BACKGROUND: We monitored pediatric invasive pneumococcal disease (IPD) in Santiago, Chile, from 1994 to 2007. METHODS: Three related data sets were generated: (1) IPD cases requiring hospitalization, 1994--2007; (2) cases of bacteremia detected among febrile patients aged 0-35 months seen in emergency departments, 2000--2007; and (3) nasopharyngeal carriage of pneumococcal serotypes, determined from repetitive culturing, among 524 newborns followed up through age 23 months. RESULTS: Of 2369 IPD cases requiring hospitalization, 1878 (79.3%) occurred in those aged 0-59 months, and 1200 (50.7%) occurred in those aged 6-35 months. Among infants aged 0-5 months, meningitis and sepsis comprised 48.4% of all IPD cases (serotype 5 predominated); among those 6-35 months old, 522 (43.5%) of 1200 cases were bacteremic pneumonia (serotype 14 predominated). Serotype 1 peritonitis was common among 5-14-year-old girls. Meningitis and sepsis exhibited high case fatality rates (14%-29%) among all ages. Remarkably, 34 (28.8%) of 118 children with sepsis died, versus 1 fatality (0.4%) among 276 children hospitalized with bacteremia without a focus (P < .001, Fisher's exact test). Serotype 5 was significantly more common among hospitalized patients < 36 months of age, whereas serotype 18C was overrepresented among ambulatory patients. The annual incidence of serotype 14 was stable; those of serotypes 1 and 5 fluctuated markedly. Serotypes 14, 5, and 1 were overrepresented among invasive compared with nasopharyngeal isolates. CONCLUSIONS: Clinical syndromes of IPD and predominant serotypes vary with age.
BACKGROUND: We monitored pediatric invasive pneumococcal disease (IPD) in Santiago, Chile, from 1994 to 2007. METHODS: Three related data sets were generated: (1) IPD cases requiring hospitalization, 1994--2007; (2) cases of bacteremia detected among febrile patients aged 0-35 months seen in emergency departments, 2000--2007; and (3) nasopharyngeal carriage of pneumococcal serotypes, determined from repetitive culturing, among 524 newborns followed up through age 23 months. RESULTS: Of 2369 IPD cases requiring hospitalization, 1878 (79.3%) occurred in those aged 0-59 months, and 1200 (50.7%) occurred in those aged 6-35 months. Among infants aged 0-5 months, meningitis and sepsis comprised 48.4% of all IPD cases (serotype 5 predominated); among those 6-35 months old, 522 (43.5%) of 1200 cases were bacteremic pneumonia (serotype 14 predominated). Serotype 1 peritonitis was common among 5-14-year-old girls. Meningitis and sepsis exhibited high case fatality rates (14%-29%) among all ages. Remarkably, 34 (28.8%) of 118 children with sepsis died, versus 1 fatality (0.4%) among 276 children hospitalized with bacteremia without a focus (P < .001, Fisher's exact test). Serotype 5 was significantly more common among hospitalized patients < 36 months of age, whereas serotype 18C was overrepresented among ambulatory patients. The annual incidence of serotype 14 was stable; those of serotypes 1 and 5 fluctuated markedly. Serotypes 14, 5, and 1 were overrepresented among invasive compared with nasopharyngeal isolates. CONCLUSIONS: Clinical syndromes of IPD and predominant serotypes vary with age.
Authors: Bruno Pichon; Laura Moyce; Carmen Sheppard; Mary Slack; Deborah Turbitt; Richard Pebody; David A Spencer; Justin Edwards; Daniel Krahé; Robert George Journal: J Clin Microbiol Date: 2010-02-17 Impact factor: 5.948
Authors: Hope L Johnson; Maria Deloria-Knoll; Orin S Levine; Sonia K Stoszek; Laura Freimanis Hance; Richard Reithinger; Larry R Muenz; Katherine L O'Brien Journal: PLoS Med Date: 2010-10-05 Impact factor: 11.069
Authors: Inci Yildirim; William P Hanage; Marc Lipsitch; Kimberly M Shea; Abbie Stevenson; Jonathan Finkelstein; Susan S Huang; Grace M Lee; Ken Kleinman; S I Pelton Journal: Vaccine Date: 2010-10-26 Impact factor: 3.641
Authors: Judith E Mueller; Seydou Yaro; Macaire S Ouédraogo; Natalia Levina; Berthe-Marie Njanpop-Lafourcade; Haoua Tall; Régina S Idohou; Oumarou Sanou; Sita S Kroman; Aly Drabo; Boubacar Nacro; Athanase Millogo; Mark van der Linden; Bradford D Gessner Journal: PLoS One Date: 2012-12-20 Impact factor: 3.240