Serotype-specific mortality from invasive Streptococcus pneumoniae disease revisited

TY - JOUR

T1 - Serotype-specific mortality from invasive Streptococcus pneumoniae disease revisited

AU - Martens, Pernille

AU - Worm, Signe Westring

AU - Lundgren, Bettina

AU - Konradsen, Helle Bossen

AU - Benfield, Thomas

PY - 2004

Y1 - 2004

N2 - 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.

AB - 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.

KW - Adolescent

KW - Adult

KW - Age Factors

KW - Aged

KW - Aged, 80 and over

KW - Bacteremia

KW - Bacterial Capsules

KW - Drug Resistance, Bacterial

KW - Female

KW - Hospital Mortality

KW - Humans

KW - Male

KW - Meningitis, Pneumococcal

KW - Middle Aged

KW - Otitis Media

KW - Pneumococcal Infections

KW - Pneumonia, Pneumococcal

KW - Retrospective Studies

KW - Serotyping

KW - Streptococcus pneumoniae

KW - Virulence

U2 - 10.1186/1471-2334-4-21

DO - 10.1186/1471-2334-4-21

M3 - Journal article

C2 - 15228629

SN - 1471-2334

VL - 4

SP - 21

JO - B M C Infectious Diseases

JF - B M C Infectious Diseases

IS - 4

ER -