RESUMO
OBJECTIVES: to analyze the epidemiology, the clinical spectrum, and to identify prognostic factors for pneumococcal bacteremia (PB). PATIENTS AND METHOD: adult patients (age>14 years) diagnosed of PB in the "Carlos Haya" University Hospital at Malaga (Spain) were selected between 1995 and 2000. A protocol was drawn up for the collection of data which included epidemiological characteristics, underlying diseases, symptoms and findings on the physical examination at admission, laboratory values, chest radiography features, and patient evolution. To identify prognostic factors was carried out multivariate analysis by logistic regression. RESULTS: One hundred twenty-three cases of PB were included. The mean age was 56.2+/-18.3 years, 71.5% occurred in males. The overall annual incidence of PB was of 5.5 cases/100,000 population. Most common underlying diseases were chronic obstructive pulmonary disease (26%), alcoholism (21.1%), liver cirrhosis (21.1%), HIV infection (19.5%), and neoplasia (25%). Lungs were more frequent source of infection (71.5%). No source of bacteremia was identified in 13 (10.6%) cases. Resistance rate to penicillin was 36.6%. Mortality rate 30.1%. In the multivariate analysis, the independent prognostic factors for mortality were hyperazotemia, multi-lobe involvement, and presence of shock CONCLUSIONS: There is a high incidence of PB in patients with underlying diseases. Lung is the most common source of bacteremia. Mortality rate was high. Prognostic factors were identified.
