title: Pediatric osteoarticular infections caused by Streptococcus pneumoniae before and after the introduction of the heptavalent pneumococcal conjugate vaccine.
abstract: Streptococcus pneumoniae is an uncommon cause of osteoarticular infections (OAI) in children. The objective of this study was to investigate the clinical and laboratory characteristics of pneumococcal OAI before and after the introduction of the heptavalent pneumococcal conjugate vaccine (PCV7). Data were retrospectively collected from children aged <16 years who were hospitalized for pneumococcal OAI between 1997 and 2007 in four Parisian teaching hospitals. Forty-three children were included (32 with arthritis and 11 with osteomyelitis) and the median age of these children was 12.5 months (range 3 months to 14 years). Serotypes were available for 19/43 strains (44 %) from 1997 onwards and for 12/13 strains (92 %) from 2005 onwards. Seven unvaccinated children were infected with vaccine serotypes and we observed only one vaccine failure. After the introduction of PCV7, we noted an increase in short-term complications and the emergence of serotype 19A, which was penicillin-intermediate in 86 % of cases. After PCV7 introduction, serotype 19A was the most frequent serotype implicated in pediatric pneumococcal OAI. The 13-valent pneumococcal conjugate vaccine introduced in France in June 2010 should cover the emerging serotype.
authors.affiliation: General Pediatric Unit, Hôpital Robert Debré APHP, Univ Paris Diderot, Sorbonne Paris Cité, EA 3105, F-75019 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Lemaître
authors.forename: A
authors.initials: A
authors.lastname: Ferroni
authors.forename: C
authors.initials: C
authors.lastname: Doit
authors.forename: H
authors.initials: H
authors.lastname: Vu-Thien
authors.forename: C
authors.initials: C
authors.lastname: Glorion
authors.forename: J
authors.initials: J
authors.lastname: Raymond
authors.forename: P
authors.initials: P
authors.lastname: Mary
authors.forename: P
authors.initials: P
authors.lastname: Wicart
authors.forename: E
authors.initials: E
authors.lastname: Bingen
authors.forename: B
authors.initials: B
authors.lastname: Ilharreborde
authors.forename: M
authors.initials: M
authors.lastname: Lorrot
mesh_terms: D000293:Adolescent; D001170:Arthritis, Infectious / Q000453:epidemiology / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005602:France / Q000453:epidemiology; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D010019:Osteomyelitis / Q000453:epidemiology / Q000382:microbiology*; D010406:Penicillins / Q000494:pharmacology; D011008:Pneumococcal Infections / Q000453:epidemiology*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D012189:Retrospective Studies; D013582:Synovial Fluid / Q000382:microbiology; D016896:Treatment Outcome; D014611:Vaccination / Q000592:standards; D055815:Young Adult
chemical_list: D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D010406:Penicillins; D022242:Pneumococcal Vaccines