Characteristics of invasive pneumococcal disease in hospitalized children in Austria.
In a prospective surveillance study covering all pediatric wards in Austria, 308 cases of invasive pneumococcal disease (IPD) were reported in hospitalized children <5 years of age between 2002 and 2012. Incidence was 7.1 per 100,000 per year for IPD with a case fatality rate of 3 %, and 1.9 per 100,000 per year for pneumococcal meningitis with a case fatality rate of 9 %. At hospital discharge, 17 % of the children were not fully recovered and suffered from problems such as hearing or motor deficits. Persistent sequelae 6 months after hospital discharge were present in 13 % of the children, a finding that emphasizes the seriousness of IPD. From 2007 onwards, we observed a shift of pneumococcal serotypes from those covered by the heptavalent vaccine to serotypes consequently added to 10- and 13-valent vaccines, particularly regarding serotype 19A. Among antimicrobial resistances detected, macrolide resistance was predominant; however, between 2002 and 2012, we saw an overall decrease of resistance rates.


CONCLUSIONS
Considering this change of serotypes and the high rate of permanent sequelae after IPD, our data show the importance of pediatric pneumococcal vaccination and the relevance of continuous monitoring of circulating serotypes. By the end of 2012, which was the first year of universal mass vaccination against pneumococcal disease in Austria, no change in the incidence of invasive pneumococcal disease was observed yet.
Institute of Specific Prophylaxis and Tropical Medicine, Center for Physiology, Pathophysiology and Immunology, Medical University Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria.
Maria
M
Paulke-Korinek
Herwig
H
Kollaritsch
Michael
M
Kundi
Birgit
B
Schmidle-Loss
Ines
I
Zwazl
Brigitte
B
Laaber
Karin
K
Lakovits
Andreas
A
Vecsei
Ursula
U
Wiedermann
Heinz
H
Burgmann
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001317:Austria / Q000453:epidemiology; D002648:Child; D002673:Child, Hospitalized; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000276:immunology*; D011159:Population Surveillance; D011446:Prospective Studies; D013296:Streptococcus pneumoniae / Q000276:immunology / Q000302:isolation & purification*; D015996:Survival Rate
D000900:Anti-Bacterial Agents; D022242:Pneumococcal Vaccines