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Pneumococcal endocarditis in children: a nationwide survey in Japan

Naruhiko Ishiwada1, Koichiro Niwa, Shigeru Tateno

  • 1Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan. ishiwada@faculty.chiba-u.jp

International Journal of Cardiology
|March 27, 2007
PubMed

Insights

Pediatric infective endocarditis (IE) caused by Streptococcus pneumoniae often involves severe infections and penicillin-resistant strains. Carbapenem shows effectiveness in treating this serious condition in children.

Area of Science:

  • Pediatric Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Infective endocarditis (IE) caused by Streptococcus pneumoniae has a high mortality rate.
  • Limited data exists on pediatric pneumococcal IE and established optimal therapies.
  • This study aimed to define clinical features of pediatric pneumococcal IE via a Japanese nationwide survey.

Purpose of the Study:

  • To identify the clinical characteristics of pediatric infective endocarditis (IE) caused by Streptococcus pneumoniae.
  • To analyze the treatment and outcomes of children diagnosed with pneumococcal IE.
  • To inform the development of management strategies for pediatric pneumococcal IE.

Main Methods:

  • A 5-year nationwide survey (1997-2001) registered 170 pediatric IE cases.
  • Nine cases (5.3%) of pneumococcal IE were identified and analyzed.
  • Clinical course, treatment, and outcomes of 9 pediatric patients (aged 7 months to 4 years) were retrospectively reviewed.

Main Results:

  • Pneumococcal IE was linked to congenital heart disease in 7 patients and systemic infections (meningitis, pneumonia, otitis media) in 4.
  • Penicillin-resistant Streptococcus pneumoniae strains accounted for 55.6% of isolates.
  • Seven patients received carbapenem; three required cardiac surgery; one patient died from septic shock.

Conclusions:

  • Pediatric pneumococcal endocarditis frequently presents with severe systemic infections.
  • Penicillin-resistant strains are common in pediatric cases.
  • Carbapenem therapy is effective against penicillin-resistant Streptococcus pneumoniae in IE.
Abstract

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