European Journal of Molecular & Clinical Medicine

Background: Acute respiratory tract infections are a major cause of under-five
childhood morbidity and mortality across the world. Knowledge of pathogenicity and
invasiveness of serotypes can help in predicting the course of disease and will permit
necessary interventions to be taken in time. This will result in better opportunities of
care and significant decrease in morbidity and mortality associated with pneumococcus.
The aim of this study to identify the various pneumococcal serotypes affecting children
as pneumococcal invasive disease and to study the clinical presentation, invasiveness
and the morbidity and mortality caused by them.
Materials & Methods: It was a hospital based prospective analytical study done at K.D.
Medical College, Mathura. All patients within the age group of six months to eighteen
years were enrolled in the study. All patients admitted with community acquired
pneumonia were screened for evidence of sepsis with the help of routine investigations
and acute phase reactants (CRP and Procalcitonin). Clinical profile was studied, and an
attempt was made for identification of causative organism by means of Blood culture
and DNA PCR.
Results: Out of 716 cases admitted with LRTI, 316 were considered to be bacterial in
origin based on clinical presentation, X-Ray findings (classical
Consolidation/Empyema), Neutrophilic Leukocytosis, raised Acute Phase Reactants
(CRP/PCT) or Blood Culture positivity. Causative organism was identified on basis of
blood culture in 28.4% cases. Pneumococcal infection was documented by blood culture
in 0.69 % cases while evidence of invasive pneumococcal disease in form of
identification of serotype was obtained in 30% cases. 21 different pneumococcal
serotypes were identified. Serotype 1 was most common isolate. Other common isolates
were serotype 14, 6B, 7F, 9B, 19F, 9N, 18C, 19A, 20, 10F and 5. Serotypes 18C and 19A
were associated with maximum mortality. Serotype 14 was another most virulent
serotype.