Childhood Pneumococcal Diseases and Serotypes: Can Vaccines Protect.

Objectives To describe pneumococcal diseases in pediatric intensive care unit (PICU) and non-PICU patients. Methods The clinical, serotypes, and antibacterial sensitivity patterns of all children admitted to the pediatric wards (including PICU) of a university-affiliated teaching hospital from 2007 through 2009 with pneumococcal isolates were reviewed. Results Twelve cases of pneumococcal disease in children from 2007 through 2009 were reported. Five patients were admitted to PICU and 7 were general pediatric admissions. Four patients (2 PICU and 2 general pediatric) had received full or partial 7-valent pneumococcal vaccinations. All four patients recovered following systemic antibiotic treatment without sequelae. The serotypes of all PICU and some general pediatric cases were available and included 3, 6B, 19A and 19F. All isolates were sensitive to vancomycin. 50% were intermediate resistant/resistant to penicillin and 17% resistant to cefotaxime. PICU cases required longer total hospital stay (23 days vs 5 days, p=0.013). Three patients were ventilated and one received inotropic support. There was no death in this series. Conclusions Pneumococcal disease may develop despite prior vaccination. The expanded coverage of newer polyvalent pneumococcal vaccines might have prevented some, but not all, of these admissions.

Orientações adotadas nas maternidades dos hospitais-escola do Brasil, sobre posição de dormir / Instructions from teaching hospital maternity wards to parents concerning the sleeping position of newborns

The prone sleeping position has been causally linked to sudden infant death syndrome (SIDS). This survey aimed to determine whether maternity hospitals in Brazil were promoting the prone sleeping position for newborns. Information was also collected on SIDS prevention messages. The study adopted a multicenter collaborative approach in hospitals with training in pediatrics, using questionnaires. Correctly completed questionnaires were received from 55 hospitals. The number of deliveries/year varied at the hospitals from 240 to 11,000 (median 2,750). The majority of hospitals encouraged the lateral (side) sleeping position in the normal care nurseries (44.4) and at discharge (67). In conclusion, the majority of hospitals surveyed are not promoting the supine sleeping position or any other intervention for SIDS prevention, although verbal information is provided to parents about breastfeeding (100), immunization (100), and smoking (85).