[Pneumococcal infections in intensive care. Retrospective 8 year study].
OBJECTIVE
The aim of this study was to analyze the clinical presentations and severity of S. pneumoniae infections requiring hospitalization in an intensive care unit and evaluate the incidence and severity of infections caused by penicillin-resistant strains.


METHODS
This retrospective study reviewed cases in our intensive care unit from January 1989 through December 1996 including all patients with pneumococcal infection.


RESULTS
The study included 102 patients, mean age 59.6 years. Pneumonia was the most frequent (83 cases) followed by bacteriemia (31 cases) and meningitis (15 cases). Mortality was high (43%) and influenced by age, simplified severity score, and presence of shock at admission. Antibiotic resistance appeared in 1991 and increased over the years reaching, in 1996: 24% for penicillin, 38% for macrolides, 20% for sulfamides, 19% for tetracyclins, and 14% for phenicols. Penicillin-resistance was not found to modify clinical expression nor severity of infection. Amoxicillin and third-generation cephalosporins were the most widely used antibiotics.


CONCLUSIONS
Pneumococcal infections in intensive care patients are severe with high mortality. The emergence of more and more resistant strains has little clinical consequence on severity or treatment.
Landreau
L
L
Réanimation Médicale et Assistance Respiratoire, CH Gui de Chauliac, Montpellier.
Moulaire
V
V
Tarodo
P
P
Jonquet
O
O
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005602:France / Q000453:epidemiology; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data* / Q000639:trends*; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D008875:Middle Aged; D010403:Penicillin Resistance; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000382:microbiology* / Q000628:therapy; D011159:Population Surveillance; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
D000900:Anti-Bacterial Agents