Objective: The clinical epidemiology, associations between serotype distributions, disease syndromes, patient characteristics, and their outcomes in children with IPD (invasive pneumococcal disease) were analyzed to support local and global policy decisions on pneumococcal disease prevention and treatment.Methods: A retrospective analysis of 64 patients less than 5 years hospitalized for IPD was conducted.We analyzed the general clinical data, laboratory tests, Streptococcus pneumoniae (S.pneumoniae) serotype distribution, outcomes and the association among these data based on different disease syndromes.Results: Diagnoses included: empyema (PE;28, 43.8%), bacteremia (PB;21, 32.8%), meningitis (PM;15, 23.4%) and necrotizing pneumonia (PNP;14, 21.9%).Serotype19A was the most common serotype and could lead to all types of IPDs.Serotype14 more likely lead to PNP.23F and the others group more likely contributed to PB.The motality was (9/64, 22.0%).Motality for meningitis was 32.4 (p<0.05).The duration of hospital stay for PE was longest of 31 days (p<0.05).36.4% (4/11) of patients with 14 died.The number and percentages of isolates resistant to different antibiotics based on serotypes were different.The rate of resistance to penicillin was 42.2%.31/64(48.4%), 33/64(51.6%), 60/64(93.8%) strains covered by PCV-7, PCV-10, PCV-13, respectively.Conclusion:High risk factors for death among patients with IPD include the following: young age, male gender, rural-area living, low total WBC count, high levels of PCT, infection with serotype 14, no prior antibiotic treatment and undiagnosed PM.PCV13 is likely to prevent more episodes of pneumococcal disease in northeast of China.