Bacteremia caused by Streptococcus pneumoniae of nonvaccine serotypes

Comparison of serotypes of Streptococcus pneumoniae blood isolates showed a 2.5-fold increase in nonvaccine strains from the Cleveland Veterans Administration Hospital compared with those from other Cleveland area hospitals. Death was more frequently associated with nonvaccine than vaccine serotypes. No patient at any of the hospitals involved in the study received pneumococcal vaccine. This suggests that Cleveland Veterans Administration Hospital represents a unique population of patients within the Cleveland area and emphasizes the need for continued serotyping of blood and body fluid isolates.