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Mortality from invasive pneumococcal pneumonia in the era of antibiotic resistance, 1995-1997

Author

Listed:
  • Feikin, D.R.
  • Schuchat, A.
  • Kolczak, M.
  • Barrett, N.L.
  • Harrison, L.H.
  • Lefkowitz, L.
  • McGeer, A.
  • Farley, M.M.
  • Vugia, D.J.
  • Lexau, C.
  • Stefonek, K.R.
  • Patterson, J.E.
  • Jorgensen, J.H.

Abstract

Objectives. This study examined epidemiologic factors affecting mortality from pneumococcal pneumonia in 1995 through 1997. Methods. Persons: residing in a surveillance area who had community-acquired pneumonia requiring hospitalization and Streptococcus pneumoniae isolated from a sterile site were included in the analysis. Factors affecting mortality were evaluated in univariate and multivariate analyses. The number of deaths from pneumococcal pneumonia requiring hospitalization in the United States in 1996 was estimated. Results. Of 5837-cases, 12% were fatal. Increased mortality was associated with older age, underlying disease, Asian race, and residence in Toronto/Peel, Ontario. When these factors were controlled for, increased mortality was not associated with resistance to penicillin i or cefotaxime. However, when deaths during the first 4 hospital days were excluded, mortality was significantly associated with penicillin minimum inhibitory concentrations of 4.0 or higher and cefotaxime minimum inhibitory concentrations of 2.0 or higher. In 1996, about 7000 to 12500 deaths occurred in the United States from pneumococcal pneumonia requiring hospitalization. Conclusions. Older age and underlying disease remain the most important factors influencing death from pneumococcal pneumonia. Mortality was not elevated in most infections with β-actam-resistant pneumococci.

Suggested Citation

  • Feikin, D.R. & Schuchat, A. & Kolczak, M. & Barrett, N.L. & Harrison, L.H. & Lefkowitz, L. & McGeer, A. & Farley, M.M. & Vugia, D.J. & Lexau, C. & Stefonek, K.R. & Patterson, J.E. & Jorgensen, J.H., 2000. "Mortality from invasive pneumococcal pneumonia in the era of antibiotic resistance, 1995-1997," American Journal of Public Health, American Public Health Association, vol. 90(2), pages 223-229.
    • Handle: RePEc:aph:ajpbhl:2000:90:2:223-229_9
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    Cited by:

    1. Stivers, Tanya, 2005. "Non-antibiotic treatment recommendations: delivery formats and implications for parent resistance," Social Science & Medicine, Elsevier, vol. 60(5), pages 949-964, March.
    2. Cheryl Cohen & Nireshni Naidoo & Susan Meiring & Linda de Gouveia & Claire von Mollendorf & Sibongile Walaza & Preneshni Naicker & Shabir A Madhi & Charles Feldman & Keith P Klugman & Halima Dawood & , 2015. "Streptococcus pneumoniae Serotypes and Mortality in Adults and Adolescents in South Africa: Analysis of National Surveillance Data, 2003 - 2008," PLOS ONE, Public Library of Science, vol. 10(10), pages 1-19, October.

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