Childhood invasive pneumococcal disease: a hospital-based study from Malaysia.

OBJECTIVE

New conjugate vaccine for Streptococcus pneumoniae has been introduced in Malaysia recently. Information on infection due to S. pneumoniae in Malaysian children is scarce. We conducted a retrospective chart review of childhood invasive pneumococcal disease (IPD) presented to a single centre in Malaysia.

METHODS

A retrospective review of 5 years and 4 months of all cases of IPD in children younger than 14 years of age (May 1999-August 2004) seen at the University of Malaya Medical Centre (UMMC), Kuala Lumpur, was conducted. Cases were identified from the record of Department of Medical Microbiology, UMMC.

RESULTS

IPD was identified in 50 children (median age 1.1 years, range 2 weeks-14 years) during the study period. Seventy-six per cent of the cases were younger than 2 years of age. Pattern of infections noted include definite pneumonia (n = 8), probable pneumonia (n = 33), meningitis (n = 4), bacteraemia without focus (n = 4) and septic arthritis (n = 1 each). Pre-morbid diseases were present in 28% of all cases. Complications (n = 12, 24%) due to IPD were seizures (n = 5), pleural effusion/empyema (n = 4), cerebral palsy (n = 2) and deafness (n = 1). No deaths were attributed to IPD. Sixty-two per cent of the pneumococcal isolates were penicillin non-susceptible and were detected throughout the study period.

CONCLUSIONS

IPD is associated with high morbidity, particularly among young children. Majority of the isolates were penicillin-non-susceptible strains. Additional information on the serotype of S. pneumoniae isolated is necessary to assess the potential impact of immunisation on preventing pneumococcal infection in Malaysia.