RECURRENT PNEUMOCOCCAL BACTEREMIA - 34 EPISODES IN 15 PATIENTS

Thirty-four episodes of pneumococcal bacteremia were identified in 15 patients over 5 years in 10 hospitals in Franklin County, Ohio. Twelve patients each had 2 episodes of pneumococcal bacteremia, 2 had 3, and 1 had 4. All patients had predisposing conditions, with lymphoma, mul tiple myeloma, and chronic obstructive pulmonary disease being the mos t frequent. The mean interval between the first and second episode was 268 days. Serotyping and genotyping were performed on 29 isolates. Th e same serotypic and genotypic patterns were found for sequential isol ates from four patients; three of these patients had a recurrence betw een 22 and 90 days after a previous episode. Seven (24%) of the 29 iso lates were serotype 23F; four isolates (14%) were not susceptible to p enicillin. All of our patients received appropriate antimicrobial ther apy and appeared to be clinically cured of their initial infection. Fo r patients with recurrent pneumococcal disease, alternate preventive m easures such as immunization with conjugate pneumococcal vaccine and/o r prophylactic antibiotic therapy should be considered.