Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2024 Dec 18;24(1):1574.
doi: 10.1186/s12913-024-11898-w.

Burden of invasive pneumococcal disease, non-invasive all-cause pneumonia, and acute otitis media in hospitalized US children: a retrospective multi-center study from 2015 to 2020

Salini Mohanty  1 , Nicole Cossrow  2 , Meghan White  2 , Kalvin C Yu  3 , Gang Ye  3 , Kristen A Feemster  4 , Vikas Gupta  3
Affiliations
Multicenter Study

Burden of invasive pneumococcal disease, non-invasive all-cause pneumonia, and acute otitis media in hospitalized US children: a retrospective multi-center study from 2015 to 2020

Salini Mohanty et al. BMC Health Serv Res. .

Abstract

Background: Despite effective pneumococcal vaccines, pneumococcal disease (PD) exerts a substantial burden on children. This study explored the clinical and economic burden of invasive PD (IPD), non-invasive all-cause pneumonia (ACP), and acute otitis media (AOM) in hospitalized children.

Methods: Data from the BD Insights Research Database of hospitalized children (< 18 years, including infants and children) in the US were analyzed retrospectively. The study cohort included patients with an ICD10 code for IPD, ACP, or AOM and/or a positive culture for S. pneumoniae. Descriptive statistics and multivariable analyses evaluated the following outcomes: length of stay [LOS], hospital cost per admission, hospital margin per admission [costs - payments], and in-hospital mortality.

Results: The study included 4575 pediatric patients with IPD (n = 36), ACP (n = 3,329), or AOM (n = 1,210) admitted to 57 US hospitals from October 2015 to February 2020. Approximately half (50.7%) were under 2 years of age. The in-hospital mortality rate was 0.6% (n = 28). The observed median (interquartile range) LOS was 4 (3, 5) days, cost per admission was $4,240 ($2,434, $8,311) US dollars, and hospital margin per admission was -$63 ($2,118, $2,025). LOS and costs were highly variable according to clinical characteristics and hospital variables. Key variables associated with poor outcomes were having a moderate- or high-risk condition (chronic or immunocompromising), intensive care unit admission, and prior 90-day admission.

Conclusions: The burden of PD among hospitalized pediatric patients in the US remains substantial. Our study highlights the burden of PD among young children (< 2 years) and children with underlying medical conditions that put them at greater risk for PD. The results support the need for ongoing prevention efforts including vaccination and antimicrobial stewardship programs to reduce the burden of PD in children.

Keywords: Streptococcus pneumoniae; Antimicrobial resistance; Children; Costs; Hospitalization; Pneumococcal disease.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was approved and exempted from consent by the New England/WGC Institutional Review Board/Human Subjects Research Committee (Wellesley, Massachusetts) based upon use of a limited retrospective dataset for an epidemiology study. The study was performed in accordance with the Declaration of Helsinki and conducted in compliance with Health Insurance Portability and Accountability Act requirements. Consent for publication: Not applicable. Competing interests: SM, NC, MW, and KAF. are employees of Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA and may own stock/stock options in Merck & Co., Inc., Rahway, NJ, USA. GY and VG were formerly employed by BD and KCY is a current BD employee. BD was contracted by Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA to conduct the study. KCY currently owns stock in BD and VG previously owned stock in BD.

Similar articles

See all similar articles

References

    1. Wahl B, O’Brien KL, Greenbaum A, et al. Burden of Streptococcus pneumoniae and Haemophilus influenzae type b disease in children in the era of conjugate vaccines: global, regional, and national estimates for 2000-15. Lancet Glob Health. 2018;6(7):e744–57. 10.1016/s2214-109x(18)30247-x. - PMC - PubMed
    1. Centers for Disease Control and Prevention. Active Bacterial Core Surveillance (ABCs) report. Emerging infections program network, Streptococcus pneumoniae, 2020. https://www.cdc.gov/abcs/downloads/SPN_Surveillance_Report_2020.pdf. Accessed 23 Jan 2023.
    1. Wasserman M, Chapman R, Lapidot R, et al. Twenty-year public health impact of 7- and 13-valent pneumococcal conjugate vaccines in US children. Emerg Infect Dis. 2021;27(6):1627–36. 10.3201/eid2706.204238. - PMC - PubMed
    1. Hu T, Song Y, Done N, et al. Incidence of invasive pneumococcal disease in children with commercial insurance or Medicaid coverage in the United States before and after the introduction of 7- and 13-valent pneumococcal conjugate vaccines during 1998–2018. BMC Public Health. 2022;22(1):1677. 10.1186/s12889-022-14051-6. - PMC - PubMed
    1. Tong S, Amand C, Kieffer A, Kyaw MH. Trends in healthcare utilization and costs associated with acute otitis media in the United States during 2008–2014. BMC Health Serv Res. 2018;18(1):318. 10.1186/s12913-018-3139-1. - PMC - PubMed

Publication types

MeSH terms

LinkOut - more resources