Childhood Pneumococcal Diseases and Serotypes: Can Vaccines Protect?

To describe pneumococcal diseases in pediatric intensive care unit (PICU) and non-PICU patients. The clinical, serotypes, and antibacterial sensitivity patterns of all children admitted to the pediatric wards (including PICU) of a university-affiliated teaching hospital from 2007 through 2009 with pneumococcal isolates were reviewed. Twelve cases of pneumococcal disease in children from 2007 through 2009 were reported. Five patients were admitted to PICU and 7 were general pediatric admissions. Four patients (2 PICU and 2 general pediatric) had received full or partial 7-valent pneumococcal vaccinations. All four patients recovered following systemic antibiotic treatment without sequelae. The serotypes of all PICU and some general pediatric cases were available and included 3, 6B, 19A and 19F. All isolates were sensitive to vancomycin. 50% were intermediate resistant/resistant to penicillin and 17% resistant to cefotaxime. PICU cases required longer total hospital stay (23 days vs 5 days, p = 0.013). Three patients were ventilated and one received inotropic support. There was no death in this series. Pneumococcal disease may develop despite prior vaccination. The expanded coverage of newer polyvalent pneumococcal vaccines might have prevented some, but not all, of these admissions.