Prospective surveillance of incidence, serotypes and antimicrobial susceptibility of invasive Streptococcus pneumoniae among hospitalized children in Austria

• Published in: Journal of antimicrobial chemotherapy Vol. 53; no. 5; pp. 826 - 831
• Main Authors: Rendi-Wagner, Pamela, Georgopoulos, Apostolos, Kundi, Michael, Mutz, Ingomar, Mattauch, Markus, Nowak, Jacek, Mikolasek, Andrea, Vecsei, Andreas, Kollaritsch, Herwig
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01-05-2004; Oxford Publishing Limited (England)
• Subjects: Anti-Infective Agents - pharmacology; Antibiotics. Antiinfectious agents. Antiparasitic agents; Austria - epidemiology; Biological and medical sciences; Child, Preschool; Drug Resistance, Bacterial; Female; Hospitalization; Humans; incidence; Infant; Infant, Newborn; Male; Medical sciences; Meningitis, Pneumococcal - epidemiology; Meningitis, Pneumococcal - microbiology; Meningitis, Pneumococcal - mortality; Pharmacology. Drug treatments; Pneumococcal Infections - epidemiology; Pneumococcal Infections - microbiology; Pneumococcal Infections - mortality; Pneumococcal Vaccines - immunology; Population Surveillance; Prospective Studies; S. pneumoniae; serotype coverage; Serotyping; Streptococcus pneumoniae; susceptibilities; Austria; Europe; Human; Typing; Drug susceptibility test; Hospitalization; Incidence; Streptococcus pneumoniae; Infection; Streptococcaceae; Surveillance; Streptococcal infection; Bacteriosis; Bacteria; Micrococcales; Serotype; Antibacterial agent; Child; Pneumococcal infection
• ISSN: 0305-7453; 1460-2091; 1460-2091
• DOI: 10.1093/jac/dkh211

Objectives: This study was undertaken to analyse incidence rates, serotype distribution and antimicrobial resistance patterns of invasive Streptococcus pneumoniae isolates from hospitalized children up to 5 years of age with invasive pneumococcal disease (IPD), including meningitis, in Austria. Methods: From February 2001–January 2003, nationwide prospective surveillance was conducted that included all paediatric hospitals and clinical microbiological laboratories. All invasive pneumococci isolated were serotyped and tested for antimicrobial susceptibility. Results: The mean annual incidence rates of IPD per 10 000 population for the age groups <24 months and <60 months were 14.5 (7.7 for meningitis) and 13.7 (6.0 for meningitis), respectively. The case fatality rate was 6% for IPD and 12% for meningitis. Of all IPD cases, 69.6% (73.1% for meningitis) were covered by serotypes and 83.9% (88.5% for meningitis) by cross-protection of vaccine-related serotypes. Intermediate penicillin G susceptibility (MIC 0.12–1 mg/L) was found in 12/56 strains. No penicillin G-resistant strains were found. A total of 19/56 isolates showed decreased susceptibility to macrolide agents (MIC ≥ 1 mg/L). Conclusions: The IPD incidence rate was similar, and serotype coverage of the 7-valent conjugated vaccine marginally superior, to Germany. The surprisingly high level of antimicrobial resistance among invasive isolates considerably amplifies the potential impact of a childhood pneumococcal vaccination programme in Austria.