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Is Streptococcus pneumoniae a Nosocomially Acquired Pathogen?

Published online by Cambridge University Press:  02 January 2015

Franco Paradisi  and
Giampaolo Corti
Franco Paradisi*
Affiliation:
Infectious Disease Unit, University of Florence School of Medicine, Florence, Italy
Giampaolo Corti
Affiliation:
Infectious Disease Unit, University of Florence School of Medicine, Florence, Italy
*
Infectious Disease Unit, University of Florence School of Medicine, Nuovo San Giovanni di Dio Hospital, Via di torre Galli 3, I-50143 Florence, Italy; e-mail infdis@cesit1.unifi.it
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Abstract

Streptococcus pneumoniae is most prominently a major cause of community-acquired infections of the respiratory tract, central nervous system, and bloodstream, but there is an increasing interest in its role in the epidemiology of hospital-acquired infections. Penicillin-resistant pneumococcal strains appeared 3 decades ago and now are present worldwide, often displaying multiple resistance due to antibiotic selective pressure. Horizontal spread can cause either sporadic cases or hospital outbreaks, primarily in younger children and elderly patients. Pneumococcal transmission from one patient to another can be documented by polymerase chain reaction or pulsed-field gel electrophoresis typing. Nosocomial acquisition of infection, along with pediatric age, previous hospitalization, and previous β-lactam therapy, are the main risk factors significantly associated with penicillin-resistant pneumococcal infections. Nosocomial acquisition also is associated with higher mortality from pneumo-coccal disease. The importance of penicillin resistance as a risk factor significantly associated with higher mortality from pneumococcal infection is found in some studies, but not in others. Mortality from pneumococcal pneumonia is approximately the same for human immunodeficiency virus (HIV)-infected patients without acquired immunodeficiency syndrome (AIDS) as for HIV-negative subjects, but it is significantly higher in AIDS patients. Penicillin-resistant strains are involved in the vast majority of hospital outbreaks, whether presenting as clinically manifest infection or a simple colonization. Pneumococcal vaccination is recommended universally in order to lower the incidence of invasive infection, although a number of problems can limit its effectiveness.

Type
From the Fifth International Conference on the Prevention of Infection
Information
Infection Control & Hospital Epidemiology , Volume 19 , Issue 8 , August 1998 , pp. 578 - 580
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1998

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