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Changing Pneumococcal Serotypes Causing Disease Abstract & Commentary By Hal B. Jenson, MD, FAAP, Professor of Pediatrics, Tufts University School of Medicine, and Chief Academic Officer, Baystate Medical Center, Springfield, [...]

Health Protection Agency figures show a rise in pneumococcal serotype 1 infections despite an overall reduction in pneumococcal infections, the Royal College of Paediatrics and Child Health annual scientific conferencehas [...]

The association between asthma and pneumococcal disease has been suspected by many clinicians; however, formal investigations confirming an increased risk of pneumococcal disease in patients with asthma are rare. Often, [...]

2003 FEB 3 - (NewsRx.com & NewsRx.net) -- by Michael Greer, senior medical writer - Immunization of hematopoietic stem cell donors may help prevent pneumococcal infections in transplant recipients, according [...]

Background: Recurrent pneumococcal bacteremia receives infrequent mention in the literature, usually in association with patients who are immunocompromised. Objective: To examine recurrent cases of pneumococcal bacteremia to determine risk factors and outcomes (mortality rates and emergence of resistance) associated with recurrences. Methods: We retrospectively reviewed all cases of pneumococcal bacteremia identified by our microbiology laboratory from January 1,1992, through December 31, 1996. Demographic, clinical, and laboratory data were abstracted. Results: There were 462 bacteremic episodes in 432 patients; 23 of these patients had 30 recurrent episodes. The 5.3% recurrence rate (23/432) is greater than that previously described. The median time to recurrence was 200 days. The mean age of patients with recurrences was 34 years, 70% were women, all were black or Hispanic (in near equal numbers), and 87% were infected with the human immunodeficiency virus (HIV). Human immunodeficiency virus infection, coexistent cancer, and female sex were independent predictors of recurrence. Only patients who were HIV-infected had multiple recurrences. Isolates from recurrent bacteremias were more likely to be penicillin-resistant than were initial bacteremic isolates (relative risk, 2.0; P=.16). Patients with recurrences had a higher (although not statistically significant) mortality rate than those without recurrences (22% vs 16%; P=.33), There was an inverse relationship between severity of illness and likelihood of recurrence. Conclusions: Rates of recurrent pneumococcal bacteremia may be higher than previously reported. In patients with recurrent pneumococcal bacteremia, the presence of an underlying immunodeficiency should be investigated.

Cigarette smoking is the strongest risk factor for invasive pneumococcal disease in otherwise healthy nonelderly adults. Dr. Pekka Nuorti of the Centers for Disease Control and Prevention and associates interviewed [...]

Background: Patients with AIDS have a high incidence of invasive pneumococcal disease, but no population-based data are available on secular trends or rates of this disease in specific demographic groups. Objective: To compare clinical characteristics, rates, and trends of pneumococcal disease in HIV-infected and non-HIV-infected persons. Design: Population-based laboratory surveillance and chart review. Setting: All of the 13 microbiology laboratories in San Francisco County, California. Patients: Persons who had a sterile site culture that was positive for Streptococcus pneumoniae between October 1994 and June 1997. Measurements: Stratified incidence rates and adjusted rate ratios, serotyping of isolates, and comparison of secular trends and rates according to census tract by Poisson regression. Results: Persons infected with HIV accounted for 54.2% of 399 patients 18 to 64 years of age who had pneumococcal disease. The incidence of pneumococcal disease per 100 000 person-years was 35.0 cases overall and 802.9 cases in patients with AIDS. Compared with persons who were not known to be HIV-infected, the rate ratio for patients with AIDS was 46.0 (95% CI, 36.0 to 58.9); 55.2% of cases were attributable to HIV. In HIV-infected patients, 82.5% of isolates were serotypes that are included in the pneumococcal polysaccharide vaccine. The incidence of pneumococcal disease in black patients with AIDS (2384.6 cases per 100 000 person-years) was 5.4 times that in nonblack patients with AIDS. Rates by census tract were inversely associated with income (P [is less than] 0.001). During the study period, the incidence of pneumococcal disease decreased from 10.6 cases per 1000 person-years to 4.2 cases per 1000 person-years in patients with AIDS (P = 0.004, Poisson regression). Conclusions: In a community with a high prevalence of HIV infection, much of the burden of pneumococcal disease was attributable to AIDS. High incidence rates were seen in young adults and especially in black persons. Efforts to increase pneumococcal vaccination rates should target HIV-infected adults, particularly those living in poor urban areas. Ann Intern Med. 2000;132:182-190., All HIV patients should receive the pneumococcal vaccine, which prevents infection by Streptococcus pneumoniae. In San Francisco, 54% of the 399 people diagnosed with pneumococcal infection during a three-year period were HIV patients. AIDS patients were 46 times more likely to develop pneumococcal infection than HIV-negative people. Black AIDS patients were five times more likely to develop pneumococcal infection than white AIDS patients. Pneumococcal infection was also more common in low-income areas. Eighty percent of the cases of pneumococcal infection could have been prevented by the pneumococcal vaccine.

ATLANTA -- Cigarette smoking in adults aged 19-64 years should be considered an indication for 23-valent pneumococcal polysaccharide vaccination, the Advisory Committee on Immunization Practices of the Centers for Disease [...]

ATLANTA -- All adults with asthma should now receive pneumococcal immunization, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention voted last month at its [...]

PALM BEACH, FLA. -- Pneumococci are the leading culprits behind community-acquired pneumonia, but the etiology should be confirmed with a Gram stain to ensure appropriate treatment, Dr. Richard J. Duma [...]

The U.S. Food and Drug Administration (FDA) issued a notice about a possible link between cochlear implants and bacterial meningitis, although the exact cause of meningitis has not been established. [...]

SAN FRANCISCO -- The highest rates of invasive pneumococcal disease were seen in children younger than 2 years of age in a Massachusetts study, Dr. Katherine K. Hsu reported during [...]