Centre of Clinical Research CIC Femme Enfant Adolescent Inserm 1413, CHU de Nantes, Nantes, France.
Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Centre of Research in Epidemiology and StatisticS (CRESS), Université de Paris, Paris, France.
Pediatr Crit Care Med. 2020 Jun;21(6):e325-e332. doi: 10.1097/PCC.0000000000002300.
To describe the epidemiology of community-onset severe bacterial infections in children and its recent evolution.
Prospective, observational, population-based study from 2009 to 2014.
An administrative area accounting for 13% of the French pediatric population.
All children 1 month to 16 years old who died before admission or were admitted to a PICU for a community-onset severe bacterial infection.
None.
The incidence and mortality rate of community-onset severe bacterial infections were compared with data from a reference population-based study conducted between 2000 and 2006, that is, before national recommendations for antimeningococcal C and antipneumococcal generalized vaccinations. Among the 261 children included (median age 25 mo), 28 (10.7%) died. The main diagnoses were meningitis (n = 85; 32%) and purpura fulminans (n = 59; 22%). The most common isolated bacteria were Neisseria meningitidis (n = 75; 29%), including 47 (63%) cases of serogroup B and 15 (20%) serogroup C, Streptococcus pneumoniae (n = 49, 19%), and Staphylococcus aureus (n = 15; 6%). The incidence of community-onset severe bacterial infections was three per 100,000 person-years (95% CI, 2.6-3.3) and had decreased by 53% from the reference period. Mortality rate was 0.3 per 100,000 person-years (95% CI, 0.2-0.4) and had decreased by 73% from the reference period. The incidence of community-onset severe bacterial infections caused by N. meningitidis and S. pneumoniae was 0.8 and 0.5 per 100,000 person-years and had decreased by 70% and 67% from the reference period. The incidence of community-onset severe bacterial infections-related to Staphylococcus aureus was 0.16 per 100,000 person-years and had increased by 220% from the reference period.
The incidence and mortality rate of community-onset severe bacterial infections, except for S. aureus infection, have decreased in France. N. meningitidis and S. pneumoniae continue to account for many infections, which indicates the need for better vaccination coverage and spectrum.
描述儿童社区获得性严重细菌感染的流行病学及其近期演变。
2009 年至 2014 年进行的前瞻性、观察性、基于人群的研究。
占法国儿科人群 13%的行政区域。
所有在入院前死亡或因社区获得性严重细菌感染而入住 PICU 的 1 个月至 16 岁儿童。
无。
比较社区获得性严重细菌感染的发病率和死亡率与 2000 年至 2006 年期间进行的参考人群基于研究的数据，即在全国建议进行脑膜炎球菌 C 型和肺炎球菌普遍疫苗接种之前。在纳入的 261 名儿童中（中位年龄 25 个月），28 名（10.7%）死亡。主要诊断为脑膜炎（n=85；32%）和暴发性紫癜（n=59；22%）。最常见的分离细菌是脑膜炎奈瑟菌（n=75；29%），包括 47 例（63%）B 群和 15 例（20%）C 群，肺炎链球菌（n=49，19%）和金黄色葡萄球菌（n=15；6%）。社区获得性严重细菌感染的发病率为每 100,000 人年 3 例（95%CI，2.6-3.3），与参考期相比下降了 53%。死亡率为每 100,000 人年 0.3 例（95%CI，0.2-0.4），与参考期相比下降了 73%。脑膜炎奈瑟菌和肺炎链球菌引起的社区获得性严重细菌感染的发病率分别为每 100,000 人年 0.8 和 0.5 例，与参考期相比分别下降了 70%和 67%。金黄色葡萄球菌引起的社区获得性严重细菌感染的发病率为每 100,000 人年 0.16 例，与参考期相比增加了 220%。
除金黄色葡萄球菌感染外，法国社区获得性严重细菌感染的发病率和死亡率均有所下降。脑膜炎奈瑟菌和肺炎链球菌仍然导致许多感染，这表明需要更好的疫苗接种覆盖率和范围。
