title: Clonal and clinical profile of Streptococcus pneumoniae serotype 19A causing pediatric invasive infections: a 2-year (2007-2009) laboratory-based surveillance in Madrid.
abstract: Studies of clonality and clinical profile of serotype 19A invasive pneumococcal disease in children (IPD-19A) are worthy after PCV7 introduction. A prospective, hospital-based surveillance of IPD-19A, culture and/or PCR confirmed, was performed in 2007-2009 in Madrid (all 22 hospitals with pediatric departments). Sixty-two cases were found: 90.3% in children <5 years, 87.1% in <36 months, and 74.2% in ≤18 months.
  
  
  METHODS
  meningitis (22.6%), primary bacteremia (19.4%), secondary bacteremia to otic foci (SBOF; 17.7%), bacteremic pneumonia (17.7%), pediatric parapneumonic empyema (PPE; 17.7%) and others (4.8%). Presentations by age: meningitis (35.7%), SBOF (28.6%) and primary bacteremia (21.4%) in children <12 months, bacteremic pneumonia, PPE and primary bacteremia (26.3% each) in 12-23 months, and bacteremic pneumonia (33.3%) and PPE (26.6%) in ≥24 months. Sequence types ST276 and ST320 represented 83.0% isolates, all oral-penicillin/erythromycin non-susceptible. In nonmeningeal isolates, non-susceptibility to parenteral penicillin/cefotaxime was 0%/17.6% (ST276) and 93.8%/75.0% (ST320). Non-susceptibility in ST276 and ST320, prevalence of these STs among 19A isolates, and serotype 19A prevalence among IPDs, indicate the importance of 19A inclusion in PCV13 for IPD-19A prevention and for reducing 19A nasopharyngeal carriage, thus preventing 19A otitis (one-third of 19A bacteremia in this study were from otic origin).
authors.affiliation: Microbiology Department, Hospital Clínico San Carlos, c/Martín Lagos s/n, 28040 Madrid, Spain. jpicazo@microb.net
authors.forename: J
authors.initials: J
authors.lastname: Picazo
authors.forename: J
authors.initials: J
authors.lastname: Ruiz-Contreras
authors.forename: B
authors.initials: B
authors.lastname: Hernandez
authors.forename: F
authors.initials: F
authors.lastname: Sanz
authors.forename: A
authors.initials: A
authors.lastname: Gutierrez
authors.forename: E
authors.initials: E
authors.lastname: Cercenado
authors.forename: M A
authors.initials: MA
authors.lastname: Meseguer
authors.forename: A
authors.initials: A
authors.lastname: Delgado-Iribarren
authors.forename: I
authors.initials: I
authors.lastname: Rodriguez-Avial
authors.forename: C
authors.initials: C
authors.lastname: Méndez
mesh_terms: D002648:Child; D002675:Child, Preschool; D003001:Cloning, Molecular / Q000379:methods; D005260:Female; D006801:Humans; D007223:Infant; D007755:Laboratories, Hospital; D008297:Male; D011008:Pneumococcal Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000276:immunology; D011159:Population Surveillance / Q000379:methods; D011446:Prospective Studies; D012703:Serotyping / Q000379:methods; D013030:Spain / Q000453:epidemiology; D013296:Streptococcus pneumoniae / Q000145:classification* / Q000302:isolation & purification*