Pneumococcal bacteremia in two tertiary care hospitals in Winnipeg, Canada. Pneumococcal Bacteremia Study Group.

STUDY OBJECTIVE

To review experience with pneumococcal bacteremia at two Canadian tertiary care centers.

DESIGN

Retrospective record review.

SETTING

Two tertiary acute care teaching hospitals in Winnipeg, Manitoba.

PATIENTS

Patients identified with pneumococcal bacteremia during an 8-year period.

RESULTS

Hospital records were reviewed for 534 of 617 patients with pneumococcal bacteremia. The overall case fatality ratio was 70 (13%), varying from 3.2% in children to 43% in those older than 80 years. Twenty-seven (18%) hospitalized children and 68 (23%) adults required ICU admission. Duration of hospitalization was 14.9 +/- 24.9 and 11.0 +/- 19.1 days for children at the two institutions and 22.5 +/- 37.6 days and 38 +/- 93 days for adults. For the 217 viable pneumococcal strains studied, 89% were serotypes included in the present 23-valent vaccine. Documentation of prior vaccination was present for only 9 (1.7%) patients, although 281 (89%) adults and 99 (45%) children met criteria for vaccination.

CONCLUSIONS

Mortality in our population is similar to previous reports. More widespread pneumococcal vaccination in eligible populations may not only decrease mortality, but may also provide savings through decreased hospital admission and need for intensive care.