Outcomes among Thai children with risk conditions hospitalized for pneumococcal disease (invasive or non-bacteraemic pneumonia): A multi-centre, observational study

Abstract

Objective: To describe the risk condition status and clinical outcomes among Thai children hospitalized with pneumococcal disease.

Methods: In this retrospective analysis, children with invasive pneumococcal disease (IPD) or x-ray-confirmed non-bacteraemic pneumococcal pneumonia (NBPP) were identified from nine hospitals in Thailand between 2010 and 2019. Data on risk factors and outcomes were extracted from medical records.

Results: In total, 413 cases were identified: 319 IPD and 94 NBPP. Overall, 133 (32.2%) patients were admitted to intensive care units and 11/406 (2.7%) died. Twenty-seven percent of IPD cases had at-risk conditions and 15% had high-risk conditions. Most IPD cases (32.9%) occurred in children aged 2-4 years, and most NBPP cases (28.7%) occurred in infants aged 0-11 months. Of 51 Streptococcus pneumoniae isolates collected, 41 (80%) were pneumococcal 13-valent conjugate vaccine serotypes. Only 5.1% of children had received a pneumococcal vaccine.

Conclusions: Most children with IPD and NBPP did not have high-risk or at-risk conditions, while 42% had at-risk or high-risk conditions for pneumococcal disease. Very few children in the cohort had received any type of pneumococcal vaccine. Increasing the availability of pneumococcal conjugate vaccines should be considered to reduce the burden of pneumococcal disease among children in Thailand.

Keywords: Invasive pneumococcal disease (IPD); Non-bacteraemic pneumococcal pneumonia; PCV13; Pneumococcal conjugate vaccine; Pneumococcal pneumonia.

Figure 1

(a) Serotypes of Streptococcus pneumoniae isolates from children aged 0–15 years with invasive pneumococcal disease (IPD) or non-bacteraemic pneumococcal pneumonia (NBPP) from nine tertiary hospitals in Thailand, 2010–2019 (n=51). PCV13 serotypes are in bold. NVT, non-vaccine serotype. *Determined to serogroup level using polymerase chain reaction. ^{^}Other, serotype unspecified. (b) Serotyped S. pneumoniae isolates from children aged 0–15 years with IPD or NBPP from nine tertiary hospitals in Thailand by year of identification, 2010–2019 (n=51). PCV13, pneumococcal 13-valent conjugated vaccine.