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Published on: February 23, 2014

Host and microbiologic factors associated with mortality in Taiwanese children with invasive pneumococcal diseases,

Chih-Jung Chen1, Chia-Ling Lin, Yi-Ching Chen

  • 1Divisions of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Taoyuan, Taiwan.

Diagnostic Microbiology and Infectious Disease
|January 20, 2009
PubMed

Insights

Underlying conditions and penicillin resistance independently predict fatal invasive pneumococcal disease in Taiwanese children. Immunization strategies should prioritize vulnerable children and combat drug-resistant strains.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Invasive pneumococcal disease (IPD) remains a significant cause of childhood morbidity and mortality globally.
  • Host and organism factors influence IPD outcomes, necessitating continued research into predictive variables.

Purpose of the Study:

  • To identify host- and organism-related factors associated with outcomes of IPD in Taiwanese children.
  • To determine independent predictors of fatality in pediatric IPD cases.

Main Methods:

  • Retrospective evaluation of 160 IPD episodes in 158 Taiwanese children (2001-2006).
  • Analysis of clinical data, including demographics, underlying conditions, disease syndromes, and treatment.
  • Univariate and multivariate logistic regression to assess factors influencing mortality.

Main Results:

  • Most IPD episodes (86.2%) occurred in children under 60 months; 22.2% had underlying conditions.
  • Common syndromes included pneumonia, occult bacteremia, and meningitis.
  • Fatality (8.1%) was linked to younger age, underlying conditions, meningitis, and penicillin MIC ≥2 µg/mL.
  • Multivariate analysis identified underlying conditions (aOR 30.5) and penicillin MIC ≥2 µg/mL (aOR 8.1) as independent predictors of death.

Conclusions:

  • Underlying conditions and penicillin non-susceptibility are critical independent predictors of fatality in pediatric IPD.
  • Findings underscore the importance of immunization programs, especially for disadvantaged children, and the need to address antibiotic resistance.

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