title: Pneumococcemia in children--a retrospective study before universal pneumococcal vaccinations.
abstract: OBJECTIVE
  To evaluate the incidence and characteristics of blood culture-positive occult pneumococcemia compared with blood culture-positive pneumococcal pneumonia in children.
  
  
  METHODS
  In years 2001-2010, 105 children with positive blood cultures for Streptococcus pneumoniae were identified from hospital electronic files. The patient cards were retrospectively charted for clinical and laboratory data, and 38 patients had and 67 had not pneumonia.
  
  
  RESULTS
  The annual incidence of pneumococcemia was, on average, 29.0/10 000 at 0-12 months, 5.3/10 000 at 13-24 months and 1.9/10 000 at 2-4 years of ages, with no increasing or decreasing trend. The incidence of bacteraemic pneumococcal pneumonia increased (p = 0.022) during the study period. The duration of fever before hospitalization (<24 h 73.9% vs. 25.0%, p = 0.022) and the duration of intravenous antibiotics, usually G-penicillin (median 72 vs. 96 h, p = 0.021) was shorter in pneumococcemia patients. On admission, blood leucocyte count was higher in pneumococcemia (mean 26.6 vs. 21.9 × 10E9/L, p = 0.012), but serum CRP was higher in pneumonia (median 160 vs. 67.4 mg/L, p < 0.001). The serotypes 6B and 14 caused 53.2% of pneumococcemia cases.
  
  
  CONCLUSIONS
  The incidence of pneumococcemia was highest in 1-2-year-old children, and typical for pneumococcemia was rapid onset of fever, high blood leucocyte count and a modestly elevated CRP on admission.
authors: Paediatric Research Centre, Tampere University and University Hospital, Tampere, Finland.
authors: Henna
authors: H
authors: Karppa
authors: Risto
authors: R
authors: Vuento
authors: Maija
authors: M
authors: Toropainen
authors: Tarja
authors: T
authors: Kaijalainen
authors: Lotta
authors: L
authors: Siira
authors: Matti
authors: M
authors: Korppi
mesh_terms: D016470:Bacteremia / Q000097:blood / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D022242:Pneumococcal Vaccines; D011018:Pneumonia, Pneumococcal / Q000097:blood / Q000453:epidemiology* / Q000382:microbiology; D012189:Retrospective Studies; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*
chemical_list: D022242:Pneumococcal Vaccines