Penicillin-resistant pneumococcal disease is not related to worse clinical outcomes in immunocompromised patients

Despite the concept of more forms of invasive disease be related to penicillin-resistant Streptococcus pneumoniae, in the general population the clinical outcomes are not worse than for penicillin susceptible disease. However, specifically for immunocompromised patients, it is still unknown if the penicillin-resistant pneumococcal infection related clinical outcomes are worse. Purpose: To compare the clinical outcomes of penicillin-resistant S. pneumoniae infections between immunocompromised (IC-) and immunocompetent (IC+) patients. Methods: A cross-sectional study was performed in a tertiary hospital, between Sep/2011 and Apr/2018. All patients with a positive culture to S. pneumoniae isolated from blood, cerebrospinal fluid, abdominal fluid or synovial fluid were evaluated. Clinical outcomes of mechanical ventilation, ICU admission and death were compared between IC- and IC+. For the study purpose, IC+ patients were defined as having at least one of the following: HIV+, active significant hematological, oncological or liver diseases, chronic renal failure, diabetes, pregnancy. Results: 133 patients were included (75 male, mean age 51,6 years). Pneumonia was the most frequent diagnosis (82,7%), and blood culture was the most frequent source. 89 (66,9%) subjects were in the IC- group. Penicillin-resistant S. pneumoniae overall prevalence was 8,3% (11), while 6,7% (6) in the IC- group, and 11,4% (5) in the IC+ group. There was no significant difference in evaluated clinical outcomes between the IC- or IC+ patients (p>0,05). Conclusion: There was no association between penicillin-resistant S. pneumoniae and worse clinical outcomes in the immunocompromised patients.