Invasive Pneumococcal Disease in a Primary Paediatric Practice in Croatia

Background: Invasive pneumococcal disease (IPD) is a major health problem in Croatia. Most cases are caused by less than 10 pneumococcal serotypes and there are opportunities for prevention in the form of conjugated vaccines.

Objective: Aim was to analyze cases of IPD in our primary paediatric practice.

Methods: We analyzed epidemiological characteristics of 18 cases of IPD treated in the period from January 2014 – January 2017. Descriptive statistical analysis was used.

Results: From a total of 18 patients, 11 were male and 7 female. The mean age of the patients was 16 months, median 14 months, age range from 9 months to 29 months. Nine patients had a diagnosis of bacteriemia, 8 had bacteriemic pneumonia, and 1 had bacterial meningitis. Antimicrobial treatment applied was ceftriaxone parenterally and later amoxicillin orally. Clinical improvement was observed in all patients. Basic immunological findings were normal in all children. The one patient with bacterial meningitis had transient neutropenia during infancy. Most of the cases occurred during winter months, only the case of bacterial meningitis during early spring. Most of the patients attended kindergarten and weren`t vaccinated with PCV13 vaccine prior the disease. Parents of all of these patients decided to vaccinate their child with PCV13 vaccine after the recovery.

Conclusion: Most cases of IPD occur in otherwise healthy children and could be prevented by existing conjugate vaccines (PCV10 and PCV13 vaccine).