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Published on: February 23, 2014
Pediatric head and neck complications of Streptococcus pneumoniae before and after PCV7 vaccination
Andrew Walls1, Matthew Pierce2, Nathan Krishnan3
1Georgetown University School of Medicine, Washington, DC Adw27@georgetown.edu.
Insights
The PCV7 vaccine significantly reduced pediatric head and neck infections like meningitis. However, it also led to increased emergency department visits and hospital costs for remaining complications.
Area of Science:
- Pediatric infectious diseases
- Vaccinology
- Public health
Background:
- Pneumococcal infections pose significant risks for pediatric head and neck complications.
- The introduction of the pneumococcal conjugate vaccine 7 (PCV7) aimed to reduce the burden of these infections.
Purpose of the Study:
- To evaluate the impact of the PCV7 vaccine on pediatric head and neck complications.
- To analyze trends in incidence, hospital costs, and emergency department admissions before and after PCV7 introduction.
Main Methods:
- Retrospective analysis of 31,738 pediatric inpatient records from the Kids National Inpatient Database.
- Examined complications including meningitis, mastoiditis, periorbital cellulitis, and Bezold abscesses.
- Calculated expected incidence rates if the vaccine had not been administered.
Main Results:
- A significant decrease in the incidence of several pneumococcal head and neck complications was observed post-PCV7 introduction.
- Despite reduced incidence, there was a significant increase in emergency department admissions, hospital costs, and length of stay for remaining cases.
- Pediatric age groups (1-4 years) showed increased inpatient admittance for specific complications.
Conclusions:
- The PCV7 vaccine effectively reduced the overall incidence of pediatric head and neck complications caused by Streptococcus pneumoniae.
- The observed increase in hospital costs and length of stay may be linked to the emergence of more pathogenic pneumococcal serotypes.
Objective:
To discuss pediatric head and neck complications of pneumococcal infections before and after the introduction of the PCV7 vaccine.
Study Design:
Cross-sectional analysis of a national database.
Study Setting:
Kids National Inpatient Database.
Methods:
A retrospective review of the Kids National Inpatient Database yielded 31,738 pediatric reports involving complications of meningitis, mastoiditis, periorbital cellulitis, and Bezold abscesses due to Streptococcus pneumoniae diagnoses. Each report was analyzed for incidence, length of stay, mean hospital cost, and inpatient admittance from the emergency department. Finally, we calculated the expected annual incidence of each complication via variance-weighted analysis to determine the expected incidence if the vaccine was not administered.
Results:
We identified a significant decrease in the incidence of several complications after the introduction of the PCV7 vaccine and also when comparing these findings to our predicted incidence calculations if the vaccine was not administered. Inpatient admittance from the emergency department for Bezold abscess, periorbital cellulitis, mastoiditis, and meningitis was significantly increased in the pediatric age group (ages 1-4; P < .05). Furthermore, there was a significant increase in the cost to provide care for each of the described conditions (P < .05).
Conclusions:
The PCV7 vaccine produced a measurable reduction in head and neck complications associated with S pneumoniae. However, our data suggest that these benefits were also met with increased inpatient admittance from the emergency department, hospital costs, and length of stay, each of which may be attributed to the selection of a more pathogenic subtype.
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