Pneumococcal bacteremia in a single center in Argentina

To determine the clinical and microbiologic characteristics of pneumococcal bacteremia at Sanatorio Mitre, Buenos Aires, Argentina.

One-hundred-and-seven episodes of pneumococcal bacteremia were prospectively analyzed from 1993 to 1998. Demographics, clinical and microbiological variables were studied.

Eighty-one patients (76%) were adults and 26 children (24%). Most cases (98%) were acquired in the community. Seventy-nine patients (74%) had at least one underlying condition. The primary source of bacteremia was found in 91 patients (85%), the lungs being the most common source. Streptococcus pneumoniae was isolated from one sterile site other than the primary focus in 25 patients (23%). Eighty-five (79%) of the Streptococcus pneumoniae were susceptible to penicillin and 22 (21%) showed intermediate or high resistance to penicillin and 2% were additionally resistant to ceftriaxone. Initial antimicrobial therapy was appropriate in 95% of the cases. The overall mortality was 21%, however adults admitted to the intensive care unit (ICU) had higher mortality (81%). No patients under 14 years old died. Multivariate analysis showed that age and recovery of the organisms from a sterile site other than the primary focus were statistically significant predictors of mortality.

Bacteremic pneumococcal infections continue to be an important worldwide problem causing morbidity and high mortality despite supportive care and appropriate antimicrobial therapy.