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  • Title: Clinical outcome of invasive pneumococcal infection in children: a 10-year retrospective analysis.
    Author: Ma JS, Chen PY, Mak SC, Chi CS, Lau YJ.
    Journal: J Microbiol Immunol Infect; 2002 Mar; 35(1):23-8. PubMed ID: 11950116.
    Abstract:
    A retrospective study was conducted on 72 children admitted to a medical center in Taiwan due to invasive pneumococcal infections diagnosed between January 1990 and April 2000. Of these patients, 28 had meningitis and 44 had other invasive diseases. Forty-one (56.9%) strains of Streptococcus pneumoniae showed reduced susceptibility to penicillin by the oxacillin disc diffusion method. The total mortality was 20.8%, 32.1% for meningitis, and 13.6% for other invasive diseases. Ten (52.6%) of the patients survived from meningitis had long-term sequelae. Statistical analysis showed that initial presentation of coma, shock, respiratory distress requiring mechanical ventilation, and leukopenia (leukocyte <4,000 /mm3) were associated with mortality of invasive pneumococcal infections. Low cerebrospinal fluid leukocyte count (<50 /mm3) and high cerebrospinal fluid protein level (> or = 660 mg/dL) were also associated with mortality of meningitis. The presence of underlying diseases and high alanine aminotransferase level (> or = 100 U/L) were associated with fatal non-meningitic invasive diseases. Patients with shock and high alanine aminotransferase level but without high C-reactive protein level (> or = 20 mg/dL) were associated with rapidly fatal outcome. The outcome of invasive pneumococcal diseases was not associated with penicillin susceptibility.
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