Ashkenazi Limor, Bar-Meir Maskit, Schlesinger Yechiel, Megged Orli
Pediatrics and Infectious Diseases Unit, Shaare Zedek Medical Center, PO Box 3235, Jerusalem 91031, Israel.
Clin Pediatr (Phila). 2012 May;51(5):478-82. doi: 10.1177/0009922811436337. Epub 2012 Feb 7.
To review the epidemiology and clinical course of invasive pneumococcal diseases of infants younger than 60 days.
All Streptococcus pneumoniae strains isolated from blood and cerebrospinal fluid cultures of infants below the age of 60 days during the years 1999-2009 were included in this study. Demographic, clinical, and laboratory data were collected from medical records.
In all, 24 cases of pneumococcal invasive infections were identified. The primary diagnoses were bacteremia without a focus (n = 13), meningitis (n = 6), bacteremia with otitis media (n = 3), and joint infection with bacteremia (n = 2). Only one of the serotypes found is included in the heptavalent pneumococcal conjugated vaccine (PCV7).
Streptococcus pneumoniae should be considered and treated empirically in infants with suspected invasive bacterial disease during the first 60 days of life. Routine vaccination with PCV7 in not expected to substantially reduce the incidence of invasive pneumococcal disease in Israeli infants of this age as a result of herd immunity.
回顾60日龄以下婴儿侵袭性肺炎球菌疾病的流行病学及临床病程。
本研究纳入了1999年至2009年间从60日龄以下婴儿的血液和脑脊液培养物中分离出的所有肺炎链球菌菌株。从病历中收集人口统计学、临床和实验室数据。
共确定了24例肺炎球菌侵袭性感染病例。主要诊断为无病灶菌血症（n = 13）、脑膜炎（n = 6）、菌血症合并中耳炎（n = 3）以及菌血症合并关节感染（n = 2）。所发现的血清型中只有一种包含在七价肺炎球菌结合疫苗（PCV7）中。
对于出生后前60天疑似侵袭性细菌疾病的婴儿，应考虑肺炎链球菌感染并进行经验性治疗。由于群体免疫，在以色列这个年龄段的婴儿中常规接种PCV7预计不会大幅降低侵袭性肺炎球菌疾病的发病率。
