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[Invasive disease caused by Streptococcus pneumoniae: a 7-year study]
I Pocheville Gurutzeta1, J L Hernández Almaraz, C Gutiérrez Villamayor
1Servicio de Pediatría, Hospital de Cruces, Baracaldo, Vizcaya.
Insights
Invasive childhood pneumococcal infections are common, with increasing incidence. Penicillin-resistant Streptococcus pneumoniae strains were frequently observed, particularly in children with risk factors.
Area of Science:
- Pediatric Infectious Diseases
- Bacteriology
- Epidemiology
Context:
- Invasive pneumococcal infections pose a significant threat to child health.
- Understanding the epidemiology and antimicrobial resistance patterns of Streptococcus pneumoniae is crucial for effective treatment and prevention.
Purpose:
- To investigate the epidemiology of invasive childhood pneumococcal infections.
- To analyze the serotypes and antibiotic susceptibility of isolated Streptococcus pneumoniae strains.
- To identify risk factors associated with antibiotic resistance.
Summary:
- A study reviewed 70 children with invasive pneumococcal infections, noting an increasing annual incidence.
- Bacteremia and pneumonia were the most common clinical presentations, predominantly affecting children under three years old.
- Penicillin resistance was observed in 45.7% of isolates, with serotype 6 being highly prevalent and resistant. Risk factors, such as underlying disease or prior hospitalization, were associated with a higher rate of antibiotic-resistant strains.
Impact:
- Highlights the significant burden of invasive pneumococcal disease in children.
- Identifies specific serotypes and resistance patterns that require monitoring.
- Informs clinical management and public health strategies for preventing and treating pneumococcal infections in pediatric populations.
Objective:
The purpose of this study was to study the epidemiology of invasive childhood pneumococcal infection in our hospital.
Patients And Methods:
The records of all children attending our hospital from whom Streptococcus pneumoniae was isolated from the blood or CSF were reviewed. Serotyping and MIC were performed at C.N.M.V.S. (Majadahonda).
Results:
Seventy-one pneumococci were isolated in 70 patients. The annual incidence increased from 0.14% to 0.40%. The clinical entities were: bacteremia without focus (45%), pneumonia (29.6%), meningitis (12.7%), cellulitis (5.6%), mastoiditis (5.6%) and endocarditis (1.4%). The age of 72% of the patients was less than 3 years. In 26.8% of the cases, the patient had an underlying disease and/or was previously hospitalized. The antibiotic susceptibility pattern was: penicillin (MIC < or = 0.06 microgram/ml) 45.7%, cefotaxime (MIC < or = 0.5 microgram/ml) 82.8% and erythromycin (MIC < or = 0.5 microgram/ml) 70%. Penicillin resistance of the isolated pneumococci was more often present in the group with risk factors than in those without such risk factors (p < 0.05). There were 13 different serotypes, the most prevalent were 6 (23%), 19 (17%), 14 (14%) and 23 (12%) and the most frequently penicillin-resistant (Resistant N(o)/Total N(o) were: 6 (15/15), 9 (4/4), 14 (8/9) and 23 (6/8).
Conclusions:
Streptococcus pneumoniae is a common cause of invasive infections in children in our hospital. There was a high prevalence of serotype 6 (penicillin-resistant) as compared to in adults where serotype 3 (penicillin-susceptible) is the most prevalent. A higher rate of antibiotic resistant strains associated with risk factors (underlying disease or nosocomial acquisition), probably related to prior antibiotic use, was observed.