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Nosocomial pneumococcal bacteremia
Abstract:
In five years we studied 56 episodes of pneumococcal bacteremia. Twenty-three (41%) were nosocomial and 33 (59%) community acquired. Most of our patients were elderly men with multiple underlying diseases; however, those patients with nosocomial infections had a significantly higher incidence of malignant neoplasms (57% vs 24%), poor functional status (70% vs 25%), and ultimately fatal underlying disease (61% vs 21%). Alcoholism was more common among the patients with community-acquired bacteremia (45% vs 17%). Nosocomial infections carried a significantly higher overall mortality (73.9% vs 45.4%). The mortality directly related to the pneumococcal bacteremia was also higher (52% vs 39%), but not significantly. Most of the isolated strains were serotypes present in the new pneumococcal vaccine, which only one study patient had received. Mixed pneumococcal bacteremia with gram-negative bacilli was more frequent in nosocomial infections. Streptococcus pneumoniae can be a nosocomial pathogen in elderly, debilitated patients. Pneumococcal vaccination should be incorporated in a hospital-based prevention program for high-risk patients.
Insights
Nosocomial pneumococcal bacteremia disproportionately affects elderly patients with severe underlying conditions, leading to higher mortality. Pneumococcal vaccination is crucial for high-risk individuals in hospital settings.
Area of Science:
- Infectious Diseases
- Epidemiology
- Geriatric Medicine
Background:
- Pneumococcal bacteremia is a significant cause of morbidity and mortality.
- Understanding the sources and risk factors for pneumococcal bacteremia is essential for effective prevention and treatment.
Purpose of the Study:
- To compare the characteristics and outcomes of nosocomial versus community-acquired pneumococcal bacteremia.
- To identify risk factors associated with nosocomial pneumococcal infections in elderly patients.
Main Methods:
- A five-year retrospective study of 56 episodes of pneumococcal bacteremia.
- Analysis of patient demographics, underlying conditions, infection source, and mortality rates.
- Comparison of nosocomial and community-acquired bacteremia groups.
Main Results:
- Nosocomial pneumococcal bacteremia occurred in 41% of cases, predominantly in elderly men with comorbidities.
- Patients with nosocomial infections had higher rates of malignancy, poor functional status, and fatal underlying diseases.
- Nosocomial infections were associated with significantly higher overall mortality (73.9% vs 45.4%).
Conclusions:
- Streptococcus pneumoniae can act as a nosocomial pathogen in elderly, debilitated patients.
- Pneumococcal vaccination should be integrated into hospital-based prevention strategies for high-risk populations.
- Targeted vaccination programs may reduce the burden of nosocomial pneumococcal infections.