Clinical significance of pneumococcal bacteraemias in a general hospital: a prospective study 1989-1993.

We studied 71 patients with pneumococcal bacteraemia (PB) who were hospitalized between 1989 and 1993. The Streptococcus pneumoniae was classified as penicillin-sensitive (PS) or resistant (PR). Age, sex, underlying disease (McCabe classification), and other clinical and laboratory features were recorded on admission, at discharge and one month later. The incidence of PB was 8.1/10,000/year. PB was most frequent in men (71.9%) aged below 60 years (60%), 76% of the patients acquired the infection in the community. An underlying disease of McCabe type II or III was found in 93%. Previous treatment with beta-lactam antibiotics was considered a risk factor for PRPB. Factors related to higher mortality were age above 60 years, nosocomial PB, McCabe type I underlying disease, an initially critical clinical situation, neutropenia, and inappropriate antibiotic treatment. When appropriate treatment was given, there were no significant differences between PS and PR groups in clinical course or mortality.