Pneumococcal Pneumonia

  • Åke Örtqvist


Streptococcus Pneumoniae Invasive Pneumococcal Disease Pneumococcal Disease Pneumococcal Pneumonia Pneumococcal Infection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Aaronson, V. A., Kristinsson, K. G., Sigurdsson, J. A., Stefansdottir, G., Mölstad, M., & Gudmudsson, S. (1996). Do antimicrobials increase the carriage rate of penicillin resistant pneumococci in children? Cross sectional prevalence study. Br. Med. J., 313, 387–391.Google Scholar
  2. Agouridas. C., Bonnefoy, A., & Chantot, J. F. (1997). Antibacterial activity of RU 6004 (HMR 3004), a novel ketolide derivate agent against respiratory pathogens. Antimicrob. Agents Chemother., 41, 2149–2158.PubMedGoogle Scholar
  3. AlonsoDeVelasco, E., Verheul, A. F. M., Verhoef, J., & Snippe, H. (1995). Streptococcus pneumoniae: Virulence factors, pathogenesis, and vaccines. Microbiol. Rev., 59, 591–603.PubMedGoogle Scholar
  4. Appelbaum, P. C., Gladkova, C., Hryniewicz, W., Kojouharov, B., Kotulova, D., Mihalcu, F., Schindler, J., Setchanova, L., Semina, N., Trupl, J., Tyski, P., Urbaskova, P., & Jacobs, M. R. (1996). Carriage of antibiotic-resistant Streptococcus pneumoniae in Eastern and Central Europe—A multicenter study with use of standardized methods, Clin. Infect. Dis., 23, 712–717.PubMedGoogle Scholar
  5. Austrian, R., & Gold, J. (1964). Pneumococcal bacteremia with especial reference to bacteremic pneumocoecal pneumonia. Ann. Intern. Med., 60, 759–776.PubMedGoogle Scholar
  6. Austrian, R. (1981). Some observations on the pneumococcus and the current status of pneumococcal disease and its prevention. Rev. Infect. Dis., 3(Suppl.), S1–SI7.PubMedGoogle Scholar
  7. Baquero, F. (1996a). Epidemiology and management of penicillin-resistant pneumococci. Curr. Opin. Infect. Dis., 9, 372–379.Google Scholar
  8. Baquero, F. (1996b). Trends in antibiotic resistance of respiratory pathogens: an analysis and commentary on a collaborative surveillance study. J. Antimicrob. Chemother., 38 (Suppl. A), 117–132.PubMedGoogle Scholar
  9. Barry, A. L., & Fuchs, P. C. (1997). Antibacterial activities of grepatloxacin, ciprofloxacin, ofloxacin and fleroxacin. J. Chemother., 9, 9–16.PubMedGoogle Scholar
  10. Bartlett, J. G., & Finegold, S. M. (1978). Bacteriology of expectorated sputum with quantitative culture and wash technique compared to Transtracheal aspirates. Am. Rev. Respir. Dis., 117, 1019–1027.PubMedGoogle Scholar
  11. Bauernfiend, A. (1997). Comparison of the antibacterial activities of the quinolones Bay 12-8039, gatifloxacin (AM 1155), trovafloxacin, clinafloxacin, levofloxacin and ciprofloxacin. J. Antimicrob. Chemother., 40, 639–651.Google Scholar
  12. Bédos, J.-P., Chevret, S., Chastang, C., Geslin, P., Regnier, B., & the French Cooperative Study Group. (1996). Epidemiological features of and risk factors for infection by Streptococcus pneumoniae strains with diminished susceptibility to penicillin: findings of a French survey, Clin. Infect. Dix., 22, 63–72.Google Scholar
  13. Berntsson, E., Blomberg, J., Lagergard, T., & Trollfors, B. (1985). Etiology of community-acquired pneumonia in patients requiring hospitalization. Eur. J. din. Microbiol., 4, 268–272.Google Scholar
  14. Boersma, W. G., & Holloway, Y. (1996). Investigation of bacterial infections of the lower respiratory tract. Curr. Opin. Infect. Dis., 9, 76–84.Google Scholar
  15. Bohte, R., van Furth, R., & van den Broek, P. J. (1995). Aetiology of community-acquired pneumonia: a prospective study among adults requiring admission to hospital. Thorax, 50, 543–547.PubMedGoogle Scholar
  16. Brayton, R. G., Stokes, P. E., Schwartz, M. S., & Louria, D. B. (1970). Effect of alcohol and various diseases on leukocyte mobilization, phagocytosis and intracellular bacterial killing. N. Engl. J. Med., 282, 123–128.PubMedCrossRefGoogle Scholar
  17. Briles, D. E., Creech Tart, R., Wu, H.-Y, Ralph, B. A., Russel, M. W., & McDaniel, L. S. (1996). Systemic and mucosal protective immunity to pneumococcal surface protein A. Ann. NY Acad, Sci., 797, 118–126.Google Scholar
  18. British Thoracic Society. (1987). Community-acquired pneumonia in adults in British hospitals in 1982–1983: a survey of aetiology, mortality, prognostic factors and outcome. Quart. J. Med., 62, 195–220.Google Scholar
  19. Bruyn, G. A., & van Furth, R. (1991). Pneumocoecal polysaccharide vaccines: indications, efficacy, and recommendations. Eur. J. Clin. Microbiol. Infect. Dis., 10, 897–910.PubMedCrossRefGoogle Scholar
  20. Bryan, C. S., Talwani, R., & Stinson, M. S. (1997). Penicillin dosing for pneumococcal pneumonia. Chest, 112, 1657–1664.PubMedGoogle Scholar
  21. Burman, L. Å., Norrby, R., & Trollfors, B. (1985). Invasive pneumococcal infections: incidence, predisposing factors, and prognosis. Rev. Infect. Dix., 7, 133–142.Google Scholar
  22. Burman, L. Å., Trollfors, B., Andersson, B., Henrichsen, J., Juto, P., Kallings, I., Lagergård, T., Mö llby, R., & Norrby, R. (1991). Diagnosis of pneumonia by cultures, bacterial and viral antigen detection tests, and serology with special reference to antibodies against pneumococcal antigens. J. Infect. Dis., 163, 1087–1093.PubMedGoogle Scholar
  23. Cabellos, C., Ariza, J., Barreiro, B., Tubau, F., Linares, J., Manresa, F., & Gudiol, F. (1998). Current usefulness of procaine penicillin in the treatment of pneumococcal pneumonia. Eur. J. Clin. Microbiol. Infect. Dis., 17, 265–268.PubMedGoogle Scholar
  24. Chen, D. K., McGreer, A., de Azavedo, J. C., and Low, D. E. (1999). Decreased susceptibility of Streptococcus pneumoniae to fluoroquinolones in Canada. N. Engl. J. Med., 341, 233–239.PubMedCrossRefGoogle Scholar
  25. Christensson, B., Sylwan, S., & Noreen, B. (1997). Carriage of multiresistant Streptococcus pneutnoniae among children attending day-care centres in the Stockholm area. Scand. J. Infect. Dis., 29, 555–558.Google Scholar
  26. Clavo-Sánchez, A. J., Girón-González, J. A., López-Prieto, D., Canueto-Quintero, J., Sánchez.-Porto, A., Vergara-Campos, A., Marin-Casanova, P., & Córdoba-Dona, J. A. (1997). Multivariate analysis of risk factors for infection due to penicillin-resistant and multidrug-resistant Streptococcus pneumoniae: a multicenter study. Clin. Infect. Dis., 24, 1052–1059.PubMedGoogle Scholar
  27. Davidson, M., Tempest, B., & Palmer, D. L. (1976). Bacteriologic diagnosis of acute pneumonia. Comparison of sputum, transtracheal aspirates, and lung aspirates. JAMA, 2.15. 158–163.Google Scholar
  28. Davidson, M., Parkinson, A. J., Bulkow, L. R., Fitzgerald, M. A., Peters, H. V., & Parks, D. J. (1994). The epidemiology of invasive pneumococcal disease in Alaska, 1986–1990—ethnic differences and opportunities for prevention. J. Infect. Dis., 170, 368–376.PubMedGoogle Scholar
  29. Duchin, J. S., Breiman, R. F., Diamond, A., Lipman, H., Block, A. L., Hedrick, J. A., Finger, R., & Elliott, J. A. (1995). High prevalence of multidrug-resistant Streptococcus pneumoniae among children in a rural Kentucky community. Pediatr. Infect. Dis., 14, 745–750.Google Scholar
  30. Ekdahl, K., Ahlinder, I., Hansson, H. B., Melander, E., Mölstad, S., Söderström, S., & Persson, K. (1997). Duration ot’nasopharyngeal carriage of penicillin-resistant Streptococcus pneumoniae: experiences from the South Swedish pneumococcal intervention project, Clin. Infect. Dis., 25, 1113–1137.PubMedGoogle Scholar
  31. Ekdahl, K., Mårtensson, A., & Kamme, C. (1998). Bacteremic pneumococcal infections in Southern Sweden 1991–1996: trends in incidence, mortality, age-distribution, sero-groups, and penicillin-resistance. Scand. J. Infect. Dis., 30, 257–262.PubMedGoogle Scholar
  32. Fang, G.-D., Fine, M., Orloff, J., Arisumi, D., Yu, V. L., Kapoor, W., Grayston, J. T., Wang, S. P., Kohler, R., Muder, R. R., Yee, Y. C., Rihs, J. D., & Vickers, R. M. (1990). New and emerging etiologies for community-acquired pneumonia with implications for therapy. Medicine, 69, 307–316.PubMedGoogle Scholar
  33. Fairchok, M. P., Ashton, S., & Fischer, G. W. (1996). Carriage of penicillin-resistant pneumococci in a military population in Washington, D.C.: risk factors and correlation with clinical isolates, Clin. Infect. Dis., 22, 966–972.PubMedGoogle Scholar
  34. Farr, B. M., Kaiser, D. L., Harrison, B. D. W., & Conolly, C. K. (1989). Prediction of microbial aetiology at admission to hospital for pneumonia from the presenting clinical features. Thorax, 44, 1031–1035.PubMedGoogle Scholar
  35. Fedson, D. S., Musher, D. M., & Eskola, J. (1999). Pneumococcal vaccine, in: Vaccines, 3rd ed. (S. A. Plotkin & W. A. Ornstein, eds.), Philadelphia: W. B. Saunders, pp. 561–569.Google Scholar
  36. Fine, M. J., Smith, M. A., Carson, C. A., Mutha, S. S., Sankey, S. S., Weissfeld, L. A., & Kapoor, W. N. (1996). Prognosis and outcomes of patients with community-acquired pneumonia. A meta-analysis. JAMA, 275, 134–141.PubMedCrossRefGoogle Scholar
  37. Foss Abrahamsen, A., Hoiby, E. A., Hannisdal, E., Jorgensen, O. G., Holte, H., Hasseltvedt, V., & Host, H. (1997). Systemic pneumococcal disease after staging splenectomy for Hodg-kin’s disease 1969–1980 without pneumococcal vaccine protection: a follow-up study 1994. Eur. J. Haematol., 58, 73–77.PubMedGoogle Scholar
  38. Friedland, I. R. (1995). Comparison of the response to antimicrobial therapy of penicillin-resistant and penicillin-susceptible pneumococcal disease. Pediatr. Infect. Dis. J., 14, 885–890.PubMedGoogle Scholar
  39. Garau, J. (1996). Clinical perspectives on the management of community-acquired pneumonia. Diagn. Microbiol. Infect. Dis., 25, 205–211.PubMedCrossRefGoogle Scholar
  40. Garcia-de-Lomas, J., Gimeno, C., Millás, E., Bermejo, M., Lázaro, M. A., Navarro, D., Garcia-Ponte, L., & Garijo, B. (1997). Antimicrobial susceptibility of Streptococcus pneumoniae from pediatric carriers. Eur. J. Clin. Microbiol. Infect. Dis., 16, 11–13.PubMedGoogle Scholar
  41. Garcia-Leoni, M. E., Moreno, S., Rodeno, P., Cercenado, E., Vincente, T., & Bouza, E. (1992). Pneumococcal pneumonia in adult hospitalized patients with the human immuno-deficiency virus. Arch. Intern. Med., 352, 1808–1812.Google Scholar
  42. Garcia-Martos, P., Galán, F., Marin, P., & Mira, J. (1997). Increase in high resistance to penicillin of clinical isolates of Streptococcus pneumoniae in Cadiz, Spain. Chemotherapy, 43, 179–181.PubMedGoogle Scholar
  43. George, J., & Morrisey, I. (1997). The bactericidal activity of levofloxacin compared with ofloxacin, ciprofloxacin, sparfloxacin and cefotaxime against Streptococcus pneumoniae. J. Antimicrob. Chemother., 39, 719–723.PubMedCrossRefGoogle Scholar
  44. Georgopoulos, A., Buxbaum, A., Straschil, U., the Austrian Bacterial Surveillance Network, & Graninger, W. (1998). Austrian national survey of prevalence of antimicrobial resistance among clinical isolates of Streptococcus pneumoniae 1994–96. Scand. J. Infect. Dis., 30, 345–349.PubMedGoogle Scholar
  45. Gerding, D. N., Hughes, C. E., Bamberger, D. M., Foxworth, J., & Larson, T. A. (1996). Extravascular antimicrobial distribution and the respective blood concentrations in humans, in: Antibiotics in Laboratory Medicine, 4th ed. (V. Lorian, ed.). Baltimore: William & Wilkins, pp. 835–899.Google Scholar
  46. Giesecke, J., & Fredlund, H. (1997). Increase in pneumococcal bacteremia in Sweden. Lancet, 349, 699–670.PubMedCrossRefGoogle Scholar
  47. Gilks, C. F., Ojoo, S. A., Brindle, R. J., Paul, J., Batchelor, B. I., Kimari, J. N., Newnham, R., Bwayo, J., Plummer, F. A., & Warrel, D. A. (1996). Invasive pneumococcal disease in a cohort of predominantly HIV-1 infected female sex workers in Nairobi, Kenya. Lancet, 347, 718–723.PubMedCrossRefGoogle Scholar
  48. Gleckman, R., & Hibert, D. (1982). Afebrile bacteremia. A phenomen in geriatric patients. JAMA, 248, 1478–1481.PubMedCrossRefGoogle Scholar
  49. Goldstein, F. W., Acar, J. F., & the Alexander Project Collaborative Group. (1996). Antimicrobial resistance among lower respiratory tract isolates of Streptococcus pneumoniae: results of a 1992–93 Western Europe and USA collaborative surveillance study. J. Antimcrob. Chemother., 38(Suppl. A), 71–84.Google Scholar
  50. Gransden, W. R., Eykyn, S. J., & Phillips, I. (1985). Pneumococcal bacteremia: 325 episodes at St Thomas’shospital. Br. Med. J., 290, 505–508.CrossRefGoogle Scholar
  51. Gratten, M., Torzillo, P., Morey, F., Dixon, J., Erlich, J., Hagger, J., & Henrichsen J. (1996). Distribution of capsular types and antibiotic susceptibility of invasive Streptococcus pneumoniae isolated from aborigines in Central Australia. J. Clin. Microbiol., 34, 338–341.PubMedGoogle Scholar
  52. Gratten, M., Nimmo, G., Carlisle, J., Schooneveld, J., Seneviratne, E., Kelly, R., Ashhurst-Smith, C., Love, K., Tiley, S., Wood, G., & Fenton, J. (1997). Emergence of further serotypes of multiple drug-resistant Streptococcus pneumoniae in Queensland. Commun. Dis. Intell., 21, 133–136.PubMedGoogle Scholar
  53. Gray, B. M., Converse, G. M. III, & Dillon, H. C. Jr. (1980). Epidemiologic studies of Streptococcus pneumoniae in infants: acquisition, carriage, and infection during the first 24 months of life. J. Infect. Dis., 142, 923–933.PubMedGoogle Scholar
  54. Gress, T. W., Yingling, K. W., Stanek, R. J., and Mufson, M. A. (1996). Infection with Streptococcus pneumoniae moderately resistant to penicillin does not alter clinical outcome. Infect. Dis. Clin. Practice, 5, 435–439.Google Scholar
  55. Gwaltney, J. M. Jr., Sande, M. A., Austrian, R., & Hendley, J. O. (1975). Spread of Streptococcus pneumoniae in families. II. Relation of transfer of Streptococcus pneumoniae to incidence of colds and serum antibody. J. Infect. Dis., 132, 62–68.PubMedGoogle Scholar
  56. Hammerschmidt, S., Talay, S. R., Brandtzaeg, P., & Chhatwal, G. S. (1997). SpsA, a novel pneumococcal surface protein with specific binding to secretory immunoglobulin A and secretory component. Mol. Microbiol, 25, 1113–1124.PubMedCrossRefGoogle Scholar
  57. Hedlund, J, Ortqvist, A., & Kalin, M. (1990). Nasopharyngeal culture in the pneumonia diagnosis. Infection, 18, 1–4.CrossRefGoogle Scholar
  58. Hedlund, J., Svenson, S. B., Kalin, M., Henrichsen, J., Olsson-Liljequist, B., Möllerberg, G., & Kållenius, G.. (1995). Incidence, capsular types, and antibiotic susceptibility of invasive Streptococcus pneumoniae in Sweden. Clin, Infect. Dis., 21, 948–953.Google Scholar
  59. Heffron, R., (1939). Pneumonia, with Special Reference to Pneumococcus Lobar Pneumonia. New York: The Common-wealth Fund.Google Scholar
  60. Hendley, J. O., Sande, M. A., Stewart, P. M., and Gwaltney, J. R. (1975). Spread of Streptococcus pneumoniae in families. I. Carriage rates and distribution of types. J. Infect. Dis., 132, 55–61.PubMedGoogle Scholar
  61. Henning, C., Bengtsson, L., Jorup, C., & Engquist, S. (1997). Antibiotic resistance in Streptococcus pneumoniae, Haemophilus influenzae and Streptococcus pyogenes in respiratory tract infections in outpatients. Scand. J. Infect. Dis., 29, 559–563.PubMedGoogle Scholar
  62. Henrichsen, J. (1995). Six newly recognized types of Streptococcus pneumoniae. J. Clin. Microbiol., 33, 2759–2762.PubMedGoogle Scholar
  63. Henriques, B., Kalin, M., Örtqvist, A., Olsson Liljequist, B., Amela, M., Gonzalez Rey, C., Marrie, T. J., Mufson, M. A., Torres, A., Woodhead, M. A., Svenson, S. B., & Kallenius, G. (2000). Molecular epidemiology of Streptococcus pneumoniae causing invasive disease in 5 countries. J. Infect. Dis., 182, 833–839.PubMedCrossRefGoogle Scholar
  64. Hermans, P. W. M., Sluijter, M., Elzenaar, K., van Veen, A., Schonkeren, J. M., Nooren, F. M., van Leeuwen, W. J., de Neeling, A. J., van Klingeren, B., Verbrugh, H. A., & de Groot, R. (1997). Penicillin-resistant Streptococcus pneumoniae in the Netherlands: results of a 1-year molecular epidemiologic study. J. Infect. Dis., 175, 1413–1422.PubMedCrossRefGoogle Scholar
  65. Hirschtick, R. E., Glassroth, J., Jordan, M. C., Wilcosky, T. C., Wallace, J. M., Kvale, P. A., Markowitz, N., Rosen, M. J., Mangura, B. T., Hopewell, P. C., & the Pulmonary Complications of HIV Infection Study Group. (1995). Bacterial pneumonia in persons infected with the human immuno-deficiency virus. N. Engl. J. Med., 333, 845–851.PubMedCrossRefGoogle Scholar
  66. Ho, P. L., Que, T. L., Tsang, D. N-C., Tak-Keung, N. G., Chow, K. H., and Seto, W. H. (1999). Emergence of fluoroquinolone resistance among multiple resistant strains of Streptococcus pneumoniae in Hong Kong. Amtimicrob. Agents Chemother., 43, 1310–1313.Google Scholar
  67. Hoffman, J., Cetron, M. S., Farley, M. M., Baughman, W. S., Facklam, R. R., Elliott, J. A., Deaver, K. A., & Breiman, R. F. (1995). The prevalence of drug-resistant Streptococcus pneumoniae in Atlanta. N. Engl. J. Med., 333, 481–486.Google Scholar
  68. Hoge, C. W., Reichler, M. R., Dominguez, E. A., Bremer, J. C., Mastro, T. D., Hendricks, K. A., Musher, D. A., Elliott, J. A., Facklam, R. R., & Breiman, R. F. (1994). An epidemic of pneumococcal disease in an overcrowded, inadequately ventilated jail. N. Engl. J. Med., 331, 643–648.PubMedCrossRefGoogle Scholar
  69. Holloway, Y., Boersma, W. G., Kuttschrutter, H., & Snijder, J. A. M. (1992). Minimum number of pneumococci required for capsular antigen to be detectable by latex agglutination. J. Clin. Microbiol., 30, 517–519.PubMedGoogle Scholar
  70. Holmberg, H. (1987). Aetiology of community-acquired pneumonia in hospital treated patients. Scand. J. Infect. Dis., 19, 491–501.PubMedGoogle Scholar
  71. Jacobs, M. R. (1992). Treatment and diagnosis of infections caused by drug-resistant Streptococcus pneumoniae. Clin. Infect. Dis., 15, 119–127.PubMedGoogle Scholar
  72. Jaero, P. W., Preheim, L. C., & Gentry, M. J. (1996). Ethanol impairs neutrophil bactericidal mechanisms against Streptococcus pneumoniae. Alcohol Clin. Exp. Res., 20, 1646–1652.Google Scholar
  73. Janoff, E. N., Breiman, R. F, Daley, C. L., & Hopewell, P. C. (1992). Pneumococcal disease during HIV infection. Ann. Intern. Med., 117. 314–324.PubMedGoogle Scholar
  74. Janoff, E. N., O’Brien, J., Thompson, P., Ehret, J., Meiklejohn, G., Duvall, G., & Douglas, J. M. Jr. (1993). Streptococcus pneumoniae colonization, bacteremia, and immune response among persons with human immunodeficiency virus infection. J. Infect. Dis., 167, 49–56.PubMedGoogle Scholar
  75. Jay, G. J., Johanson, W. G., & Pierce, A. K. (1975). The radiographic resolution of Streptococcus pneumoniae pneumonia. N. Engl. J. Med., 293, 798–801.PubMedCrossRefGoogle Scholar
  76. Jetté, L. P., Lamothe, F, & the Pneumococcus Study Group. (1989). Surveillance of invasive Streptococcus pneumoniae infection in Quebec, Canada. J. Clin. Microbiol., 27, 1–5.PubMedGoogle Scholar
  77. Jokinen, C., Heiskanen, L., Juvonen, H., Kallinen, K., Karkola, K., Korppi, M., Kurki, S., Rönnberg, P.-R., Seppå, A., Soimakallio, S., Stén, M., Tanska, S., Tarkiainen, A., Tukiainen, H, Pyörålå, K., and Måkålå, H. (1993). Incidence of community-acquired pneumonia in the population of four municipalities in eastern Finland. Am. J. Epidemiol., 137, 977–988.PubMedGoogle Scholar
  78. Kalin, M., & Lindberg, A. A. (1983). Diagnosis of pneumococcal pneumonia: A comparison between microscopic examination of expectorate, antigen detection and cultural procedures. Scand. J. Infect. Dis., 15, 247–255.PubMedGoogle Scholar
  79. Kalin, M., Örtqvist, Å., Almela, M., Aufwerber, A., Dwyer, R., Henriques, B., Jorup, C., Julander, I., Marrie, T., Mufson, M., Riquelme, R., Thalme, A., Torres, A., & Woodhead M. (2000). Prospective study of prognostic factors in community-acquired bacteremic pneumococcal disease in 5 countries. J. Infect. Dis., 182, 840–847.PubMedCrossRefGoogle Scholar
  80. Kim, S.-N., Kim, S.-W., Choi, 1.-H., Pyo, S.-N., & Rhee, D.-K. (1996). High incidence of multidrug-resistant Streptococcus pneumoniae in South Korea. Microb. Drug Resist., 2, 401–406.PubMedCrossRefGoogle Scholar
  81. Klugman, K. P., & Gootz, T. D. (1997). In-vitro and in-vivo activity of trovafloxacin against Streptococcus pneumoniae. J. Antimicroh. Chemother., 39(Suppl B):51–55.Google Scholar
  82. Kristinsson, K. G. (1997). Effect on antimicrobial use and other risk factors on antimicrobial resistance in pneumococci. Microb. Drug Res., 3, 117–123.CrossRefGoogle Scholar
  83. Lehmann, D., Gratten, M., & Montgomery, J. (1997). Susceptibility of pneumococcal carriage isolates to penicillin provides a conservative estimate of susceptibility of invasive pneumococci. Pediatr, Infect. Dis. J., 16, 297–305.Google Scholar
  84. Lentino, J. R., & Lucks, D. A. (1987). Non value of sputum culture in the management of lower respiratory tract infections. J. Clin. Micmbiol., 25, 758–762.Google Scholar
  85. Levy, M., Dromer, F., Brion, N., Leturdy, F., & Carbon, C. (1988). Community-acquired pneumonia. Importance of initial noninvasive bacteriologic and radiographic investigations. Chest, 92, 43–48.Google Scholar
  86. Lieberman, D., Schlaefter, F., Boldur, I., Lieberman, D., Horowitz, S., Friedman, M. G., Leinonen, M., Horovitz, O., Manor, H., & Porath, A. (1995). Multiple pathogens in adult patients admitted with community-acquired pneumonia: a one year prospective study of 346 consecutive patients. Thorax, 51, 179–184.Google Scholar
  87. Linares, J., de la Campa, A. G., and Pallares, R. (1999). Fluoroquinolone resistance in Streptococcus pneumoniae. N. Engl. J. Med., 341, 1546–1547.PubMedCrossRefGoogle Scholar
  88. Lipsky, B. A., Boyko, E. J., Inui, T. S., & Koepsell, T. D. (1986). Risk factors for acquiring pneumococcal infections. Arch. Intern. Med., 146, 2179–2185.PubMedCrossRefGoogle Scholar
  89. Lode, H., Garau, J., Grassi, C., Hosie, J., Huchon, G., Laegakis, N., Segev, S., & Wijnands, G. (1995). Treatment of community-acquired pneumonia: a randomized comparison of sparfloxacin, amoxicillin-clavulanic acid and erythromycin. Eur. Respir. J., 8, 1999–2007.PubMedCrossRefGoogle Scholar
  90. Lääveri, T., Nikoskelainen, J., Meurman, O., Eerola, E., & Kotilainen, P. (1996). Bacteremic pneumococcal disease in a teaching hospital in Finland. Scand. J. Infect. Dis., 28, 41–46.PubMedCrossRefGoogle Scholar
  91. Macfarlane, J. T., Ward, M. J., Finch, R. G., & Macrae, D. (1982). Hospital-study of adult community-acquired pneumonia. Lancet, 2, 255–258.PubMedGoogle Scholar
  92. Magnus, T., & Andersen, B. M. (1995). Serotypes and resistance patterns of Streptococcus pneumoniae causing systemic disease in Northern Norway. Eur. J. Clin. Micmbiol. Infect. Dis., 14, 229–234.Google Scholar
  93. Manninen, R., Huovinen, P., & Nissinen, A. (1997). Increasing antimicrobial resistance in Streptococcus pneumoniae. Haemophilus influenzae and Moraxella catarhralis in Finland. J. Antimicrob. Chemother., 40, 387–392.PubMedCrossRefGoogle Scholar
  94. Marfin, A. A., Sporrer, J., Moore, P. S., & Siefkin, A. D. (1995). Risk factors for adverse outcome in persons with pneumococcal pneumonia. Chest, 107, 457–462.PubMedGoogle Scholar
  95. McLaughlin, V., Riley, T., & Roberts, C. (1997). Invasive Streptococcus pneumoniae in Perth hospitals, 1990 to 1994. Commun. Dis. Intell., 21, 73–76.PubMedGoogle Scholar
  96. Meduri, G. U., & Baselski, V. (1991), The role of bronchoalveolar lavage in diagnosing nonopportunistic bacterial pneumonia. Chest, 100, 179–190.PubMedGoogle Scholar
  97. Mercat, A., Nguyen, J., & Dautzenberg, B. (1991). An outbreak of pneumococcal pneumonia in two men’sshelters. Chest, 99, 147–151.PubMedGoogle Scholar
  98. Mirzanejad, Y., Roman, S., Talbot, J., Nicolle, L., & the Pneumococcal Bacteremia Study Group. (1996). Pneumococcal bacteremia in two tertiary care hospitals in Winnipeg, Canada. Chest, 109, 173–178.PubMedGoogle Scholar
  99. Mittermayer, H., Jebelean, C., Binder, L., Haditsch, M., & Watschinger, R. (1996). Antibiotic susceptibility of pneumococci isolated in Austria over a four-year period. Eur. J. Clin. Microbiol. infect. Dis., 15, 817–820.PubMedCrossRefGoogle Scholar
  100. Mufson, M. A., Oley, G., & Hughey, D. (1982). Pneumococcal disease in a middle-sized community in the United States. JAMA, 248, 1486–1489.PubMedCrossRefGoogle Scholar
  101. Munos, R., Coffey, T. J., Daniels, M., Dowson, C. G., Laible, G., Casal, J., Hakenbeck, R., Jacbobs, M., Musser, J. M., Spratt, B. G., & Tomasz, A. (1991). Intercontinental spread of a multiresistant clone of serotype 23F Streptococcus pneumoniae. J. Infect. Dis., 164, 302–306.Google Scholar
  102. Musher, D. (1992). Infections caused by Streptococcus pneumoniae: clinical spectrum, pathogenesis, immunity, and treatment. Clin. Infect. Dis., 14, 801–809.PubMedGoogle Scholar
  103. Musher, D. M., Groover J. E., Reichler, M. R., Riedo, F. X., Schwartz, B., Watson, D. A., Baughn, R. E., & Breiman, R. F.(1997). Emergence of antibody to capsular polysaccharides of Streptococcus pneumoniae during outbreaks of pneumonia: association with nasopharyngeal colonization. Clin. Infect. Dis., 24, 441–446.PubMedGoogle Scholar
  104. National Committee for Clinical Laboratory Standards. (1995). Definitions of susceptibility and resistance according to the criteria of the National Committee for Clinical Laboratory Standards (NCCLS). Performance Standards for Antimicrobial Susceptibility Testing, 6th informational supplement (M100-S6). Villanova, PA: National Committee for Clinical Laboratory Standards.Google Scholar
  105. Nava, J. M., Bella, F., Garau, J., Lite, J., Morera, M.-A., Marti, C., Fontanals, D., Font, B., Pineda, V., Uriz, S., Deulofeu, F., Calderon, A., Duran, P., Grau, M., & Agudo, A. (1994). Predictive factors for invasive disease due to penicillinresistant Streptococcus pneumoniae: a population-based study. Clin. Infect. Dis., 19, 884–890.PubMedGoogle Scholar
  106. Nayak, A. R., Tinge, R. C., MacDaniel, L. S., Briles, D. E., & Curtis, R. (1998). A live recombinant avirulent oral Salmonella vaccine expressing pneumococcal surface protein A induces protective responses against Streptococcus pneumoniae. Infect. Immun., 66, 3744–3751.PubMedGoogle Scholar
  107. Nielsen, S. V., & Henrichsen, J. (1992). Capsular types of Streptococcus pneumoniae isolated from blood and CSF during 1982–1987. Clin. Infect. Dis., 15, 794–798.PubMedGoogle Scholar
  108. Nielsen, S. V., & Henrichsen, J. (1996). Incidence of invasive pneumococcal disease and distribution of capsular types of pneumococci in Denmark, 1989–94. Epidemiol. Infect., 117, 411–416.PubMedCrossRefGoogle Scholar
  109. Novak, R., Henriques, B., Charpentier, E., Normark, S., Tuomanen, E. (1999). Emergence of vancomycin tolerance in Streptococcus pneumoniae [see comments]. Nature, 399, 590–593.PubMedGoogle Scholar
  110. Nuorti, J. P., Butler, J. C., Farley, M. M., Harrison, L. H., McGeer, A., Lolczak, M. S., and Breiman, R. F. (2000). Cigarette smoking and invasive pneumococcal disease. N. Engl. J. Med., 342, 681–689.PubMedCrossRefGoogle Scholar
  111. Ort, S., Ryan, J. L., Barden, G., & D’Esopo, N. (1983). Pneumococcal pneumonia in hospitalized patients. Clinical and radiological presentations. JAMA, 249, 214–218.PubMedCrossRefGoogle Scholar
  112. Örtqvist, Å. (1994). Initial investigation and treatment of the patient with severe community-acquired pneumonia. Semin. Respir. Infect., 9, 165–178.Google Scholar
  113. Örtqvist, Å., Grepe, A., Julander, I., & Kalin, M. (1988). Bacteremic pneumococcal pneumonia in Sweden: clinical course and outcome, and comparison with non-bacteremic and mycoplasmal pneumonias. Scand. J. Infect. Dis., 20, 163–171.PubMedGoogle Scholar
  114. Örtqvist, Å., Jönsson, I., Kalin, M., & Krook, A. (1989). Comparison of three methods for detection of pneumococcal antigen in sputum of patients with community-acquired pneumonia. Eur. J. Clin. Microbiol., Infect. Dis., 8, 956–961.CrossRefGoogle Scholar
  115. Örtqvist, Å., Hedlund, J., Grillner, L., Jalonen, E., Kallings, I., Leinonen, M., & Kalin, M. (1990a). Aetiology, outcome and prognostic factors in community-acquired pneumonia requiring hospitalization. Eur. Respir. J., 3, 1105–1113.PubMedGoogle Scholar
  116. Örtqvist, Å., Kalin, M., Lejdeborn, L., & Lundberg, L. (1990b). Diagnostic fiberoptic bronchoscopy and protected brush culture in patients with community-acquired pneumonia. Chest, 97, 576–582.PubMedGoogle Scholar
  117. Örtqvist, Å., Julander, I., Kalin, M., & Mufson, M. (1993). Deaths in bacteremic pneumococcal pneumonia: a comparison of two populations-Huntington, USA, and Stockholm, Sweden. Chest, 103, 710–716.PubMedGoogle Scholar
  118. Örtqvist, Å., Hedlund, J., Wretlind, B., Carlström, A., & Kalin, M. (1995). Diagnostic and prognostic value of interleukin-6 and C-reactive protein in community-acquired pneumonia. Scand. J. Infect. Dis., 27, 457–462.PubMedGoogle Scholar
  119. Örtqvist, Å., Valtonen, M., Cars, O., Wahl, M., Saikku, P., Jean, C., & the Scandinavian Sparfloxacin Study Group. (1996). Oral empirical treatment of community-acquired pneumonia: a multicenter, double blind, randomized study comparing sparfloxacin with roxithromycin. Chest, 110, 1499–1506.PubMedGoogle Scholar
  120. Örtqvist, Å., Hedlund, J., Höfer, M., Burman, L.-Å., Elbel, E., Leinonen, M., Lindblad, I., Sundelöf, B., Kalin, M., & the Swedish Pneumococcal Vaccination Study Group. (1998). Effectiveness of the pneumococcal capsular polysaccharide vaccine in the prevention of pneumonia in middle-aged and elderly persons. Lancet, 351, 399–403.PubMedGoogle Scholar
  121. Pallares, R., Linares, J., Vadillo, M., Cabellos, C., Manresa, F., Viladrich, P.F., Martin, R., & Gudiol, F. (1995). Resistance to penicillin and mortality from severe pneumococcal pneumonia in Barcelona, Spain. N. Engl. J. Med., 333, 474–480.PubMedCrossRefGoogle Scholar
  122. Paton, J. C., Berry, A. M., & Lock, R. A. (1997). Molecular analysis of putative pneumococcal virulence proteins. Microbial. Drug Resist., 3, 1–10.Google Scholar
  123. Perlino, C. A., & Rimland D. (1985). Alcoholism, leukopenia, and pneumococcal sepsis. Am. Rev. Respir. Dis., 132, 757–760.PubMedGoogle Scholar
  124. Pikis, A., Donkersloot, J. A., Akram, S., Keith, J. M., Campos, J. M., & Rodriquez, W. J. (1997). Decreased susceptibility to imipenem among penicillin-resistant Streptococcus pneumoniae. J. Antimicrob. Chemother., 40, 105–108.PubMedCrossRefGoogle Scholar
  125. Plouffe, J. F., Breiman, R. F., & Facklam, R. R. (1996). Bacteremia with Streptococcus pneumoniae. JAMA, 275, 194–198.PubMedCrossRefGoogle Scholar
  126. Redd, S. C., Rutherford, G. W. III, Sande, M. A., Lifson, A. R., Hadley, W. K., Facklam, R. R., & Spika, J. S. (1990). The role of human immunodeficiency virus infection in pneumococcal bacteremia in San Francisco residents. J. Infect. Dis., 162, 1012–1017.PubMedGoogle Scholar
  127. Reichler, M. R., Rakovsky, J., Sláciková, M., Hlavácová, B., Krajciková, L., Tarina, P., Sobotová, A., Facklam, R. R., & Breiman, R. F. (1996). Spread of multidrug-resistant Streptococcus pneumoniae among hospitalized children in Slovakia. J. Infect. Dis., 173, 374–379.PubMedGoogle Scholar
  128. Rosenow, C., Ryan, P., Weiser, J. N., Johnson, S., Fontan, P., örtqvist, Å., & Masure, H. R. (1997). Contribution of novel choline-binding proteins to adherence, colonization and immunogenicity of Streptococcus pneumoniae. Mol. Microbiol., 25, 819–829.PubMedCrossRefGoogle Scholar
  129. Rubins, J. B., Charbonneau, D., Paton, J. C., Mitchell, T. J., & Andrew, P. W. (1995). Dual function of pneumolysin in the early pathogenesis of murine pneumococcal pneumonia. J. Clin. Invest., 95, 142–150.PubMedGoogle Scholar
  130. Salo, P., Örtqvist, Å., & Leinonen, M. (1995). Diagnosis of bacteremic pneumococcal pneumonia by amplification of pneumolysin gene fragment in serum. J. Infect. Dis., 171, 479–482.PubMedGoogle Scholar
  131. Sampson, J. S., O’Connor, S. P., Stinson, A. R., Tharpe, J. A., & Russel, H. (1994). Cloning and nucleotide sequence analysis of psaA, the Streptococcus pneumoniae gene encoding a 37-kilodalton protein homologous to previously reported Streptococcus sp. adhesins. Inject. Immun., 62, 319–324.Google Scholar
  132. Sanchez, C., Armengol, R., Lite, J., Mir, I., & Garau, J. (1992). Penicillin-resistant pneumococci and community-acquired pneumonia. Lancet, 339, 988. Letter.PubMedCrossRefGoogle Scholar
  133. Sankilampi, U., Haikala, E. H. R., Liimitainen, O., Renkonen, O.-V, & Leinonen, M. (1997). Epidemiology of invasive Streptococcus pneumoniae infections in adults in Finland. Epidemiol. Infect., 118, 7–15.PubMedCrossRefGoogle Scholar
  134. Schlegel, L., Sissia, G., Fremaux, A., & Geslin, P. (1997). Invitro killing activity of combinations of beta-lactam agents with aminoglycosides against penicillin-resistant pneumococci. J. Antimicrob. Chemother., 39, 95–98.PubMedCrossRefGoogle Scholar
  135. Schönheyder, H. C., & Sorensen, H. T. (1997). Reasons for increase in pneumococcalbacteremia. Lancet, 349, 1554. Letter.PubMedGoogle Scholar
  136. Scott, J. A. G., Hall, A. J., Dagan, R., Dixon, J. M. S., Eykyn, S. J., Fenoll, A., Hortal, M., Jetté, L. P., Jörgensen, J. H., Lamothe, F., Latorre, C., Macfarlane, J. T., Smart, L. E., & Taunay, A. (1996). Serogroup-specific epidemiology of Streptococcus pneumoniae: associations with age, sex, and geography in 7000 episodes of invasive disease. Clin. Infect. Dis., 22, 973–981.PubMedGoogle Scholar
  137. Skull, S. A., Leach, A. J., & Currie, B. J. (1996). Streptococcus pneumoniae carriage and penicillin/ceftriaxone resistance in hospitalised children in Darwin. Aust. N.Z. J. Med., 26, 391–395.PubMedGoogle Scholar
  138. Soares, S., Kristinsson, K. G., Musser, J. M., & Tomasz, A. (1993). Evidence for the introduction of a multiresistant clone of serotype 6B Streptococcus pneumoniae from Spain to Iceland in the late 1980. J. Infect. Dis., 168, 158–163.PubMedGoogle Scholar
  139. Spangler, S. K., Jacobs, M. R., & Appelbaum, P. C. (1996). Activities of RPR 106972 (a new oral streptogramin), cefditoren (a new oral cephalosporin), two new oxazolidones (U-100592 and U-100766), and other oral and parenteral agents against 203 penicillin-susceptible and-resistant pneumococci. Antimicrob. Agents Chemother., 40, 481–484.PubMedGoogle Scholar
  140. Stanek, R. J., & Mufson, M. A. (1995). Emergence of penicillinresistant invasive pneumococci in a single American community. Am. J. Med. Sci., 310, 150–155.PubMedGoogle Scholar
  141. Stratton, C. W. (1986). Bacterial pneumonias—an overview with emphasis on pathogenesis, diagnosis, and treatment. Heart Lung, 15, 226–244.PubMedGoogle Scholar
  142. Szalai, A. J., Briles, D. E., & Volanakis, J. E. (1995). Human C-reactive protein is protective against fatal Streptococcus pneumoniae infection in transgenic mice. J. Immunol., 155, 2557–2563.PubMedGoogle Scholar
  143. Tan, T. Q., Mason, E. O., & Kaplan, S. L. (1992). Systemic infections due to Streptococcus pneumoniae relatively resistant to penicillin in a children’s hospital: clinical management and outcome. Pediatrics, 90, 928–933.PubMedGoogle Scholar
  144. Tilghman, R. C., & Finland, M. (1937). Clinical significance of bacteremic pneumococcal pneumonia. Arch. Intern. Med., 59, 602–619.Google Scholar
  145. Tomasz, A. (1997). Antibiotic resistance in Streptococcus pneumoniae. Clin. Infect. Dis., 24(Suppl 1), S85–S88.PubMedGoogle Scholar
  146. Torres, A., Jimenéz, P., Puig de la Bellasca, J., Celis, R., González, J., & Gea, J. (1990). Diagnostic value of nonfluoroscopic lung needle aspiration in patients with pneumonia. Chest, 98, 840–844.PubMedGoogle Scholar
  147. Trupl, J., Hupkova, H., Appelbaum, P. C., & Jacobs, M. R. (1997). The incidence of penicillin-resistant pneumococci in the Slovak republic. Chemotherapy, 43, 316–322.PubMedCrossRefGoogle Scholar
  148. Tuomanen, E., Austrian, R., & Masure, H. R. (1995). Pathogenesis of pneumococcal infection. N. Engl. J. Med., 332, 1280–1284.PubMedCrossRefGoogle Scholar
  149. Urban, C., Mariano, N., Mosinka-Snipas, K., Wadee, C., Chahrour, T., & Rahal, J. J. (1996). Comparative in-vitro activity of SCH 27899, a novel evernomicin, and vancomycin. J. Antimicrob. Chemother., 37, 361–364.PubMedGoogle Scholar
  150. Watanakunakorn, C., & Bailey, T. A. (1997). Adult bacteremic pneumococcal pneumonia in a community teaching hospital, 1992–1996. Arch. Intern. Med., 157, 1965–1971.PubMedCrossRefGoogle Scholar
  151. Watson, D. A., & Musher, D. M. (1990). Interruption of capsule expression in Streptococcus pneumoniae serotype 3 by insertion of transposon Tn916. Infect. Immun., 58, 3135–3138.PubMedGoogle Scholar
  152. Watson, D. A., Musher, D. M., & Verhoef, J. (1995). Pneumococcal virulence factors and host immune response to them. Eur. J. Clin. Microbiol. Infect. Dis., 14, 479–490.PubMedCrossRefGoogle Scholar
  153. Wimberley, N. W., Faling, L. J., & Bartlett, J. G. (1979). A fiberoptic bronchoscopy technique to obtain uncontaminated lower respiratory secretions for bacterial culture. Am. Rev. Respir. Dis., 119, 337–343.PubMedGoogle Scholar
  154. Woodhead, M. A., & Macfarlane, J. T. (1987). Comparative clinical and laboratory features of Legionella with pneumococcal and mycoplasma pneumonias. Br. J. Dis. Chest, 81, 133–139.PubMedCrossRefGoogle Scholar
  155. Woodhead, M. A., Macfarlane, J. T., Finch, R. G., & Mc-Cracken, J. S. (1990). A comparison of counter current immunoelectrophoresis and latex agglutination for the detection of pneumococcal antigen in a community based study. Serodiagn. Immunother. Infect. Dis., 4, 159–165.Google Scholar
  156. Wu, H. Y., Nahm, M. H., Guo, Y., Russel, M. W., & Briles, D. E. (1997). Intranasal immunization of mice with PspA (pneumococcal surface protein A) can prevent intranasal carriage, pulmonary infection, and sepsis with Streptococcus pneumoniae. J. Infect. Dis., 175, 839–846.PubMedCrossRefGoogle Scholar
  157. Zangwill, M. K., Vadheim, C. M., Vannier, A. M., Hemenway, L. S., Greenberg, D. P., & Ward, J. I. (1996). Epidemiology of invasive pneumococcal disease in Southern California: implications for the design and conduct of a pneumococcal conjugate vaccine efficacy trial. J. Infect. Dis., 174, 752–759.PubMedGoogle Scholar

Copyright information

© Kluwer Academic Publishers 2002

Authors and Affiliations

  • Åke Örtqvist
    • 1
  1. 1.Department of Infectious Diseases Karolinska InstitutetKarolinska HospitalStockholmSweden

Personalised recommendations