Invasive pneumococcal infections in southwestern Sweden: A second follow-up period of 15 years

In a retrospective study, the incidence, clinical manifestations, concomita nt conditions and case fatality rate were studied in patients with invasive pneumococcal infections in the Goteborg area of Sweden during 1981-95, whe n the pneumococcal polysaccharide vaccine was available but little used. Pa tients were identified from the records of the Departments of Clinical Bact eriology and from the computer-based hospital discharge registers of the re levant departments. Individual case records were found for 876 patients wit h invasive pneumococcal infections verified by cultures from blood, cerebro spinal fluid or other sterile body fluids. A study from the same area with the same design covering the years 1964-80 has previously been published. T here was an increase in total incidence from 5.3 to 10.3 cases/100,000/y fr om the previous to the present study. This increase was due to an increase in patients with non-meningitic infections aged greater than or equal to 60 y. The incidence of meningitis was virtually unchanged (1.4/100,000/y), as was the incidence of non-meningitic infections in individuals < 60 y. Ther e were no other important changes between the 2 studies, which confirm that invasive pneumococcal infections have the highest incidence rates in child ren < 2 y and in the elderly, that a wide variety of underlying conditions are seen in the patients and that the case fatality rate, 15% in the presen t study, is still high.