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Outcome of invasive pneumococcal disease: a UK based study. Oxford Pneumococcal Surveillance Group
F Shackley1, K Knox, J B Morris
1Oxford Vaccine Group, University of Oxford, UK.
Insights
Streptococcus pneumoniae infections in young UK children show low fatality but significant illness. Most cases involved specific serotypes, many targeted by new conjugate vaccines.
Area of Science:
- Pediatric Infectious Diseases
- Bacteriology
- Vaccinology
Background:
- Invasive Streptococcus pneumoniae infections pose a significant public health concern in young children.
- Understanding the epidemiology and clinical impact of pneumococcal disease is crucial for prevention strategies.
Purpose of the Study:
- To analyze the clinical characteristics and outcomes of invasive Streptococcus pneumoniae infections in children under five years old in the UK.
- To identify prevalent serotypes and assess their coverage by existing and emerging conjugate vaccines.
Main Methods:
- Retrospective review of medical records for 106 children under five years old diagnosed with invasive Streptococcus pneumoniae disease.
- Analysis of clinical manifestations, serotypes involved, and patient outcomes, including mortality and long-term morbidity.
Main Results:
- The most common clinical presentations were meningitis (37%), upper respiratory tract infections (24%), pneumonia (19%), and occult bacteremia (18%).
- A low case fatality rate was observed, with one death among the 106 children. However, seven children experienced persistent neurological impairment, indicating substantial morbidity.
- Five specific serotypes were responsible for 83% of the invasive diseases. Notably, 92% of these disease-causing serotypes are included in the seven-valent conjugate vaccines currently undergoing clinical trials.
Conclusions:
- Streptococcus pneumoniae infections in young children in the UK are associated with a low mortality rate but a considerable burden of morbidity.
- The findings highlight the importance of serotype distribution in disease causation and underscore the potential impact of seven-valent conjugate vaccines in reducing invasive pneumococcal disease in this age group.
Methods:
The records of 106 children aged less than 5 years with invasive disease caused by Streptococcus pneumoniae were reviewed.
Results:
The clinical manifestations were meningitis (37%), upper respiratory tract infection (24%), pneumonia (19%), and occult bacteraemia (18%). One child died and seven had persisting neurological impairment. Five serotypes caused 83% of disease and 92% of the serotypes are included in the seven valent conjugate vaccines which are undergoing trials.
Conclusions:
These data suggest that S pneumoniae infection is associated with a low case fatality rate but substantial morbidity in the UK.