Please use this identifier to cite or link to this item:
Title: Risk factor profiles and clinical outcomes for children and adults with pneumococcal infections in Singapore: A need to expand vaccination policy?
Authors: Martinez-Vega, R.
Jauneikaite, E.
Thoon, K.C.
Chua, H.Y.
Chua, A.H.
Khong, W.X.
Tan, B.H.
Hong, J.L.G.
Venkatachalam, I.
Tambyah, P.A. 
Hibberd, M.L.
Clarke, S.C.
Ng, O.T.
Issue Date: 2019
Publisher: Public Library of Science
Citation: Martinez-Vega, R., Jauneikaite, E., Thoon, K.C., Chua, H.Y., Chua, A.H., Khong, W.X., Tan, B.H., Hong, J.L.G., Venkatachalam, I., Tambyah, P.A., Hibberd, M.L., Clarke, S.C., Ng, O.T. (2019). Risk factor profiles and clinical outcomes for children and adults with pneumococcal infections in Singapore: A need to expand vaccination policy?. PLoS ONE 14 (10) : e0220951. ScholarBank@NUS Repository.
Rights: Attribution 4.0 International
Abstract: Invasive pneumococcal infection is a major cause of morbidity and mortality worldwide despite the availability of pneumococcal vaccines. The aim of this study was to re-evaluate the clinical syndromes, prognostic factors and outcomes for pneumococcal disease in adults and children in Singapore during the period before and after the introduction of the pneumococcal vaccine. We retrospectively analyzed a large cohort of patients admitted to the four main public hospitals in Singapore with S. pneumoniae infection between 1997 and 2013. A total of 889 (64% of all isolates identified in the clinical laboratories) cases were included in the analysis; 561 (63.1%) were adult (?16 years) cases with a median age of 62 years and 328 (36.9%) were paediatric cases with a median age of 3 years. Bacteraemic pneumonia was the most common syndrome in both groups (69.3% vs. 44.2%), followed by primary bacteraemia without pneumonia (14.3% vs. 13.4%), meningitis (6.4% vs. 7.6%) and non-bacteraemic pneumonia (5.2% vs. 21%). The major serotypes in adults were 3, 4, 6B, 14, 19F and 23F whereas in children they were 14, 6B and 19F, accounting both for nearly half of pneumococcal disease cases. No particular serotype was associated with mortality or severity of the pneumococcal disease. Overall mortality rate was 18.5% in adults and 3% in children. Risk factors for mortality included acute cardiac events in adults, meningitis in children and critical illness and bilateral pulmonary infiltrates in both adults and children. Penicillin resistance was not associated with increased mortality. Our results agree with global reports that the course of pneumococcal disease and its clinical outcome were more severe in adults than in children. The main serotypes causing invasive disease were mostly covered by the vaccines in use. The high mortality rates reflect an urgent need to increase vaccination coverage in both adults and children to tackle this vaccine-preventable infection. Copyright: © 2019 Martinez-Vega et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Source Title: PLoS ONE
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0220951
Rights: Attribution 4.0 International
Appears in Collections:Staff Publications

Show full item record
Files in This Item:
File Description SizeFormatAccess SettingsVersion 
10_1371_journal_pone_0220951.pdf989.73 kBAdobe PDF



Google ScholarTM



This item is licensed under a Creative Commons License Creative Commons