International Journal of Infectious Diseases (Aug 2019)
Hospital-onset adult invasive pneumococcal disease in Israel: Sicker patients, different pathogens
- Ariel Kenig,
- Gili Regev-Yochay,
- Shirley Khakshoor,
- Ronit Cohen-Poradosu,
- Jihad Bishara,
- Daniel Glikman,
- Mirit Hershman-Sarafov,
- Ron Dagan,
- Oren Zimhony,
- Ron Dagan,
- Marc Assous,
- Haim Ben-Zvi,
- Jihad Bishara,
- Rita Bardenstein,
- Larissa Brik,
- Bibiana Chazan,
- Michal Chowers,
- Ronit Cohen-Poradosu,
- Talia Finn,
- Alicia Embon,
- Sarit Freimann,
- Yuval Geffen,
- Danny Glikman,
- Mirit Hershman,
- Valery Istomin,
- Michal Katzir,
- Yoram Kennes,
- Shirley Khakshoor,
- Camellia Khoury-Assi,
- Mandelbaum Sari,
- Yasmin Maor,
- Danny Miron,
- Ilana Oren,
- Yosi Paitan,
- Yael Paran,
- Nehama Peled,
- Avi Peretz,
- Nurit Porat,
- Israel Potasman,
- Galia Rahav,
- Hagai Rechnitzer,
- Klaris Reisenberg,
- Shifra Sela,
- David Schwartz,
- Orna Schwartz,
- Pninit Shaked-Mishan,
- Yehudit Sheindler,
- Gill Smollan,
- Itzhak Srugo,
- Michal Stein,
- Jacob Strahilevitz,
- Olga Sverdlob,
- Violetta Temper,
- Evgenia Tsyba,
- Yonit Wiener-Well,
- Gabriel Weber,
- Miriam Weinberger,
- Oren Zimhony
Affiliations
- Ariel Kenig
- Hadassah Medical Center, Affiliated to the School of Medicine, Hebrew University, Jerusalem, Israel
- Gili Regev-Yochay
- Sheba Medical Center, Ramat-Gan, Affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Corresponding author at: Infection Prevention and Control Unit, Sheba Medical Center, Ramat-Gan, Affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
- Shirley Khakshoor
- Sheba Medical Center, Ramat-Gan, Israel
- Ronit Cohen-Poradosu
- Tel Aviv Medical Center, Affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Jihad Bishara
- Rabin Medical Center, Petach Tikva, Affiliated to the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Daniel Glikman
- Galilee Medical Center, Naharia, Affiliated to The Faculty of Medicine in the Galilee, Tzfat, Israel
- Mirit Hershman-Sarafov
- Bnai Zion Medical Center, Affiliated to the Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Ron Dagan
- Ben-Gurion University, Beer-Sheva, Israel
- Oren Zimhony
- Kaplan Medical Center, Affiliated to the School of Medicine, Hebrew University and Hadassah, Jerusalem, Israel; Corresponding author at: Infectious Diseases Unit, Kaplan Medical Center, Affiliated to the School of Medicine, Hebrew University and Hadassah, Jerusalem, Israel.
- Ron Dagan
- Marc Assous
- Haim Ben-Zvi
- Jihad Bishara
- Rita Bardenstein
- Larissa Brik
- Bibiana Chazan
- Michal Chowers
- Ronit Cohen-Poradosu
- Talia Finn
- Alicia Embon
- Sarit Freimann
- Yuval Geffen
- Danny Glikman
- Mirit Hershman
- Valery Istomin
- Michal Katzir
- Yoram Kennes
- Shirley Khakshoor
- Camellia Khoury-Assi
- Mandelbaum Sari
- Yasmin Maor
- Danny Miron
- Ilana Oren
- Yosi Paitan
- Yael Paran
- Nehama Peled
- Avi Peretz
- Nurit Porat
- Israel Potasman
- Galia Rahav
- Hagai Rechnitzer
- Klaris Reisenberg
- Shifra Sela
- David Schwartz
- Orna Schwartz
- Pninit Shaked-Mishan
- Yehudit Sheindler
- Gill Smollan
- Itzhak Srugo
- Michal Stein
- Jacob Strahilevitz
- Olga Sverdlob
- Violetta Temper
- Evgenia Tsyba
- Yonit Wiener-Well
- Gabriel Weber
- Miriam Weinberger
- Oren Zimhony
- Journal volume & issue
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Vol. 85
pp. 195 – 202
Abstract
Objectives: Invasive pneumococcal disease (IPD) usually has its onset in the community (CO-IPD), but it can commence following hospitalization (HO-IPD). This study compared HO-IPD and CO-IPD cases during the implementation of the pneumococcal conjugate vaccine (PCV) program for children in Israel. Methods: This was a nationwide retrospective cohort study of adult (age >18 years) IPD patients covering the period from the implementation of the PCV7/13 program in 2009/2010 through 2015. HO-IPD and CO-IPD were defined as IPD with onset ≥4 and ≤2 days from admission, respectively. Patient characteristics, outcome measures, serotypes, and antimicrobial susceptibility were compared for the entire cohort, followed by a matched case–control analysis. Results: The study included 114 patients with HO-IPD and 2180 with CO-IPD. After matching HO-IPD to CO-IPD patients by age, sex, and comorbidities, the mortality rate and discharge to long-term care facility rate were significantly higher for HO-IPD patients than for CO-IPD patients (44.6% vs. 26.3% and 26.5% vs. 8.2%, respectively). HO-IPD isolates were less often covered by PCV13 (39.6% vs. 49.0%) and pneumococcal polysaccharide vaccine PPSV23 (56.6% vs. 71.3%) and more often resistant to penicillin (9.3% vs. 3.6%), ceftriaxone (3.8% vs. 0.75%), and levofloxacin (9.3% vs. 0.8%). Conclusions: HO-IPD was associated with higher morbidity and mortality than CO-IPD and was more often caused by non-vaccine serotypes (primarily non-PCV13 types) and antibiotic-resistant strains. Keywords: Streptococcus pneumoniae, Invasive pneumococcal disease, Pneumococcal conjugate vaccine, Hospital onset, Nosocomial infection
