ABSTRACT
OBJECTIVE: To determine the incidence, as well as the implicated serotypes and patterns of antibiotic resistance of Streptococcus pneumoniae meningitis in Spanish children. MATERIAL AND METHOD: We performed a prospective, multicenter study in five Autonomous Communities (Catalonia, Galicia, Madrid, Navarre and the Basque Country) for 1 year (1 February 2000 31 January 2001). All children aged 0-14 years with pneumococcal meningitis from all the hospitals in the Autonomous Communities studied were included. Diagnosis was based on clinical findings and isolation of S. pneumoniae in the cerebrospinal fluid/blood using routine methods or polymerase chain reaction. Serotyping was performed using the guellung reaction and/or immunoblotting and susceptibility to antibiotics was evaluated by the technique of agar dilution. The pediatric population aged 0-14 years in the Autonomous Communities studied comprises 2,290,304 children. RESULTS: Fifty-two cases were identified. One patient was aged less than 2 months old, 25 (48 %) were aged 2-12 months, and 12 patients (23 %) were aged 12-24 months. The annual incidence per 100,000 children aged between 1 and 2 years was 17.75 cases (95 % CI: 11.59 26.01) and 8.39 cases (95 % CI: 4.67 15.79) respectively, and that for children in the first 2 and 5 years of life was 13.13 (95 % CI: 9.29 18.02) and 6.29 (95 % CI: 4.57 8.,45) cases respectively. Nearly half the strains isolated (47.6 %) showed reduced sensitivity to penicillin. The most frequent serotype was 19F (12 cases [28.6 %]). Eighty percent of the isolated serotypes were included in the formula of the heptavalent conjugate vaccine. CONCLUSIONS: The incidence of pneumococcal meningitis in children from five Spanish Autonomous Communities is high, nearly twice that found in a prior retrospective studied performed in the same population 1-3 years previously. Almost all the isolated serotypes were included in the heptavalent conjugate vaccine. Half the strains showed reduced sensitivity to penicillin.
Subject(s)
Meningitis, Pneumococcal/epidemiology , Adolescent , Child , Child, Preschool , Drug Resistance, Microbial , Female , Humans , Incidence , Infant , Male , Prospective Studies , Serotyping , Spain , Streptococcus pneumoniae/classification , Streptococcus pneumoniae/drug effectsABSTRACT
Objetivo: Conocer la incidencia, así como los serotipos implicados y los patrones de resistencia antibiótica de meningitis producidas por Streptococcus pneumoniae en niños españoles. Material y método: Estudio prospectivo, multicéntrico, realizado en 5 comunidades autónomas (Cataluña, Galicia, Madrid, Navarra y País Vasco) a lo largo de 1 año (1 de febrero de 2000 a 31 de enero de 2001). Se incluyeron todos los niños entre 0 y 14 años con meningitis neumocócica diagnosticados por sintomatología y líquido cefalorraquídeo (LCR) sugerente con aislamiento de S. pneumoniae en LCR/sangre por métodos habituales o por técnica de reacción en cadena de la polimerasa (PCR), de la totalidad de hospitales de las comunidades autónomas estudiadas. La serotipia se realizó mediante la reacción de quellung y/o immunoblotting y susceptibilidad a antibióticos por la técnica de dilución en agar. La población infantil de 0-14 años de estas comunidades es de 2.290.304 niños. Resultados: Se encontraron 52 casos. Uno tenía menos de 2 meses de edad, 25 (48%) entre 2 y 12 meses y 12 (23%) entre 12 y 24 meses. La incidencia anual por 100.000 niños en el primer y segundo año de vida fue de 17,75 casos (intervalo de confianza [IC] al 95%, 11,59-26,01) y 8,39 casos (IC 95%, 4,67-15,79) respectivamente, siendo en los primeros 2 y 5 años de vida de 13,13 (IC 95%, 9,29-18,02) y 6,29 (IC 95%, 4,57-8,45) casos, respectivamente. Casi la mitad de las cepas aisladas (47,6%) mostraron sensibilidad disminuida a la penicilina. El serotipo 19F fue el más frecuente (12 casos: 28,6%). El 80% de los serotipos aislados estuvieron incluidos en la formulación de la vacuna conjugada heptavalente. Conclusión: La incidencia de meningitis neumocócica en niños de las 5 comunidades autónomas españolas es elevada, casi el doble que la encontrada en un estudio previo de diseño retrospectivo, realizado en la misma población 1-3 años antes. Casi todos los serotipos aislados están incluidos en la vacuna conjugada heptavalente. La mitad de las cepas mostraron sensibilidad disminuida a la penicilina (AU)
Subject(s)
Child, Preschool , Child , Adolescent , Male , Infant , Female , Humans , Spain , Streptococcus pneumoniae , Serotyping , Incidence , Meningitis, Pneumococcal , Prospective Studies , Drug Resistance, MicrobialABSTRACT
OBJECTIVE: To determine the prevalence of pneumococcal meningitis in the pediatric population in Spain. Material and methods Retrospective multicenter study performed in five autonomous communities (Catalonia, Galicia, Madrid, Navarre and the Basque Country) between January 1998 and December 2000. All patients aged between 0 and 14 years old with a diagnosis of pneumococcal meningitis (Streptococcus pneumoniae isolation or presence of Gram-positive diplococcus in the cerebrospinal fluid (CSF) and CSF with more than 20 cells) in all the hospitals of the five autonomous communities were included in the study. The pediatric population in these communities aged between 0 and 14 years old was 2,327,079. RESULTS: We detected 107 cases in 64 boys and 43 girls with a mean age of 1.19 years old (p 25-0.57; p 75-3.34). The incidence was higher in the first 2 years of life [72/107 (67 %)]. The overall annual prevalence in the five autonomous communities in the first 24 months of life was 8.26 per 100,000 children aged under 2 years (95 % CI: 3.45-15.76). The highest number of cases was detected in Catalonia and Madrid but the highest annual prevalence was found in the Basque Country with 15.52 cases per 100,000 children younger than 2 years old (95 % CI: 8.38-24.74). In the first 12 months of life the prevalence was high in all the autonomous communities, especially in the Basque Country with 22.76 cases per 100,000 newborn infants aged under 12 months (95 % CI 14.58-34.5). In the first 5 years of life the annual global adjusted prevalence per 100,000 children was as follows: Catalonia 3.21 (95 % CI: 1.31-5.11), Galicia 2.65 (95 % CI: 0.35-5.64), Madrid 3.49 (95 % CI: 1.36-5.61), Navarre 3.36 (95 % CI 5,08-11,81), the Basque Country 5.63 (95 % CI: 1.08-10.18). CONCLUSION: The prevalence of pneumococcal meningitis in children from different autonomous communities is high and is greatest in the Basque Country and in children aged under 2 years. This prevalence is similar to that of other European countries and the USA.
