This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. This is a 2:1 matched case-control study to span over the first 2 years of the grant. Cases are all patients with apositive culture for S. pneumoniae isolated from sputum or any sterile sites. The cases and controls will be stratified by age and history of previous pneumococcal vaccination. Moreover, HIV-seropositive patients will be matched by CD4 lymphocyte count stratum for subgroup analysis. Based on our preliminary data, we expect to enroll a total of 180 subjects in the case-control study, including drop-outs and withdrawals. We will use two-sample t-test or Mann-Whitney U test to compare antibody levels and their functionality between blacks and non-blacks In a multipe regression model, we will assess risk factors and outcome dterminants for invasive pneumococcal disease and infectios with penicillin resistant S. pneumoniae. Study subjects will be recruit among patients hospitalized at Nashville General Hospital, a tertiary academic medical center.
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