Active hospital-based surveillance of invasive pneumococcal disease and clinical pneumonia in infants and young children in two Polish counties.
BACKGROUND
Invasive pneumococcal disease (IPD) incidence, serotype distribution, and antibiotic susceptibility of Streptococcus pneumoniae were estimated in children aged 28 days to < 60 months.


METHODS
One-year prospective, hospital-based surveillance was conducted starting on February 15, 2008, at two children's hospitals serving the city and surrounding county of Poznań and Poznański, Poland. Eligible children had fever ≥ 39.0°C or physician-suspected IPD. Blood cultures were obtained from all children, cerebrospinal fluid in suspected meningitis cases, and chest radiographs (CXRs) in suspected pneumonia cases.


RESULTS
Seven of 1,581 eligible children had confirmed IPD. Estimated IPD incidence per 100,000 children was 11.89 (95% CI: 4.78-24.50) overall and 20.1 (95% CI: 6.52-46.84) in subjects aged 28 days to < 24 months. One S. pneumoniae isolate of each of the following serotypes was obtained: 6B, 14, 23A, 23F, and 33F. Two isolates were resistant to both trimethoprim-sulfamethoxazole and erythromycin. Clinical pneumonia incidence among children aged 28 days to < 24 months and 24 months to < 60 months was 3,151.3 (95% CI: 2934.7-3379.7) and 962.7 (95% CI: 861.2-10,072.9) per 100,000 children, respectively. CXR-confirmed pneumonia rates in the same groups were 1,035.7 (95% CI: 913.2-1,170.1) and 379.8 (95% CI: 317.1-451.3) per 100,000 children, respectively.


CONCLUSIONS
IPD is an important cause of morbidity in Poznań and Poznański county, Poland. Among participants aged < 5 years with fever or suspected IPD, pneumonia was the most common diagnosis and was highest in children aged < 24 months.
Department of Preventive Medicine, Poznan University of Medical Sciences, Poznan, Poland.
Jacek
J
Wysocki
Department of Infectious Diseases and Pediatric Neurology, Poznan University of Medical Sciences, Poznan, Poland.
Wojciech
W
Sluzewski
Via Research, LLC, Princeton Junction, NJ, USA.
Elane
E
Gutterman
former employee of Pfizer Inc, Paris, France.
Sylvie
S
Jouve
Pfizer Inc, Collegeville, PA, USA.
Michele
M
Moscariello
former employee of Pfizer Inc, Paris, France.
Ivana
I
Balter
X-ray-confirmed pneumonia; bacteremia; incidence rate; meningitis