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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.
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.
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.
- 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.
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