Serotype-specific mortality from invasive Streptococcus pneumoniae disease revisited

Pernille Martens, Signe Westring Worm, Bettina Lundgren, Helle Bossen Konradsen, Thomas Benfield

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Abstract

Serotype-specific mortality from invasive Streptococcus pneumoniae disease revisited.Martens P, Worm SW, Lundgren B, Konradsen HB, Benfield T. Department of Infectious Diseases 144, Hvidovre University Hospital, DK-2650 Hvidovre, Denmark. [email protected] BACKGROUND: Invasive infection with Streptococcus pneumoniae (pneumococci) causes significant morbidity and mortality. Case series and experimental data have shown that the capsular serotype is involved in the pathogenesis and a determinant of disease outcome. METHODS: Retrospective review of 464 cases of invasive disease among adults diagnosed between 1990 and 2001. Multivariate Cox proportional hazard analysis. RESULTS: After adjustment for other markers of disease severity, we found that infection with serotype 3 was associated with an increased relative risk (RR) of death of 2.54 (95% confidence interval (CI): 1.22-5.27), whereas infection with serotype 1 was associated with a decreased risk of death (RR 0.23 (95% CI, 0.06-0.97)). Additionally, older age, relative leucopenia and relative hypothermia were independent predictors of mortality. CONCLUSION: Our study shows that capsular serotypes independently influenced the outcome from invasive pneumococcal disease. The limitations of the current polysaccharide pneumococcal vaccine warrant the development of alternative vaccines. We suggest that the virulence of pneumococcal serotypes should be considered in the design of novel vaccines.
Original languageEnglish
JournalB M C Infectious Diseases
Volume4
Issue number4
Pages (from-to)21
ISSN1471-2334
DOIs
Publication statusPublished - 2004

Keywords

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Bacteremia
  • Bacterial Capsules
  • Drug Resistance, Bacterial
  • Female
  • Hospital Mortality
  • Humans
  • Male
  • Meningitis, Pneumococcal
  • Middle Aged
  • Otitis Media
  • Pneumococcal Infections
  • Pneumonia, Pneumococcal
  • Retrospective Studies
  • Serotyping
  • Streptococcus pneumoniae
  • Virulence

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