Background: Invasive pneumococcal disease (IPD) results in high morbidity and mortality globally each year,\nalthough it is a vaccine-preventable disease. This study aimed to characterize the clinical features of IPD in a\npediatric intensive care unit (PICU) in Taiwan. The seven-valent pneumococcal conjugate vaccine (PCV7) was\nintroduced in the private sector in October 2005. The estimated coverage rate of PCV7 vaccination in 2010 was\n45.5 % among children <5 years of age.\nMethods: We conducted a retrospective study at a single center in northern Taiwan for invasive pneumococcal\ndisease in a PICU from 2009 to 2013. Demographic characteristics, clinical courses, serotype, antibiotic susceptibility,\nand outcomes were analyzed.\nResults: Over the 5-year study period, 2167 patients were admitted to the PICU; 48 (2.2 %) had IPD. There were 29\nfemale and 19 male patients. Their mean age was 3.7 years (range 0.7ââ?¬â??12.5 years, with the peak age at 2ââ?¬â??5 years;\nn = 30, 63 %). Pneumonia was the most frequent type (n = 38, 79 %), followed by meningitis (n = 10, 21 %). In total,\nthree patients died, all within 72 h after admission; the final diagnoses were all meningitis. Thirty-four children with\npneumonia received chest tube insertion for pleural effusion drainage. Of them, 22 (65 %) finally still underwent\nvideo-assisted thoracoscopic surgery. Eight (17 %) children had hemolytic uremic syndrome, and seven of them\nunderwent hemodialysis. In total, 37 serotypes were detected; 95 % were covered by PCV13. Serotype 19A was\nmost common (54 %) overall; however, in those with meningitis, serotype 19 F was most common.\nConclusions: Meningitis is the most severe type of invasive pneumococcal disease in our pediatric intensive care\nunit. It may progress rapidly even when subjects are given antibiotics promptly. The most common serotype in\nmeningitis is 19 F, which is vaccine preventable. Thus, universal mass pneumococcal vaccination is still needed.
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