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

Objective: To document the pattern and sequelae of invasive pneumococc al infection in hospitalized children. Methodology: Retrospective revi ew of Streptococcus pneumoniae (Sp) isolates from normally sterile sit es from 1981 to 1992 at three paediatric centres in Sydney for demogra phic data, spectrum of disease, predisposing conditions, mortality, an d sequelae from meningitis. Results: Four hundred and thirty-one episo des in 417 patients were identified. Foci of infection were: meningiti s, 34%; pneumonia, 29%; bacteraemia without apparent focus, 30%; and o ther foci, 7%. Sixty-one per cent of all cases and 64% of cases with m eningitis were less than 2 years old. Predisposing conditions were pre sent in 37%, were significantly more common in patients over age 2 yea rs and were more common with foci other than meningitis. Overall morta lity was 6.6% whereas the mortality for those with meningitis was 8%. Neurological sequelae were identified in 34% of previously normal chil dren, and severe hearing loss occurred in 11.5%. Conclusions: The high morbidity and mortality from invasive pneumococcal infection in child ren justifies further evaluation of preventive strategies.