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Polymicrobial pneumococcal bacteraemia: a case–control study

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European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

Polymicrobial bacteraemia involving Streptococcus pneumoniae and other bacteria (e.g. Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Haemophilus influenza, viridans streptococci, Salmonella spp.) occurred in 3.4% of our pneumococcal bacteraemia cases. Compared with 308 controls (monomicrobial bacteraemia), the 77 polymicrobial cases included more males (83 vs 62%, p = 0.001), had serious underlying diseases (100 vs 80%, p < 0.001), abdominal infection (18 vs 5%, p < 0.001), nosocomial infection (33 vs 8%, p < 0.001), shock (40 vs 13%, p < 0.001), and higher mortality (52 vs 18%, p < 0.001). Clinicians must be aware that some patients with pneumococcal bacteraemia may have other bacteria in their blood, which would confer higher mortality and may lead to inappropriate or incomplete antibiotic therapy.

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Author contributions

I.G. and R.P. had full access to all data and take responsibility for the integrity and accuracy of the data and analyses. Study concept and design: I.G. and R.P.; acquisition of the data: I.G., C.A., M.H.S., J.L., and R.P.; analysis and interpretation of data: I.G., C.A., M.H.S., J.L., and R.P.; drafting of the manuscript: I.G. and R.P.; critical revision of the manuscript for important intellectual content: I.G., C.A., M.H.S., J.L., and R.P.; statistical analysis: I.G. and R.P.; obtaining funding: J.L., C.A., and R.P.; administrative, technical, or material support: I.G., C.A., M.H.S., J.L., and R.P.; study supervision: I.G. and R.P.

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Authors and Affiliations

  1. Infectious Diseases, Hospital Bellvitge, Ciberes, Idibell, University of Barcelona, L’Hospitalet, 08907, Barcelona, Spain

    I. Grau & R. Pallares

  2. Microbiology Department, Hospital Bellvitge, Ciberes, Idibell, University of Barcelona, L’Hospitalet, 08907, Barcelona, Spain

    C. Ardanuy & J. Liñares

  3. Institute for Medical Microbiology, University Medical Center Göttingen, Göttingen, Germany

    M. H. Schulze

Authors
  1. I. Grau
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  2. C. Ardanuy
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  3. M. H. Schulze
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  4. J. Liñares
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  5. R. Pallares
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Corresponding author

Correspondence to I. Grau.

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Conflicts of interest

I. Grau, C. Ardanuy and J. Liñares have received funding from Pfizer unrelated to the current paper. All other authors had no conflicts of interest.

Ethical approval

The Ethics Institutional Review Board approved this study, and they specifically waived the need for informed consent because the study analysed the data retrospectively and the source of data was anonymised.

Funding

This study was supported in part by grants PI 08/1922, PI 06/0647 and PI 11/0763 from the Ministry of Health, Madrid, Spain; and CIBERES—CB06/06/0037, from the ISCIII (Instituto de Salud Carlos III), Madrid, Spain.

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Grau, I., Ardanuy, C., Schulze, M.H. et al. Polymicrobial pneumococcal bacteraemia: a case–control study. Eur J Clin Microbiol Infect Dis 36, 911–915 (2017). https://doi.org/10.1007/s10096-016-2885-4

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  • DOI: https://doi.org/10.1007/s10096-016-2885-4

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