Pediatric head and neck complications of Streptococcus pneumoniae before and after PCV7 vaccination.
OBJECTIVE
To discuss pediatric head and neck complications of pneumococcal infections before and after the introduction of the PCV7 vaccine.


METHODS
Cross-sectional analysis of a national database.


METHODS
Kids National Inpatient Database.


METHODS
A retrospective review of the Kids National Inpatient Database yielded 31,738 pediatric reports involving complications of meningitis, mastoiditis, periorbital cellulitis, and Bezold abscesses due to Streptococcus pneumoniae diagnoses. Each report was analyzed for incidence, length of stay, mean hospital cost, and inpatient admittance from the emergency department. Finally, we calculated the expected annual incidence of each complication via variance-weighted analysis to determine the expected incidence if the vaccine was not administered.


RESULTS
We identified a significant decrease in the incidence of several complications after the introduction of the PCV7 vaccine and also when comparing these findings to our predicted incidence calculations if the vaccine was not administered. Inpatient admittance from the emergency department for Bezold abscess, periorbital cellulitis, mastoiditis, and meningitis was significantly increased in the pediatric age group (ages 1-4; P < .05). Furthermore, there was a significant increase in the cost to provide care for each of the described conditions (P < .05).


CONCLUSIONS
The PCV7 vaccine produced a measurable reduction in head and neck complications associated with S pneumoniae. However, our data suggest that these benefits were also met with increased inpatient admittance from the emergency department, hospital costs, and length of stay, each of which may be attributed to the selection of a more pathogenic subtype.
Georgetown University School of Medicine, Washington, DC Adw27@georgetown.edu.
Andrew
A
Walls
Department of Otolaryngology-Head & Neck Surgery, Georgetown University Hospital, Washington, DC.
Matthew
M
Pierce
Georgetown University School of Medicine, Washington, DC.
Nathan
N
Krishnan
Ear, Nose, & Throat Associates of Corpus Christi, Otolaryngology-Head and Neck Surgery, Corpus Christi, Texas.
Matthew
M
Steehler
Georgetown University School of Medicine, Washington, DC Department of Otolaryngology-Head & Neck Surgery and Pediatrics, Georgetown University Hospital, Washington, DC.
Earl H
EH
Harley
D000038:Abscess / Q000382:microbiology; D002481:Cellulitis / Q000382:microbiology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D017722:Hospital Charges; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008417:Mastoiditis / Q000382:microbiology; D016920:Meningitis, Bacterial / Q000382:microbiology; D011008:Pneumococcal Infections / Q000150:complications* / Q000382:microbiology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D012189:Retrospective Studies; D013296:Streptococcus pneumoniae
D022242:Pneumococcal Vaccines
PCV7; otolaryngology; pediatrics; vaccination