[Invasive pneumoccal disease in children in Oslo 1998-2004].
BACKGROUND
Invasive pneumococcal disease (IPD) is an important cause of morbidity and mortality in Norwegian children.


METHODS
This retrospective study included all children (under 16 years) with isolates of Streptococcus pneumoniae from a normally sterile site admitted to the Department of Paediatrics at Ullevaal University Hospital in the period 1998 to 2004. We studied the epidemiology, predisposing factors, clinical picture, antimicrobial resistance, outcome of IPD and the theoretical coverage of the 7-valent conjugate pneumococcal vaccine (PCV7) in these children. The isolates were tested for antimicrobial susceptibility, serogrouped and serotyped.


RESULTS
68 children were identified; 31 of them had one or more predisposing factors. Six children died, all of them had a predisposing factor. Six of the seven children who survived with sequelae were previously healthy. 67 of 68 isolates were fully susceptible to benzyl penicillin and 13 isolates showed intermediate susceptibility or resistance to erythromycin. Serogroups or serotypes were obtained in 66 children. 24 (36.8%) children fulfilled the criteria for PCV7. 35 (51.1%) children had serotypes covered by the vaccine. Only 12 (17.6%) fulfilled the criteria for PCV7 and had serotypes covered by it. Four of the six children who died had serotypes covered by PCV7.


CONCLUSIONS
Invasive pneumococcal disease is a serious condition in children and vaccination can prevent disease in many children.
Barneklinikken Ullevål universitetssykehus 0407 Oslo. linvigdis.brauteset@ulleval.no
Lin Vigdis
LV
Brauteset
Ernst Arne
EA
Høiby
Gaute
G
Syversen
Pål
P
Surén
Karl-Olaf
KO
Wathne
D000293:Adolescent; D000667:Ampicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D004917:Erythromycin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008586:Meningitis, Pneumococcal / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality; D009664:Norway / Q000453:epidemiology; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality; D022242:Pneumococcal Vaccines / Q000008:administration & dosage; D011018:Pneumonia, Pneumococcal / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification / Q000472:pathogenicity
D000900:Anti-Bacterial Agents; D022242:Pneumococcal Vaccines; D004917:Erythromycin; D000667:Ampicillin