Abstract
Background and aims: Streptococcus pneumoniae (SP or pneumococcus) causes many childhood diseases and is a significant cause of morbidity and mortality in children worldwide. Invasive pneumococcal disease could result in death or permanent disabilities despite treatment with systemic antibiotics. Aims: To investigate the pattern of morbidity and mortality associated with severe SP infection and pediatric intensive care unit (PICU) admission. Methods: A retrospective study between 2002 and 2013 of all children in the PICU with a laboratory isolation of SP. Results: There were 20 (1.2%) PICU patients with SP isolations [blood culture (n=6 patients), CSF (n=1) and pleural/pulmonary specimens (n=13)]. 90% of SP were sensitive to penicillin, and all SP specimens were sensitive to cefotaxime and vancomycin. SP infections were associated with high PICU mortality of 25% (or 5% of total PICU mortality), high rates of need for mechanical ventilatory (65%), inotropic supports (35%) and dialysis (15%), and an odds of PICU deaths of 5.96 (p=0.0008). Older children had significantly higher prevalence of premorbid conditions such as malignancy, mental retardation/cerebral palsy (MRCP)+/-seizure disorders, chromosomal or genetic disorders (p=0.003) than children < 5 years of age. Serotypes were available for some of these specimens which included 19A, 19F, 6B, 3 and 6C. There were 4 deaths with multi-organ system failure and hemolytic uremic syndrome (two 19A, and two serotype 3). Conclusions: Severe SP infections are associated with significant morbidity and mortality despite treatment with systemic antibiotics and ICU support. The expanded coverage of newer polyvalent pneumococcal vaccines can probably prevent infections by serotypes 19A, 6B and 3.
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call