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Volume 18, Number 11—November 2012

Dispatch

Streptococcus pneumoniae Serotype 15A in Psychiatric Unit, Rhode Island, USA, 2010–2011

Katherine Fleming-DutraComments to Author , Chukwuma Mbaeyi, Ruth Link-Gelles, Nicole Alexander, Alice Guh, Elizabeth Forbes, Bernard Beall, Jonas M. Winchell, Maria da Gloria Carvalho, Fabiana Pimenta, Maja Kodani, Cindy Vanner, Hilary Stevens, Diane Brady, Mardea Caulcrick-Grimes, Utpala Bandy, and Matthew R. Moore
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (K. Fleming-Dutra, C. Mbaeyi, R. Link-Gelles, A. Guh, B. Beall, J.M. Winchell, M.G. Carvalho, F. Pimenta, M. Kodani, H. Stevens, M.R. Moore); Rhode Island Department of Health, Providence, Rhode Island, USA (N. Alexander, C. Vanner, D. Brady, M. Caulcrick-Grimes, U. Bandy); Brown University–affiliated Hospitals, Providence (N. Alexander); Brown University, Providence (E. Forbes)

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Table 2

Cases, clinical isolates, and results of pneumococcal carriage and respiratory pathogen survey associated with Streptococcus pneumoniae serotype 15A outbreak, Rhode Island, USA, December 25, 2010–January 31, 2011*

Case status Case no. Onset date Culture date, specimen and result Chest imaging results Treatment Outcome Carriage Sero Other pathogens by TAC†
IPD S1 Jan 9 Jan 14, blood, S. pneumoniae 15A Right upper lobe pneumonia Moxifloxacin Rec Neg Neg
IPD P1 Jan 11 Jan 25, blood, S. pneumoniae 15A Negative Ceftriaxone Rec Pos 15A Rhinovirus, adenovirus
Noninvasive pneumococcal disease P2 Jan 2 Jan 28, otorrhea, S. pneumoniae 15A Cefuroxime, topical ofloxacin Rec Pos 15A Mycoplasma pneumoniae
Confirmed pneumonia P3 Jan 2 Left lower lobe pneumonia Amoxicillin/ clavulanate, azithromycin Rec Pos NT‡ Rhinovirus
Confirmed pneumonia S2 Jan 5 Left upper lobe pneumonia Amoxicillin/ clavuanate, ciprofloxacin Rec NS NS
Confirmed pneumonia V1 Jan 15 Right basilar pneumonia Moxifloxacin Rec NS NS
Confirmed pneumonia P4 Jan 18 Right lower lobe pneumonia Ceftriaxone, ampicillin, amoxicillin Rec Neg M. pneumoniae
Confirmed pneumonia V2 Feb 4 Left lower lobe pneumonia Doxycycline, levofloxacin Rec NS NS
Confirmed pneumonia§ V3 Feb 23 Left lower lobe pneumonia Unk Unk NS NS
Suspected pneumonia S3 Jan 11 Azithromycin Rec NS NS
Suspected pneumonia P5 Jan 13 Clindamycin Rec Neg Neg
Non-case P6 Neg S. pyogenes
Non-case P7 Neg Adenovirus
Non-case P8 Neg Neg
Non-case P9 Pos 34 S. pyogenes
Non-case P10 Neg Neg
Non-case P11 Pos 15A Enterovirus
Non-case P12 Pos 15A Neg
Non-case P13 Pos 11 A/D, 20 S. pyogenes
Non-case P14 Neg Neg
Non-case P15 Pos 15A Rhinovirus, M. pneumoniae
Non-case P16 Pos 15A M. pneumoniae
Non-case S4 Neg Rhinovirus
Non-case S5 Neg Neg
Non-case S6 Neg S. pyogenes

*Sero, serotype; TAC, TaqMan Array Card; IPD, invasive pneumococcal disease; S, staff; rec, recovered; neg, negative; P, patient; pos, positive; NS, no carriage screen; V, visitor; NT, nontypeable; Unk, unknown.
†TAC used to test for influenza viruses A (H1 and H3) and B, respiratory syncytial virus, human parainfluenza viruses 1–3, human metapneumovirus, rhinovirus, enterovirus, parechovirus, adenovirus, Legionella species, Haemophilus influenzae, Streptococcus pyogenes, Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Bordetella pertussis.
‡NT by real-time PCR (for serotypes: 1, 2, 3, 4, 5, 6A/B/C, 6C, 7F/7A, 9V/9A, 11A/11D, 12F/(12A/44/46), 14, 15A/15F, 16F, 18/(18A/18B/18C/18F), 19A, 19F, 22F/22A, 23A, 23F, 33F/33A/37).
§Refused further involvement with investigation.

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