title: Prospective surveillance of incidence, serotypes and antimicrobial susceptibility of invasive Streptococcus pneumoniae among hospitalized children in Austria.
abstract: OBJECTIVE
  This study was undertaken to analyse incidence rates, serotype distribution and antimicrobial resistance patterns of invasive Streptococcus pneumoniae isolates from hospitalized children up to 5 years of age with invasive pneumococcal disease (IPD), including meningitis, in Austria.
  
  
  METHODS
  From February 2001-January 2003, nationwide prospective surveillance was conducted that included all paediatric hospitals and clinical microbiological laboratories. All invasive pneumococci isolated were serotyped and tested for antimicrobial susceptibility.
  
  
  RESULTS
  The mean annual incidence rates of IPD per 10 000 population for the age groups <24 months and <60 months were 14.5 (7.7 for meningitis) and 13.7 (6.0 for meningitis), respectively. The case fatality rate was 6% for IPD and 12% for meningitis. Of all IPD cases, 69.6% (73.1% for meningitis) were covered by serotypes and 83.9% (88.5% for meningitis) by cross-protection of vaccine-related serotypes. Intermediate penicillin G susceptibility (MIC 0.12-1 mg/L) was found in 12/56 strains. No penicillin G-resistant strains were found. A total of 19/56 isolates showed decreased susceptibility to macrolide agents (MIC >/= 1 mg/L).
  
  
  CONCLUSIONS
  The IPD incidence rate was similar, and serotype coverage of the 7-valent conjugated vaccine marginally superior, to Germany. The surprisingly high level of antimicrobial resistance among invasive isolates considerably amplifies the potential impact of a childhood pneumococcal vaccination programme in Austria.
authors.affiliation: Department of Specific Prophylaxis and Tropical Medicine, Institute of Pathophysiology, Medical University Vienna, Kinderspitalgasse 15, A-1095 Vienna, Austria.
authors.forename: Pamela
authors.initials: P
authors.lastname: Rendi-Wagner
authors.forename: Apostolos
authors.initials: A
authors.lastname: Georgopoulos
authors.forename: Michael
authors.initials: M
authors.lastname: Kundi
authors.forename: Ingomar
authors.initials: I
authors.lastname: Mutz
authors.forename: Markus
authors.initials: M
authors.lastname: Mattauch
authors.forename: Jacek
authors.initials: J
authors.lastname: Nowak
authors.forename: Andrea
authors.initials: A
authors.lastname: Mikolasek
authors.forename: Andreas
authors.initials: A
authors.lastname: Vecsei
authors.forename: Herwig
authors.initials: H
authors.lastname: Kollaritsch
mesh_terms: D000890:Anti-Infective Agents / Q000494:pharmacology*; D001317:Austria / Q000453:epidemiology; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008586:Meningitis, Pneumococcal / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D022242:Pneumococcal Vaccines / Q000276:immunology; D011159:Population Surveillance; D011446:Prospective Studies; D012703:Serotyping
chemical_list: D000890:Anti-Infective Agents; D022242:Pneumococcal Vaccines