ISSN: 0034-8376
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ABSTRACT

Invasive and Complicated Pneumococcal Infection in Patients with Cancer

VOLUME 68 - NUMBER 5 / September - October (Original Article)

Sugehily Zarco-Márquez, Microbiology Laboratory, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
Patricia Volkow-Fernández, Department of Infectious Diseases, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
Consuelo Velázquez-Acosta, Microbiology Laboratory, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
Gabriela Echániz-Avilés, Infectious Diseases Research Center, Instituto Nacional de Salud Pública (INSP), Cuernavaca, Morelos, Mexico
María Noemí Carnalla-Barajas, Infectious Diseases Research Center, Instituto Nacional de Salud Pública (INSP), Cuernavaca, Morelos, Mexico
Araceli Soto-Noguerón, Infectious Diseases Research Center, Instituto Nacional de Salud Pública (INSP), Cuernavaca, Morelos, Mexico
Patricia Cornejo-Juárez, Department of Infectious Diseases, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico

Background: In susceptible patients, Streptococcus pneumoniae can cause complicated pneumonia and invasive pneumococcal disease. The aim of this study was to assess the clinical and antimicrobial features of complicated and invasive pneumococcal disease in patients with cancer. Methods: We conducted a retrospective study including all S. pneumoniae isolates between January 1, 2007 and December 31, 2015 in an oncology center. Capsular serotyping was done in isolates from sterile sites. Results: There were 103 episodes: 69 with invasive pneumococcal disease and 34 with complicated pneumonia. Sixty-two patients were male (60%); mean age was 50 years. Eighty-four isolates were susceptible to penicillin (81.6%), 11 (10%) were intermediate, and eight (8.3%) were resistant. Serotyping was performed in 64 isolates; the main serotypes identified were 3 (n = 13) and 19A (n = 11). No patient had a record of vaccination. Mortality at seven days attributed to pneumococcal infection was different in invasive pneumococcal disease (n = 18, 28.6%) vs. pneumonia (n = 3, 8.9%; p = 0.04). Thirty-day mortality related with the infectious process was statistically different between both groups: 21 patients with invasive pneumococcal disease (30.4%) and six with pneumonia (17.6%; p = 0.04). By logistic analysis, the risk factor associated with mortality was not having received appropriate antimicrobial treatment in the first 48 hours. Conclusions: S. pneumoniae is a pathogen related with high mortality in patients with cancer. Pneumococcal immunization needs to be reinforced in this population.

Keywords: Cancer. Invasive pneumococcal disease. Pneumonia. Streptococcus pneumoniae.

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