Institutional members access full text with Ovid®

Share this article on:

Serotype Childhood Invasive Pneumococcal Disease has Unique Characteristics Compared to Disease Caused by Other Streptococcus pneumoniae Serotypes

Fuchs, Inbal MD; Dagan, Ron MD; Givon-Lavi, Noga PhD; Greenberg, David MD

The Pediatric Infectious Disease Journal: June 2013 - Volume 32 - Issue 6 - p 614–618
doi: 10.1097/INF.0b013e31828691cb
Original Studies

Background: We aimed to determine whether serotype 1 (SP1) invasive pneumococcal disease (IPD) can be distinguished by demographic, clinical and laboratory characteristics from IPD caused by the other most common serotypes (MCS) in our region: 5, 14, 6A, 6B, 19A, 19F, 23F.

Methods: Data for all IPD episodes in children <18 years old treated at the Soroka University Medical Center during 2000 to 2009 were retrospectively retrieved. Episodes caused by SP1-IPD were compared with those caused by MCS-IPD (both grouped and individual serotypes). Analyses were adjusted for age and ethnicity.

Results: Ninety-four SP1-IPD and 250 MCS-IPD episodes were documented. SP1-IPD cases were older (68.3 ± 52.6 months versus 30.4 ± 39.2 months; P < 0.001) and more likely to be found in Bedouin children than MCS-IPD (87.5% versus 58.6%; P < 0.001). SP1 was less frequently isolated from patients with underlying disease than MCS (14.9% versus 31.6 %; P < 0.001; relative risk 0.15 [95% confidence interval: 0.07–0.32]). SP1 was more often associated with bacteremic pneumonia and primary peritonitis than MCS (66% versus 38.4% and 7.4% versus 0.8%, respectively; P < 0.001); the proportion of bacteremia without focus was higher in MCS-IPD (32.4% versus 12.5%; P < 0.001). There were no differences in hospitalization and mortality rates (70.2% versus 68.0% [P = 0.22] and 4.3% versus 5.6% [P = 0.26], respectively).

Conclusions: SP1 was found less frequently than MCS in children with underlying diseases, but it was more frequent in older and Bedouin children with IPD. SP1 was more frequently associated with bacteremic pneumonia and primary peritonitis than MCS grouped.

From the Pediatric Infectious Disease Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel.

Accepted for publication January 07, 2013.

The authors have no funding or conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (

Address for correspondence: David Greenberg, MD, The Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel. E-mail:

© 2013 Lippincott Williams & Wilkins, Inc.