title: Clinical outcome of invasive pneumococcal infection in children: a 10-year retrospective analysis.
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.
authors.affiliation: Department of Pediatrics, Taichung Veterans General Hospital, Taiwan, ROC.
authors.forename: Jui-Shan
authors.initials: JS
authors.lastname: Ma
authors.forename: Po-Yen
authors.initials: PY
authors.lastname: Chen
authors.forename: Suk-Chun
authors.initials: SC
authors.lastname: Mak
authors.forename: Ching-Shiang
authors.initials: CS
authors.lastname: Chi
authors.forename: Yeu-Jun
authors.initials: YJ
authors.lastname: Lau
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011008:Pneumococcal Infections / Q000150:complications / Q000188:drug therapy / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies