitus in Community-Acquired Pneumonia: A Prospective Cohort Study.

Diabetes mellitus is an important risk factor for community-acquired pneumonia, whereas the prevalence of undiagnosed diabetes mellitus and prediabetes in patients with community-acquired pneumonia is largely unknown. We aimed to determine the prevalence of prediabetes, undiagnosed diabetes mellitus, and risk factors associated with undiagnosed diabetes mellitus in a large European community-acquired pneumonia cohort. This was a multicenter prospective cohort study of hospitals and private practices in Germany and Austria encompassing 1961 adults with community-acquired pneumonia included in the German Community-Acquired Pneumonia Competence Network (CAPNETZ) study between 2007 and 2014. The prevalence of undiagnosed diabetes mellitus and prediabetes was estimated based on hemoglobin A1c measurements. Logistic regression was used to assess risk factors for undiagnosed diabetes mellitus. Fifteen percent of patients had known diabetes mellitus. Among patients without known diabetes mellitus, 5.0% had undiagnosed diabetes mellitus and 37.5% had prediabetes. Male sex (odds ratio [OR], 2.45 [95% confidence interval {CI}, 1.35-4.45]), body mass index ≥25 kg/m2 (OR, 2.64 [95% CI, 1.48-4.72]), and hyperglycemia at admission (6-11 mM: OR, 2.93 [95% CI, 1.54-5.60] and ≥11 mM: OR, 44.76 [95% CI, 17.58-113.98]) were associated with undiagnosed diabetes mellitus. Patients with undiagnosed diabetes mellitus had a higher 180-day mortality rate compared to patients without diabetes mellitus (12.1% vs 3.8%, respectively; P = .001). Undiagnosed diabetes mellitus was prevalent among community-acquired pneumonia. Male sex, overweight, and hyperglycemia at admission were associated with undiagnosed diabetes mellitus. The long-term mortality among patients with undiagnosed diabetes mellitus was high compared to patients without diabetes mellitus.

Risk factors for community-acquired pneumonia in adults

Risk factors for community-acquired pneumonia in adults

Predictors of a prolonged course of community-acquired pneumonia

Almost 30% of patients with community-acquired pneumonia have prolonged duration and association with increase of complications, length of hospital stay, treatment costs and mortality.Aim: To find the predictors of community-acquired pneumonia prolonged course.Material and Methods. 100 patients with community-acquired pneumonia group 3 were included in the randomized, controlled, prospective open study. The average age of patients was 43,63 ± 14,58 years, 59% were men. Patients were divided into two groups depending on the character and severity of pneumonia: prolonged course (more than 21 days) was in 15 patients, other (n = 85) recovered within 3 weeks. All patients have been examined on the first day of hospitalization by general clinical and X-ray examination, laboratory tests, immunogram, ADP-induced platelet aggregation, the study of respiratory function, transthoracic echocardiography; glomerular filtration rate was calculated by Cockcroft-Gault formula.Results and Discussion. Patients with community-acquired pneumonia group 3with a prolonged duration represented 15% of the total number involved in our study patients, and had 65% more length of hospital stay. According to logistic regression model the predictors of prolonged duration of community-acquired pneumonia are a fasting blood sugar, glomerular filtration rate by Cockcroft-Gault, time of ADP-induced platelet aggregation, body mass index, heart rate, blood flow in the pulmonary artery, the reserve volume of inhalation. There are independent risk factors for community-acquired pneumonia with prolonged duration: blood glucose level less than 4.8 mmol / L, glomerular filtration rate less than 82 mL / min, body mass index less than23.12 kg / m2, the time of ADP -induced platelet aggregation is 370 s.Conclusions. Independent risk factors for community-acquired pneumonia with prolonged duration are: blood glucose level (Odds Ratio = 27,87; p = 0,037), glomerular filtration rate (OR = 16,95; p = 0,011), body mass index (OR = 19,72; p = 0,030), time of ADP-induced platelet aggregation (OR = 37,02; p = 0,011).

Risk factors for community-acquired pneumonia in children under five years of age in the post-pneumococcal conjugate vaccine era in Brazil: a case control study.

BackgroundPneumonia plays an important role in children’s morbidity and mortality. In Brazil, epidemiological and social changes occurred concomitantly with the universal introduction of the 10-valent pneumococcal conjugate vaccine. This study identified risk factors for pneumonia following the implementation of a pneumococcal vaccination program.MethodsA hospital-based, case-control study involving incident cases of pneumonia in children aged 1–59 months was conducted between October 2010 and September 2013 at a tertiary hospital in northeastern Brazil. The diagnosis of pneumonia was based on the World Health Organization (WHO) criteria. The control group consisted of children admitted to the day-hospital ward for elective surgery. Children with comorbidities were excluded. The risk factors for pneumonia that were investigated were among those classified by the WHO as definite, likely and possible. A multivariate analysis was performed including variables that were significant at p ≤ 0.25 in the bivariate analysis.ResultsThe study evaluated 407 children in the case group and 407 children in the control group. Household crowding (OR = 2.15; 95 % CI, 1,46–3,18) and not having been vaccinated against the influenza virus (OR = 3.59; 95 % CI, 2,62–4.91) were the only factors found to increase the likelihood of pneumonia. Male gender constituted a protective factor (OR = 0.53; 95 % CI, 0,39–0,72).ConclusionChanges on risk factors for pneumonia were most likely associated with the expansion of the vaccination program and social improvements; however, these improvements were insufficient to overcome inequalities, given that household crowding remained a significant risk factor. The protection provided by the influenza vaccine must be evaluated new etiological studies. Furthermore, additional risk factors should be investigated.

Risk Factors for Community-acquired Pneumonia in Adults: A Review

Risk Factors for Community-acquired Pneumonia in Adults: A Review

Analysis on risk factors for community-acquired pneumonia in the elderly

Objective To explore the risk factors for community-acquired pneumonia (CAP) in the elderly, in order to provide the basis for clinical prevention and treatment. Methods 168 elderly patients with CAP (observation group) and 100 elderly patients without CAP (control group) were chosen from our hospital from Jan. 2013 to Dec. 2014. The clinical data were investigated, and the risk factors for CAP were analyzed. Results Single factor analysis showed that there were significant differences between the two groupsin serum protein level, pets-raising, smoking, dust exposure, bronchial disease, renal dysfunction and diabetes mellitus (all P<0.05). Multivariate logistic regression analysis showed that serum protein level, pets-raising, smoking, bronchial disease and diabetes were the independent risk factors for CAP in the elderly (OR=2.793, 2.578, 3.017, 3.168 and 2.643, all P<0.05). Conclusions The community-acquired pneumonia is related with many risk factors in the elderly. The clinical corresponding prevention and treatment for the risk factors should be developed, which have an important significance in the early diagnosis, early treatment and prognostic improvement in community-acquired pneumonia. Key words: Community-acquired infections; Risk factors

Aetiology and risk factors of community-acquired pneumonia in hospitalized patients in Norway.

In Norway, data on the aetiology of community-acquired pneumonia (CAP) in hospitalized patients are limited. The aims of this study were to investigate the bacterial aetiology of CAP in hospitalized patients in Norway, risk factors for CAP and possible differences in risk factors between patients with Legionnaire's disease and pneumonia because of other causes. Adult patients with radiologically confirmed CAP admitted to hospital were eligible for the study. Routine aerobic and Legionella culture of sputum, blood culture, urinary antigen test for Legionella pneumophila and Streptococcus pneumoniae, polymerase chain reaction detection of Chlamydophila pneumoniae, Mycoplasma pneumoniae and Bordetella pertussis from throat specimens, and serology for L. pneumophila serogroup 1-6 were performed. A questionnaire, which included demographic and clinical data, risk factors and treatment, was completed. We included 374 patients through a 20-month study period in 2007-2008. The aetiological agent was detected in 37% of cases. S. pneumoniae (20%) was the most prevalent agent, followed by Haemophilus influenzae (6%) and Legionella spp. (6%). Eight Legionella cases were diagnosed by urinary antigen test, of which four also had positive serology. In addition, 13 Legionella cases were diagnosed by serology. The degree of comorbidity was high. An increased risk of hospital-diagnosed Legionella pneumonia was found among patients with a diagnosis of chronic congestive heart failure. Our results indicate that S. pneumoniae is the most common bacterial cause of pneumonia in hospitalized patients, and the prevalence of Legionella pneumonia is probably higher in Norway than recognized previously.

Risk factors for community-acquired pneumonia in adults: Recommendations for its prevention

Community-acquired pneumonia (CAP) remains an important cause of morbidity and mortality in developed countries. The disease is one of the top 10 causes of death and up to the present time, standard aggressive medical care has not resulted in a decrease in mortality. Knowledge of risk factors for CAP is essential to the design of preventive measures to reduce its incidence. Preventive strategies promoting effective vaccines or identifying and acting on modifiable risk factors are of paramount importance in reducing CAP-related death. Most studies have been performed in patients referred for inpatient care or in CAP cases in which a specific pathogen has been identified, but data from population-based studies are scarcer. We present a review of the main risk factors for CAP in adults, classified in the following categories: (a) Comorbidities and their treatments, (b) demographic and socioeconomic factors, (c) lifestyle factors and (d) environmental factors. We conclude with some brief recommendations on preventive measures and vaccination.

Passive smoking at home is a risk factor for community-acquired pneumonia in older adults: a population-based case–control study

ObjectiveTo assess whether passive smoking exposure at home is a risk factor for community-acquired pneumonia (CAP) in adults.SettingA population-based case-control study was designed in a Mediterranean area with 860 000...

Clinical and microbiological characteristics of community-acquired pneumonia in human immunodeficiency virus-infected patients: a retrospective analysis of 79 HIV/AIDS patients

HIV infections are prevalent; however, the clinical characteristics of these patients are atypical. In the present study, we analysed 79 patients who were newly diagnosed with HIV/acquired immunodeficiency syndrome (AIDS) at Ruijin Hospital between January 1998 and August 2011 to improve awareness of the physicians' diagnoses and to elucidate the risk factors for community-acquired pneumonia (CAP) and the progression to severe pneumonia or respiratory failure in AIDS patients. The patients were divided into a CAP group (A) and a non-CAP group (B). Furthermore, group A was divided into a severe pneumonia group (A1 ) and a non-severe pneumonia group (A2 ). The serum albumin (25.60 ± 5.31 vs 34.00 ± 6.90; P < 0.05) and CD4 cell count (28.5 ± 30.5 vs 229.50 ± 229.45; P < 0.05) of group A were much lower than those of group B. The serum albumin and CD4 cell count negatively correlated with the incidence of CAP. The CD4 cell count (24.15 ± 25.1 vs 47.85 ± 132.5; P < 0.05) and partial pressure of oxygen (7.86 ± 1.43 vs 9.41 ± 2.15; P < 0.05) of group A1 were significantly lower than those of group A2 . Low serum albumin levels and high blood urea nitrogen levels were the risk factors of hypoxaemia in group A. Early screening and diagnosis of AIDS, as well as nutritional support, would prevent AIDS patients from developing CAP or progressing to severe pneumonia or respiratory failure.

Poor Oral Health as Risk Factor for Community-Acquired Pneumonia

Objectives: Considerable evidence exists of the relationship between poor oral hygiene (therefore greater presence of plaque) and risk of pneumonia in special-care populations, including intensive care unit and nursing home settings. However, the effect of poor oral health on the development of community-acquired pneumonia (CAP) remains to be established. We assessed the relationship between CAP and oral health in general adult population. Study design: Over 1-year period, 1,336 incident cases of CAP and 1,326 controls were enrolled in a populationbased case-control study. A questionnaire on CAP risk factors that included oral health-related questions, including visit to dentist in the last month, bleeding gums, gingivitis, dental dysaesthesia, dental prosthesis, gumboil in the last month, teeth move or lost, and periodontal disease was administered to all participants. Results: The prevalence of dental dysaesthesia and use of dental prosthesis was significantly higher among patients with CAP than in control subjects (23.3% vs. 19.7%, P = 0.043, and 45.6% vs. 40.8%, P = 0.016, respectively), whereas visit to the dentist in the last month was a preventive factor against the development of CAP (odds ratio 0.71, 95% confidence interval 0.55-0.92, P = 0.008). Results of bivariate analysis were confirmed in the adjusted multivariate logistic regression models. Conclusions: Poor oral health may contribute to a higher risk for CAP in adult patients. Oral hygiene practices are particularly important in subjects with dental dysaesthesia and dental prosthesis. Not only odontologists but also dental hygienists should be aware of the relationship between oral health and potentially severe lung infection.

The incidence and aetiology of hospitalised community-acquired pneumonia among Vietnamese adults: a prospective surveillance in Central Vietnam

BackgroundLower respiratory tract infection (LRTI) including Community-acquired pneumonia (CAP) is a common infectious disease that is associated with significant morbidity and mortality. The patterns of aetiological pathogens differ by region and country. Special attention must be paid to CAP in Southeast Asia (SEA), a region facing rapid demographic transition. Estimates burden and aetiological patterns of CAP are essential for the clinical and public health management. The purposes of the study are to determine the incidence, aetiological pathogens, clinical pictures and risk factors of community-acquired pneumonia (CAP) in the Vietnamese adult population.MethodsA prospective surveillance for hospitalised adult CAP was conducted in Khanh Hoa Province, Central Vietnam. All adults aged ≥15 years with lower respiratory tract infections (LRTI) admitted to a provincial hospital from September 2009 to August 2010 were enrolled in the study. Patients were classified into CAP and non-pneumonic LRTI (NPLRTI) according to the radiological findings. Bacterial pathogens were identified from sputum samples by the conventional culture and polymerase chain reaction (PCR) for Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis; 13 respiratory viruses were identified from nasopharyngeal specimens by PCR.ResultsOf all 367 LRTI episodes examined, 174 (47%) were CAP. Older age, the presence of underlying respiratory conditions, and higher index score of smoking were associated with CAP. The one-year estimated incidence of hospitalised adult CAP in our study population was 0.81 per 1,000 person years. The incidence increased considerably with age and was highest among the elderly. The case fatality proportion of hospitalised CAP patients was 9.8%. Among 286 sputum samples tested for bacterial PCR, 79 (28%) were positive for H. influenzae, and 65 (23%) were positive for S. pneumoniae. Among 357 samples tested for viral PCR, 73 (21%) were positive for respiratory viruses; influenza A (n = 32, 9%) was the most common.ConclusionsThe current adult CAP incidence in Vietnam was relatively low; this result was mainly attributed to the young age of our study population.

Previous general practitioner consulting behaviour as a predictor of pneumonia in children

To the Editor: As a consequence of increasing antimicrobial resistance, general practitioners (GPs) are encouraged to prescribe antibiotics only for patients most likely to benefit, for example children at high risk of hospitalisation for pneumonia. Secondary to clinical assessment, knowledge of a child's background may improve the identification of those at high risk, since several studies have described medical, social and environmental risk factors for paediatric community-acquired pneumonia. Most of these studies, including the only two case–control studies conducted in primary care [1], [2], compared cases of pneumonia with healthy community controls, and therefore may have identified risk factors for respiratory tract infections (RTIs) in general and not specifically pneumonia. Two case–control studies used hospital controls with RTIs [3], [4], but these findings may not be applicable to children consulting in primary care. We used an existing case–control study dataset [5] to explore demographic, medical and social risk factors for community-acquired pneumonia or empyema among children consulting in general practice. This is the first such comparison of children seen in primary care with RTIs with and without subsequent hospital presentation for pneumonia. The selection and recruitment of cases and controls and data collection procedures have been described elsewhere [5]. Cases were recruited from seven hospitals in south Wales, UK. Eligible cases were children aged 6 months …

Host genetic risk factors for community-acquired pneumonia

This study was conducted to establish the contribution of genetic host factors in the susceptibility to community acquired pneumonia (CAP) in the Russian population. Patients with CAP (n=334), volunteers without a previous history of CAP, constantly exposed to infectious agents, control A group (n=141) and a second control group B consisted of healthy persons (n=314) were included in the study. All subjects were genotyped for 13 polymorphic variants in the genes of xenobiotics detoxification CYP1A1 (rs2606345, rs4646903, and rs1048943), GSTM1 (Ins/del), GSTT1 (Ins/del), ABCB1 rs1045642); immune and inflammation response IL-6 (rs1800795), TNF-a (rs1800629), MBL2 (rs7096206), CCR5 (rs333), NOS3 (rs1799983), angiotensin-converting enzyme ACE (rs4340), and occlusive vascular disease/hyperhomocysteinemia MTHFR (rs1801133). Seven polymorphic variants in genes CYP1A1, GSTM1, ABCB1, NOS3, IL6, CCR5 and ACE were associated with CAP. For two genes CYP1A1 and GSTM1 associations remained significant after correction for multiple comparisons. Multiple analysis by the number of all risk genotypes showed a highly significant association with CAP (P=2.4×10−7, OR=3.03, 95% CI 1.98–4.64) with the threshold for three risk genotypes. Using the ROC-analysis, the AUC value for multi-locus model was estimated as 68.38.