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Published on: February 23, 2014
[Invasive pneumoccal disease in children in Oslo 1998-2004]
Lin Vigdis Brauteset1, Ernst Arne Høiby, Gaute Syversen
1Barneklinikken Ullevål universitetssykehus 0407 Oslo. linvigdis.brauteset@ulleval.no
Insights
Invasive pneumococcal disease (IPD) is a serious threat to children. Vaccination offers significant protection against IPD, preventing many cases and reducing mortality in pediatric populations.
Area of Science:
- Pediatric infectious diseases
- Microbiology
- Vaccinology
Context:
- Invasive pneumococcal disease (IPD) poses a significant public health challenge in children, contributing to substantial morbidity and mortality.
- Understanding the epidemiology and characteristics of IPD is crucial for effective prevention and treatment strategies.
Purpose:
- To investigate the epidemiology, predisposing factors, clinical presentation, antimicrobial resistance, and outcomes of IPD in Norwegian children.
- To assess the theoretical impact and coverage of the 7-valent conjugate pneumococcal vaccine (PCV7) on identified IPD cases.
Summary:
- A retrospective analysis of 68 children under 16 with IPD revealed that 31 had predisposing factors, and all six deaths occurred in this subgroup.
- Antimicrobial susceptibility testing showed high susceptibility to benzyl penicillin, with some resistance to erythromycin. PCV7 could have potentially covered serotypes in 35% of cases.
- While PCV7 showed limited coverage for the specific serotypes causing IPD in this cohort, vaccination remains a key strategy for preventing pneumococcal disease.
Impact:
- This study highlights the severity of IPD in children and underscores the critical role of pneumococcal vaccination in disease prevention.
- Findings provide valuable data for public health initiatives and inform vaccination policies aimed at reducing the burden of IPD in pediatric populations.
Background:
Invasive pneumococcal disease (IPD) is an important cause of morbidity and mortality in Norwegian children.
Material And Methods:
This retrospective study included all children (under 16 years) with isolates of Streptococcus pneumoniae from a normally sterile site admitted to the Department of Paediatrics at Ullevaal University Hospital in the period 1998 to 2004. We studied the epidemiology, predisposing factors, clinical picture, antimicrobial resistance, outcome of IPD and the theoretical coverage of the 7-valent conjugate pneumococcal vaccine (PCV7) in these children. The isolates were tested for antimicrobial susceptibility, serogrouped and serotyped.
Results:
68 children were identified; 31 of them had one or more predisposing factors. Six children died, all of them had a predisposing factor. Six of the seven children who survived with sequelae were previously healthy. 67 of 68 isolates were fully susceptible to benzyl penicillin and 13 isolates showed intermediate susceptibility or resistance to erythromycin. Serogroups or serotypes were obtained in 66 children. 24 (36.8%) children fulfilled the criteria for PCV7. 35 (51.1%) children had serotypes covered by the vaccine. Only 12 (17.6%) fulfilled the criteria for PCV7 and had serotypes covered by it. Four of the six children who died had serotypes covered by PCV7.
Interpretation:
Invasive pneumococcal disease is a serious condition in children and vaccination can prevent disease in many children.
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