PNEUMOCOCCAL BACTEREMIA IN HOSPITALIZED ISRAELI ADULTS - EPIDEMIOLOGYAND RESISTANCE TO PENICILLIN

In April 1993 a national survey of pneumococcal bacteremia in hospital ized Israeli adults was started, and this survey covered 23 of the 24 Israeli medical centers, During the first 2 years, 603 episodes of pne umococcal bacteremia were recorded. The overall annual incidence of pn eumococcal bacteremia in Israeli adults was 14.5 episodes per 100,000 inhabitants, and the overall mortality rate was 27.8%. Pneumonia was t he source of bacteremia in 70.8% of cases, primary bacteremia was the source in 17.5%, meningitis was the source in 7.5%, and otitis media/s inusitis was the source in 4.2%. Of the 258 pneumococcal isolates for which an MIC was determined, 88.8% were susceptible to penicillin, 9.3 % were partially resistant, and only 1.9% were highly resistant. Twent y-four serogroups were identified from 398 strains tested, The highest percentage of penicillin-resistant strains belonged to serogroups 23, 19, 9, 4, and 6. Although only 13 of these 24 serogroups correspond t o the serotypes included in the 23-valent pneumococcal vaccine, they a ccounted for 94% of all isolates.