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[Pneumococcal bacteremia: what is new?]

I Carey1, M P Glauser, J Bille

  • 1Département de médecine interne, Centre hospitalier universitaire vaudois, Lausanne.

Schweizerische Medizinische Wochenschrift
|May 13, 1995
PubMed
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Streptococcus pneumoniae bacteremia remains a significant threat with high mortality, even after vaccine introduction. Increased incidence in younger adults and frequent antibiotic resistance highlight the need for better vaccination strategies.

Area of Science:

  • Infectious Diseases
  • Public Health
  • Vaccinology

Background:

  • Streptococcus pneumoniae (S. pneumoniae) bacteremia poses a significant public health challenge.
  • Antipneumococcal vaccination was introduced in Switzerland, necessitating a reassessment of S. pneumoniae bacteremia's impact.

Purpose of the Study:

  • To retrospectively review S. pneumoniae bacteremia cases to evaluate the pathology's importance post-vaccine introduction.
  • To compare current data with historical findings from 1974-1978.

Main Methods:

  • Retrospective analysis of 85 patients with S. pneumoniae bacteremia hospitalized between January 1990 and December 1991.
  • Comparison of epidemiological, clinical, and mortality data with a previous study (1974-1978).

Main Results:

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  • Epidemiology, underlying diseases (82%), clinical presentation (78% pneumonia), and mortality (31%) were comparable to the earlier study.
  • Increased incidence observed in 20-40 year olds, particularly HIV-positive individuals, with high mortality.
  • Nosocomial S. pneumoniae bacteremia was frequent (7%) and severe.
  • 17% of strains showed antibiotic resistance.
  • Vaccine uptake was low, with only one vaccinated patient despite 82% having indications.

Conclusions:

  • Pneumococcal bacteremia remains frequent and associated with substantial mortality.
  • Antibiotic-resistant strains are increasingly prevalent.
  • Low vaccination rates among at-risk populations underscore the need for improved vaccine implementation.