title: Invasive pneumococcal diseases in children and adolescents--a single centre experience.
abstract: BACKGROUND
  S. pneumoniae is a major cause of meningitis, pneumonia and sepsis in children. In 2006 universal pneumococcal vaccination was recommended in Germany for all children up to their second birthday. We have compared the prevalence and outcome of IPD at a single hospital before and after the introduction of vaccination.
  
  
  RESULTS
  55 cases of IPD were identified over an 11 year period. Almost half of the patients were younger than 2 years of age. Most of the children were affected by pneumonia. The second highest incidence seen was for meningitis and sepsis. 17 patients exhibited additional complications. Significant pre-existing and predisposing disorders, such as IRAK 4 defect, ALPS or SLE were identified in 4 patients. Complete recovery was seen in 78% of affected children; 11% had a fatal outcome and 11% suffered from long term complications. Only 31% overall had been vaccinated. The most common serotype was 14. Serotypes not covered by any of the current vaccines were also found. Antibiotic treatment commenced with cephalosporins in over 90%.
  
  
  CONCLUSIONS
  Frequency of IPD in our hospital did not decrease after initiation of the pneumococcal vaccination. This might be due to vaccinations not being administered satisfactorily as well as to poor education about the need of the vaccination. Pre-existing diseases must be monitored and treated accordingly and rare deficiencies taken into account when IPD takes a foudroyant course. In addition, antibiotic stewardship has been initiated at this hospital centre as a consequence of the high cephalosporin use detected in this study.
authors.forename: Christin
authors.initials: C
authors.lastname: Schnappauf
authors.forename: Arne
authors.initials: A
authors.lastname: Rodloff
authors.forename: Werner
authors.initials: W
authors.lastname: Siekmeyer
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hirsch
authors.forename: Ina
authors.initials: I
authors.lastname: Sorge
authors.forename: Volker
authors.initials: V
authors.lastname: Schuster
authors.affiliation: Department of Woman and Child Health, Hospital for Children and Adolescents, Centre of Paediatric Research, University Hospital of Leipzig, Liebigstraße 20a, D-04103 Leipzig, Germany. Wieland.Kiess@medizin.uni-leipzig.de.
authors.forename: Wieland
authors.initials: W
authors.lastname: Kiess
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016920:Meningitis, Bacterial / Q000453:epidemiology / Q000276:immunology* / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000008:administration & dosage / Q000276:immunology*; D011018:Pneumonia, Pneumococcal / Q000453:epidemiology / Q000276:immunology* / Q000517:prevention & control; D015995:Prevalence; D018805:Sepsis / Q000453:epidemiology / Q000276:immunology* / Q000517:prevention & control; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000276:immunology*; D016896:Treatment Outcome; D014611:Vaccination / Q000379:methods
chemical_list: D022242:Pneumococcal Vaccines