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Streptococcus pneumoniae bacteraemia in Belgium: differential characteristics in children and the elderly population

J Flamaing1, J Verhaegen, W E Peetermans

  • 1Department of Geriatric Medicine, Department of Microbiology, Department of General Internal Medicine, University Hospital Leuven, Leuven, Belgium.

The Journal of Antimicrobial Chemotherapy
|July 4, 2002
PubMed

Insights

Invasive Streptococcus pneumoniae bloodstream infections (bacteraemia) are common in children and the elderly. Antibiotic resistance is rising in both groups, with children showing higher erythromycin resistance, and vaccine strategies need to consider these trends.

Area of Science:

  • * Infectious Diseases
  • * Microbiology
  • * Pediatrics and Geriatrics

Background:

  • * Streptococcus pneumoniae is a leading cause of bacterial infections worldwide.
  • * Bacteraemia, a serious bloodstream infection, requires understanding of epidemiological trends and resistance patterns.
  • * Vulnerable populations, including young children and the elderly, are at higher risk for invasive pneumococcal disease.

Purpose of the Study:

  • * To compare the characteristics of Streptococcus pneumoniae bacteraemia in children (0-4 years) and the elderly (>=60 years).
  • * To analyze trends in antibiotic resistance and serotype distribution over a 7-year period (1994-2000).
  • * To evaluate the potential impact of current and future pneumococcal vaccines in these age groups.

Main Methods:

  • * Retrospective analysis of 5837 blood isolates of invasive Streptococcus pneumoniae.
  • * Comparison of data from children (n=843) and the elderly (n=3144) from 1994-2000.
  • * Assessment of penicillin and erythromycin resistance, serogroup and serotype (SGTs) distribution, and vaccine coverage.

Main Results:

  • * Penicillin resistance increased significantly in both children (8.2% to 18.9%) and the elderly (5.1% to 16.35%).
  • * Erythromycin resistance was higher in children (44.7%) than the elderly (25.7%) and increased in the elderly (18.6% to 33.65%).
  • * The elderly had a broader range of SGTs (36) compared to children (26), with distinct prevalent SGTs in each group. Conjugate vaccines showed higher coverage in children, while the 23-valent vaccine offered broad coverage in the elderly.

Conclusions:

  • * Rising antibiotic resistance in Streptococcus pneumoniae necessitates ongoing surveillance and updated treatment guidelines.
  • * Distinct serotype prevalence in children and the elderly highlights the need for age-specific vaccination strategies.
  • * A combined vaccination approach, utilizing both conjugate and polysaccharide vaccines, may be optimal for comprehensive protection in the elderly.

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