Bacteremia with Streptococcus pneumoniae: implications for therapy and prevention

Article Abstract:

The incidence of drug-resistant pneumococcal infection appears to be increasing in Franklin County, Ohio. Pneumococcal infections are caused by the bacterium Streptococcus pneumoniae. A total of 590 cases of pneumococcal infection occurred between January 1991 and April 1994. The overall incidence was 18.9 per 100,000, but the incidence in the elderly was 83 per 100,000. Overall mortality was approximately 19% each year, but mortality varied by age group. Mortality was 11% in those younger than 65, 22% in those between 65 and 84 and 38% in those over 84. In 1994, 14% of bacterial strains isolated from patients' blood were resistant to penicillin, up from 4% in 1991. Mortality was not significantly higher in patients infected with penicillin-resistant pneumococcus, but these patients spent 3.7 more days in the hospital on average. Most of the penicillin-resistant strains would be covered by the pneumococcal vaccine.

Microbiology

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Minimizing the impact of drug-resistant Streptococcus pneumoniae (DRSP): a strategy from the DRSP Working Group

Article Abstract:

Increased surveillance and information dissemination is needed to cope with the rise of drug-resistant Streptococcus pneumoniae (DRSP). Streptococcus pneumoniae is responsible for millions of infections in children and the elderly. Infections are usually treated with penicillin, but since the 1960's, bacterial strains have been isolated that are resistant to penicillin and other antibiotics. The magnitude of DRSP in the US is unknown and a group of physicians and public health officials met in June 1994 to address this problem. The group recommends creating an electronic laboratory-based surveillance network, which would allow clinical laboratories to report incidents of DRSP to the Centers for Disease Control (CDC). CDC would disseminate this information in print and on the Internet. The group also recommends guidelines on judicious antibiotic use and programs to vaccinate high-risk groups.

Management, Communicable diseases, Drug resistance in microorganisms, Microbial drug resistance, Disease reporting

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Cost-effectiveness of vaccination against pneumococcal bacteremia among elderly people

Article Abstract:

Pneumococcal vaccine appears to be cost-effective in preventing infection with Streptococcus pneumoniae in elderly people. Researchers estimated the costs and benefits of vaccinating all elderly residents in three US communities. Vaccination saved about $8 per capita in future medical expenses and added about one quality-adjusted day of life per person. If extended to all elderly Americans, pneumococcal vaccine would have saved $194 million in health care costs in 1993 and added 78,000 years of life to the population. The vaccine would not be cost-effective if its effectiveness was less or the vaccine cost twice as much.

Health aspects, Aged, Elderly, Usage, Economic aspects, Prevention, Pneumococcal vaccine, Pneumococcal vaccines, Cost benefit analysis

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