Volume 28, Number 1—January 2022
Research
Streptococcus pneumoniae Serotypes Associated with Death, South Africa, 2012–2018
Table 4
Multivariable analysis of factors associated with in-hospital death among patients >15 years of age with invasive pneumococcal disease, South Africa, 2012–2018
Risk factor |
No. deaths/total no. (%) |
Unadjusted OR (95% CI) |
p value |
Adjusted OR (95% CI) |
p value |
---|---|---|---|---|---|
Serotype | |||||
4 | 64/208 (30.8) | 0.9 (0.6–1.2) | 0.406 | 1.1 (0.7–1.8) | 0.541 |
6B | 14/34 (41.2) | 1.3 (0.7–2.8) | 0.415 | 1.6 (0.7–1) | 0.296 |
9V | 7/31 (22.6) | 0.6 (0.2–1.3) | 0.194 | 0.6 (0.2–1.8) | 0.344 |
14 | 20/54 (37.0) | 1.1 (0.6–2.1) | 0.681 | 1.5 (0.8–3) | 0.236 |
18C | 13/37 (35.1) | 1 (0.5–2.1) | 0.907 | 0.7 (0.3–1.9) | 0.524 |
19F | 47/109 (43.1) | 1.5 (0.9–2.3) | 0.091 | 1.5 (0.9–2.5) | 0.154 |
23F | 31/79 (39.2) | 1.2 (0.8–2.1) | 0.395 | 1.6 (0.9–2.9) | 0.127 |
1 | 87/202 (43.1) | 1.5 (1–2.1) | 0.038 | 1.7 (1.1–2.7) | 0.017 |
3 | 88/251 (35.1) | 1 (0.7–1.5) | 0.823 | 1.1 (0.8–1.7) | 0.524 |
5 | 7/14 (50.0) | 1.9 (0.7–5.6) | 0.230 | 2.3 (0.7–7.8) | 0.180 |
6A | 42/87 (48.3) | 1.8 (1.1–2.9) | 0.015 | 1.6 (0.9–2.8) | 0.127 |
7F | 23/79 (29.1) | 0.8 (0.5–1.3) | 0.388 | 1 (0.5–1.8) | 0.885 |
19A | 97/306 (31.7) | 0.9 (0.6–1.2) | 0.499 | 1.3 (0.9–2) | 0.176 |
2 | 1/2 (50.0) | 1.9 (0.1–31.1) | 0.644 | 4.5 (0.3–74.4) | 0.288 |
8 | 121/354 (34.2) | Referent | Referent | Referent | Referent |
9N | 34/112 (30.4) | 0.8 (0.5–1.3) | 0.454 | 1.3 (0.8–2.3) | 0.307 |
10A | 35/84 (41.7) | 1.4 (0.8–2.2) | 0.199 | 1.5 (0.8–2.6) | 0.185 |
11A | 12/34 (35.3) | 1.1 (0.5–2.2) | 0.896 | 0.9 (0.3–2.7) | 0.881 |
12F | 97/307 (31.6) | 0.9 (0.6–1.2) | 0.481 | 0.8 (0.5–1.2) | 0.250 |
15B/C | 38/80 (47.5) | 1.7 (1.1–2.8) | 0.027 | 2.1 (1.2–3.7) | 0.010 |
17F | 23/87 (26.4) | 0.7 (0.4–1.2) | 0.169 | 0.7 (0.4–1.3) | 0.250 |
20 | 2/13 (15.4) | 0.4 (0.1–1.6) | 0.177 | 0.3 (0–2.8) | 0.309 |
22F | 39/99 (39.4) | 1.3 (0.8–2) | 0.338 | 1.3 (0.7–2.2) | 0.413 |
33F | 3/11 (27.3) | 0.7 (0.2–2.8) | 0.635 | 0.8 (0.2–3.9) | 0.781 |
16F | 52/121 (43.0) | 1.5 (1–2.2) | 0.083 | 1.6 (1–2.7) | 0.066 |
15A | 42/104 (40.1) | 1.3 (0.8–2) | 0.246 | 1.2 (0.6–2) | 0.629 |
13 | 19/71 (26.8) | 0.7 (0.4–1.2) | 0.226 | 0.8 (0.4–1.6) | 0.534 |
7C | 20/59 (33.9) | 1 (0.6–1.8) | 0.966 | 1.4 (0.7–2.7) | 0.342 |
35B | 19/52 (36.5) | 1.1 (0.6–2) | 0.738 | 1 (0.5–2.1) | 0.922 |
23A | 19/62 (30.7) | 0.9 (0.5–1.5) | 0.587 | 0.6 (0.3–1.2) | 0.141 |
6C |
11/34 (32.4) |
0.9 (0.4–2) |
0.830 |
0.8 (0.3–2) |
0.590 |
Age group, y | |||||
15–24 | 86/282 (30.5) | Referent | Referent | Referent | Referent |
25–44 | 549/1,738 (31.6) | 1.1 (0.8–1.4) | 0.714 | 1.2 (0.8–1.7) | 0.392 |
45–64 | 385/917 (42.0) | 1.6 (1.2–2.2) | 0.001 | 2 (1.4–2.9) | <0.001 |
>65 |
107/240 (44.6) |
1.8 (1.3–2.6) |
0.001 |
3.1 (1.8–5.2) |
<0.001 |
Sex | |||||
F | 557/1,679 (33.2) | Referent | Referent | Referent | Referent |
M |
568/1,495 (38.0) |
1.2 (1.1–1.4) |
0.005 |
1.3 (1.1–1.6) |
0.003 |
HIV status† | |||||
Negative | 154/556 (27.7) | Referent | Referent | Referent | Referent |
Positive |
618/2,007 (30.8) |
1.2 (0.9–1.4) |
0.160 |
1.3 (1–1.7) |
0.021 |
Diagnosis‡ | |||||
Nonmeningitis | 607/2,138 (28.4) | Referent | Referent | Referent | Referent |
Meningitis |
520/1,039 (50.1) |
2.5 (2.2–2.9) |
<0.001 |
2.8 (2.3–3.4) |
<0.001 |
Year | |||||
2012 | 205/555 (36.9) | 1.4 (1.1–1.8) | 0.013 | 1.1 (0.8–1.5) | 0.549 |
2013 | 144/486 (29.6) | Referent | Referent | Referent | Referent |
2014 | 143/407 (35.1) | 1.3 (1–1) | 0.08 | 1.1 (0.8–1.5) | 0.626 |
2015 | 177/465 (38.1) | 1.5 (1.1–1.9) | 0.006 | 1.4 (1.0–2.0) | 0.031 |
2016 | 168/449 (37.4) | 1.4 (1.1–1.9) | 0.012 | 1.3 (0.9–1.8) | 0.106 |
2017 | 159/447 (35.6) | 1.3 (1–1.7) | 0.053 | 1.3 (0.9–1.8) | 0.140 |
2018 |
131/368 (35.6) |
1.3 (1–1.8) |
0.065 |
1.4 (1.0–1.9) |
0.082 |
Province | |||||
Eastern Cape | 77/217 (35.5) | 0.8 (0.5–1.3) | 0.406 | ||
Free State | 55/138 (39.9) | Referent | Referent | ||
Gauteng | 410/1,219 (33.6) | 0.8 (0.5–1.1) | 0.145 | ||
KwaZulu–Natal | 176/505 (34.9) | 0.8 (0.5–1.2) | 0.278 | ||
Limpopo | 29/56 (51.8) | 1.6 (0.9–3) | 0.130 | ||
Mpumalanga | 65/139 (46.8) | 1.3 (0.8–2.1) | 0.246 | ||
Northern Cape | 63/178 (35.4) | 0.8 (0.5–1.3) | 0.416 | ||
North West | 42/93 (45.2) | 1.2 (0.7–2.1) | 0.423 | ||
Western Cape | 210/632 (33.2) | 0.8 (0.5–1.1) | 0.138 |
*Underlying medical conditions as a risk factor was analyzed but not significant in the univariate model. Empty fields indicate that the model did not calculate numbers due to small amount of data, or it was not included in the final multivariable model. Factors evaluated in the univariable model but not significant were race and province. †HIV status was not significant upon initial multivariate analysis but was kept in the final analysis because of the high percentage of HIV positive cases in our study population (78%). ‡Meningitis cases include patients diagnosed with meningitis and those simultaneously diagnosed with meningitis and lower respiratory tract infection; nonmeningitis cases include all other cases.