Journal article
Streptococcus pneumoniae-associated Hemolytic Uremic Syndrome Among Children in North America
The Pediatric infectious disease journal, Vol.30(9), pp.736-739
09/01/2011
DOI: 10.1097/INF.0b013e3182191c58
PMID: 21772230
Abstract
Background: To better characterize Streptococcus pneumoniae-associated hemolytic-uremic syndrome (SP-HUS), we report the largest series of SP-HUS among children in North America.
Methods: We surveyed pediatric members of the Emerging Infections Network to identify SP-HUS cases. Respondents contributed clinical and laboratory features of these pediatric cases.
Results: A total of 37 cases occurring between 1997 and 2009 were submitted. Of them, 33 cases (89%) were culture-confirmed and 4 (11%) were diagnosed clinically. The median patient age was 2 years, and 28 (76%) patients had completed their heptavalent pneumococcal conjugate vaccination (PCV7) series. Most patients presented with pneumonia (84%) and bacteremia (78%), whereas other clinical manifestations such as pericardial effusion (14%) and meningitis (11%) were less common. Of 29 patients, with bacteremia 6 (21%) had S. pneumoniae concurrently isolated from cerebrospinal fluid or pleural fluid. Severe illness was common with 35 (95%) patients requiring admission to the intensive care unit, over half requiring mechanical ventilation and chest tube placement or video-assisted thoracoscopic surgery, and 27 (73%) requiring dialysis during hospitalization. Among 30 patients with follow-up of 6 months, 7 (23%) remained dialysis dependent, 3 (10%) had undergone renal transplantation, 4 (13%) had neurologic sequelae, and 1 (3%) died. Among 24 serotyped isolates, 96% were non-PCV7 serotypes, most commonly 19A (50%), 92% are included in PCV13, and 10% were penicillin nonsusceptible (minimal inhibitory concentration > 2 mu g/mL).
Conclusions: North American children with SP-HUS had severe clinical manifestations and significant morbidity. In this series, nearly all cases were caused by serotypes that are not in PCV7 but are included in PCV13.
Details
- Title: Subtitle
- Streptococcus pneumoniae-associated Hemolytic Uremic Syndrome Among Children in North America
- Creators
- Ritu Banerjee - Pediatric and Adolescent MedicineAdam L. Hersh - Pediatric Infectious Diseases SocietyJason Newland - University of Missouri–Kansas CitySusan E. Beekmann - University of IowaPhilip M. Polgreen - University of IowaJeffrey Bender - Kaiser PermanenteJana Shaw - SUNY Upstate Medical UniversityLawrence Copelovitch - University of PennsylvaniaBernard S. Kaplan - University of PennsylvaniaSamir S. Shah - University of PennsylvaniaEmerging Infections Network Hemoly
- Resource Type
- Journal article
- Publication Details
- The Pediatric infectious disease journal, Vol.30(9), pp.736-739
- DOI
- 10.1097/INF.0b013e3182191c58
- PMID
- 21772230
- NLM abbreviation
- Pediatr Infect Dis J
- ISSN
- 0891-3668
- eISSN
- 1532-0987
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 4
- Grant note
- U50 CCU112346 / Centers for Disease Control and Prevention; United States Department of Health & Human Services; Centers for Disease Control & Prevention - USA
- Language
- English
- Date published
- 09/01/2011
- Academic Unit
- Infectious Diseases; Epidemiology; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984359809702771
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