title: Distribution of capsular types and penicillin-resistance of strains of Streptococcus pneumoniae causing systemic infections in Argentinian children under 5 years of age. Streptococcus pneumoniae Working Group.
abstract: Streptococcus pneumoniae (SPN) is the most common cause of invasive infections in children, with high levels of mortality in developing countries. An increase in frequency of penicillin-resistant strains is reported in most parts of the world. A study was undertaken in Argentina and 5 other countries of the region, to determine the type distribution and penicillin resistance rate of SPN isolated from invasive infections in children less than 5 years old. Between June 1994 and March 1996, a total of 505 SPN isolated from sterile sites were collected from 15 hospitals located in 9 cities of different geographic areas. Clinical and epidemiological data from 443 children were analyzed. Sixty five percent SPN were isolated from children less than 2 years old. Pneumonia was the clinical diagnosis in 58% of the cases, meningitis in 22%, and sepsis in 10.6%. Isolates were recovered from blood (51.2%), pleural fluid (22.7%), CSF (20.7%), and other sterile sites (5.4%). Thirty different pneumococcal capsular types were identified and the 10 most frequent in descending order were: 14, 5, 1, 6A/6B, 7F, 9V, 19F, 19A, 16F y 23F, representing 89.3% of the total. Overall, 13.1% of isolates showed intermediate resistance to penicillin while 11.3% showed high resistance. Lethality was 8.8%, without correlation with penicillin-resistance and/or type. These result should be used in selecting the optimal combination of specific types for a conjugate vaccine, useful in children less than 2 years old and for considering therapeutic strategies for invasive pneumococcal infections.
authors.affiliation: Instituto Nacional de Microbiología Dr C. Malbrán, Bacteriology Department, Buenos Aires, Argentina.
authors.forename: A
authors.initials: A
authors.lastname: Rossi
authors.forename: R
authors.initials: R
authors.lastname: Ruvinsky
authors.forename: M
authors.initials: M
authors.lastname: Regueira
authors.forename: A
authors.initials: A
authors.lastname: Corso
authors.forename: J
authors.initials: J
authors.lastname: Pace
authors.forename: A
authors.initials: A
authors.lastname: Gentile
authors.forename: J L
authors.initials: JL
authors.lastname: Di Fabio
mesh_terms: D001118:Argentina / Q000453:epidemiology; D002675:Child, Preschool; D006801:Humans; D008826:Microbial Sensitivity Tests; D010403:Penicillin Resistance; D010406:Penicillins / Q000494:pharmacology / Q000627:therapeutic use; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology* / Q000401:mortality; D011159:Population Surveillance; D012307:Risk Factors; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification* / Q000187:drug effects
chemical_list: D010406:Penicillins