Invasive pneumococcal disease in a third level pediatric hospital in Mexico City: epidemiology and mortality risk factors

Salud Publica Mex. 2010 Sep-Oct;52(5):391-7. doi: 10.1590/s0036-36342010000500006.

Abstract

Objective: To assess the epidemiologic characteristics of invasive pneumococcal diseases (IPD) among a population in a pediatric hospital in Mexico City and analyze mortality-related risk factors, serotype distribution and antibiotic susceptibility related to S.pneumoniae.

Material and methods: We performed a retrospective review of IPD cases at a third level pediatric hospital between 1997-2004.

Results: A total of 156 patients were included. The mortality rate was 27.5% and was associated with six pneumococcal serotypes: 14, 6B, 23F, 6A, 19F and 19A. There was no relationship between mortality and antimicrobial susceptibility pattern. A total of 28.2% of isolates were resistant to penicillin and 24.6% were resistant to cefotaxime. A statistically significant relationship was observed between mortality and previous underlying disease (CI 95%; 2.5-18.3; p< 0.05) using a multivariate logistic regression model.

Conclusions: Our outcomes show that IPD mortality in our population is closely related to underlying disease and to six serotypes, five of which are included in the 7-valent pneumococcal conjugate vaccine.

MeSH terms

  • Child
  • Child Day Care Centers
  • Child, Preschool
  • Community-Acquired Infections / drug therapy
  • Community-Acquired Infections / epidemiology
  • Community-Acquired Infections / microbiology
  • Community-Acquired Infections / mortality
  • Cross Infection / drug therapy
  • Cross Infection / epidemiology
  • Cross Infection / microbiology
  • Cross Infection / mortality
  • Disease Susceptibility
  • Drug Resistance, Microbial
  • Female
  • Heptavalent Pneumococcal Conjugate Vaccine
  • Hospital Mortality*
  • Hospitals, Pediatric / statistics & numerical data*
  • Hospitals, Urban / statistics & numerical data*
  • Host-Pathogen Interactions
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Mexico
  • Pneumococcal Infections / drug therapy
  • Pneumococcal Infections / epidemiology*
  • Pneumococcal Infections / microbiology
  • Pneumococcal Infections / mortality
  • Pneumococcal Infections / prevention & control
  • Pneumococcal Vaccines
  • Retrospective Studies
  • Risk
  • Serotyping
  • Sex Distribution
  • Streptococcus pneumoniae / classification
  • Streptococcus pneumoniae / drug effects
  • Streptococcus pneumoniae / isolation & purification
  • Young Adult
  • beta-Lactams / pharmacology
  • beta-Lactams / therapeutic use

Substances

  • Heptavalent Pneumococcal Conjugate Vaccine
  • Pneumococcal Vaccines
  • beta-Lactams