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Characteristics of invasive pneumococcal disease in hospitalized children in Austria

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Abstract

In a prospective surveillance study covering all pediatric wards in Austria, 308 cases of invasive pneumococcal disease (IPD) were reported in hospitalized children <5 years of age between 2002 and 2012. Incidence was 7.1 per 100,000 per year for IPD with a case fatality rate of 3 %, and 1.9 per 100,000 per year for pneumococcal meningitis with a case fatality rate of 9 %. At hospital discharge, 17 % of the children were not fully recovered and suffered from problems such as hearing or motor deficits. Persistent sequelae 6 months after hospital discharge were present in 13 % of the children, a finding that emphasizes the seriousness of IPD. From 2007 onwards, we observed a shift of pneumococcal serotypes from those covered by the heptavalent vaccine to serotypes consequently added to 10- and 13-valent vaccines, particularly regarding serotype 19A. Among antimicrobial resistances detected, macrolide resistance was predominant; however, between 2002 and 2012, we saw an overall decrease of resistance rates. Conclusion: Considering this change of serotypes and the high rate of permanent sequelae after IPD, our data show the importance of pediatric pneumococcal vaccination and the relevance of continuous monitoring of circulating serotypes. By the end of 2012, which was the first year of universal mass vaccination against pneumococcal disease in Austria, no change in the incidence of invasive pneumococcal disease was observed yet.

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Abbreviations

IPD:

Invasive pneumococcal disease

PCV7:

Heptavalent conjugated pneumococcal vaccines

PCV10:

Ten-valent conjugated pneumococcal vaccine

PCV13:

Thirteen-valent conjugated pneumococcal vaccine

MIC:

Minimal inhibitory concentrations

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Acknowledgments

Between 2009 and 2011, this study was supported by a grant of the Research Foundation of the Austrian National Bank (grant no. 13229). Between 2002 and 2008 and in 2012, this study was supported by Wyeth Lederle now Pfizer. We would like to thank Apostolos Georgopoulos who performed serotyping of S. pneumoniae between 2002 and 2007, and all pediatricians and the staff of the wards from the participating hospitals for their continued support: Univ.-Klinik f. Kinder- u. Jugendheilkunde, AKH Wien; Gottfried v. Preyer'sches Kinderspital d. Stadt Wien; Sozialmedizinisches Zentrum Ost – Donauspital; St. Anna Kinderspital Wien; Wilhelminenspital; Krankenanstalt Rudolfstiftung der Stadt Wien; Landesklinikum Baden – Mödling; Landesklinikum Tulln; LK Mistelbach – Gänserndorf; Landesklinikum Wiener Neustadt; Landesklinikum Zwettl; Landesklinikum Krems an der Donau; Landesklinikum St. Pölten; Landesklinikum Mostviertel Amstetten; Landesklinikum Scheibbs; LKH Stolzalpe; LKH Leoben; LKH - Univ. Klinikum Graz; SALK – Salzburger Universitätsklinikum; Kardinal Schwarzenberg'sches Krankenhaus; Krankenhaus St. Josef Braunau; Klinikum Wels – Grieskirchen; LKH Vöcklabruck; LKH Schärding; KH St. Franziskus; LKH Kirchdorf a. d. Krems; Landes- Frauen- und Kinderklinik Linz; Krankenhaus der Barmherzigen Schwestern Linz; LKH Steyr; KH der Bamherzigen Schwestern Ried; LKH Rohrbach; LKH Bad Ischl; Klinikum Klagenfurt am Wörthersee; LKH Villach; KH Spittal/Drau; LKH Bludenz; LKH Dornbirn; LKH Bregenz; LKH Feldkirch; Univ.klinik f. Kinder-und Jugendheilkunde, Innsbruck; Krankenhaus St. Vinzenz in Zams; BKH St. Johann in Tirol; BKH Lienz; BKH Reutte; Bezirkskrankenhaus Kufstein; KH der Barmherzigen Brüder Eisenstadt; KH Oberwart; Sozial Medizinisches Zentrum Süd – KFJ; IMED Wien; Labor Dr. Kosak; LK Mistelbach – Gänserndorf; Landesklinikum Horn; IMED Graz; Mikrobiologisches Labor Dr. Kochanowski, Dr. Mattes; KH der Elisabethinen Linz; LKH Steyr; Labor Schubach; Landesnervenklinik Wagner-Jauregg; IMED Klagenfurt; MVZ Labor Dr. Gärtner & Kollegen; Inst. f. Hygiene und Sozialmedizin, Innsbruck; and KH der Barmherzigen Brüder Eisenstadt.

Conflict of interest

Maria Paulke-Korinek accepted fees for speaking and serving on advisory boards and received funding to attend conferences from Pfizer and GlaxoSmithKline. Herwig Kollaritsch accepted educational grant fees and payment for lectures, for serving on advisory boards and as an independent safety monitor in clinical studies, and reimbursement for attending meetings from GlaxoSmithKline and Pfizer. Michael Kundi received funding for participating in advisory boards and for consultancy from Wyeth Lederle now Pfizer. Ursula Wiedermann has received grant money for investigator-initiated studies by Baxter and educational grant money by Pfizer and Novartis. Heinz Burgmann accepted fees for speaking, educational grant fees, and serving on advisory boards from Wyeth Lederle, now Pfizer. The authors have no other relevant affiliations or financial involvement with the subject matter or materials discussed in the manuscript.

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Authors and Affiliations

  1. Institute of Specific Prophylaxis and Tropical Medicine, Center for Physiology, Pathophysiology and Immunology, Medical University Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria

    Maria Paulke-Korinek, Herwig Kollaritsch, Birgit Schmidle-Loss, Ines Zwazl, Brigitte Laaber & Ursula Wiedermann

  2. Institute of Environmental Health, Center for Public Health, Medical University Vienna, Vienna, Austria

    Michael Kundi

  3. Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University Vienna, Vienna, Austria

    Karin Lakovits & Heinz Burgmann

  4. St. Anna Children’s Hospital, Department of Pediatric and Adolescent Medicine, Medical University Vienna, Vienna, Austria

    Andreas Vecsei

Authors
  1. Maria Paulke-Korinek
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  2. Herwig Kollaritsch
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  3. Michael Kundi
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  4. Birgit Schmidle-Loss
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  5. Ines Zwazl
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  6. Brigitte Laaber
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  7. Karin Lakovits
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  8. Andreas Vecsei
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  9. Ursula Wiedermann
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  10. Heinz Burgmann
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Corresponding author

Correspondence to Herwig Kollaritsch.

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Paulke-Korinek, M., Kollaritsch, H., Kundi, M. et al. Characteristics of invasive pneumococcal disease in hospitalized children in Austria. Eur J Pediatr 173, 469–476 (2014). https://doi.org/10.1007/s00431-013-2193-2

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  • DOI: https://doi.org/10.1007/s00431-013-2193-2

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