Volume 18, Number 5—May 2012
Research
Epidemic of Invasive Pneumococcal Disease, Western Canada, 2005–2009
, 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
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.
1Current affiliation: University of British Columbia, Vancouver, British Columbia, Canada.
2Current affiliation: Dalhousie University, Halifax, Nova Scotia, Canada.