Increase in Streptococcus Pneumoniae

[mixin]

I went through some of the MMWRs beginning this year, comparing the cases of Streptococcus P. this year to the same time periods last year. I'm puzzled by the large increase this year. The rates have stayed pretty much the same for children under 5 but what has happened with the "all ages" group?

Weeks ending January 9, 2010, and January 10, 2009 (1st week), Jan 16, Jan 30, Feb 27, Mar 27, April 24, May 22, June 19, July 4

All ages: cumulative 2010, cm. 2009, <5 years old: cm. 2010, cm. 2009

(All ages: 2010 =99, 2009 =89, Under 5: 2010 = 95, 2009 =43)
99, 89, 95, 43
171, 147, 183, 76
867, 283, 111, 179
2048, 663, 311, 453
3609, 1027, 603, 706
5098, 1334, 844, 977
6522, 1638, 1054, 1179
8323, 1807, 1263, 1328
8681, 1863, 1329, 1369

Then I found this older report from the New York City health dept:

The most serious pneumococcal infections (e.g., infections of the blood, joints, or central nervous system) must be reported to the New York City Department of Health. In 2003, 964 serious pneumococcal infections (invasive infections) were reported among individuals hospitalized in New York City. This represents a slight decrease from previous years.

http://www.nyc.gov/html/doh/html/cd/cdpne.shtml

But looking at the latest MMWR report, it states that NYC has 255 cases this year compared to 4 in 2009 at this time; 255 seems low for being halfway through the year.

http://www.cdc.gov/mmwr/PDF/wk/mm5926.pdf

 

[gsgs]

Re: Increase in Streptococcus Pneumoniae

the weekly numbers don't add to 8880, they say the numbers
for 2009,2010 are preliminary.

In 2009 they had 2 tables, non-resistant and resistant
in 2010 they only have one table.

Cumulative numbers in 2009 in both tables is ~5000





24,--------------------------------------------------,58 sum=4861+2823
28,25,36,23,33,23,40,15,26,101,41,34,61

99,63,107,172,168,104,207,221,233,277,174,249,249,231,223,180,127,181,195,151,118,138,93,166,156,84,97(week 27)



weeks 1-27,2009 : 3126+1732
weeks 1-27,2010 : 8880 4214

 

[Missouriwatcher]

Re: Increase in Streptococcus Pneumoniae

I believe the numbers presented in current MMWR week 27 are cumulative up to week 27 for 2009.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5927md.htm?s_cid=mm5927md_e

CDC: May 25, 2010
"Until 2000, S. pneumoniae infections caused 60,000 cases of invasive disease each year and up to 40% of these were caused by pneumococci non-susceptible to at least one drug...In the year 2008, there were 41,500 cases of invasive pneumococcal disease. Of these, 28% were caused by pneumococci non-susceptible to at least one drug and 11% were due to a strain non-susceptible to 3 or more drugs...

...Among those with pneumococcal infections, those who recently used antibiotics are more likely to have a resistant infection than those who have not.

...Widespread overuse of antimicrobial agents and the spread of resistant strains have contributed to emerging resistance..."
http://www.cdc.gov/ncidod/dbmd/diseaseinfo/drugresisstreppneum_t.htm

 

[gsgs]

Re: Increase in Streptococcus Pneumoniae

> ...Widespread overuse of antimicrobial agents and the spread of resistant > strains have contributed to emerging resistance..."
> http://www.cdc.gov/ncidod/dbmd/disea...reppneum_t.htm

so, how to treat pneumonia ? fewer antibiotics ?
compare with Tamiflu, where the fear is, that not enough is
taken to eradiate the virus which then may become resistant

 

[mixin]

Re: Increase in Streptococcus Pneumoniae

One month later, cases still continue to rise; 9387 cases so far this year. From previous MMWRs, the cases peaked in March or April and then started declining.

In one of the other MMWRs, for those <5 years old, resistant cases were around 22.6% of all cases. So 9387 total cases compared to 1977 resistant cases last year may not be so unusual.