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Updated: Mar 9, 2026
Experimental Human Pneumococcal Carriage
Published on: February 15, 2013
Polymicrobial pneumococcal bacteraemia: a case-control study
I Grau1, C Ardanuy2, M H Schulze3
1Infectious Diseases, Hospital Bellvitge, Ciberes, Idibell, University of Barcelona, L'Hospitalet, 08907, Barcelona, Spain. igrau@ub.edu.
Abstract:
Polymicrobial bacteraemia involving Streptococcus pneumoniae and other bacteria (e.g. Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Haemophilus influenza, viridans streptococci, Salmonella spp.) occurred in 3.4% of our pneumococcal bacteraemia cases. Compared with 308 controls (monomicrobial bacteraemia), the 77 polymicrobial cases included more males (83 vs 62%, p = 0.001), had serious underlying diseases (100 vs 80%, p < 0.001), abdominal infection (18 vs 5%, p < 0.001), nosocomial infection (33 vs 8%, p < 0.001), shock (40 vs 13%, p < 0.001), and higher mortality (52 vs 18%, p < 0.001). Clinicians must be aware that some patients with pneumococcal bacteraemia may have other bacteria in their blood, which would confer higher mortality and may lead to inappropriate or incomplete antibiotic therapy.
Insights
Polymicrobial bloodstream infections, involving Streptococcus pneumoniae and other bacteria, are linked to worse outcomes. Early detection and appropriate antibiotic therapy are crucial for improving patient survival rates.
Area of Science:
- Infectious Diseases
- Microbiology
- Clinical Medicine
Background:
- Streptococcus pneumoniae is a common cause of bacteraemia.
- Coinfections with other bacteria can complicate pneumococcal bacteraemia.
- Understanding the characteristics and outcomes of polymicrobial bacteraemia is essential for clinical management.
Purpose of the Study:
- To investigate the incidence and clinical features of polymicrobial bacteraemia in patients with Streptococcus pneumoniae bacteraemia.
- To compare outcomes between patients with monomicrobial and polymicrobial bacteraemia.
- To highlight the implications for antibiotic therapy and patient prognosis.
Main Methods:
- Retrospective analysis of pneumococcal bacteraemia cases.
- Comparison of clinical characteristics and outcomes between polymicrobial (n=77) and monomicrobial (n=308) bacteraemia groups.
- Statistical analysis to determine significant differences between groups.
Main Results:
- Polymicrobial bacteraemia occurred in 3.4% of pneumococcal bacteraemia cases.
- Polymicrobial cases had a higher proportion of males, serious underlying diseases, abdominal and nosocomial infections, and shock.
- Mortality was significantly higher in the polymicrobial group (52% vs 18%).
Conclusions:
- Polymicrobial bacteraemia in the context of pneumococcal infection is associated with increased severity and mortality.
- Clinicians should consider the possibility of coinfections in pneumococcal bacteraemia.
- Incomplete or inappropriate antibiotic therapy may result from overlooking polymicrobial infections.
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