Epidemiology of pneumococcal infection in Singapore (1977-1986)

Streptococcus pneumoniae was isolated from 43 children and 143 adults in a ten year period from 1977 through 1986. There was a high incidence in the males, in the extremes of ages and in the Indian and Others racial groups. The overall mortality rate was 29.5% with a higher rate associated in those with chronic obstructive lung disease, smoking, malignancy and alcoholism, 0.5% of the isolates were resistant to penicillin (of intermediate resistance only) and 16% resistant to tetracycline. Common serotypes isolated were types 1, 4, 14, 3 and 6B, all of which are covered by the pneumococcal vaccine. In children, the common serotypes associated with primary bacteraemia were types 14 and 20; with pneumonia, types 6B, 14, 19A and with meningitis, types 6B, 19F and 19A. In adults, the common serotypes associated with primary bacteraemia were types 20, 11A and 1; with pneumonia, types 3, 4, 7F, 14; with meningitis, types 1, 13, 34 and with endocarditis, type 13. Characteristics of pneumococcal infection, the organism's antibiogram and the serotype distribution are discussed in relation to the work of other investigators.