Clinical and Epidemiological Description of Cases of Invasive Pneumococcal Disease Admitted to a Referral Cardiology Hospital

Invasive pneumococcal disease (IPD) is defined as any infection by Streptococcus pneumoniae with isolation of the pathogen from a normally sterile site, such as blood or cerebrospinal fluid (CSF). Although it can affect any age group, the extremes of age are at higher risk. The presence of comorbidities such as cardiovascular, renal, and respiratory diseases is associated with higher mortality. We aimed to analyze the demographic and clinical profile of patients with IPD in a tertiary cardiology hospital, assessing clinical presentations, comorbidities, empirical antimicrobial coverage, susceptibility profile of isolates, and outcomes including ICU admission, need for invasive mechanical ventilation, and in-hospital mortality. We reviewed the medical records of all patients admitted between July 2017 and May 2025 to a tertiary cardiology hospital who had positive cultures for Streptococcus pneumoniae from sterile sites (blood, CSF, or pleural fluid). Of the 59 identified cases, 48 were analyzed (excluding transferred patients or those without digitized records). Among the 48 cases analyzed, the median age was 69 years, with a predominance of males (64.6%). Hypertension was present in 73% (n=35), type 2 diabetes mellitus in 42% (n=20), coronary artery disease in 35% (n=17), and heart failure in 46% (n=22). Pneumonia was the infectious focus in 85% of cases, and all patients (100%) received at least one antimicrobial with antipneumococcal activity. Around 48% of patients were admitted to the ICU (n=22) and required mechanical ventilation. Most isolates were susceptible to penicillins, with 88% classified as susceptible and 10% with intermediate susceptibility; no resistant strains were identified. All samples were also susceptible to ceftriaxone and vancomycin (100%). The median length of hospital stay was 14 days, and 52% of patients died during hospitalization. IPD showed high lethality in a predominantly elderly population with multiple cardiometabolic comorbidities. Despite high susceptibility of strains to penicillin and ceftriaxone, the clinical severity of cases was reflected in high ICU admission rates and in-hospital mortality.