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Volume 18, Number 5—May 2012

Research

Epidemic of Invasive Pneumococcal Disease, Western Canada, 2005–2009

Gregory J. TyrrellComments to Author , Marguerite Lovgren, Quazi Ibrahim, Sipi Garg, Linda Chui, Tyler J. Boone, Carol Mangan, David M. Patrick1, Linda Hoang, Greg B. Horsman, Paul Van Caeseele, and Thomas J. Marrie2
Author affiliations: Provincial Laboratory for Public Health (Microbiology) Edmonton, Alberta, Canada (G.J. Tyrrell, M. Lovgren, Q. Ibrahim, S. Garg, L Chui, T.J. Boone, C. Mangan, T.J. Marrie); University of Alberta, Edmonton (G.J. Tyrrell, M. Lovgren, Q. Ibrahim, S. Garg, L Chui, T.J. Boone, C. Mangan, T.J. Marrie); British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada (D.M. Patrick, L. Hoang); Saskatchewan Disease Control Laboratory, Regina, Saskatchewan, Canada (G.B. Horsman); Cadham Provincial Laboratory, Winnipeg, Manitoba, Canada (P. Van Caeseele)

Main Article

Table 1

Characteristics of 1,112 patients with pneumococcal disease, northern Alberta, Canada, 2005–2009*

Characteristic Total Streptococcus pneumoniae serotype
p value
Not serotype 5, n = 827 Serotype 5, n = 285
Demographic
Age, mean ± SD, y 45.4 ± 22.5 47.1 ± 23.9 40.6 ± 16.7 <0.001
Age group, y
<16 137 (12.3) 119 (14.4) 18 (6.3) <0.001
16–65 771 (69.3) 522 (63.1) 249 (87.4)
>65 204 (18.4) 186 (22.5) 18 (6.3)
Male sex 659 (59.3) 471 (57.0) 188 (66.2) 0.006
First Nations heritage 145 (13.0) 83 (10.0) 62 (21.8) <0.001
Homeless. 85 (7.6) 39 (4.7) 46 (16.1) <0.001
Substance abuse
Tobacco 687 (61.8) 471 (57.0) 216 (75.8) <0.001
Alcoholism 257 (23.1) 159 (19.2) 98 (34.4) <0.001
Illicit drug 259 (23.3) 135 (16.3) 124 (43.5) <0.001
Concurrent conditions
Cancer 103 (9.3) 96 (11.6) 7 (2.5) <0.001
<5 y before IPD 103 (9.3) 96 (11.6) 7 (2.5) <0.001
>5 y before IPD 41 (3.7) 33 (4.0) 8 (2.8) 0.361
Central nervous system disorder† 167 (15.0) 135 (16.3) 32 (11.2) 0.038
Cardiovascular disease‡ 317 (28.5) 281 (34.0) 36 (12.6) <0.001
Hematologic abnormality§ 80 (7.2) 76 (9.2) 4 (1.4) <0.001
Diabetes mellitus 134 (12.1) 119 (14.4) 15 (5.3) <0.001
Cirrhosis 53 (4.8) 48 (5.8) 5 (1.8) 0.006
Chronic renal failure¶ 48 (4.3) 46 (5.6) 2 (0.7) <0.001
HIV/AIDS 46 (4.1) 29 (3.5) 17 (6.0) 0.072
Rheumatoid arthritis 21 (1.9) 19 (2.3) 2 (0.7) 0.088
Systemic lupus erythematosus 9 (0.8) 8 (1.0) 1 (0.4) 0.461
Mental problem# 180 (16.2) 141 (17.0) 39 (13.7) 0.183
Musculoskeletal impairment** 201 (18.1) 172 (20.8) 29 (10.2) <0.001
Chronic obstructive pulmonary disease 161 (14.5) 131 (15.8) 30 (10.5) 0.028
Hepatitis C 157 (14.1) 91 (11.0) 66 (23.2) <0.001
Type of pneumococcal disease
Bacteremia 1054 (94.8) 782 (94.6) 272 (95.4) 0.564
Pneumonia 887 (79.8) 617 (74.6) 270 (94.7) <0.001
Meningitis 68 (6.1) 66 (8.0) 2 (0.7) <0.001
Outcome
Death 126 (11.3) 117 (14.1) 9 (3.2) <0.001
Hospitalization
No. hospitalized 826 581 245
Length of stay, d, mean ± SD 17.9 ± 39.7 20.1 ± 46.4 12.9 ± 13.1 0.001

*All values are no. (%) unless indicated otherwise. IPD, invasive pneumococcal disease.
†Chronic central nervous system leak, epilepsy or other seizure disorder, Parkinsonism or other neurodegenerative disorder, Alzheimer or other dementia, or stroke or other neurologic disease.
‡Congestive heart failure, coronary artery disease, myocardial infarction, arrhythmia, congenital defect, atrial fibrillation, hypertension, or other.
§Sickle cell anemia, other anemia, bleeding disorder/coagulopathy, or other.
¶Nephritic syndrome or other.
#Depression or other.
**Osteoarthritis, osteoporosis, or other.

Main Article

1Current affiliation: University of British Columbia, Vancouver, British Columbia, Canada.

2Current affiliation: Dalhousie University, Halifax, Nova Scotia, Canada.

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