title: Invasive pneumococcal disease in Phramongkutklao Hospital 2004-2008: clinical data, serotype distribution and antimicrobial resistance patterns.
abstract: OBJECTIVE
  To describe the clinical course, serotype distribution and antimicrobial resistance patterns of invasive pneumococcal disease (IPD) cases in a public hospital.
  
  
  METHODS
  Retrospective review of IPD cases occurring from January 2004 through December 2008 was performed. Antibiotic susceptibility testing and serotyping were performed for available isolates.
  
  
  RESULTS
  Fifty one IPD cases occurred during the study period, of which 47 had medical records available for review. The majority of cases occurred among children under 5 years of age (23.4%) and adults over 60 years of age (36.1%). Underlying diseases were identified in 72.3% of patients. Fifty-three percent of cases were associated with pneumonia, while 17% had meningitis, and 15% had isolated bacteremia. Serotype could be determined for 15 (31.9%) isolates, and 6B was most common. Based on current antibiotic susceptibility breakpoints for meningitis, 4 of the 7 available isolates from meningitis cases were penicillin resistant and one had reduced susceptibility to cefotaxime. Among non-meningitis isolates, 96.7% were penicillin susceptible and 3.3% had intermediate susceptibility to penicillin. Overall case fatality proportion was 19%.
  
  
  CONCLUSIONS
  At this tertiary care hospital in Bangkok, IPD has disproportionately affected young children and the elderly. High rates of penicillin resistance among meningitis cases, the most severe form of IPD, underscore the need of appropriate treatment strategies and vaccine usage.
authors.affiliation: Pediatric Infectious Disease Unit, Phramongkutklao Hospital, Bangkok, Thailand. detchvijitr@gmail.com
authors.forename: Detchvijitr
authors.initials: D
authors.lastname: Suwanpakdee
authors.forename: Rudiwilai
authors.initials: R
authors.lastname: Samakoses
authors.forename: Sayomporn
authors.initials: S
authors.lastname: Sirinavin
authors.forename: Angkool
authors.initials: A
authors.lastname: Kerdpanich
authors.forename: Sriluck
authors.initials: S
authors.lastname: Simasathien
authors.forename: Sudaluck
authors.initials: S
authors.lastname: Thunyaharn
authors.forename: Surang
authors.initials: S
authors.lastname: Dejsirilert
authors.forename: Veerachai
authors.initials: V
authors.lastname: Watanaveeradej
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D024881:Drug Resistance, Bacterial; D006779:Hospitals, Public; D006801:Humans; D008826:Microbial Sensitivity Tests; D011008:Pneumococcal Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D012189:Retrospective Studies; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification*; D013785:Thailand / Q000453:epidemiology
chemical_list: D000890:Anti-Infective Agents