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Death or survival from invasive pneumococcal disease in Scotland: associations with serogroups and multilocus sequence types

Death or survival from invasive pneumococcal disease in Scotland: associations with serogroups and multilocus sequence types
Death or survival from invasive pneumococcal disease in Scotland: associations with serogroups and multilocus sequence types
We describe associations between death from invasive pneumococcal disease (IPD) and particular serogroups and sequence types (STs) determined by multilocus sequence typing (MLST) using data from Scotland. All IPD episodes where blood or cerebrospinal fluid (CSF) culture isolates were referred to the Scottish Haemophilus, Legionella, Meningococcal and Pneumococcal Reference Laboratory (SHLMPRL) from January 1992 to February 2007 were matched to death certification records by the General Register Office for Scotland. This represented 5959 patients. The median number of IPD cases in Scotland each year was 292. Deaths, from any cause, within 30 days of pneumococcal culture from blood or CSF were considered to have IPD as a contributing factor. Eight hundred and thirty-three patients died within 30 days of culture of Streptococcus pneumoniae from blood or CSF [13.95?%; 95?% confidence interval (13.10, 14.80)]. The highest death rates were in patients over the age of 75. Serotyping data exist for all years but MLST data were only available from 2001 onward. The risk ratio of dying from infection due to particular serogroups or STs compared to dying from IPD due to all other serogroups or STs was calculated. Fisher's exact test with Bonferroni adjustment for multiple testing was used. Age adjustment was accomplished using the Cochran-Mantel-Haenszel test and 95?% confidence intervals were reported. Serogroups 3, 11 and 16 have increased probability of causing fatal IPD in Scotland while serogroup 1 IPD has a reduced probability of causing death. None of the 20 most common STs were significantly associated with death within 30 days of pneumococcal culture, after age adjustment. We conclude that there is a stronger association between a fatal outcome and pneumococcal capsular serogroup than there is between a fatal outcome and ST.
0022-2615
793-802
Inverarity, Donald
07057477-80f0-46b2-bf24-4a0b74828dc0
Lamb, Karen
396c7c7e-c1ef-4912-9541-c69725a0b525
Diggle, Mathew
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Robertson, Chris
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Greenhalgh, David
211223ac-af18-47d0-b5e8-084e38558e17
Mitchell, Tim J.
d11e17e1-428b-4b7c-a0f3-4e954ea0562c
Smith, Andrew
28d2a985-1801-4e42-9a43-8061526d8e48
Jefferies, Johanna M.C.
9468e292-0b41-412d-9470-944e257c7bcf
Clarke, Stuart C.
f7d7f7a2-4b1f-4b36-883a-0f967e73fb17
McMenamin, Jim
c62f80f2-788d-4a1a-919b-129fe2707da0
Edwards, Giles F.S.
3f1eb457-5c18-4151-aeb8-71d7c56372eb
Inverarity, Donald
07057477-80f0-46b2-bf24-4a0b74828dc0
Lamb, Karen
396c7c7e-c1ef-4912-9541-c69725a0b525
Diggle, Mathew
7eace7e0-cd32-4158-9814-0ad14c7e04bf
Robertson, Chris
322804f8-8dd6-4719-89b1-b6be72562620
Greenhalgh, David
211223ac-af18-47d0-b5e8-084e38558e17
Mitchell, Tim J.
d11e17e1-428b-4b7c-a0f3-4e954ea0562c
Smith, Andrew
28d2a985-1801-4e42-9a43-8061526d8e48
Jefferies, Johanna M.C.
9468e292-0b41-412d-9470-944e257c7bcf
Clarke, Stuart C.
f7d7f7a2-4b1f-4b36-883a-0f967e73fb17
McMenamin, Jim
c62f80f2-788d-4a1a-919b-129fe2707da0
Edwards, Giles F.S.
3f1eb457-5c18-4151-aeb8-71d7c56372eb

Inverarity, Donald, Lamb, Karen, Diggle, Mathew, Robertson, Chris, Greenhalgh, David, Mitchell, Tim J., Smith, Andrew, Jefferies, Johanna M.C., Clarke, Stuart C., McMenamin, Jim and Edwards, Giles F.S. (2011) Death or survival from invasive pneumococcal disease in Scotland: associations with serogroups and multilocus sequence types. Journal of Medical Microbiology, 60 (6), 793-802. (doi:10.1099/jmm.0.028803-0). (PMID:21393453)

Record type: Article

Abstract

We describe associations between death from invasive pneumococcal disease (IPD) and particular serogroups and sequence types (STs) determined by multilocus sequence typing (MLST) using data from Scotland. All IPD episodes where blood or cerebrospinal fluid (CSF) culture isolates were referred to the Scottish Haemophilus, Legionella, Meningococcal and Pneumococcal Reference Laboratory (SHLMPRL) from January 1992 to February 2007 were matched to death certification records by the General Register Office for Scotland. This represented 5959 patients. The median number of IPD cases in Scotland each year was 292. Deaths, from any cause, within 30 days of pneumococcal culture from blood or CSF were considered to have IPD as a contributing factor. Eight hundred and thirty-three patients died within 30 days of culture of Streptococcus pneumoniae from blood or CSF [13.95?%; 95?% confidence interval (13.10, 14.80)]. The highest death rates were in patients over the age of 75. Serotyping data exist for all years but MLST data were only available from 2001 onward. The risk ratio of dying from infection due to particular serogroups or STs compared to dying from IPD due to all other serogroups or STs was calculated. Fisher's exact test with Bonferroni adjustment for multiple testing was used. Age adjustment was accomplished using the Cochran-Mantel-Haenszel test and 95?% confidence intervals were reported. Serogroups 3, 11 and 16 have increased probability of causing fatal IPD in Scotland while serogroup 1 IPD has a reduced probability of causing death. None of the 20 most common STs were significantly associated with death within 30 days of pneumococcal culture, after age adjustment. We conclude that there is a stronger association between a fatal outcome and pneumococcal capsular serogroup than there is between a fatal outcome and ST.

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Published date: June 2011
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 194781
URI: http://eprints.soton.ac.uk/id/eprint/194781
ISSN: 0022-2615
PURE UUID: 2f0e580a-e77b-40d7-9575-173a41c15b74
ORCID for Stuart C. Clarke: ORCID iD orcid.org/0000-0002-7009-1548

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Date deposited: 10 Aug 2011 13:50
Last modified: 15 Mar 2024 03:26

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Contributors

Author: Donald Inverarity
Author: Karen Lamb
Author: Mathew Diggle
Author: Chris Robertson
Author: David Greenhalgh
Author: Tim J. Mitchell
Author: Andrew Smith
Author: Johanna M.C. Jefferies
Author: Jim McMenamin
Author: Giles F.S. Edwards

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