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Recurrent pneumococcal bacteremia: 34 episodes in 15 patients

M R Coccia1, R R Facklam, L D Saravolatz

  • 1Ohio State University Medical Center, Columbus, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|June 13, 1998
PubMed
Summary

Recurrent pneumococcal bacteremia occurred in 15 patients with underlying conditions. Preventive strategies like vaccination and prophylactic antibiotics are recommended for those with recurring pneumococcal disease.

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Area of Science:

  • Infectious Diseases
  • Clinical Microbiology
  • Epidemiology

Background:

  • Pneumococcal bacteremia, a serious bloodstream infection, can recur in vulnerable populations.
  • Identifying risk factors and patterns of recurrence is crucial for effective management.

Purpose of the Study:

  • To analyze the incidence, characteristics, and recurrence patterns of pneumococcal bacteremia in Franklin County, Ohio.
  • To evaluate the role of serotyping and genotyping in understanding recurrent infections.
  • To inform preventive strategies for patients at high risk.

Main Methods:

  • Retrospective review of pneumococcal bacteremia cases over five years across multiple hospitals.
  • Serotyping and genotyping of bacterial isolates to identify specific strains.

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  • Analysis of patient demographics, predisposing conditions, and treatment outcomes.

    • Main Results:

    • Fifteen patients experienced 34 episodes of pneumococcal bacteremia, with most having multiple episodes.
    • Common predisposing conditions included lymphoma, multiple myeloma, and chronic obstructive pulmonary disease.
    • Genotyping confirmed recurrence in four patients, with three experiencing early re-infection (22-90 days).
    • Serotype 23F was prevalent, and some isolates showed penicillin non-susceptibility.

    Conclusions:

    • Recurrent pneumococcal bacteremia poses a significant challenge, particularly in immunocompromised individuals.
    • Understanding strain characteristics aids in identifying true recurrences.
    • Preventive measures, including pneumococcal conjugate vaccination and prophylactic antibiotics, should be considered for high-risk patients.