title: Childhood pneumococcal diseases and serotypes: can vaccines protect?
abstract: OBJECTIVE
  To describe pneumococcal diseases in pediatric intensive care unit (PICU) and non-PICU patients.
  
  
  METHODS
  The clinical, serotypes, and antibacterial sensitivity patterns of all children admitted to the pediatric wards (including PICU) of a university-affiliated teaching hospital from 2007 through 2009 with pneumococcal isolates were reviewed.
  
  
  RESULTS
  Twelve cases of pneumococcal disease in children from 2007 through 2009 were reported. Five patients were admitted to PICU and 7 were general pediatric admissions. Four patients (2 PICU and 2 general pediatric) had received full or partial 7-valent pneumococcal vaccinations. All four patients recovered following systemic antibiotic treatment without sequelae. The serotypes of all PICU and some general pediatric cases were available and included 3, 6B, 19A and 19F. All isolates were sensitive to vancomycin. 50% were intermediate resistant/resistant to penicillin and 17% resistant to cefotaxime. PICU cases required longer total hospital stay (23 days vs 5 days, p=0.013). Three patients were ventilated and one received inotropic support. There was no death in this series.
  
  
  CONCLUSIONS
  Pneumococcal disease may develop despite prior vaccination. The expanded coverage of newer polyvalent pneumococcal vaccines might have prevented some, but not all, of these admissions.
authors.affiliation: Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, 6/F, Clinical Sciences Building, Shatin, Hong Kong. ehon@cuhk.edu.hk
authors.forename: Kam Lun
authors.initials: KL
authors.lastname: Hon
authors.forename: Margaret
authors.initials: M
authors.lastname: Ip
authors.forename: Kenneth
authors.initials: K
authors.lastname: Lee
authors.forename: Edmund Anthony
authors.initials: EA
authors.lastname: Nelson
authors.forename: Ka Ho Eric
authors.initials: KH
authors.lastname: Shea
authors.forename: Yiu Sang Tony
authors.initials: YS
authors.lastname: Yuen
authors.forename: Ting Fan
authors.initials: TF
authors.lastname: Leung
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003422:Critical Care; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008297:Male; D011008:Pneumococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control*; D022242:Pneumococcal Vaccines; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D022242:Pneumococcal Vaccines