Journal Article

Prevalence of Human Immunodeficiency Virus Infection, Mortality Rate, and Serogroup Distribution Among Patients with Pneumococcal Bacteremia at Denver General Hospital, 1984–1994

Jonathan R. Hibbs, John M. Douglas, Franklyn N. Judson, William L. McGill, Cornelius A. M. Rietmeijer, Edward N. Janoff and Michael R. Jacobs

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 25, issue 2, pages 195-199
Published in print August 1997 | ISSN: 1058-4838
Published online August 1997 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/514538
Prevalence of Human Immunodeficiency Virus Infection, Mortality Rate, and Serogroup Distribution Among Patients with Pneumococcal Bacteremia at Denver General Hospital, 1984–1994

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Pandemics of human immunodeficiency virus (HIV) type 1 infection and penicillin resistance highlight the urgency of preventing invasive pneumococcal disease with vaccination. We characterized pneumococcal serogroup distribution and the mortality rate among 460 patients with pneumococcal bacteremia from 1984 through 1994 at Denver General Hospital and the prevalence of HIV infection in patients for whom pneumococcal bacteremia was diagnosed from 1989 to 1994. Vaccinerelated serogroups accounted for 426 isolates (92.6%), including 48 (92.3%) of 52 isolates from HIVinfected patients. Mortality among patients 15 years of age or older was higher during 1984–1988 (18 [12.9%] of 140) than during 1989–1994 (10 [5.2%] of 191: rate ratio, 2.5; 95% confidence interval, 1.2–5.2). Of patients 15–59 years of age from 1989 to 1994, 44 (39.6%) of 111 men and three (7.3%) of 41 women were HIV-infected. Four (8.5%) of 47 HIV-infected patients and four (3.8%) of 105 other patients in this group died (age-weighted rate ratio, 1.8; 95% confidence interval, 0.5–6.2). We recommend routine screening of young adults with pneumococcal bacteremia for HIV infection and immunization of HIV-infected patients with pneumococcal vaccine (which includes most serogroups of infecting strains).

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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