Epidemiology of Streptococcus pneumoniae infections at the Edinburgh City Hospital: 1980-95.

We present data on pneumococcal isolates collected from deep and superficial sites over a 16-year period at the Edinburgh City Hospital. The 10 most frequent serotypes overall were 6, 19, 11, 9, 3, 14, 1, 15 and 18 in children and 19, 23, 6, 6, 9, 11 3, 15, 14, 22 and 4 in adults. Over 88% (2588/2932, 88.3%) of these pneumococci were of serotypes represented in the 23-valent polysaccharide pneumococcal vaccine. Within the 20-45 years age group, 228/434 (52.5%) of specimens were from HIV-infected individuals. The isolations showed a seasonal distribution with peaks in February and troughs in September. The annual numbers of blood culture isolates showed an upward trend. Recurrent isolations were more frequent in HIV-infected individuals (49/132, 37%) than in non-HIV-infected individuals (218/2421, 9.9%) (relative risk = 5.05, 95% confidence interval, 3.46-7.03). The prevalence of resistance to penicillin and erythromycin was lower than that reported in other parts of the UK.