Affiliations: Division of Infectious Diseases, CHOC Children's and
the Department of Pediatrics, University of California Irvine, CA, USA
Note: [] Correspondence: Dr. Antonio C. Arrieta M.D., Department of
Pediatrics, Division of Infectious Diseases, University of California Irvine,
CHOC Children's Clinical, 455 S Main St. Orange, 92868 CA, USA. Tel.: +1 714
532 8403: Fax: +1 714 289 4014; E-mail: aarrieta@choc.org
Abstract: The introduction of Streptococcus pneumoniae 7-valent conjugate
vaccine has decreased pneumococcal infections in children. Recently a
resurgence of invasive pneumococcal infections has been reported. Delineating
populations at risk and microbiological changes responsible for this is
important to develop new preventive strategies. We conducted a retrospective
review of medical records of children hospitalized with pneumococcal bacteremia
from July 1st 2005 through February 28th 2010 in a large tertiary care center
in Southern California. We identified 74 subjects (mean age 5 yr; range 32 days
to 21 yr and 2 mo) of which the majority (58.1%) had underlying medical
conditions associated with increased risk for pneumococcal infections for whom
pneumococcal polysaccharide vaccine is recommended after 2 yr of age.
Seventy-seven isolates were recovered from 76 positive blood cultures; serotype
was available for 57 isolates, 5 (6B, 14, 23F and two were 19F) were 7-valent
conjugate vaccine isolates. Forty were included in the 23-valent polysaccharide
vaccine. Nineteen (35.2%) were 19A. Pneumonia was common particularly among
previously healthy children (74%). New vaccines, targeted against serotypes
that have emerged following the introduction of the 7-valent conjugate vaccine
and better utilization of existing vaccines in patients at risk should further
decrease invasive pneumococcal disease.
