Invasive pneumococcal disease in children

Uvod: Invazivna pneumokokna bolest je značajan medicinski problem u djece u Hrvatskoj. Invazivni oblici bolesti su bakterijemija/sepsa, bakterijemična pneumonija i bakterijski meningitis. Većina slučajeva IPB-a bolesti uzrokovana je ograničenim brojem serotipova pneumokoka (manje od 10). Postoje mogućnosti prevencije IPB-a u obliku konjugiranih cjepiva. ----- Materijali i metode: Analizirano je 67 ispitanika koji su liječeni na Zavoda za infektivne bolesti djece Klinike za infektivne bolesti „Dr. Fran Mihaljević“ u razdoblju od 2011. - 2013. Godine. Promatrane su epidemiološke karakteristike IPB-a u djece te distribucija serotipova. ----- Rezultati: Od ukupno 67 ispitanika, njih 32 je muškog spola, a 35 ženskog spola. Srednja dob svih ispitanika jest 32 mjeseca, medijan 23 mjeseca, a raspon dobi od 2 mjeseca do 96 mjesec. Od 67 bolesnika, njih 47 je imalo dijagnozu bakterijemije, 11 bolesnika se prezentiralo s kliničkom slikom bakterijemične pneumonije, a 9 bolesnika se prezentiralo s kliničkom slikom bakterijskog meningitisa. Poboljšanje stanja postignuto je u 63 bolesnika, 4 bolesnika su preminula. 84% invazivnih pneumokoknih bolesti uzrokovano je sa 8 serotipova (1, 6A, 6B, 14, 18C, 19A, 19F i 23F). Cjepivom PCV10 moglo se prevenirati 38 (70%) slučajeva, a cjepivom PCV13, 45 (82%) slučajeva. ----- Zaključak: Većina slučajeva IPB-a u djece u Hrvatskoj uzrokovana je malim brojem invazivnih serotipova i može se prevenirati cijepljenjem pomoću već postojećih cjepiva.Background: Invasive pneumococcal disease is a major health problem in children in Croatia. Invasive diseases are bacteremia/sepsis, bacteremic pneumonia and bacterial meningitis. Most cases of IPB's disease are caused by a limited number of pneumococcal serotypes (less than 10). There are opportunities for prevention of IPB in the form of conjugated vaccines. ----- Materials and methods: A total of 67 pediatric patients who were treated at the Department of Pediatric Infectious Diseases at University Hospital for Infectious Diseases "Dr. Fran Mihaljevic "in the period of 2011 - 2013. Epidemiological characteristics of IPB and the distribution of serotypes were analysed. ----- Results: From a total of 67, 32 were male and 35 female. The mean age of the respondents is 32 months, median 23 months, and the age range from 2 months to 96 months. Of the 67 patients, 47 had a diagnosis of bacteremia, 11 patients had been diagnosed with a bacteremic pneumonia, and 9 patients with bacterial meningitis. Clinical improvement following antimicrobial treatmentwas observed in 63 patients, 4 patients have died. 84% of invasive pneumococcal disease cases was caused by 8 serotypes (1, 6A, 6B, 14, 18C, 19A, 19F and 23F). PCV10 vaccine could prevent 38 (70%), and PCV13 vaccine could prevent 45 (82%) cases. ----- The conclusion: Most cases of IPD in children in Croatia are caused by a limited number of serotypes and could be prevented by vaccination using existing conjugate vaccines