title: [Influence of age on the clinical manifestations of invasive pneumococcal disease and antibiotic resistance rates].
abstract: OBJECTIVE
  Invasive pneumococcal disease (IPD) shows different epidemiological characteristics depending on age and pneumococcus serotype. The aims of the work were to analyze the clinical manifestations and mortality associated with IPD, the serotype isolated and the antibiotic resistance rates in different age groups.
  
  
  METHODS
  Retrospectively, 141 patients with IPD diagnosed between 2002 and 2008 were studied. Patients were classified in 4 age groups: ≤ 2 year-old, 3-14 year-old, 15-64 year-old and ≥ 65 year-old.
  
  
  RESULTS
  Pneumonia was the most common manifestation in all age groups (71%). Pneumococcal meningitis was more prevalent in patients ≤ 2 year-old (28 vs. 9%, P=.054) and empyema was more frequent in those between 3-14 year-old (31 vs. 5%, P<.001). Mortality was associated with age ≥ 65 year-old (odds ratio [OR] 7, 95% confidence interval [95% CI] 1.9-28.9), primary bacteremia (OR 7, 95% CI 1.9-28.9) and orotracheal intubation (OR 9, 95% CI 1.9-41.1). The more prevalent serotypes among patients ≤ 2 year-old were 14, 19A and 19F. The serotype 1 was most common in patients between 3-14 year-old and serotype 3 in those ≥ 65 year-old. A higher rate of non-susceptible penicillin strains was observed in pediatric population (42 vs. 19%, P=.007).
  
  
  CONCLUSIONS
  Age was related to the clinical manifestations, mortality and antibiotic resistance rates. Primary bacteremia was one of the risk factors of mortality.
authors.affiliation: Unidad de Patología Infecciosa, Servicio de Medicina Interna, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España. Electronic address: maite_perezes@yahoo.es.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Pérez-Rodríguez
authors.affiliation: Unidad de Patología Infecciosa, Servicio de Medicina Interna, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España.
authors.forename: Bernardo
authors.initials: B
authors.lastname: Sopeña
authors.affiliation: Servicio de Microbiología, Hospital Arquitecto Marcide, Ferrol, A Coruña, España.
authors.forename: Susana
authors.initials: S
authors.lastname: Méndez-Lage
authors.affiliation: Departamento de Estadística e Investigación Operativa, Facultad de Mateméticas, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, España.
authors.forename: M de los Angeles
authors.initials: Mde L
authors.lastname: Casares
authors.affiliation: Laboratorio de Apoyo a la Investigación, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España.
authors.forename: Lucía
authors.initials: L
authors.lastname: Constenla
authors.affiliation: Unidad de Patología Infecciosa, Servicio de Medicina Interna, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España.
authors.forename: Ana
authors.initials: A
authors.lastname: Argibay
authors.affiliation: Unidad de Patología Infecciosa, Servicio de Medicina Interna, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España.
authors.forename: Andrés
authors.initials: A
authors.lastname: Nodar
authors.affiliation: Unidad de Patología Infecciosa, Servicio de Medicina Interna, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España.
authors.forename: Iria
authors.initials: I
authors.lastname: Villaverde
authors.affiliation: Unidad de Patología Infecciosa, Servicio de Medicina Interna, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España.
authors.forename: César
authors.initials: C
authors.lastname: Martínez-Vázquez
authors.affiliation: Servicio de Microbiología, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, España.
authors.forename: Maximiliano
authors.initials: M
authors.lastname: Álvarez-fernández
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000175:diagnosis / Q000382:microbiology / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification / Q000302:isolation & purification; D055815:Young Adult
keywords: Age; Antimicrobial resistance; Clinical manifestations; Edad; Enfermedad invasiva por Streptococcus pneumoniae; Invasive pneumococcal disease; Manifestaciones clínicas; Mortalidad; Mortality; Resistencia a antimicrobianos