Authors: Thea K Chibuk Joan L Robinson Dawn S Hartfield
Publish Date: 2010/04/10
Volume: 169, Issue: 9, Pages: 1123-1128
Abstract
Recent studies have described an increase in the incidence of complicated pneumonia in children primarily caused by Streptococcus pneumoniae The objective of this study was to determine if the incidence of complicated pneumonias in total and due to different pneumococcal serotypes has changed following the introduction of routine immunization with heptavalent pneumococcal conjugate vaccine PCV7 A retrospective review of patients admitted to the Stollery Children’s Hospital in Edmonton Alberta with complicated pneumonia between July 1 1997 and June 30 2007 5 years before and after the introduction of PCV7 was completed There were 34 children in the pre and 68 in the postPCV7 era 1431 and 1991 per 10000 discharges respectively p = 0114 Patient characteristics were not significantly different and pneumococcus was the most common organism isolated pre 21 7/34 post 26 18/68 p = 0515 In patients where serotype data was available nonvaccine pneumococcal serotypes accounted for 67 12/18 cases in the postPVC7 era versus 14 1/7 in the prePCV7 era p = 0031 The incidence of nonvaccine serotypes was 042 and 351 per 10000 discharges in the pre and postPCV7 eras respectively p = 0020 There has been a nonsignificant trend towards an increase in the incidence of complicated pneumonia following the introduction of PCV7 S pneumoniae remains the predominant organism identified with nonvaccine serotypes now accounting for almost all cases Although it is not clear if this increase is attributable to the use of PCV7 expanding pneumococcal serotype coverage has the potential to prevent complicated pneumonia
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