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Trends in US hospital stays for Streptococcus pneumoniae-associated hemolytic uremic syndrome

Angela F Veesenmeyer1, M Bruce Edmonson

  • 1University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792–4108, USA. aveesenmeyer@pediatrics.wisc.edu

The Pediatric Infectious Disease Journal
|July 11, 2013
PubMed

Insights

Hospitalizations for Streptococcus pneumoniae-associated hemolytic uremic syndrome (SpHUS) in children doubled between 1997 and 2009. This severe condition is linked to complicated pneumonia and primarily affects young children.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Epidemiology

Background:

  • Hemolytic uremic syndrome (HUS) typically follows diarrheal illness but can also arise from Streptococcus pneumoniae (pneumococcal) infections, termed SpHUS.
  • SpHUS is a severe complication often seen in children with complicated pneumonia.
  • Increasing hospitalizations for complicated pneumococcal pneumonia in US children prompted this investigation into SpHUS trends.

Purpose of the Study:

  • To determine if hospital discharges for SpHUS in US children have increased.
  • To analyze the characteristics and associations of SpHUS hospitalizations.

Main Methods:

  • Utilized the Kids' Inpatient Database (1997-2009) to identify pediatric hospital discharges (0-18 years) for invasive pneumococcal disease, HUS, or SpHUS.
  • Employed univariate and multivariate analyses, with a focus on 2009 data, to assess trends and associations.

Main Results:

  • Annual US hospital discharges for SpHUS approximately doubled over the study period.
  • In 2009, SpHUS constituted a small but significant percentage of HUS, invasive pneumococcal disease, and complicated pneumococcal pneumonia discharges.
  • SpHUS cases were more common in children under 3 years, associated with longer hospital stays, higher charges, and strongly linked to pneumococcal sepsis/bacteremia and complicated pneumonia.

Conclusions:

  • Streptococcus pneumoniae-associated hemolytic uremic syndrome (SpHUS) is an uncommon yet severe pediatric illness.
  • SpHUS is strongly associated with complicated pneumococcal pneumonia and primarily affects young children.
  • Trends indicate an increase in US hospitalizations for SpHUS, mirroring the rise in complicated pneumococcal pneumonia.
Abstract

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