Serologically indicated pneumococcal pneumonia in children: a population-based study in primary care settings.
The aim of the study was to assess age-specific incidences of community-acquired pneumonia (CAP) caused by Streptococcus pneumoniae and diagnosed serologically in a child population. The study was population-based, and prospective, and performed in primary health care settings. During a surveillance period of 12 months from 1981-1982, all pneumonia cases in a defined child population (57% urban residents) were registered prospectively. In total, 201 CAP cases were diagnosed (mean age 5.6 years; 57% boys; 58% urban residents). S. pneumoniae etiology was studied by antibody and immune complex (IC) assays to C-polysacchride (C-PS), type-specific capsular polysaccharides (CPS), and to pneumolysin (Ply), in acute and convalescent sera. Serologic evidence of S. pneumoniae etiology was indicated in 57(28%) cases, 35(61%) being mixed infections with other microbes. The distribution of pneumococcal cases was 44%, 30% and 26% in the three 5-year age groups, respectively. There were 33 (58%) males and 34 (60%) urban residents. In total, 26 cases were identified by antibody assays and 35 cases by IC assays, 26/35 being positive in acute sera. Responses to C-PS, CPS and Ply, when antibody and IC results are combined, were found equally often in 23-25 cases. The total annual incidence of pediatric S. pneumoniae CAP was 6.4/1000/year. S. pneumoniae etiology was found in 28% of the children and was similar at all ages. The incidence of pneumococcal CAP was assessed for the first time, being high (19/1000/year) in 0- to 4-year-old urban boys and rather stable (5-9/1000/year) in all other groups by age, sex and residence.
Heiskanen-Kosma
Tarja
T
Department of Pediatrics, Kuopio University and University Hospital, Kuopio and Public Health Institute, Oulu, Finland.
Korppi
Matti
M
Leinonen
Maija
M
D000293:Adolescent; D000907:Antibodies, Bacterial / Q000097:blood; D000936:Antigen-Antibody Complex / Q000097:blood; D016667:Bacterial Capsules / Q000276:immunology; D001426:Bacterial Proteins; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011018:Pneumonia, Pneumococcal / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D011320:Primary Health Care; D011446:Prospective Studies; D012698:Serologic Tests; D013296:Streptococcus pneumoniae / Q000276:immunology; D013301:Streptolysins / Q000276:immunology
D000907:Antibodies, Bacterial; D000936:Antigen-Antibody Complex; D001426:Bacterial Proteins; D013301:Streptolysins; C032290:plY protein, Streptococcus pneumoniae