Childhood Pneumococcal Diseases and Serotypes: Can Vaccines Protect?
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To describe pneumococcal diseases in pediatric intensive care unit (PICU) and non-PICU patients.
The clinical, serotypes, and antibacterial sensitivity patterns of all children admitted to the pediatric wards (including PICU) of a university-affiliated teaching hospital from 2007 through 2009 with pneumococcal isolates were reviewed.
Twelve cases of pneumococcal disease in children from 2007 through 2009 were reported. Five patients were admitted to PICU and 7 were general pediatric admissions. Four patients (2 PICU and 2 general pediatric) had received full or partial 7-valent pneumococcal vaccinations. All four patients recovered following systemic antibiotic treatment without sequelae. The serotypes of all PICU and some general pediatric cases were available and included 3, 6B, 19A and 19F. All isolates were sensitive to vancomycin. 50% were intermediate resistant/resistant to penicillin and 17% resistant to cefotaxime. PICU cases required longer total hospital stay (23 days vs 5 days, p = 0.013). Three patients were ventilated and one received inotropic support. There was no death in this series.
Pneumococcal disease may develop despite prior vaccination. The expanded coverage of newer polyvalent pneumococcal vaccines might have prevented some, but not all, of these admissions.
KeywordsInvasive S pneumoniae, Septicemia Antibiotic resistance
KLH is the principal author, MIP is the microbiologist, KL is the pharmacist, EDN and TFL are the paediatricians caring for some of these patients. They contributed in the drafting and management of these patients.
KHES and YSTY were medical graduates of the Chinese University of Hong Kong. They helped with data collection for this research before their graduation.
Conflict of Interest
KLH has received travel support from Pfizer,Wyeth and GlaxoSmithKline.
MI has received funding and support from Wyeth for childhood respiratory disease surveillance studies and for consultancy, Daiichi Pharmaceuticals for adult respiratory disease studies, and has participated in antimicrobial studies funded by AstraZeneca, and Janssen Pharmaceuticals Ltd.
KL has received funding and support from GSK, Pfizer and Wyeth for health economic studies on vaccines, has participated in regional advisory boards funded by GSK, Pfizer and Wyeth and received travel support from GSK, Pfizer and Wyeth.
EASN has received funding and support from Merck and Wyeth for diarrhoeal and respiratory disease surveillance studies, has participated in a vaccine studies funded by Baxter, GlaxoSmithKline, MedImmune and Wyeth and has received lecture fees and travel support from GlaxoSmithKline, Merck, Intercell and Wyeth.
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