Cobo Fernando, Cabezas-Fernández Maria Teresa, Cabeza-Barrera Maria Isabel
Department of Microbiology, APES Hospital de Poniente, El Ejido, Almería, Spain.
Infect Dis Rep. 2012 Apr 20;4(2):e29. doi: 10.4081/idr.2012.e29. eCollection 2012 Apr 27.
Streptococcus pneumoniae remains an important cause of bacteremia worldwide. Last years, a decrease of S. pneumoniae penicillin-resistant isolates has been observed. The objective of this study was to describe the episodes of bacteremia due to S. pneumoniae during a period of 11 years. Epidemiological and clinical data, serotypes causing bacteremia, antibiotic susceptibility and prognosis factors were studied. Over a period of 11 years, all the episodes of S. pneumoniae bacteremia were analysed. Their clinical and microbiological features were recorded. Statistical analysis was carried out to determine risk factors for pneumococcal bacteremia and predictors of fatal outcome. Finally, 67 S. pneumoniae bacteremia episodes were included in this study. The majority of cases were produced in white men in the middle age of their life. The main predisposing factors observed were smoking, antimicrobial and/or corticosteroids administration, chronic pulmonary obstructive disease and HIV infection, and the most common source of bacteremia was the low respiratory tract. The main serotypes found were 19A, 1, 14 and 7F. Seventy-seven percent of these isolates were penicillin-susceptible, and the mortality in this serie was really low. Statistical significance was observed between age, sex and race factors and the presence of bacteremia, and there was relationship between the patient's condition and the outcome. In our study, S. pneumoniae bacteremia is mainly from community-acquired origin mainly caused in men in the median age of the life. 40% of bacteremias were caused by serotypes 19A, 1, 7F and 14. During the period of study the incidence of bacteremia was stable and the mortality rate was very low.
肺炎链球菌仍是全球菌血症的重要病因。近年来，已观察到肺炎链球菌对青霉素耐药菌株数量有所减少。本研究的目的是描述11年间肺炎链球菌所致菌血症的发病情况。对流行病学和临床数据、引起菌血症的血清型、抗生素敏感性及预后因素进行了研究。在11年期间，分析了所有肺炎链球菌菌血症病例。记录了其临床和微生物学特征。进行统计分析以确定肺炎球菌菌血症的危险因素和死亡结局的预测因素。最终，本研究纳入了67例肺炎链球菌菌血症病例。大多数病例发生在中年白人男性中。观察到的主要易感因素为吸烟、使用抗菌药物和/或皮质类固醇、慢性阻塞性肺疾病和HIV感染，菌血症最常见的来源是下呼吸道。发现的主要血清型为19A、1、14和7F。这些分离株中有77%对青霉素敏感，该组病例的死亡率很低。在年龄、性别和种族因素与菌血症的存在之间观察到统计学意义，并且患者状况与结局之间存在关联。在我们的研究中，肺炎链球菌菌血症主要源自社区获得性感染，主要发生在中年男性中。40%的菌血症由19A、1、7F和14血清型引起。在研究期间，菌血症发病率稳定，死亡率很低。
