PURPOSE: Streptococcal pneumoniae is a common infectious disease processes. We wanted to describe a cohort of patients with bacteremic Streptococcal pneumoniae in a large inner city community hospital setting.
METHODS: A retrospective chart review of 27 patients with bacteremic Streptococcal pneumoniae infection between January 1, 2008 and December 31 2008. We examined demographic data, laboratory findings, mortality rates, ICU admission, Intubation rate, bacteria sensitivity, appropriateness of initial antibiotic, and a Pneumonia Severity Index (PSI) was calculated.
RESULTS: Overall Mortality was 3 of 27 (11.1%), and overall length of stay was 10.4 days, ICU admission for 13 of 27 (48.1%) patients. Average stay for patients who stayed in ICU versus Non ICU setting was 12.9 versus 8.1 days. 10 of 13 (76.9%) of ICU patients were intubated, for an average of 10.8 days, 3 (30%) needed tracheostomies. Steroids and Pressors were started in 44.4% and 25.9% of patients respectively. All reported cultures were pan-sensitive/penicillin sensitive and each patient was started on an appropriate antibiotic. 3 of the 27 patients developed bateremia from non-pulmonary sources (2 had epidural abscesses, 1 had infective endocarditis). 6 of 27 (22.2%) did not have radiological evidence of Pneumonia. The average Pneumonia Severity Index Score was 3.8.
CONCLUSION: Streptococcal pneumoniae infections are common infections and mostly result from community acquired pneumonia. However, Streptococcal pneumoniae bacteremia is uncommon. While mortality was modestly high (11%), morbidity (ICU admission, Mechanical Ventilation, Pressor use) was very high, even despite appropriate antibiotic use in all patients.
CLINICAL IMPLICATIONS: Invasive Streptococcal pneumoniae is associated with high morbidity. Even though the rate of antibiotic resistant bacteria remains low.
DISCLOSURE: Francis D’ Orazi, No Financial Disclosure Information; No Product/Research Disclosure Information