PEDIATRICS Vol. 64 No. 3 September 1979, pp. 296-300
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Pneumococcal Bacteremia in Infants and Children: A Ten-Year Experience at the Cook County Hospital with Special Reference to the Pneumococcal Serotypes Isolated

Norman M. Jacobs MD1, Somchitt Lerdkachornsuk MD1, and William I. Metzger PhD1

1 Departments of Pediatrics and Microbiology, Cook County Hospital, Hektoen Institute, and Abraham Lincoln School of Medicine, Chicago

In a ten-year period we identified 305 hospitalized children with a pneumococcal bacteremia. From these children 293 pneumococcal isolates were serotyped, and 90% belonged to a group of 11 "prevalent serotypes." These 11 serotypes were the prevalent serotypes isolated from children in all disease categories, as well as from children with sickle-cell disease. No more than 1% of the isolates belonged to any one of the other serotypes. A pneumococcal vaccine effective against these 11 prevalent serotypes should be optimal for use in children. Our highest case fatality rates were noted in children with meningitis (13%) and children with sickle-cell disease (20%). A polysaccharide pneumococcal vaccine might not have prevented most of our pneumococcal meningitis, as 80% of these children were less than 1 year old, an age when polysaccharide vaccines are poor antigens. On the other hand, many of our children with sickle-cell disease acquired their pneumococcal bacteremia at an older age and should have benefitted from such a vaccine.

Submitted on December 15, 1978
Accepted on January 30, 1979




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