Comparison of invasive pneumococcal disease caused by serotype 19A and non-19A pneumococci in children: More empyema in serotype 19A invasive pneumococcal disease

Objective: To delineate whether serotype 19A invasive pneumococcal disease (IPD) comprised significantly more necrotizing pneumonia and empyema in children, we compared the clinical characteristics between serotype 19A and non-19A IPD. Methods: Between January 2007 and December 2011, cases of children with IPD who were treated at the National Taiwan University Hospital were reviewed. Patients were assigned to the 19A group or the non-19A group based on the serotype. Their demographic data, clinical course, laboratory results, diagnosis, complications, and sequelae were collected and analyzed. Results: Overall, 27 patients were included in the 19A group and 29 patients in the non-19A group. Compared with non-19A group, serotype 19A tended to cause IPD in patients without major underlying diseases (p=0.015). Bacteremia without pneumonia or meningitis was found more frequently in the non-19A group (45% vs. 11%, p=0.01), and pneumonia with or without empyema occurred significantly more frequently in the 19A group (89% vs. 52%, p=0.006). Patients in the19A group had longer duration of fever (12 vs. 3 days, p=0.01), and required more intensive care (78% vs. 41%, p=0.01) and more video-assisted thoracoscopic surgery (74% vs. 28%, p=0.001). Conclusion: In comparison with the other serotypes, serotype 19A IPD has significantly more empyema which required more video-assisted thoracoscopic surgery and more intensive care. ? 2012.