PREDICTIVE FACTORS FOR INVASIVE DISEASE DUE TO PENICILLIN-RESISTANT STREPTOCOCCUS-PNEUMONIAE - A POPULATION-BASED STUDY

A prospective population-based study was carried out to determine pred ictive factors associated with penicillin-resistant pneumococcal invas ive disease. A total of 374 patients (250 males and 124 females; mean age, 50.3 +/- 27 years) with invasive pneumococcal infection were admi tted to one of the five hospitals in El Valles County (an industrial a rea with 800,000 inhabitants in the province of Barcelona, Spain) over a period of 5 years. Of the 374 episodes, 21 (5.6%) were due to highl y penicillin-resistant pneumococci and 67 (17.9%) to intermediately pe nicillin-resistant pneumococci. Multivariate analysis showed a statist ically significant association between infection with intermediately p enicillin-resistant pneumococci and an age of 0-4 years (odds ratio [O R] = 5.3; 95% confidence interval [CI] = 2.2-12.6), the presence of an immunosuppressive underlying disease (OR = 3.0; 95% CI = 1.5-6.0), an d the previous use of beta-lactam antibiotics (OR = 2.1; 95% CI = 1.0- 4.5). Infection with highly penicillin-resistant pneumococci was assoc iated only with the previous use of beta-lactam antibiotics (OR = 5.9; 95% CI = 2.2-15.8). Highly resistant strains were of serotypes 6, 9, 14, 15, 19, and 23, of which all but serotypes 9 and 15 are included i n the newly formulated conjugated vaccine.