Thirty-day mortality risk according to serotype and antibiotic resistance in patients with bacteraemic pneumococcal pneumonia
| No of patients (column %) | No of deaths (row %) | Crude OR (95% CI) | Adjusted OR† (95% CI) | |
|---|---|---|---|---|
| Individual serotype | ||||
| 9V | 191 (12.1) | 10 (5.2) | 0.62 (0.28 to 1.40) | 0.83 (0.36 to 1.93) |
| 7F | 177 (11.2) | 4 (2.3) | 0.26 (0.09 to 0.79) | 0.51 (0.16 to 1.59) |
| 4 | 158 (10.0) | 8 (5.1) | 0.60 (0.25 to 1.43) | 0.88 (0.36 to 2.16) |
| 3 | 142 (9.0) | 17 (12.9) | 1.54 (0.76 to 3.12) | 1.85 (0.87 to 3.93) |
| 23F | 97 (6.1) | 11 (11.3) | 1.44 (0.65 to 3.21) | 1.23 (0.54 to 2.81) |
| 22F | 79 (5.0) | 7 (8.9) | 1.10 (0.44 to 2.76) | 1.25 (0.48 to 3.23) |
| 6B | 78 (4.9) | 15 (19.2) | 2.69 (1.27 to 5.69) | 2.09 (0.96 to 4.57) |
| 6A | 76 (4.8) | 10 (13.1) | 1.71 (0.75 to 3.92) | 1.17 (0.49 to 2.75) |
| 19A | 55 (3.5) | 4 (7.3) | 0.89 (0.29 to 2.75) | 0.69 (0.21 to 2.22) |
| 14 | 209 (13.2) | 17 (8.3) | 1.00 (ref) | 1.00 (ref) |
| Other | 318 (20.1) | 44 (13.8) | – | – |
| Serotype category according to CFR‡ | ||||
| High | 509 (32.2) | 63 (12.4) | 3.28 (1.89 to 5.70) | 1.63 (0.89 to 2.98) |
| Medium | 484 (30.6) | 35 (7.2) | 1.81 (1.00 to 3.28) | 1.27 (0.67 to 2.42) |
| Low | 412 (26.1) | 17 (4.1) | 1.00 (ref)* | 1.00 (ref)** |
| Serotype category according to invasiveness§ | ||||
| Low | 461 (29.2) | 58 (12.6) | 4.21 (1.89 to 9.40) | 1.67 (0.70 to 4.00) |
| Medium | 591 (37.4) | 40 (6.8) | 2.13 (0.94 to 4.82) | 1.19 (0.49 to 2.87) |
| High | 212 (13.4) | 7 (3.3) | 1.00 (ref)* | 1.00 (ref)*** |
| PCV 13 serotypes ¶ | ||||
| Yes | 1277 (80.8) | 107 (8.4) | 0.60 (0.41 to 0.89) | 0.78 (0.51 to 1.19) |
| No | 303 (19.2) | 40 (13.2) | 1.00 (ref) | 1.00 (ref) |
| Penicillin non-susceptible†† | ||||
| Yes | 45 (2.9) | 6 (13.3) | 1.52 (0.63 to 3.65) | 1.07 (0.42 to 2.74) |
| No | 1535 (97.2) | 141 (9.2) | 1.00 (ref) | 1.00 (ref) |
| Erythromycin non-susceptible†† | ||||
| Yes | 69 (4.4) | 5 (7.4) | 0.75 (0.30 to 1.90) | 0.83 (0.32 to 2.16) |
| No | 1511 (95.6) | 141 (9.4) | 1.00 (ref) | |
Significant results in bold.
p Value trend: *<0.001, **0.09, ***0.11.
†Adjusted ORs: individual serotypes and antibiotic resistance adjusted for age, sex and Charlson Index score; grouped serotypes adjusted for age, sex, smoking, alcohol and comorbidities associated with mortality at a p value of <0.1 in univariate analyses (ie, heart disease, pulmonary disease, liver disease, renal disease and solid tumour).
‡Serotypes classified as associated with low (serotype 1, 4, 5, 7F, 8), medium (serotypes 9V, 12F, 14, 22F) and high (serotypes 3, 6A, 6B, 9N, 19A, 19F, 23F) case fatality rate in a recent meta-analysis.9 There were 175 patients infected with serotypes not included in this classification.
§Serotypes classified as associated with high (serotype 1, 5 and 7F), medium (serotype 4, 9V, 14 and 18C) and low (serotype 3, 6A, 6B, 8, 19F and 23F) invasiveness.8 ,15 There were 316 patients infected with serotypes not included in this classification.
¶Serotypes included in 13-valent pneumococcal conjugate vaccine: 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F and 23F.
††Non-susceptibility for penicillin was defined as minimal inhibitory concentration ≥0.12 mg/l and for erythromycin a zone diameter of ≤21 mm.22.
CFR, case-fatality rates; PCV, pneumococcal vaccine.