Korean J Pediatr Infect Dis.  2005 Nov;12(2):140-148. 10.14776/kjpid.2005.12.2.140.

Epidemiology and Clinical Features of Invasive Pneumococcal Infections in Children

• Song EK
• Lee JH
• Kim NH
• Lee JA
• Kim DH
• Park KW
• Choi EH
• Lee HJ

• KMID: 2440008
• DOI: http://doi.org/10.14776/kjpid.2005.12.2.140

Abstract

PURPOSE
To characterize the epidemiology and clinical features of invasive pneumococcal infections in Korean children.
METHODS
One hundred ninety four cases of invasive pneumococcal infections diagnosed at the Seoul National University Children's Hospital from October 1985 to December 2003 were analysed retrospectively. All isolates were screened for resistance to penicillin by oxacillin disc diffusion test. Serotypes were determined for 125 isolates.
RESULTS
The types of infection were bacteremia without focus 84/194(43%), meningitis 36/194(19%), pneumonia with bacteremia 36/194(19%), peritonitis 24/194(12%), other focal infections 3/194(2%). Fifty seven percent(110/194) of the episodes developed in the immunocompromised and 20%(37/194) were nosocomially acquired. The patients younger than 2 years of age was 60% in the immunocompetent patients and 25% in the immunocompromised patients. The overall case fatality rate was 7%. All the isolates by 1988 were susceptible to penicillin screened by oxacillin disk. Penicillin resistance was first detected in 1989(20%), and then increased rapidly; 89% in 1995, 69% in 1996, and 80~100% thereafter. The seven most frequently isolated serotypes were 23F, 19F, 14, 6B, 6A, 9V and 19A, which accounted for 70% of total isolates.
CONCLUSION
S. pneumoniaeis an important cause of morbidity and mortality in children. Invasive infections caused by S. pneumoniae most often occurred in infants and young children, while they are frequent in older immunocompromised children as well. This is the largest case series on invasive pneumococcal infections in Korean children.

Keyword

Streptococcus pneumoniae; Invasive infection; Bacteremia; Meningitis; Epidemiology; Korea

MeSH Terms

Bacteremia
Child*
Diffusion
Epidemiology*
Focal Infection
Humans
Immunocompromised Host
Infant
Korea
Meningitis
Mortality
Oxacillin
Penicillin Resistance
Penicillins
Peritonitis
Pneumococcal Infections*
Pneumonia
Retrospective Studies
Seoul
Serogroup
Streptococcus pneumoniae
Oxacillin
Penicillins