We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......

Nosocomial Pneumococcal Bacteremia

Salvador Alvarez, MD; Juan Guarderas, MD; Charles G. Shell; Shirley Holtsclaw-Berk, MS; Steven L. Berk, MD
Arch Intern Med. 1986;146(8):1509-1512. doi:10.1001/archinte.1986.00360200059010.
Text Size: A A A
Published online


• In five years we studied 56 episodes of pneumococcal bacteremia. Twenty-three (41%) were nosocomial and 33 (59%) community acquired. Most of our patients were elderly men with multiple underlying diseases; however, those patients with nosocomial infections had a significantly higher incidence of malignant neoplasms (57% vs 24%), poor functional status (70% vs 25%), and ultimately fatal underlying disease (61% vs 21%). Alcoholism was more common among the patients with community-acquired bacteremia (45% vs 17%). Nosocomial infections carried a significantly higher overall mortality (73.9% vs 45.4%). The mortality directly related to the pneumococcal bacteremia was also higher (52% vs 39%), but not significantly. Most of the isolated strains were serotypes present in the new pneumococcal vaccine, which only one study patient had received. Mixed pneumococcal bacteremia with gram-negative bacilli was more frequent in nosocomial infections. Streptococcus pneumoniae can be a nosocomial pathogen in elderly, debilitated patients. Pneumococcal vaccination should be incorporated in a hospital-based prevention program for high-risk patients.

(Arch Intern Med 1986;146:1509-1512)


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

35 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.