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Characteristics of invasive Streptococcus pneumoniae samples

Abstract number: P961

Infante A., Garcia M.V., Odero V., Arana C., Viciana I., Sanchez M.A.

Objectives: To study evolution of the sensibility of Streptococcus pneumoniae in the last 10 years, and analyze the presentation, clinical course and serotypes.

Methods: Retrospective observational study of S. pneumoniae isolated from invasive samples (blood and CSF) in the HCU Virgen de la Victoria of Málaga, from January 2001 to November 2010. The blood culture system used was the BD BACTEC 9600 (Becton-Dickinson). The sensibility study was carried out by E-test method and the interpretation of the cut-off points were used CLSI standards 2008. Serotyping was performed on all isolates from 2004 (Instituto Salud Carlos III).

Results: We can see the characteristics of the patients in Table 1. The sensibility to penicillin was 99% for non-meningeal sites, presenting a MIC50/90in 0.016 to 0.5 (range: <0016–3) and 99.7% for meningeal location. As for cefotaxime 95.5% of the cases were sensible to locations not meningeal, MIC50/90in 0.016 to 0.25 (range: <0016–2) and 93.5% for meningeal infections. Sensibility to other antibiotics, erythromycin, tetracycline, clindamycin, moxifloxacin, levofloxacin and cotrimoxazole was 76.8%, 77.7%, 82.8%, 99.3% and 64.5% respectively.

The crude mortality was 25%, associated with sepsis and/or septic shock 57.6%, 24.3% with meningitis and 16.1% with CAP. Mortality in the first 48 hours was 48.2% and was due to sepsis and/or septic shock in 67% of cases and 25% CAP, however, if it occurred after 48 hours in a 74.2% of the cases was due to CAP. As the most common serotypes associated with mortality within 48 hours to 50% were not included in the heptavalent vaccine (1, 14, 19A, 4, 7F, 3).

Conclusions:

1S. pneumoniae bacteriemia are more common in men with a mean age of 60 years, being the most common clinical presentation of CAP.

2The high mortality (25%), especially in the first 48 hours (50%) was due to serotypes not included in the heptavalent vaccine.

3b-lactams is still first-line treatment at present for both meningeal and not-meningeal infections.

Session Details

Date: 07/05/2011
Time: 00:00-00:00
Session name: Abstracts of 21st ECCMID / 27th ICC
Subject:
Location: Milan, Italy, 7 - 10 May 2011
Presentation type:
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