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1 January 2006

Volume 42, Number 1
Clinical Infectious Diseases 2006;42:e1–e5
© 2005 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2006/4201-00E1$15.00
DOI: 10.1086/498745
MAJOR ARTICLE

Trends in Invasive Pneumococcal Disease–Associated Hospitalizations

Samir S. Shah1,2,3,4 and

Adam J. Ratner1

Divisions of 1Infectious Diseases and 2General Pediatrics, The Children’s Hospital of Philadelphia, and 3Center for Clinical Epidemiology and Biostatistics and 4Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

Background.The heptavalent pneumococcal conjugate vaccine was licensed in the United States in 2000 for use in infants and children. Postlicensure surveillance revealed substantial regional and national decreases in invasive pneumococcal disease. It is not known whether widespread vaccine use has led to a concomitant decrease in invasive pneumococcal disease–associated hospitalization rates.

Objective.We examined national trends in rates of hospitalization among both children and adults with invasive pneumococcal disease.

Methods.Data from the 1998–2003 National Hospital Discharge Survey and population estimates from the National Center for Health Statistics were used to calculate rates of hospital discharge for patients admitted with invasive pneumococcal disease, defined as meningitis or bacteremia caused by Streptococcus pneumoniae.

Results.Rates of hospital discharge for patients admitted with invasive pneumococcal disease decreased during the study period from a peak of 12.03 discharges per 100,000 population in 1999 to 5.60 discharges per 100,000 population in 2003 ( ). Rates of hospital discharge for persons admitted with pneumococcal meningitis decreased from 1.60 discharges per 100,000 person‐years in the prelicensure period to 0.53 discharges per 100,000 person‐years in the postlicensure period. For persons 65 years of age but not for those <4 years of age, the rates of hospital discharge for those admitted with pneumococcal bacteremia were significantly lower during the postlicensure period, compared with the prelicensure period.

Conclusions.Hospital discharge rates for persons admitted with invasive pneumococcal disease, including meningitis, have decreased since introduction of the heptavalent pneumococcal conjugate vaccine. The decrease was driven in part by the reduction of invasive pneumococcal disease–associated hospitalizations in the subgroup aged 65 years.

Received 14 July 2005; accepted 3 September 2005; electronically published 23 November 2005.

Reprints or correspondence: Dr. Adam J. Ratner, Div. of Infectious Diseases, Children’s Hospital of Philadelphia, ARC 1202, 34th St. and Civic Center Blvd., Philadelphia, PA 19104 ().
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