1. Streptococcus pneumoniae bacteremia: clinical and microbiological epidemiology in a health area of Southern Spain
- Author
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Maria Teresa Cabezas-Fernández, Fernando Cobo, María Isabel Cabeza-Barrera, [Cobo,F, Cabezas-Fernandez,MT, and Cabeza-Barrera,MI] Department of Microbiology, APES Hospital de Poniente. El Ejido, Almeria, Spain.
- Subjects
medicine.medical_specialty ,Pediatrics ,Epidemiology ,medicine.drug_class ,España ,Antibiotics ,medicine.disease_cause ,Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents::Antibiotics, Antitubercular [Medical Subject Headings] ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors [Medical Subject Headings] ,Article ,serotypes ,Streptococcus pneumoniae ,medicine ,risk factors ,bacteremia ,Epidemiologia ,Factores de Riesgo ,Geographicals::Geographic Locations::Europe::Spain [Medical Subject Headings] ,business.industry ,Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Bacteremia [Medical Subject Headings] ,Mortality rate ,Incidence (epidemiology) ,Andalucía ,antibiotic susceptibility ,epidemiology ,lcsh:Other systems of medicine ,serotipos ,lcsh:RZ201-999 ,medicine.disease ,bacterial infections and mycoses ,Penicillin ,Pneumonia ,antibiotico ,Infectious Diseases ,Organisms::Bacteria::Gram-Positive Bacteria::Lactobacillales::Streptococcaceae::Streptococcus::Streptococcus pneumoniae [Medical Subject Headings] ,Bacteremia ,Bacteriemia ,Disciplines and Occupations::Health Occupations::Medicine::Public Health::Epidemiology [Medical Subject Headings] ,business ,Streptococcus pneumoniae, bacteremia, risk factors, antibiotic susceptibility, epidemiology, serotypes ,medicine.drug - Abstract
Streptococcus pneumoniae remains an important cause of bacteremia worldwide. Last years, a decrease of S. pneumoniae penicillin- resistant isolates has been observed. The objec- tive of this study was to describe the episodes of bacteremia due to S. pneumoniaeduring a peri- od of 11 years. Epidemiological and clinical data, serotypes causing bacteremia, antibiotic susceptibility and prognosis factors were stud- ied. Over a period of 11 years, all the episodes of S. pneumoniaebacteremia were analysed. Their clinical and microbiological features were recorded. Statistical analysis was carried out to determine risk factors for pneumococcal bac- teremia and predictors of fatal outcome. Finally, 67 S. pneumoniae bacteremia episodes were included in this study. The majority of cases were produced in white men in the middle age of their life. The main predisposing factors observed were smoking, antimicrobial and/or corticosteroids administration, chronic pul- monary obstructive disease and HIV infection, and the most common source of bacteremia was the low respiratory tract. The main serotypes found were 19A, 1, 14 and 7F. Seventy-seven per- cent of these isolates were penicillin-suscepti- ble, and the mortality in this serie was really low. Statistical significance was observed between age, sex and race factors and the pres- ence of bacteremia, and there was relationship between the patient's condition and the out- come. In our study, S. pneumoniaebacteremia is mainly from community-acquired origin mainly caused in men in the median age of the life. 40% of bacteremias were caused by serotypes 19A, 1, 7F and 14. During the period of study the incidence of bacteremia was stable and the mortality rate was very low. In adults, the majority of cases of pneumococcal bacteremia are asso- ciated with pneumonia, while in children the primary site of infection is frequently unknown. The overall mortality rate for pneu- mococcal bacteremia is 15-20% among adults, with the rate increasing to 30-40% among eld- erly patients. Since introduction of the 7-valent pneumo- coccal conjugate vaccine (PCV7), the estimat- ed annual incidence of invasive disease (including bacteremia) in the USA has decreased. 4 However, together with reduction in invasive disease due to serotypes encom- passed in PCV7, non PCV7 serotypes have emerged. 5 Moreover, for several reasons, a decrease of S. pneumoniae penicillin-resistant strains has been observed last years world- wide. Clearly, there is a need for evaluation the new serotypes related with these episodes, the susceptibility evolution to penicillin and other antibiotics and clinical aspects to this infec- tion. Thus, the aim of this study was to describe the episodes of bacteremia due to S. pneumoniae during a period of 11 years in our health area. Epidemiological and clinical data, serotypes causing bacteremia and prognosis factors were analysed.
- Published
- 2011