Presentation (CTI)

OBJECTIVES: We aimed to estimate the burden of hospitalized pneumococcal infections (non-bacteriemic pneumonia (NBPP), bacteriemia (PB), meningitis (PM)) between 2015 and 2019 in a pediatric population with a focus on infants <1 years of age (yoa). Primary objective was to estimate the annual incidence of hospitalized stays of interest. Secondary objectives were to characterize the patients, to estimate the hospital case fatality rates (CFR), to describe rates and timelines of rehospitalizations for respiratory causes and to evaluate the associated costs.
METHODS: This study was longitudinal, retrospective, observational and conducted from the PMSI; stays were identified through ICD10 codes diagnosis and associated hospital costs estimated in a health insurance perspective.
RESULTS: Infants <1 yoa represented 23.9%, 30.7% and 45.4% of hospitalizations for NBPP, PB and PM respectively. Incidences (per 100,000) were 25.3, 10.6 and 10.9, respectively. A transfer to a critical care unit was observed for 27.1%, 28.4% and 52.6% of children with NBPP, PB and PM, respectively, being 43.5%, 33.6% and 57.1% respectively for infants. CFR for children with NBPP, PB and PM was 0.8%, 2.1% and 5.1% respectively, being 1.3% and 6.5% for NBPP and PM respectively for infants; the median length of stays for NBPP, PB and PM was 4, 6 and 12, respectively, being 5, 7 and 14, respectively, for infants. In the 30, 90 and 180 days following the discharge, 1.0%, 3.2% and 5.3% of children with NBPP were rehospitalized for a respiratory reason, these ratios being slightly the same for infants. The total cost of NBPP, PB and PM was 17,807,451 €, 10,083,656 € and 6,561,198 €, infants representing 25.9%, 26.9% and 47.3% respectively of these total costs.
CONCLUSIONS: This study highlights the health-economic impact of pneumococcal infections in pediatric populations. Ongoing monitoring is essential to adapt public health policies for the most vulnerable groups.