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Pneumococcus
remains a leading cause of serious illness among young children worldwide and
is the most frequent cause of
meningitis,pneumonia,sinusitis and acute otitis media.
Our objective was to determine
the incidence of invasive disease, and the associated morbidity and
mortality.
We performed a retrospective
chart review of all the clinical isolates recorded in the Laboratory from
January 1995 through December 1999. IPD was defined as the isolation of
pneumoccus from blood, CSF, peritoneal fluid, bone, joint, pleural fluid, and
trachea. Data were collected pertaining focus, hospital stay, days of
antibiotics(ABX), mortality and sequelae. For estimation of the incidence we retrieved from
statistics the number of patiens seen yearly.
212
patients had IPD. 60% were male; the mean(range)age was 26mo(4days-10yrs).
Isolates were recovered from blood in 50(106)%; CSF,32(68)%; trachea,10(21)%;
soft tissue abscess (STA),4(8)%, peritoneal fluid,3(6)% and bone and joint in
1(3)%. Diseases consisted on meningitis,32%; pneumonia,31%;
bacteremia,19%;tracheitis,10%; deep seeded STA,4%; peritonitis,3% and
osteomyelitis and arthritis,1%.All patients required hospitalization;
67(142)% were admitted to the ICU for a mean(range) time of 2(1-8) days. Mean(range)hospital stay was 11.2(1-50)days, and ABX days
10.9(1-42). Mortality was 4(8)% and sequelae developed in 30(14%)pts. The
incidence of IPD in children aged less than 12mo and 12-23 mo was 167 and 215
cases/100,000.
At HNN, IPD is a significant
cause of morbidity and mortality with an incidence similar to that reported
in the literature.Evaluation of the impact of pneumococcal conjugate vaccines
deserves evaluation.
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