Outcomes of pediatric community-acquired pneumonia before and after national pneumococcal immunization in Taiwan
I-Fan Chang MD
Department of Pediatrics, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
Contribution: Validation, Formal analysis, Data curation, Investigation, Writing - original draft, Writing - review & editing, Software
Search for more papers by this authorI-Fan Lin MS
Department of Pediatrics, College of Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
Contribution: Software, Data curation, Formal analysis, Validation
Search for more papers by this authorYun-Chung Liu MS
Department of Pediatrics, College of Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
Contribution: Methodology, Data curation, Validation, Writing - review & editing, Formal analysis
Search for more papers by this authorChia-Ching Chou PhD
Institute of Applied Mechanics, National Taiwan University, Taipei, Taiwan
Contribution: Methodology, Supervision, Resources, Writing - review & editing
Search for more papers by this authorTu-Hsuan Chang MD
Department of Pediatrics, Chi-Mei Medical Center, Tainan, Taiwan
Contribution: Supervision, Visualization, Writing - review & editing
Search for more papers by this authorTing-Yu Yen MD
Department of Pediatrics, College of Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
Contribution: Supervision, Resources, Visualization, Writing - review & editing
Search for more papers by this authorChun-Yi Lu MD, PhD
Department of Pediatrics, College of Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
Contribution: Supervision, Resources, Visualization, Writing - review & editing
Search for more papers by this authorCorresponding Author
Luan-Yin Chang MD, PhD
Department of Pediatrics, College of Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
Correspondence Luan-Yin Chang, MD, PhD, Department of Pediatrics, College of Medicine, National Taiwan University Hospital, National Taiwan University, 8 Chung-Shan South Rd, Taipei 10002, Taiwan.
Email: [email protected]
Contribution: Conceptualization, Funding acquisition, Supervision, Project administration, Writing - review & editing, Investigation
Search for more papers by this authorFeipei Lai PhD
Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan
Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan
Contribution: Supervision, Resources, Writing - review & editing, Funding acquisition
Search for more papers by this authorLi-Min Huang MD, PhD
Department of Pediatrics, College of Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
Contribution: Writing - review & editing, Supervision, Resources
Search for more papers by this authorI-Fan Chang MD
Department of Pediatrics, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
Contribution: Validation, Formal analysis, Data curation, Investigation, Writing - original draft, Writing - review & editing, Software
Search for more papers by this authorI-Fan Lin MS
Department of Pediatrics, College of Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
Contribution: Software, Data curation, Formal analysis, Validation
Search for more papers by this authorYun-Chung Liu MS
Department of Pediatrics, College of Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
Contribution: Methodology, Data curation, Validation, Writing - review & editing, Formal analysis
Search for more papers by this authorChia-Ching Chou PhD
Institute of Applied Mechanics, National Taiwan University, Taipei, Taiwan
Contribution: Methodology, Supervision, Resources, Writing - review & editing
Search for more papers by this authorTu-Hsuan Chang MD
Department of Pediatrics, Chi-Mei Medical Center, Tainan, Taiwan
Contribution: Supervision, Visualization, Writing - review & editing
Search for more papers by this authorTing-Yu Yen MD
Department of Pediatrics, College of Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
Contribution: Supervision, Resources, Visualization, Writing - review & editing
Search for more papers by this authorChun-Yi Lu MD, PhD
Department of Pediatrics, College of Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
Contribution: Supervision, Resources, Visualization, Writing - review & editing
Search for more papers by this authorCorresponding Author
Luan-Yin Chang MD, PhD
Department of Pediatrics, College of Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
Correspondence Luan-Yin Chang, MD, PhD, Department of Pediatrics, College of Medicine, National Taiwan University Hospital, National Taiwan University, 8 Chung-Shan South Rd, Taipei 10002, Taiwan.
Email: [email protected]
Contribution: Conceptualization, Funding acquisition, Supervision, Project administration, Writing - review & editing, Investigation
Search for more papers by this authorFeipei Lai PhD
Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan
Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan
Contribution: Supervision, Resources, Writing - review & editing, Funding acquisition
Search for more papers by this authorLi-Min Huang MD, PhD
Department of Pediatrics, College of Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
Contribution: Writing - review & editing, Supervision, Resources
Search for more papers by this authorAbstract
Objective
In Taiwan, the incidence of invasive pneumococcal disease (IPD) in children declined after the catch-up primary vaccination programs and the full national immunization program (NIP) with PCV13. The objective of the study was to investigate the clinical outcomes of pediatric community-acquired pneumonia (CAP) before and after the NIP.
Methods
The study included patients aged 3 months to 17 years who were diagnosed with CAP and treated at the National Taiwan University Hospital between 2007 and 2019. Patients were assigned to three birth cohorts according to their birth years and vaccination eligibility: non-NIP, catch-up, and full NIP. We compared the rates of severe outcomes, including case fatality and pathogens.
Results
A total of 6557 patients who met the CAP criteria were enrolled during the study period. The case-fatality rate decreased from 3.2% (94/2984) in the non-NIP cohort to 0.3% (7/2176) in the catch-up cohort and 0.8% (11/1397) in the full NIP cohort (p < 0.001). Furthermore, there was a significant decrease in invasive ventilation from the non-NIP (17.9%) to both catch-up (6.8%) and full NIP cohorts (9.1%). The rate of IPD declined from the non-NIP cohort to the catch-up cohort (1.8% vs. 0.6%, p < 0.001) and from the catch-up to the full NIP cohort (0.6% vs. 0.07%, p = 0.014). In contrast, the rates of infections with other pathogens increased after NIP.
Conclusion
The introduction of PCV13 showed significant reduction in case-fatality and IPD rates. The increasing rates of other pathogens warrant further surveillance for their clinical significance.
CONFLICT OF INTEREST STATEMENT
The authors declare no conflict of interest.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
Supporting Information
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| ppul26651-sup-0001-Online_Supporting_Information_revised.docx406 KB | Supporting information. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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