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Paediatric, invasive pneumococcal disease in Switzerland, 1985-1994. Swiss Pneumococcal Study Group
I Venetz1, K Schopfer, K Mühlemann
1Institute of Medical Microbiology, University of Bern, Switzerland.
Insights
Invasive pneumococcal disease in children is less common in Switzerland than elsewhere, with meningitis being the most frequent severe infection. Rural residence and a history of basal skull fracture increase risk.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology
- Vaccinology
Background:
- Understanding pneumococcal disease epidemiology is crucial for cost-effective vaccination strategies in children.
- Detailed local data on pneumococcal infections are needed to guide public health interventions.
Purpose of the Study:
- To analyze the epidemiology of invasive pneumococcal infections in children in Switzerland.
- To identify risk factors and outcomes associated with pediatric pneumococcal disease.
Main Methods:
- Retrospective data collection of 393 culture-confirmed invasive pneumococcal infections in children (<17 years) from Swiss pediatric clinics (1985-1994).
Main Results:
- Meningitis (42%), pneumonia (28%), and bacteremia (26%) were the most common presentations.
- Overall incidence was 2.7/100,000 children (<17 years), with higher rates in those <2 years (11/100,000).
- Lethality was high for meningitis (8.6%) and bacteremia (8.9%); rural residence was linked to increased risk (RR 1.45).
Conclusions:
- Pediatric invasive pneumococcal disease appears less frequent in Switzerland compared to other regions, potentially due to diagnostic practices and lower daycare use.
- Children with a history of basal skull fracture face a higher risk of pneumococcal meningitis.
- Further research into rural residence associations and antibiotic use for respiratory infections could illuminate disease dynamics and antibiotic resistance.
Background:
Cost effective use of new vaccines against pneumococcal disease in children requires detailed information about the local epidemiology of pneumococcal infections.
Methods:
Data on 393 culture-confirmed cases of invasive pneumococcal infection in children (<17 years) hospitalized in Swiss paediatric clinics were collected retrospectively for the years 1985-1994.
Results:
Meningitis (42%) was most frequent, followed by pneumonia (28%) and bacteraemia (26%). The overall annual incidence was 2.7 cases per 100000 children <17 years old and 11 cases per 100000 children <2 years old. Annual incidence rates were stable over the study period. Lethality was high for meningitis (8.6%) and bacteraemia (8.9%). A history of basal skull fracture was reported in 3.3% of children with pneumococcal meningitis. Residence in a rural region was associated with an increased risk of pneumococcal infection (relative risk = 1.45, 95% confidence interval: 1.01-2.00).
Conclusions:
Paediatric, invasive pneumococcal disease seems to be less frequent in Switzerland than in other European and non-European countries. This may be due to differences in diagnostic strategies and lower frequency of risk factors such as the use of day care. Children with a history of basal skull fracture are at increased risk for pneumococcal meningitis. Further investigation of the association of invasive pneumococcal infection with rural residence and the use of antibiotics for upper respiratory tract infections might give new insight into the dynamics of Streptococcus pneumoniae infection and the development of antibiotic resistance.