Volume 24, Number 7—July 2018
Research
Pneumococcal Meningitis in Adults after Introduction of PCV7 and PCV13, Israel, July 2009–June 20151
, Klaris Reisenberg, Michal Katzir, Yonit Wiener-Well, Galia Rahav, Jacob Strahilevitz, Valery Istomin, Evgenia Tsyba, Avi Peretz, Shirley Khakshoor, Ron Dagan, on behalf of the Israeli Adult Invasive Pneumococcal Disease Group
Table 1
Univariate analysis of the characteristics of patients with meningitis IPD and nonmeningitis IPD by IPD source, Israel, July 1, 2009–June 30, 2015*
| Variable |
Meningitis IPD, n = 221 |
Nonmeningitis IPD, n = 2,124† | p value§ |
|||
|---|---|---|---|---|---|---|
| Pneumonia |
Bacteremia, no source |
IPD, rare types‡ |
All |
|||
| Population with full data available |
213 |
1,596 |
301 |
203 |
2,124 |
|
| Sex¶ | ||||||
| M | 104 (48.6) | 890 (55.8) | 171 (56.8) | 108 (53.2) | 1,182 (55.7) | 0.047 |
| F |
110 (51.4) |
704 (44.2) |
130 (43.2) |
95 (46.8) |
940 (44.3) |
|
| Jewish ethnicity¶ |
166 (75.5) |
1,157 (72.6) |
221 (73.7) |
154 (75.9) |
1,551 (73.0) |
0.46 |
| Age, y¶ | <0.0001 | |||||
| Mean | 57.68 | 64.83 | 61.83 | 64.03 | 64.37 | |
| Median (range) | 61.47 (18.2–91.3) | 66.53 (18.1–105.0) | 65.45 (18.1–98.3) | 66.91 (18.1–97.8) | 66.35 (18.1–105.0) | |
| 18–49 | 72 (32.6) | 368 (23.1) | 74 (24.6) | 45 (22.2) | 491 (23.1) | |
| 50–64 | 68 (30.8) | 382 (23.9) | 75 (24.9) | 47 (23.2) | 510 (24.0) | |
| >65 |
81 (36.7) |
846 (53.0) |
152 (50.5) |
111 (54.7) |
1,123 (52.9) |
|
| Concurrent medical conditions | ||||||
| Any | 186 (87.3) | 1,481 (92.8) | 287 (95.4) | 189 (93.1) | 1,972 (92.8) | 0.004 |
| High risk and at risk | 130 (61.0) | 1,093 (68.5) | 233 (77.4) | 156 (76.49) | 1,495 (70.4) | 0.005 |
| High risk | 81 (38.0) | 645 (40.4) | 179 (59.5) | 107 (52.7) | 939 (44.2) | 0.083 |
| Any immunosuppression | 16 (7.5) | 187 (11.7) | 61 (20.3) | 35 (17.2) | 285 (13.4) | 0.014 |
| Bone marrow transplantation | 4 (1.9) | 42 (2.6) | 17 (5.7) | 12 (5.9) | 71 (3.3) | 0.248 |
| HIV | 0 | 33 (2.1) | 3 (1.0) | 3 (1.5) | 39 (1.8) | 0.046 |
| Hematologic malignancy | 19 (8.9) | 208 (13.0) | 68 (22.6) | 41 (20.2) | 320 (15.1) | 0.015 |
| Metastatic cancer | 3 (1.4) | 73 (4.6) | 34 (11.3) | 8 (3.9) | 116 (5.5) | 0.010 |
| Asplenia | 9 (4.2) | 26 (1.6) | 18 (6.0) | 14 (6.9) | 58 (2.7) | 0.213 |
| Chronic renal failure | 14 (6.6) | 277 (17.4) | 46 (15.3) | 35 (17.2) | 363 (17.1) | <0.0001 |
| Previous neurosurgery, CSF leak | 43 (20.2) | 29 (1.8) | 6 (2.0) | 7 (3.5) | 42 (2.0) | <0.0001 |
| At risk | 49 (23.0) | 448 (28.1) | 54 (17.9) | 49 (24.1) | 556 (26.2) | 0.314 |
| Congestive heart failure | 13 (6.1) | 270 (16.9) | 38 (12.6) | 36 (17.7) | 350 (16.5) | <0.0001 |
| Chronic lung disease | 20 (9.4) | 358 (22.5) | 35 (11.6) | 29 (14.3) | 425 (20.0) | 0.0002 |
| Cirrhosis | 2 (0.9) | 29 (1.8) | 16 (5.3) | 17 (8.4) | 62 (2.9) | 0.091 |
| Diabetes mellitus | 47 (22.1) | 437 (27.4) | 87 (28.9) | 54 (26.6) | 584 (27.5) | 0.089 |
| Alcohol abuse |
3 (1.4) |
51 (3.2) |
10 (3.3) |
8 (3.9) |
69 (3.3) |
0.138 |
| Healthy | 27 (12.7) | 115 (7.2) | 14 (4.7) | 14 (6.9) | 152 (7.2) | 0.004 |
*Values are no. (%) except as indicated. CSF, cerebospinal fluid; IPD, invasive pneumococcal disease.
†The source of 24 nonmeningitis IPD cases was not reported, so these cases were only included in the “All” column.
‡These IPD cases occurred after endocarditis, sinusitis, mastoiditis, peritonitis, endometritis, osteomyelitis, cellulitis, or septic arthritis; a few resulted from abscesses in various locations.
§p value of meningitis vs. nonmeningitis IPD cases. Bold indicates significance.
¶The denominators are the total number of cases with information available pertaining to the relevant variable.
1Some results from this study were presented at the 10th International Symposium on Pneumococci and Pneumococcal Diseases, June 26–30, 2016, Glasgow, Scotland.
2Additional members of the Israeli Adult Invasive Pneumococcal Disease Group are listed at the end of this article.