Clinical and microbiological aspects of acute community-acquired pneumonia due to Streptococcus pneumoniae.

Abstract Introduction The objectives of the present study were: (a) to describe the mortality rate and its associated variables in community-acquired pneumoniae (CAP) due to Streptococcus pneumoniae ( S. pneumoniae ), (b) to identify therapeutic issues to improve, (c) to describe the main serotypes of S. pneumoniae and (d) to know the potential coverage of antipneumococcal 23-valent vaccine. Materials and methods Inclusion criteria were age >16 years-old hospitalized due to PAC. Pneumococcal PAC etiology was considered if S. pneumoniae was isolated from blood culture and/or positive capsular urinary antigen detected at hospital admission. Exclusion criteria were patients who refused participation and/or pneumococcal infection diagnosis was made within the last month before hospital admission. Results A total of 192 patients were included, mean age 54.6 ± 19.2 years. The most frequent comorbidities were diabetes, COPD and immunosupression. There were 147 patients with bacteremia. The most frequent serotypes were 7F, 1 and 3. Beta-lactamic resistant microorganisms were not identified and only 8 (5.4%) strains were erythromycin-resistant. Potential anti-pneumococcal 23-valent vaccine coverage was 93%. Thirty-seven patients died. Variables associated with mortality were shock within the first 72 h of hospital admission (OR: 7.51; 95% CI: 2.94–19.17) and antibiotic delay ≥6 h (OR: 2.47; 95% CI: 1.00–6.17). Conclusions Pneumococcal pneumonia mortality was 19.3%. Septic shock and antibiotic delay ≥6 h since hospital admission were associated with hospital mortality. The most frequent serotype was 7F. The potential anti-pneumococcal vaccine coverage is almost 90%.