Pneumococcal Infections In Children Research Articles

Clinical and epidemiologic studies of pneumococcal infection in children.

Streptococcus pneumoniae was isolated from 1310 children in a 5-year period from 1979 through 1984. There were 44 cases of meningitis, 172 bacteremic infections, 787 cases of otitis media and 307 respiratory and miscellaneous isolates. The majority of infections could be accounted for by a small number of serotypes, with types 3, 6, 14, 19 and 23 predominating. Most infections (70%) occurred in infants younger than 2 years of age. However, nearly one-fourth of those suffering systemic illness had some underlying condition which may have contributed to their risk for infection, even beyond 2 years of age. Ten of the 12 deaths occurred in patients with altered host defenses. Characteristics of pneumococcal disease and the distribution of serotypes are discussed in relation to the work of other investigators over the past 50 years.

Recommendations for Using Pneumococcal Vaccine in Children

A 23-valent pneumococcal polysaccharide vaccine licensed in the United States in 1983 replaces the 14-valent polysaccharide vaccine licensed in 1977. This statement contains new data about pneumococcal vaccine and its effectiveness that have become available since 1977 and new recommendations regarding its use in children. PNEUMOCOCCAL DISEASE Streptococcus pneumoniae (pneumococcus) is the most common cause of acute otitis media, and it is a frequent cause of bacterial pneumonia, bacterial meningitis, and sinusitis in children. Pneumococcus is the most common cause of bacteremia in infants and children aged 1 to 24 months; some of these children with fever and bacteremia have no evidence of a primary focus of infection. Mortality from pneumococcal disease is highest in patients who have bacteremia or meningitis and in patients with certain underlying medical conditions. Patients at increased risk of developing severe pneumococcal disease, because of impaired immunologic response to pneumococcus, are those with sickle cell anemia, Hodgkin disease, congenital or acquired immunodeficiency, nephrotic syndrome, and splenic dysfunction, and those who have had splenectomy or organ transplantation. Certain other patients also may be at greater risk of suffering severe pneumococcal infections, such as some patients with diabetes mellitus, congestive heart failure, chronic pulmonary disease, and renal failure. Patients with CSF leakage complicating skull fracture or neurosurgical procedure may have recurrent pneumococcal meningitis. To date, 83 pneumococcal types have been identified by the serologic properties of their capsular polysaccharides. Certain of these polysaccharides share physicochemical and antigenic properties. Ten serotypes account for the majority of pneumococcal infections in children and adults.

Is There an Increased Risk of Haemophilus influenzae Septicemia in Children with Sickle Cell Anemia?

The risk of Haemophilus influenzae septicemia/meningitis to children who have sickle cell anemia (SS) has been determined to be greater than that seen among normal infants. Of ten bacteriologically proven cases, eight episodes of infection were observed among 234 children with sickle cell anemia (645 person-years), who were less than 5 years of age. There was one case per 69 infants with sickle cell anemia who were less than 18 months old and one case per 36 children with sickle cell anemia between 19 and 59 months of age. Unexpectedly, two infections occurred among 224 children (824 person-years), aged 5 to 9 years; both died. Contrary to the rapid clinical course of pneumococcal infections in children with sickle cell anemia H influenzae septicemia was regularly heralded by a greater than 24-hour prodrome of upper respiratory tract infection, low-grade fever, and otitis media. Three (30%) preventable deaths occurred. Antibiotic therapy for the febrile child with sickle cell anemia must be predicated on the known 400-fold increased risk of pneumococcal septicemia in those less than 5 years old and the fourfold risk of H influenzae septicemia in those less than 9 years of age.

Pneumococcal serotypes, epidemiological factors and vaccine strategy in Nigerian patients

Summary Serotyping of pneumococci in different disease conditions in Nigerian adults and children was undertaken to ascertain the prevalent types. Measles is one of the important conditions predisposing to pneumococcal infection in children and effective measles prophylactic vaccination should be ensured. Pneumococcal types 1, 2, 3 and 5 are the most important disease-causing serotypes in both children and adults. Effective vaccination with polyvalent pneumococcal vaccine in which type 5 is included, aimed mainly at children is suggested as the most cost-effective means of achieving herd immunity and reducing morbidity and mortality in Nigerians.

Hematology: An Annotated Bibliography of Recent Literature

Hematology: An Annotated Bibliography of Recent Literature

Serotypically defined pneumococcal infections in children

Serotypically defined pneumococcal infections in children

Pneumococcal infections in sickle cell anemia.

To the Editor .—This letter is prompted by the article of Seeler et al (Amer J Dis Child123:8-10, 1972) and by the editorial of Lukens (123:6-7, 1972), both of which express a pessimistic outlook regarding the potential utility of pneumococcal vaccines for the prevention of pneumococcal infections in children with sickle cell anemia. A more optimistic view of prophylactic vaccination seems warranted, perhaps, although extrapolations based upon the small sample reported by Seeler et al must be guarded. Study of pneumococcal infection in large numbers of both children and adults demonstrates clearly that the preponderance of such infections is caused by a limited number of the 82 pneumococcal capsular types, although there are some clear-cut differences in the types afflicting these two segments of the population. Among more than 2,000 pneumococcal bacteremias occurring in adults in the United States in the past five years, over half were caused by pneumococcal