Pneumococcemia in children – a retrospective study before universal pneumococcal vaccinations
Article first published online: 28 FEB 2013
©2013 Foundation Acta Pædiatrica. Published by Blackwell Publishing Ltd
Volume 102, Issue 5, pages 514–519, May 2013
How to Cite
Karppa, H., Vuento, R., Toropainen, M., Kaijalainen, T., Siira, L. and Korppi, M. (2013), Pneumococcemia in children – a retrospective study before universal pneumococcal vaccinations. Acta Paediatrica, 102: 514–519. doi: 10.1111/apa.12194
- Issue published online: 9 APR 2013
- Article first published online: 28 FEB 2013
- Accepted manuscript online: 9 FEB 2013 10:58AM EST
- Manuscript Accepted: 5 FEB 2013
- Manuscript Revised: 18 JAN 2013
- Manuscript Received: 1 NOV 2012
- Occult bacteraemia;
- Streptococcus pneumoniae
To evaluate the incidence and characteristics of blood culture-positive occult pneumococcemia compared with blood culture-positive pneumococcal pneumonia in children.
In years 2001–2010, 105 children with positive blood cultures for Streptococcus pneumoniae were identified from hospital electronic files. The patient cards were retrospectively charted for clinical and laboratory data, and 38 patients had and 67 had not pneumonia.
The annual incidence of pneumococcemia was, on average, 29.0/10 000 at 0–12 months, 5.3/10 000 at 13–24 months and 1.9/10 000 at 2–4 years of ages, with no increasing or decreasing trend. The incidence of bacteraemic pneumococcal pneumonia increased (p = 0.022) during the study period. The duration of fever before hospitalization (<24 h 73.9% vs. 25.0%, p = 0.022) and the duration of intravenous antibiotics, usually G-penicillin (median 72 vs. 96 h, p = 0.021) was shorter in pneumococcemia patients. On admission, blood leucocyte count was higher in pneumococcemia (mean 26.6 vs. 21.9 × 10E9/L, p = 0.012), but serum CRP was higher in pneumonia (median 160 vs. 67.4 mg/L, p < 0.001). The serotypes 6B and 14 caused 53.2% of pneumococcemia cases.
The incidence of pneumococcemia was highest in 1–2-year-old children, and typical for pneumococcemia was rapid onset of fever, high blood leucocyte count and a modestly elevated CRP on admission.