title: Predictive factors for invasive disease due to penicillin-resistant Streptococcus pneumoniae: a population-based study.
abstract: A prospective population-based study was carried out to determine predictive factors associated with penicillin-resistant pneumococcal invasive disease. A total of 374 patients (250 males and 124 females; mean age, 50.3 +/- 27 years) with invasive pneumococcal infection were admitted to one of the five hospitals in El Vallés County (an industrial area with 800,000 inhabitants in the province of Barcelona, Spain) over a period of 5 years. Of the 374 episodes, 21 (5.6%) were due to highly penicillin-resistant pneumococci and 67 (17.9%) to intermediately penicillin-resistant pneumococci. Multivariate analysis showed a statistically significant association between infection with intermediately penicillin-resistant pneumococci and an age of 0-4 years (odds ratio [OR] = 5.3; 95% confidence interval [CI] = 2.2-12.6), the presence of an immunosuppressive underlying disease (OR = 3.0; 95% CI = 1.5-6.0), and the previous use of beta-lactam antibiotics (OR = 2.1; 95% CI = 1.0-4.5). Infection with highly penicillin-resistant pneumococci was associated only with the previous use of beta-lactam antibiotics (OR = 5.9; 95% 95% CI = 2.2-15.8). Highly resistant strains were of serotypes 6, 9, 14, 15, 19, and 23, of which all but serotypes 9 and 15 are included in the newly formulated conjugated vaccine.
authors.affiliation: Hospital Mútua de Terrassa, Barcelona, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Nava
authors.forename: F
authors.initials: F
authors.lastname: Bella
authors.forename: J
authors.initials: J
authors.lastname: Garau
authors.forename: J
authors.initials: J
authors.lastname: Lite
authors.forename: M A
authors.initials: MA
authors.lastname: Morera
authors.forename: C
authors.initials: C
authors.lastname: Martí
authors.forename: D
authors.initials: D
authors.lastname: Fontanals
authors.forename: B
authors.initials: B
authors.lastname: Font
authors.forename: V
authors.initials: V
authors.lastname: Pineda
authors.forename: S
authors.initials: S
authors.lastname: Uriz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010403:Penicillin Resistance; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000209:etiology*; D011446:Prospective Studies; D013296:Streptococcus pneumoniae / Q000187:drug effects