LEXAU C, LYNFIELD R, JOHNSON S, BELLRICHARD R, BESSER J, DANILA R, WHITNEY CG; Interscience Conference on Antimicrobial Agents and Chemotherapy.

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1999 Sep 26-29; 39: 678 (abstract no. 1186).

Minnesota Dept. of Health, Minnneapolis, MN

BACKGROUND: Streptococcus pneumoniae is the most common cause of invasive bacterial infection in U.S. children. IPI among children 5 and younger is examined, including penicillin resistance and serotyping relevant to the new conjugate vaccine.METHODS: MDH has conducted active laboratory-based surveillance for IPI since April 1995 in the Minneapolis-St. Paul metropolitan area (MSP). A case is defined as S. pneumoniae isolated from a normally sterile site. Laboratory records were audited twice yearly to validate case counts. Isolates were submitted to MDH for serotyping and antimicrobial susceptibility (broth microdilution) testing.RESULTS: The annualized rate of IPI among children < 5 years was 92.7/100,000 (4/1/95-12/31/98, 744 cases total). Rates of disease varied by age: children aged 0-11 months: 179.2; 12-23 months: 241.4; 24-35 months: 76.5; and 3-5 years: 19.2 /100,000. Types of infection included 507 (68%) bacteremia without focus, 124 (17%) pneumonia, 36 (5%) meningitis, and 77 (10%) other infections. There were 7 (1%) deaths, with 6 deaths in children < 2. Isolates were submitted for 671 (90%) cases. An increased number of penicillin-resistant (PR) isolates (MIC > 2 mcg./ml) were seen in 1997-98, 61/ 375 (16%) compared to 29/296 (10%) from 1995-96. Annual rates of PR invasive infections (per 100,000) based on results from 1997-98 were for children aged 0-11 months: 18.7; 12-23 months: 45.7; 24-35 months: 17.2.; and 3-5 years: 2.7. Of 663 isolates serotyped, 495 (75%) were serotype 4, 6B, 9V, 14, 18C, 19F, or 23F (serotypes included in the pneumococcal conjugate vaccine now under FDA consideration). Of these 495 isolates, 71 (14%) were also PR and accounted for 79% of the total PR isolates.CONCLUSION: In MSP, the incidence of IPI was particularly h igh among children 0-23 months of age. There was a marked increase in PR observed from 1995-6 to 1997-8. The potential public health benefit of an effective pneumococcal conjugate vaccine for young children can be seen in that 75% of all and 79% of PR isolates were serotypes included in the vaccine.

Publication Types:

• Meeting Abstracts

Keywords:

• Bacteremia
• Child
• Child Day Care Centers
• Humans
• Incidence
• Microbial Sensitivity Tests
• Penicillin Resistance
• Penicillins
• Pneumococcal Infections
• Serotyping
• Streptococcus pneumoniae
• United States
• Vaccines, Conjugate
• epidemiology
• immunology
• supply & distribution

Other ID:

• GWAIDS0008825

UI: 102246322

From Meeting Abstracts