Surveillance of invasive Streptococcus pneumoniae infection in Quebec, Canada, from 1984 to 1986: serotype distribution, antimicrobial susceptibility, and clinical characteristics

Abstract

were serotyped, their susceptibilities to antimicrobial agents were determined, and the laboratory data were correlated with the clinical information. The distribution pattern of the serogroups and serotypes was similar to that observed previously in Quebec and to that in other parts of Canada and in the United States. No regional variation was observed. The distribution of serogroups and serotypes was different in pediatric patients (<18 years old) when compared with that of adults (P < 0.001). Overall, 94% of the strains were represented in 23-valent vaccine. The total mortality rate was 12.8% and increased with age: 1.6% in pediatric patients, 14.8% in patients 18 to 64 years old, and 31% in those .65 years old (P < 0.001). In patients 18 to 64 years old, the mortality rate was higher when an underlying condition that could have justified prior vaccination was present (P = 0.008). In patients .65 years old, the mortality rates were similar in those with and those without underlying conditions, suggesting that vaccine use in all patients .65 years old might be appropriate. Only six patients had received pneumococcal vaccine before infection. Only 15 strains (3.2%) were moderately susceptible or resistant to one or more of the antimicrobial agents tested. Six strains were moderately susceptible to penicillin G, and none was fully resistant.

Improvement of CRB-65 as a prognostic scoring system in adult patients with bacteraemic pneumococcal pneumonia

“…Older age, in accord with previous studies (35,78,80,82,(84)(85)(86)(87)(88), as well as pulmonary disease, were independent risk factors for death. In a large meta analysis by Fine et al Nursing home living; however, not smoking or alcohol abuse, were independently important regarding prognosis.…”

Pneumococcal resistance to antibiotics.

“…It may have a role in the eradication from the nasopharynx of pneumococci resistant to other agents (128), although despite its use in combination with fusidic acid or erythromycin in an attempt to prevent the emergence of resistance, rifampin-resistant strains were detected (128). A single rifampin-resistant strain was identified in a series of 468 clinical isolates in Canada (131). In South Africa, however, where the pediatric population is widely exposed to the agent during therapy for tuberculosis, 90 blood or CSF isolates resistant to rifampin have been reported (142).…”

Bacteremic Pneumonia Caused by Penicillin‐Resistant Pneumococci: Case Report and Review with a Canadian Perspective

“…Invasive infection v.rith penicillin-resistant pneumococci has been reported from Canada. A survey of isolates from blood or other sterile body flu ids done in Quebec from 1984-86 revealed relative penicillin resistance (MIC 0.12 to 1.0 pg/mL) in six of 468 isolates (1.3%) (14). Furthermore, individual cases of serious pneu mococcal disease due to relatively penicillin-resistant organism s have been reported (1 5 .1 6).…”