title: Pneumococcal disease in a paediatric population in a hospital of central Italy: a clinical and microbiological case series from 1992 to 2006.
abstract: OBJECTIVE
  Streptococcus pneumoniae is frequently isolated from carrier children, but it also causes localized and invasive diseases. Increasing incidence of chemoresistance can affect the efficacy of empiric therapy and it motivates interest in primary prophylaxis. The study aims to investigate clinical and microbiological features of paediatric pneumococcal infections in an Italian province.
  
  
  METHODS
  Retrospective clinical analysis of 640 children, hospitalized from 1992 to 2006 with one culture positive for S. pneumoniae, was performed. Chemosusceptibility tests and serotyping were carried out on isolates; statistical analysis was applied to compare variables.
  
  
  RESULTS
  Overall, 47.8% were carriers, 49% and 3.2% had, respectively, a localized or invasive disease; S. pneumoniae aetiology accounted for 25% of meningitis and 16% of sepsis. On the total isolates, 10.2% were penicillin non-susceptible, 35.15% were erythromycin resistant, with increasing rates over years. Prevalent invasive serotypes were 1 (38.1%) and 7F (9.5%).
  
  
  CONCLUSIONS
  The study sustains pneumococcal disease relevance in children, on the strength of a 15 year observation. Long time period can represent a limit due to population characteristics changing; a selection bias could also be present due to hospitalized only patient analysis. However, we documented variable evolution of chemoresistance and a peculiar serotype spreading, offering microbiological basis for an appropriate clinical approach.
authors.affiliation: Clinica e Laboratorio di Malattie Infettive, Dipartimento di Biologia Molecolare, Università di Siena, viale Bracci 16, IV lotto piano 0, 53100 Siena, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Montagnani
authors.forename: Alessandra
authors.initials: A
authors.lastname: Fanetti
authors.forename: Lucia
authors.initials: L
authors.lastname: Stolzuoli
authors.forename: Leonardo
authors.initials: L
authors.lastname: Croci
authors.forename: Fabio
authors.initials: F
authors.lastname: Arena
authors.forename: Alessandra
authors.initials: A
authors.lastname: Zanchi
authors.forename: Carla
authors.initials: C
authors.lastname: Cellesi
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000503:physiopathology; D024881:Drug Resistance, Bacterial; D004917:Erythromycin / Q000494:pharmacology; D005260:Female; D006761:Hospitals; D006801:Humans; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D008581:Meningitis / Q000453:epidemiology / Q000382:microbiology; D008826:Microbial Sensitivity Tests; D010403:Penicillin Resistance; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000503:physiopathology; D012189:Retrospective Studies; D018805:Sepsis / Q000453:epidemiology / Q000382:microbiology; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents; D004917:Erythromycin