INVASIVE STREPTOCOCCUS-PNEUMONIAE INFECTION IN LATIN-AMERICAN CHILDREN - RESULTS OF THE PAN-AMERICAN HEALTH-ORGANIZATION SURVEILLANCE STUDY

Protein-polysaccharide conjugate vaccines against Streptococcus pneumo niae promise to be an effective public health intervention for childre n, especially in an era of increasing antimicrobial resistance. To cha racterize the distribution of capsular types in Latin America, surveil lance for invasive pneumococcal infection in children less than or equ al to 5 years of age was done in six countries between February 1993 a nd April 1996. Fifty percent of 1,649 sterile-site isolates were from children with pneumonia, and 52% were isolated from blood. The 15 most common of the capsular types prevalent throughout the region accounte d for 87.7% of all isolates. Overall, 24.9% of isolates had diminished susceptibility to penicillin: 16.7% had intermediate resistance and 8 .3% had high-level resistance. Three customized vaccine formulas conta ining 7, 12, and 15 capsular types were found to have regional coverag es of 72%, 85%, and 88%, respectively. This study emphasizes the need for local surveillance for invasive pneumococcal disease prior to the development and evaluation of protein-polysaccharide conjugate vaccine s for children.