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Invasive pneumococcal infections. A comparison between adults and children

G Rahav¹, Y Toledano, D Engelhard

¹Collins Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Hospital, Jerusalem, Israel.

|July 1, 1997

Summary

Invasive pneumococcal infections affected adults and children similarly, but adults faced higher complication and mortality rates. Penicillin-resistant strains increased hospitalization but not mortality, despite low vaccination coverage.

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Area of Science:

Infectious Diseases
Bacteriology
Epidemiology

Background:

Invasive pneumococcal infection (IPI) represents a significant global health burden.
Understanding demographic, clinical, and microbiological differences in IPI between adults and children is crucial for targeted interventions.
Antimicrobial resistance patterns, particularly to penicillin, are a growing concern in managing IPI.

Purpose of the Study:

To compare the epidemiology, clinical presentation, and outcomes of invasive pneumococcal infections in adult and pediatric populations.
To investigate the prevalence and impact of antibiotic resistance, specifically penicillin resistance, in *Streptococcus pneumoniae* isolates.
To assess the serotype distribution of *Streptococcus pneumoniae* and its relation to antibiotic resistance and vaccination status.

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Main Methods:

Retrospective analysis of adult and pediatric patients diagnosed with invasive pneumococcal infection.
Data collection included demographics, underlying conditions, clinical presentation, complications, treatment, and outcomes.
Antimicrobial susceptibility testing was performed, with a focus on penicillin and cefotaxime resistance. Serotyping of isolates was conducted.

Main Results:

Similar numbers of adults and children presented with IPI, with male predominance noted.
Adults exhibited a higher prevalence of underlying diseases (78%) compared to children (24%), leading to more frequent complications and a significantly higher mortality rate (21.5% vs. 3.8%).
Penicillin resistance was observed in 23% of isolates, with no significant difference between pediatric and adult cases. Penicillin-resistant isolates were associated with longer hospital stays and nosocomial infections, but not increased mortality. Serotype distribution varied between age groups and resistance profiles.

Conclusions:

Invasive pneumococcal infections present distinct clinical and epidemiological profiles in adults and children, with adults experiencing more severe outcomes.
While penicillin resistance is prevalent, it did not significantly impact mortality in this study cohort.
Low vaccination rates despite high vaccine-type prevalence highlight a critical gap in prevention strategies for invasive pneumococcal disease.