INVASIVE PNEUMOCOCCAL INFECTION IN CHILDREN, 1981-92 - A HOSPITAL-BASED STUDY

Objective: To document the pattern and sequelae of invasive pneumococcal infection in hospitalized children. Methodology: 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. Results: 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%. Conclusions: The high morbidity and mortality from invasive pneumococcal infection in children justifies further evaluation of preventive strategies.