Brauteset Lin Vigdis, Høiby Ernst Arne, Syversen Gaute, Surén Pål, Wathne Karl-Olaf
Barneklinikken Ullevål universitetssykehus 0407 Oslo.
Tidsskr Nor Laegeforen. 2008 Jun 12;128(12):1380-3.
Invasive pneumococcal disease (IPD) is an important cause of morbidity and mortality in Norwegian children.
This retrospective study included all children (under 16 years) with isolates of Streptococcus pneumoniae from a normally sterile site admitted to the Department of Paediatrics at Ullevaal University Hospital in the period 1998 to 2004. We studied the epidemiology, predisposing factors, clinical picture, antimicrobial resistance, outcome of IPD and the theoretical coverage of the 7-valent conjugate pneumococcal vaccine (PCV7) in these children. The isolates were tested for antimicrobial susceptibility, serogrouped and serotyped.
68 children were identified; 31 of them had one or more predisposing factors. Six children died, all of them had a predisposing factor. Six of the seven children who survived with sequelae were previously healthy. 67 of 68 isolates were fully susceptible to benzyl penicillin and 13 isolates showed intermediate susceptibility or resistance to erythromycin. Serogroups or serotypes were obtained in 66 children. 24 (36.8%) children fulfilled the criteria for PCV7. 35 (51.1%) children had serotypes covered by the vaccine. Only 12 (17.6%) fulfilled the criteria for PCV7 and had serotypes covered by it. Four of the six children who died had serotypes covered by PCV7.
Invasive pneumococcal disease is a serious condition in children and vaccination can prevent disease in many children.
侵袭性肺炎球菌疾病（IPD）是挪威儿童发病和死亡的重要原因。
这项回顾性研究纳入了1998年至2004年期间在乌勒瓦尔大学医院儿科住院的所有16岁以下、从通常无菌部位分离出肺炎链球菌的儿童。我们研究了IPD的流行病学、易感因素、临床表现、抗菌药物耐药性、预后以及7价肺炎球菌结合疫苗（PCV7）对这些儿童的理论覆盖范围。对分离株进行抗菌药物敏感性测试、血清群鉴定和血清型鉴定。
共确定68名儿童；其中31名有一个或多个易感因素。6名儿童死亡，他们均有易感因素。7名留有后遗症存活的儿童中有6名此前健康。68株分离株中有67株对苄星青霉素完全敏感，13株对红霉素显示中介敏感性或耐药性。66名儿童获得了血清群或血清型信息。24名（36.8%）儿童符合PCV7标准。35名（51.1%）儿童的血清型在疫苗覆盖范围内。只有12名（17.6%）符合PCV7标准且血清型在其覆盖范围内。6名死亡儿童中有4名的血清型在PCV7覆盖范围内。
侵袭性肺炎球菌疾病在儿童中是一种严重疾病，接种疫苗可预防许多儿童患病。
