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Pneumococcal disease in Sweden: experiences and current situation
1Division of Infectious Diseases, Karolinska Institutet, Danderyd Hospital, Sweden.
The American Journal of Medicine
|August 18, 1999
Summary
Invasive pneumococcal disease is rising in Sweden, particularly among the elderly, though mortality remains low. While beta-lactam resistance in Streptococcus pneumoniae is generally minimal, local outbreaks with higher resistance have been observed in children.
Area of Science:
- Infectious Diseases
- Microbiology
- Epidemiology
Background:
- Invasive pneumococcal disease (IPD) incidence has increased in Sweden over the past decade.
- The rise is primarily attributed to an increase in pneumococcal bacteremia among the elderly population.
- Despite rising incidence, mortality from invasive pneumococcal disease in Sweden remains low, around 10% for bacteremic pneumococcal pneumonia.
Purpose of the Study:
- To analyze trends in invasive pneumococcal disease in Sweden.
- To assess the prevalence of beta-lactam resistance in Streptococcus pneumoniae strains.
- To identify specific populations and regions affected by pneumococcal disease and resistance.
Main Methods:
- Retrospective analysis of invasive pneumococcal disease surveillance data in Sweden.
- Microbiological testing of Streptococcus pneumoniae isolates to determine antimicrobial susceptibility, focusing on beta-lactam resistance.
- Epidemiological analysis to identify trends in incidence, mortality, and resistance patterns across different age groups and geographical regions.
Main Results:
- A notable increase in the incidence of invasive pneumococcal disease has been observed in Sweden during the last decade.
- Pneumococcal bacteremia in the elderly is a significant driver of this rising incidence.
- Beta-lactam resistance in Streptococcus pneumoniae is generally low (3%-4%), but localized outbreaks with up to 10% resistance have occurred among children, particularly in southern Sweden.
Conclusions:
- Invasive pneumococcal disease surveillance in Sweden indicates an increasing trend, predominantly in the elderly population.
- While overall mortality is low, the emergence of beta-lactam resistance in Streptococcus pneumoniae, especially in pediatric populations during local outbreaks, warrants continued monitoring.
- Public health strategies may need to adapt to address the changing epidemiology of pneumococcal disease and antimicrobial resistance in Sweden.