[Invasive neumococcal disease in Costa del Sol Hospital: replacement by non-vaccinable serotypes]

Streptococcus pneumoniae can cause invasive and noninvasive diseases. Invasive pneumococcal disease causes infections in tissues, organs and fluids that are normally sterile and is associated with severe clinical processes generally. The aim of this study was to characterize ENI episodes as well as to describe the antimicrobial susceptibility and distribution of serotypes (vaccinal and non-vacunal) of S. pneumoniae strains isolated in blood cultures of patients treated at the Hospital Costa del Sol between September 2012 and January 2017.

Descriptive study from S. pneumoniae strains isolated in blood cultures. The variables studied were: age, sex, death, smoking, HIV infection, clinical diagnosis, serotype and antibiotic susceptibility profile. The source of information used was the clinic management program called Doctor.

76 S. pneumoniae strains were isolated. The most prevalent serotypes were 8, 3, 9N, 6C, 22F, 11A and 14. 77.3% of the strains were responsible for IPD (Invasive Pneumococcal Disease) episodes with clinical diagnosis of bacterial pneumonia. According to the CLSI 2016 (Clinical & Laboratory Standards Institute) criteria, 2 strains were non-susceptible to penicillin, 23 strains were non-susceptible to erythromycin and 3 were strains non-susceptible to levofloxacin.

The results of this study show that the most frequent serotypes among ENI patients attended in our hospital are not covered by conjugate vaccines, although they do so by VNP23. Serotype 6C, not covered by any vaccine, was among the three most frequently isolated, causing death in one third of patients.