Host and microbiologic factors associated with mortality in Taiwanese children with invasive pneumococcal diseases, 2001 to 2006.
We concurrently evaluated host- and organism-related factors in determining the outcomes of 160 invasive pneumococcal diseases episodes in 158 Taiwanese children during 2001 and 2006. Most (138/160, 86.2%) episodes occurred at age less than 60 months, and an underlying condition was present in 35 (22.2%) cases. Common disease syndromes included complicated pneumonia (29.4%), uncomplicated pneumonia (29.4%), occult bacteremia (17.5%), and meningitis (14.4%). Mortality (13/160, 8.1%) was associated with age less than 24 months, underlying conditions, meningitis, cytopenia, intensive care, and penicillin MIC >or=2 microg/mL in univariate analysis. Pneumococcal serotypes, genotypes, origin of infections, and discordant therapy did not influence the outcome. Multivariate analysis determined the presence of underlying conditions (adjusted odds ratio [OR], 30.5; 95% confidence interval [CI], 4.8-193.1) and penicillin MIC >or=2 microg/mL (adjusted OR, 8.1; 95% CI, 1.4-47.3), which are the independent predictors for fatality. This finding highlighted the importance of immunization of disadvantaged children, targeting drug-resistant pneumococci.
Chen
Chih-Jung
CJ
Divisions of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Lin
Chia-Ling
CL
Chen
Yi-Ching
YC
Wang
Chun-Wei
CW
Chiu
Cheng-Hsun
CH
Lin
Tzou-Yien
TY
Huang
Yhu-Chering
YC
D000900:Anti-Bacterial Agents / Q000494:pharmacology; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D015999:Multivariate Analysis; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D013624:Taiwan
D000900:Anti-Bacterial Agents