Invasive Pneumococcal disease in Singapore children

Introduction: Our retrospective study examined community-acquired invasive pneumococcal disease (IPD) in children admitted to KK Women's and Children's Hospital, Singapore. Methods: All pneumococcal isolates from sterile sites from 1997 to 2004 were surveyed. Results: There were 147 positive pneumococcal isolates with a mean age of 45 months. The estimated incidence of IPD was 13.6 per 105 children under 5 years old. Diagnoses at presentation were: Pneumonia 63.3% (included 14.3% empyema), bacteremia 17%, meningitis 15.6% (included 2.8% meningitis and pneumonia), 4.1% others. The morbidity rate was 25.2%, mortality rate was 6.1%. Antibiotic resistance was: Penicillin 44%, ceftriaxone 15%, erythromycin 62%, trimethoprim-sulfamethoxazole 67%. A separate serotype analysis (n = 93, 63%) showed that the current 7valent pneumococcal conjugate vaccine (PCV7) would cover 78.1% of vaccine serotypes and 89% of vaccine-related serotypes for children under 5 years old.