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Retrospective study of prognostic factors in pediatric invasive pneumococcal disease
- Source :
- PeerJ, Vol 5, p e2941 (2017), PeerJ
- Publication Year :
- 2017
- Publisher :
- PeerJ Inc., 2017.
-
Abstract
- Streptococcus pneumoniaeremains the leading causative pathogen in pediatric pneumonia and bacteremia throughout the world. The invasive pneumococcal disease (IPD) is known as isolation ofS. pneumoniaefrom a normally sterile site (e.g., blood, cerebrospinal fluid, synovial fluid, pericardial fluid, pleural fluid, or peritoneal fluid). The aim of this study is to survey the clinical manifestations and laboratory results of IPD and identify the prognostic factors of mortality. From January 2001 to December 2006, a retrospective review of chart was performed in a teaching hospital in Taipei. The hospitalized pediatric patients with the diagnosis of pneumonia, arthritis, infectious endocarditis, meningitis or sepsis were recruited. Among them, 50 patients were pneumococcal infections proved by positive culture results or antigen tests. Clinical manifestations, laboratory data and hospitalization courses were analyzed. The median age was 3.5-year-old and there were 30 male patients (60%). Eight patients (16%) had underlying disease such as leukemia or congenital heart disease. Hemolytic uremic syndrome (HUS) was observed in ten patients and extracorporeal membrane oxygenation (ECMO) was performed in three patients. Leukocytosis, elevated C-reactive protein and AST level were noted in most of the patients. The overall mortality rate was 10%. We found that leukopenia, thrombocytopenia and high CRP level were significant predictors for mortality. In conclusion,S. pneumoniaeremains an important health threat worldwide and IPD is life-threatening with high mortality rate. We found leukopenia, thrombocytopenia, and high CRP levels to be associated with mortality in pediatric IPD, and these factors are worthy of special attention at admission. Although we failed to identify a statistically significant prognostic factor in multivariate analysis due to relatively small sample size, we suggest an aggressive antibiotic treatment in patients with these factors at admission. Further large-scale studies are warranted.
- Subjects :
- medicine.medical_specialty
Emergency and Critical Care
Epidemiology
lcsh:Medicine
medicine.disease_cause
Pediatrics
General Biochemistry, Genetics and Molecular Biology
Sepsis
03 medical and health sciences
0302 clinical medicine
030225 pediatrics
Internal medicine
Streptococcus pneumoniae
medicine
030212 general & internal medicine
Intensive care medicine
Prognostic factor
Leukopenia
business.industry
General Neuroscience
Mortality rate
lcsh:R
Invasive pneumococcal disease
General Medicine
Pneumococcus
Pneumonia
medicine.disease
Pneumococcal infections
Infectious Diseases
Bacteremia
Public Health
medicine.symptom
General Agricultural and Biological Sciences
business
Meningitis
Subjects
Details
- Language :
- English
- ISSN :
- 21678359
- Volume :
- 5
- Database :
- OpenAIRE
- Journal :
- PeerJ
- Accession number :
- edsair.doi.dedup.....c6f02aaa6aee30549f0bc95d744ee8c2