Streptococcus pneumoniae is a Gram-positive encapsulated bacterium. It can cause a wide disease spectrum, from otitis media to sepsis and meningitis [1]. Invasive pneumococcal disease (IPD) is defined as S. pneumoniae isolated from sterile sites, such as blood, cerebrospinal fluid, pleural fluid, or ascites. IPD results in high global morbidity and mortality each year [2], but it is a vaccine-preventable disease [3–5]. Its incidence decreased after the introduction of a seven-valent pneumococcal conjugate vaccine (PCV7) in the private sector in Taiwan in October 2005 [6, 7]. The estimated coverage rate of PCV7 vaccination was 5.7 % in 2006 and 45.5 % in 2010 among children <5 years of age. PCV13 was introduced in April 2010, and in 2013, a national catch-up program was launched in Taiwan to provide government-funded PCV13 for all children aged 2–5 years [7].The symptoms and signs of IPD are related to host immunity, S. pneumoniae virulence, and the site of infection [1]. Early recognition and prompt diagnosis remain challenges. There have been few studies analyzing the early clinical presentation in severe IPD in children since the introduction of PCV7 in Taiwan. We designed this study to characterize the clinical features and outcomes of IPD in a pediatric intensive care unit (PICU) under partial PCV immunization.
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