BACKGROUND: Invasive pneumococcal disease (IPD) in children may manifest as bacteremia/sepsis, bacteremic pneumonia, or meningitis, with serious outcomes that include hospitalization, neurologic sequelae, or death. The risk of severe or fatal outcome of disease is associated with host-related factors, such as age or comorbid conditions. Furthermore, there is an ongoing discussion about organism-related factors, such as the pneumococcal serotype. METHODS: Data on 494 children aged <16 years hospitalized for IPD between 1997 and 2003 in pediatric hospitals in Germany were analyzed. Serotype specific case-fatality rates and rates of severe outcome were compared using standardized mortality ratios (SMR). The risk of severe or fatal outcome for the serotype with the highest case-fatality rate was further analyzed using multivariate logistic regression adjusting for age younger than 1 year, meningitis, sex, and immunocompromised status as potential confounders. RESULTS: The overall case-fatality rate was 5.3% and the rate of severe outcome was 17.0%. Serotype 7F had the highest case-fatality rate (14.8%, SMR 3.1), followed by serotypes 23F (8.3%, SMR 1.7) and 3 (8.3%, SMR 1.7). The highest rate of severe outcome was also observed for 7F (40.7%, SMR 2.4). Multivariate analysis showed an odds ratio of 4.3 (1.3-14.7) for fatal outcome and 4.0 (1.6-10.4) for severe outcome comparing 7F to all other serotypes. CONCLUSIONS: In this study population, serotype 7F accounted for a higher risk of severe and fatal outcome than other serotypes of Streptococcus pneumoniae. In describing the epidemiology of IPD, the serotype-specific risk for severe or fatal outcome is an important complement to other serotype-specific aspects like incidence and antibiotic resistance pattern.
BACKGROUND: Invasive pneumococcal disease (IPD) in children may manifest as bacteremia/sepsis, bacteremic pneumonia, or meningitis, with serious outcomes that include hospitalization, neurologic sequelae, or death. The risk of severe or fatal outcome of disease is associated with host-related factors, such as age or comorbid conditions. Furthermore, there is an ongoing discussion about organism-related factors, such as the pneumococcal serotype. METHODS: Data on 494 children aged <16 years hospitalized for IPD between 1997 and 2003 in pediatric hospitals in Germany were analyzed. Serotype specific case-fatality rates and rates of severe outcome were compared using standardized mortality ratios (SMR). The risk of severe or fatal outcome for the serotype with the highest case-fatality rate was further analyzed using multivariate logistic regression adjusting for age younger than 1 year, meningitis, sex, and immunocompromised status as potential confounders. RESULTS: The overall case-fatality rate was 5.3% and the rate of severe outcome was 17.0%. Serotype 7F had the highest case-fatality rate (14.8%, SMR 3.1), followed by serotypes 23F (8.3%, SMR 1.7) and 3 (8.3%, SMR 1.7). The highest rate of severe outcome was also observed for 7F (40.7%, SMR 2.4). Multivariate analysis showed an odds ratio of 4.3 (1.3-14.7) for fatal outcome and 4.0 (1.6-10.4) for severe outcome comparing 7F to all other serotypes. CONCLUSIONS: In this study population, serotype 7F accounted for a higher risk of severe and fatal outcome than other serotypes of Streptococcus pneumoniae. In describing the epidemiology of IPD, the serotype-specific risk for severe or fatal outcome is an important complement to other serotype-specific aspects like incidence and antibiotic resistance pattern.
Authors: Tatiana Barichello; Graziele Milioli; Jaqueline S Generoso; Andreza L Cipriano; Caroline S Costa; Ana Paula Moreira; Márcia Carvalho Vilela; Clarissa M Comim; Antonio Lucio Teixeira; João Quevedo Journal: J Neural Transm (Vienna) Date: 2011-12-13 Impact factor: 3.575
Authors: D S Klobassa; B Zoehrer; M Paulke-Korinek; U Gruber-Sedlmayr; K Pfurtscheller; V Strenger; A Sonnleitner; R Kerbl; B Ausserer; W Arocker; W Kaulfersch; B Hausberger; B Covi; F Eitelberger; A Vécsei; B Simma; R Birnbacher; H Kurz; K Zwiauer; D Weghuber; S Heuberger; F Quehenberger; H Kollaritsch; W Zenz Journal: Eur J Pediatr Date: 2014-01-14 Impact factor: 3.183
Authors: L Selva; P Ciruela; C Esteva; M F de Sevilla; G Codina; S Hernandez; F Moraga; J J García-García; A Planes; F Coll; I Jordan; N Cardeñosa; J Batalla; L Salleras; A Dominguez; C Muñoz-Almagro Journal: Eur J Clin Microbiol Infect Dis Date: 2011-11-04 Impact factor: 3.267
Authors: Carrie L Byington; Kristina G Hulten; Krow Ampofo; Xiaoming Sheng; Andrew T Pavia; Anne J Blaschke; Melinda Pettigrew; Kent Korgenski; Judy Daly; Edward O Mason Journal: J Clin Microbiol Date: 2009-12-16 Impact factor: 5.948
Authors: Liset Olarte; Krow Ampofo; Chris Stockmann; Edward O Mason; Judy A Daly; Andrew T Pavia; Carrie L Byington Journal: Pediatrics Date: 2013-06-03 Impact factor: 7.124
Authors: Bruno Pichon; Shamez N Ladhani; Mary P E Slack; Anne Segonds-Pichon; Nick J Andrews; Pauline A Waight; Elizabeth Miller; Robert George Journal: J Clin Microbiol Date: 2012-12-26 Impact factor: 5.948