Clinical Manifestations and Molecular Epidemiology of Necrotizing Pneumonia and Empyema Caused by Streptococcus pneumoniae in Children in Taiwan

Yu-Chia Hsieh, Alan R.; Po-Ren Hsueh; Chun-Yi Lu; Ping-Ing Lee, Alan R.; Chin-Yun Lee; Li-Min Huang
March 2004
Clinical Infectious Diseases;3/15/2004, Vol. 38 Issue 6, p830
Academic Journal
Recently, there have been increasing numbers of pneumococcal pneumonia cases, with their associated complications. We conducted a retrospective review to increase the understanding of childhood pneumococcal pneumonia. Seventy-one patients with pneumococcal pneumonia were identified. Forty (56.3%) of them developed complicated pneumonia. Multivariate analysis showed that presence of immature polymorphonuclear leukocytes in peripheral blood (odds ratio [OR], 3.67; 95% confidence interval [CI], 1.08-12.63), high C-reactive protein levels (> 12 mg/dL) (OR, 5.24; 95% CI, 1.10-24.93), and no underlying disease at presentation (OR, 5.48; 95% CI, 1.06-28.25) were independent predictors of the occurrence of necrosis or/and abscess. Fourteen isolates (35%), which were genotypically identical and had the same pulsed-field gel electrophoresis pattern (serogroup 14, with MICs of penicillin of 0.1-0.5 μg/mL), were significantly associated with complicated pneumonia (p = 0.47 ). Whether the virulence of antibiotic-resistant pneumococci is evolving deserves further investigation.


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