Clinical Outcomes of Bacteremic Pneumococcal Infections in an Area With High Resistance

Eur J Clin Microbiol Infect Dis. 2006 May;25(5):323-7. doi: 10.1007/s10096-006-0139-6.


In a retrospective study designed to gather information in a region with high antimicrobial resistance, the outcomes of 216 episodes of laboratory-confirmed pneumococcal bacteremia treated in Hong Kong between 1995 and 2001 were assessed. The patients had a mean age (+/-standard deviation) of 40+/-33.7 years. In all patients, the clinical diagnosis was confirmed by isolation of Streptococcus pneumoniae from blood (n=216), cerebrospinal fluid (n=7) and/or other sterile sites (n=12). Penicillin nonsusceptibility was found in 37.5% of the isolates (20.8% intermediate and 16.7% resistant). Penicillin nonsusceptibility was not a risk factor for inpatient mortality (p=0.7), nor did it affect duration of fever (p=0.4), requirement for intensive care unit admission (p=0.4) or development of suppurative complications (p=0.2). Advanced age (OR 11.3, 95%CI 4.5-28.2, p<0.01), critical illness (OR 11.3, 95%CI 4.5-28.2, p<0.001) and discordant therapy (OR 4.3, 95%CI 1.7-10.9, p<0.002) involving agents with poor anti-pneumococcal activity (but not penicillins and broad-spectrum beta-lactam agents) were significantly associated with mortality.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bacteremia / drug therapy*
  • Bacteremia / microbiology
  • Child
  • Child, Preschool
  • Cohort Studies
  • Drug Resistance
  • Female
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Pneumococcal Infections / drug therapy*
  • Pneumococcal Infections / microbiology
  • Retrospective Studies
  • Streptococcus pneumoniae / isolation & purification*
  • Treatment Outcome