Predictive factors for invasive disease due to penicillin-resistant Streptococcus pneumoniae: a population-based study

• Published in: Clinical infectious diseases Vol. 19; no. 5; p. 884
• Main Authors: Nava, J M, Bella, F, Garau, J, Lite, J, Morera, M A, Martí, C, Fontanals, D, Font, B, Pineda, V, Uriz, S
• Format: Journal Article
• Language: English
• Published: United States 01.11.1994
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Female; Humans; Infant; Male; Middle Aged; Penicillin Resistance; Pneumococcal Infections - drug therapy; Pneumococcal Infections - etiology; Prospective Studies; Streptococcus pneumoniae - drug effects
• ISSN: 1058-4838
• DOI: 10.1093/clinids/19.5.884

A prospective population-based study was carried out to determine predictive factors associated with penicillin-resistant pneumococcal invasive disease. A total of 374 patients (250 males and 124 females; mean age, 50.3 +/- 27 years) with invasive pneumococcal infection were admitted to one of the five hospitals in El Vallés County (an industrial area with 800,000 inhabitants in the province of Barcelona, Spain) over a period of 5 years. Of the 374 episodes, 21 (5.6%) were due to highly penicillin-resistant pneumococci and 67 (17.9%) to intermediately penicillin-resistant pneumococci. Multivariate analysis showed a statistically significant association between infection with intermediately penicillin-resistant pneumococci and an age of 0-4 years (odds ratio [OR] = 5.3; 95% confidence interval [CI] = 2.2-12.6), the presence of an immunosuppressive underlying disease (OR = 3.0; 95% CI = 1.5-6.0), and the previous use of beta-lactam antibiotics (OR = 2.1; 95% CI = 1.0-4.5). Infection with highly penicillin-resistant pneumococci was associated only with the previous use of beta-lactam antibiotics (OR = 5.9; 95% 95% CI = 2.2-15.8). Highly resistant strains were of serotypes 6, 9, 14, 15, 19, and 23, of which all but serotypes 9 and 15 are included in the newly formulated conjugated vaccine.