Prevalence of Human Immunodeficiency Virus Infection, Mortality Rate, and Serogroup Distribution Among Patients with Pneumococcal Bacteremia at Denver General Hospital, 1984–1994

• Published in: Clinical infectious diseases Vol. 25; no. 2; pp. 195 - 199
• Main Authors: Hibbs, Jonathan R., Douglas, John M., Judson, Franklyn N., McGill, William L., Rietmeijer, Cornelius A. M., Janoff, Edward N., Jacobs, Michael R.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01-08-1997; University of Chicago Press
• Subjects: Adolescent; Adult; Aged; AIDS; AIDS-Related Opportunistic Infections; AIDS/HIV; Antibodies, Bacterial - immunology; Antigens, Bacterial - analysis; Bacteremia; Bacteremia - complications; Bacteremia - epidemiology; Bacteremia - microbiology; Bacterial diseases; Biological and medical sciences; Child; Child, Preschool; Clinical Articles; Colorado - epidemiology; Disease resistance; Female; HIV; HIV infections; HIV Infections - complications; HIV Infections - epidemiology; HIV Infections - mortality; HIV-1; Human bacterial diseases; Human immunodeficiency virus; Humans; Infant; Infant, Newborn; Infections; Infectious diseases; Male; Medical sciences; Middle Aged; Mortality; Penicillin Resistance; Pneumococcal Infections - complications; Pneumococcal Infections - epidemiology; Pneumococcal Infections - prevention & control; Prevalence; Preventive medicine; Staphylococcal infections, streptococcal infections, pneumococcal infections; Streptococcus pneumoniae; Streptococcus pneumoniae - immunology; Vaccination; Colorado; Human; Immunopathology; Prevalence; Typing; Mortality; Retroviridae; AIDS; Immune deficiency; Epidemiology; Bacteremia; Streptococcus pneumoniae; Infection; Virus; Streptococcaceae; Viral disease; Risk factor; Bacteriosis; Bacteria; Lentivirinae; Micrococcales; Hospital; Serotype; Human immunodeficiency virus
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/514538

Pandemics of human immunodeficiency virus (HIV) type 1 infection and penicillin resistance highlight the urgency of preventing invasive pneumococcal disease with vaccination. We characterized pneumococcal serogroup distribution and the mortality rate among 460 patients with pneumococcal bacteremia from 1984 through 1994 at Denver General Hospital and the prevalence of HIV infection in patients for whom pneumococcal bacteremia was diagnosed from 1989 to 1994. Vaccinerelated serogroups accounted for 426 isolates (92.6%), including 48 (92.3%) of 52 isolates from HIVinfected patients. Mortality among patients 15 years of age or older was higher during 1984–1988 (18 [12.9%] of 140) than during 1989–1994 (10 [5.2%] of 191: rate ratio, 2.5; 95% confidence interval, 1.2–5.2). Of patients 15–59 years of age from 1989 to 1994, 44 (39.6%) of 111 men and three (7.3%) of 41 women were HIV-infected. Four (8.5%) of 47 HIV-infected patients and four (3.8%) of 105 other patients in this group died (age-weighted rate ratio, 1.8; 95% confidence interval, 0.5–6.2). We recommend routine screening of young adults with pneumococcal bacteremia for HIV infection and immunization of HIV-infected patients with pneumococcal vaccine (which includes most serogroups of infecting strains).