Serotypes in pneumococcal disease. A ten year study in Australia 1970 through 1979

During the ten year period 1970 through 1979, pneumococci from 1205 episodes of pneumococcal disease affecting children and adults in Australia were studied. These included 188 cases of bacteremic pneumonia (85% in adults), 103 cases of primary bacteremia (50% adults), 201 cases of meningitis (69% children), 13 cases of osteomyelitis and/or arthritis, and 13 cases of peritonitis. Otitis media (403 cases), conjunctivitis and sinusitis were predominant amongst 672 localised infections. Of 36 serotypes of pneumococci met with, the leading types were 19, 14, 6, 3 and 9: type 14 predominated in children with primary bacteremia, bacteremic pneumonia or meningitis, type 9 in adults with bacteremic pneumonia, and types 3 and 7 in adults with meningitis. In otitis media types 19 and 3 predominated, in conjunctivitis types 19 and 6, and in sinusitis types 6 and 19. For bacteremic and meningeal infections the current (United States) vaccine provides 83% cover, deletion of the rare (in Australia) types 2, 12 and 25 and the substitution of types 11, 15 and 33 would increase cover by 5% to 88%.