Invasive pneumococcal disease in infants younger than 60 days.
OBJECTIVE
To review the epidemiology and clinical course of invasive pneumococcal diseases of infants younger than 60 days.


METHODS
All Streptococcus pneumoniae strains isolated from blood and cerebrospinal fluid cultures of infants below the age of 60 days during the years 1999-2009 were included in this study. Demographic, clinical, and laboratory data were collected from medical records.


RESULTS
In all, 24 cases of pneumococcal invasive infections were identified. The primary diagnoses were bacteremia without a focus (n = 13), meningitis (n = 6), bacteremia with otitis media (n = 3), and joint infection with bacteremia (n = 2). Only one of the serotypes found is included in the heptavalent pneumococcal conjugated vaccine (PCV7).


CONCLUSIONS
Streptococcus pneumoniae should be considered and treated empirically in infants with suspected invasive bacterial disease during the first 60 days of life. Routine vaccination with PCV7 in not expected to substantially reduce the incidence of invasive pneumococcal disease in Israeli infants of this age as a result of herd immunity.
Pediatrics and Infectious Diseases Unit, Shaare Zedek Medical Center, PO Box 3235, Jerusalem 91031, Israel. ashkenazyli@gmail.com
Limor
L
Ashkenazi
Maskit
M
Bar-Meir
Yechiel
Y
Schlesinger
Orli
O
Megged
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D002439:Cefotaxime / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007557:Israel / Q000453:epidemiology; D008297:Male; D008586:Meningitis, Pneumococcal / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D010406:Penicillins / Q000627:therapeutic use; D011008:Pneumococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D010406:Penicillins; D002439:Cefotaxime