Archive for August 12, 2008

Association of Serotypes of Streptococcus pneumoniae with Disease Severity and Outcome in Adults: An International Study

Clinical Infectious Diseases  1 July 2007  V.45  N.1  p.46–51

 S. R. J. Alanee,1 L. McGee,2 D. Jackson,3 C. C. Chiou,6 C. Feldman,8 A. J. Morris,9 A. Ortqvist,9 J. Rello,10,11 C. M. Luna,13 L. M. Baddour,4 M. Ip,7 V. L. Yu,5 and K. P. Klugman,2 for the International Pneumococcal Study Group

1Department of Epidemiology and 2Hubert Department of Global Health, Rollins School of Public Health, Emory University, and 3Centers for Disease Control and Prevention, Atlanta, Georgia; 4Mayo Clinic, Rochester, Minnesota; 5University of Pittsburgh, Pennsylvania; 6Department of Pediatrics, Veterans General Hospital Kaohsiung, National Yang Ming University, Taipei, Taiwan; 7Department of Microbiology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China; 8Pulmonology Division, Department of Medicine, Johannesburg Hospital and University of the Witwatersrand, Johannesburg, South Africa; 9Clinical Microbiology Laboratory, Auckland Hospital, Auckland, New Zealand; 10Unit of Infectious Diseases, Karolinska Institutet, Karolinska University Hospital, Solna, and 11Department of Communicable Diseases Control and Prevention, Stockholm, Sweden; 12University Hospital Joan XXIII, University Rovira and Virgili, Tarragona, Spain; and 13Division of Pulmonary Medicine, Hospital de Clinicas, Universidad de Buenos Aires, Buenos Aires, Argentina

Background.  The introduction of conjugate pneumococcal vaccination for children has reduced the burden of invasive disease due to pneumococcal conjugate vaccine (PCV) types (i.e., serotypes 9V, 14, 6B, 18C, 23F, 19F, and 4) in adults. As nonvaccine serotypes become predominant causes of invasive disease among adults, it is necessary to evaluate the disease severity and mortality associated with infection due to nonvaccine serotypes, compared with PCV serotypes, in adults.

Methods.  The association of pneumococcal serotype and host-related variables with disease severity and mortality was statistically examined (with multivariable analysis) in 796 prospectively enrolled, hospitalized adult patients with bacteremia due to Streptococcus pneumoniae.

Results.  In multivariate analyses of risk in patients with invasive pneumococcal disease, older age (age, 65 years;  ), underlying chronic disease ( ), immunosuppression ( ), and severity of disease ( ) were significantly associated with mortality; no association was found between nosocomial infection with invasive serotypes 1, 5, and 7 and mortality. The risk factors meningitis ( ), suppurative lung complications ( ), and preexisting lung disease ( ) were significantly associated with disease severity, independent of infecting serotype. No differences were seen in disease severity or associated mortality among patients infected with PCV serotypes, compared with patients infected with nonvaccine serotypes.

Conclusions.  Our data support the notion that host factors are more important than isolate serotype in determining the severity and outcome of invasive pneumococcal disease and that these outcomes are unlikely to change in association with nonvaccine serotype infection in the post–conjugate vaccine era.



August 12, 2008 at 11:23 am Leave a comment

Capsular Types and Predicting Patient Outcomes in Pneumococcal Bacteremia

Clinical Infectious Diseases  1 July 2007  V.45  N.1  p.52–54


Javier Garau and Esther Calbo

Department of Medicine, Hospital Mutua de Terrassa, University of Barcelona, Spain



August 12, 2008 at 11:19 am Leave a comment


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