High incidence of septic shock caused by Streptococcus pneumoniae serotype 3-a retrospective epidemiological study
Ahl, Jonas LU ; Littorin, Nils LU ; Forsgren, Arne LU ; Odenholt, Inga LU ; Resman, Fredrik LU and Riesbeck, Kristian LU
(2013)
In BMC Infectious Diseases
13.
- Abstract
- Background: More than 90 immunologically distinct serotypes of Streptococcus pneumoniae exist, and it is not fully elucidated whether the serotype is a risk factor for severity of invasive pneumococcal disease (IPD). Our hypothesis is that serotypes differ in their capacity to cause septic shock. Methods: We performed a retrospective study in Southern Sweden based upon 513 patients with IPD in the pre-vaccine era 2006-2008. The serotype, co-morbidity, and sepsis severity were determined. Serotypes were compared to serotype 14 as a reference and grouped according to their invasive potential, that is, high (serogroups 1, 5 and 7), intermediate (serogroups 4, 9, 14 and 18) and, finally, low invasive potential (serogroups 3, 6, 8, 15, 19, 23... (More)
- Background: More than 90 immunologically distinct serotypes of Streptococcus pneumoniae exist, and it is not fully elucidated whether the serotype is a risk factor for severity of invasive pneumococcal disease (IPD). Our hypothesis is that serotypes differ in their capacity to cause septic shock. Methods: We performed a retrospective study in Southern Sweden based upon 513 patients with IPD in the pre-vaccine era 2006-2008. The serotype, co-morbidity, and sepsis severity were determined. Serotypes were compared to serotype 14 as a reference and grouped according to their invasive potential, that is, high (serogroups 1, 5 and 7), intermediate (serogroups 4, 9, 14 and 18) and, finally, low invasive potential (serogroups 3, 6, 8, 15, 19, 23 and 33). Results: Patients with S. pneumoniae serotype 3 had significantly more often septic shock (25%, odds ratio (OR) 6.33 [95% confidence interval (CI) 1.59-25.29]), higher mortality (30%, OR 2.86 [CI 1.02-8.00]), and more often co-morbidities (83%, OR 3.82 [CI 1.39-10.54]) when compared to serotype 14. A significant difference in age and co-morbidities (p= 0.001) was found when patient data were pooled according to the invasive potential of the infecting pneumococci. The median age and percentage of patients with underlying co-morbidities were 72 years and 79%, respectively, for serogroups associated with low invasiveness, 68 years and 61%, respectively, for serogroups with intermediate invasiveness, and, finally, 62 years and 48%, respectively, for serogroups with high invasiveness. No difference in sepsis severity was found between the three groups. Conclusions: S. pneumoniae serotype 3 more often caused septic shock compared to serotype 14. Our results support the hypothesis that serotypes with high invasiveness mainly cause IPD in younger patients with less co-morbidities. In contrast, serogroups with low and intermediate invasive potential mostly cause IPD in the elderly with defined co-morbidities, and thus can be considered as opportunistic. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/4272104
- author
- Ahl, Jonas
LU
; Littorin, Nils
LU
; Forsgren, Arne
LU
; Odenholt, Inga
LU
; Resman, Fredrik
LU
and Riesbeck, Kristian
LU
- organization
- publishing date
- 2013
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Invasive pneumococcal disease, Sepsis, Serotype 3, Serotype 19F, Streptococcus pneumoniae
- in
- BMC Infectious Diseases
- volume
- 13
- article number
- 492
- publisher
- BioMed Central (BMC)
- external identifiers
-
- wos:000328902100004
- scopus:84886878416
- pmid:24148181
- ISSN
- 1471-2334
- DOI
- 10.1186/1471-2334-13-492
- project
- Bacterial respiratory tract infections - aspects on virulence, epidemiology and future vaccines
- language
- English
- LU publication?
- yes
- id
- 6026ee36-e11c-4ede-857c-de9a62f2fd54 (old id 4272104)
- date added to LUP
- 2016-04-01 13:01:32
- date last changed
- 2022-03-13 21:44:43
@article{6026ee36-e11c-4ede-857c-de9a62f2fd54,
abstract = {{Background: More than 90 immunologically distinct serotypes of Streptococcus pneumoniae exist, and it is not fully elucidated whether the serotype is a risk factor for severity of invasive pneumococcal disease (IPD). Our hypothesis is that serotypes differ in their capacity to cause septic shock. Methods: We performed a retrospective study in Southern Sweden based upon 513 patients with IPD in the pre-vaccine era 2006-2008. The serotype, co-morbidity, and sepsis severity were determined. Serotypes were compared to serotype 14 as a reference and grouped according to their invasive potential, that is, high (serogroups 1, 5 and 7), intermediate (serogroups 4, 9, 14 and 18) and, finally, low invasive potential (serogroups 3, 6, 8, 15, 19, 23 and 33). Results: Patients with S. pneumoniae serotype 3 had significantly more often septic shock (25%, odds ratio (OR) 6.33 [95% confidence interval (CI) 1.59-25.29]), higher mortality (30%, OR 2.86 [CI 1.02-8.00]), and more often co-morbidities (83%, OR 3.82 [CI 1.39-10.54]) when compared to serotype 14. A significant difference in age and co-morbidities (p= 0.001) was found when patient data were pooled according to the invasive potential of the infecting pneumococci. The median age and percentage of patients with underlying co-morbidities were 72 years and 79%, respectively, for serogroups associated with low invasiveness, 68 years and 61%, respectively, for serogroups with intermediate invasiveness, and, finally, 62 years and 48%, respectively, for serogroups with high invasiveness. No difference in sepsis severity was found between the three groups. Conclusions: S. pneumoniae serotype 3 more often caused septic shock compared to serotype 14. Our results support the hypothesis that serotypes with high invasiveness mainly cause IPD in younger patients with less co-morbidities. In contrast, serogroups with low and intermediate invasive potential mostly cause IPD in the elderly with defined co-morbidities, and thus can be considered as opportunistic.}},
author = {{Ahl, Jonas and Littorin, Nils and Forsgren, Arne and Odenholt, Inga and Resman, Fredrik and Riesbeck, Kristian}},
issn = {{1471-2334}},
keywords = {{Invasive pneumococcal disease; Sepsis; Serotype 3; Serotype 19F; Streptococcus pneumoniae}},
language = {{eng}},
publisher = {{BioMed Central (BMC)}},
series = {{BMC Infectious Diseases}},
title = {{High incidence of septic shock caused by Streptococcus pneumoniae serotype 3-a retrospective epidemiological study}},
url = {{https://lup.lub.lu.se/search/files/3111938/4588287}},
doi = {{10.1186/1471-2334-13-492}},
volume = {{13}},
year = {{2013}},
}