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Invasive disease due to Streptococcus pneumoniae in an area with a high rate of relative penicillin resistance
G R Istre1, M Tarpay, M Anderson
1Epidemiology Service, Oklahoma State Department of Health, Oklahoma City 73152.
Abstract:
During 1984 we conducted a population-based survey of culture-confirmed invasive disease due to Streptococcus pneumoniae among persons who lived in the Oklahoma City, Oklahoma, metropolitan area (population, 846,000) through the 20 clinical laboratories in the area. There were 139 residents identified with invasive pneumococcal disease (11 with meningitis and 128 with other bacteremic infections), for an infection rate of 16.4 per 100,000 population (meningitis, 1.3 cases per 100,000; other bacteremias, 15.1 cases per 100,000). Cases peaked in January-May and December (75% of cases). Rates were highest among infants less than 12 months old (97 cases per 100,000) and persons greater than or equal to 80 years old (87 cases per 100,000). Seventeen (12.2%) of the pneumococcal isolates were relatively penicillin resistant. These isolates were most prevalent among elderly persons greater than or equal to 70 years old (six [17.6%] of 34) and young children 0-4 years old (7 [15.9%] of 44) compared with persons 5-69 years old (four [6.6%] of 61).
Insights
Invasive pneumococcal disease (Streptococcus pneumoniae) affected 16.4 per 100,000 in Oklahoma City during 1984, with highest rates in infants and the elderly. Penicillin resistance was noted in 12.2% of cases.
Area of Science:
- Epidemiology
- Infectious Diseases
- Microbiology
Background:
- Invasive pneumococcal disease (IPD) caused by Streptococcus pneumoniae remains a significant public health concern.
- Understanding the epidemiology of IPD is crucial for developing effective prevention and treatment strategies.
Purpose of the Study:
- To determine the incidence and characteristics of invasive pneumococcal disease in the Oklahoma City metropolitan area during 1984.
- To identify high-risk populations and assess the prevalence of penicillin resistance in Streptococcus pneumoniae isolates.
Main Methods:
- A population-based survey was conducted in 1984, encompassing the Oklahoma City metropolitan area (population 846,000).
- Data were collected from 20 clinical laboratories, identifying culture-confirmed cases of invasive pneumococcal disease.
- Infection rates, demographic data, seasonality, and antimicrobial susceptibility (penicillin resistance) were analyzed.
Main Results:
- A total of 139 residents had invasive pneumococcal disease, yielding an overall infection rate of 16.4 per 100,000 population.
- Incidence rates were highest among infants (<12 months old) at 97 per 100,000 and elderly individuals (≥80 years old) at 87 per 100,000.
- Seventeen percent (12.2%) of isolates showed relative penicillin resistance, with higher prevalence in the elderly (≥70 years) and young children (0-4 years).
Conclusions:
- Invasive pneumococcal disease disproportionately affects the very young and the elderly.
- The observed penicillin resistance highlights the need for ongoing surveillance and consideration of antibiotic stewardship.
- Seasonal patterns indicate a peak during colder months and early spring, suggesting potential for targeted public health interventions.