Davis C W, McIntyre P B
Department of Paediatrics, Westmead Hospital, New South Wales, Australia.
J Paediatr Child Health. 1995 Aug;31(4):317-22. doi: 10.1111/j.1440-1754.1995.tb00819.x.
To document the pattern and sequelae of invasive pneumococcal infection in hospitalized children.
Retrospective review of Streptococcus pneumoniae (Sp) isolates from normally sterile sites from 1981 to 1992 at three paediatric centres in Sydney for demographic data, spectrum of disease, predisposing conditions, mortality, and sequelae from meningitis.
Four hundred and thirty-one episodes in 417 patients were identified. Foci of infection were: meningitis, 34%; pneumonia, 29%; bacteraemia without apparent focus, 30%; and other foci, 7%. Sixty-one per cent of all cases and 64% of cases with meningitis were less than 2 years old. Predisposing conditions were present in 37%, were significantly more common in patients over age 2 years and were more common with foci other than meningitis. Overall mortality was 6.6% whereas the mortality for those with meningitis was 8%. Neurological sequelae were identified in 34% of previously normal children, and severe hearing loss occurred in 11.5%.
The high morbidity and mortality from invasive pneumococcal infection in children justifies further evaluation of preventive strategies.
记录住院儿童侵袭性肺炎球菌感染的模式及后遗症。
回顾性分析1981年至1992年悉尼三家儿科中心从通常无菌部位分离出的肺炎链球菌（Sp）菌株，获取人口统计学数据、疾病谱、易感因素、死亡率及脑膜炎后遗症。
共识别出417例患者的431次感染发作。感染部位为：脑膜炎，34%；肺炎，29%；无明显感染灶的菌血症，30%；其他感染灶，7%。所有病例的61%及脑膜炎病例的64%年龄小于2岁。37%的病例存在易感因素，在2岁以上患者中显著更常见，且在除脑膜炎外的其他感染灶中更常见。总体死亡率为6.6%，而脑膜炎患者的死亡率为8%。34%既往正常的儿童出现神经后遗症，11.5%出现严重听力丧失。
儿童侵袭性肺炎球菌感染的高发病率和死亡率证明有必要进一步评估预防策略。
