Spectrum of 2,836 Cases of Invasive Bacterial or Fungal Infections in Children: Results of Prospective Nationwide Five-Year Surveillance in Finland

In a prospective nationwide laboratory-based surveillance study of all invasive bacterial and fungal infections among children < 16 years of age, 2,836 clinical cases were registered during the 5-year period 1985-1989. Of these cases, 136 were polymicrobial. During the study period, nationwide administration of Haemophilus influenzae type b conjugate vaccine reduced the incidence rates of invasive infection caused by this organism. The most common clinical diagnosis (48 % of cases) was bacteremia without an identified focus of infection. The age-specific annual incidence rates of all invasive infections in children 15 years of age, in children <4 years of age, in children., 1 year of age, and in children-._28 days of age were 55.8, 141.4, 272.7, and 2,749.0 cases/100,000 person-years, respectively. Thirty percent of the children in the study had an underlying condition predispos-ing to infection. The case-fatality rate was 4.1 % for all cases of invasive infection. Despite improved diagnostic methods, new antimicrobial drugs, and advances in anti-infective therapy, invasive bacterial infections still cause considerable mortality. A full view of the spectrum of all invasive bacterial and fungal diseases (as opposed to selected single diagnoses or pathogens) is essential to the establishment of public health priorities in areas such as prevention. On the other hand, accurate information on the relative importance of the various pathogens in terms of the age of the affected patients, the site of infection, the case-fatality rate, and underlying conditions is valuable to the clini-cian in choosing antimicrobial treatment. We studied the spectrum of all invasive bacterial and fungal pediatric infections in Finland during the 5-year period 1985--1989 through prospective nationwide laboratory-based surveil-lance. This report summarizes our findings for a population of 5.05 million people, of whom 1.02 million were--_15 years of age. Materials and Method