HOSPITAL ADMISSIONS IN CHILDREN DUE TO PNEUMOCOCCAL PNEUMONIA IN ENGLAND

Hospital records of 116 children under 5 years of age discharged from 11 hospitals in three regions in England with a diagnosis of lobar (pn eumococcal) pneumonia were reviewed to estimate the proportion likely to be attributable to infection with Streptococcus pneumoniae. Of thes e, 100 (86%) had lobar/focal changes on chest X-ray consistent with pn eumococcal infection, although only one (1%) had pneumococcus isolated from blood. However a further 89 (89%) with a lobar/focal picture wer e considered to be likely or possibly due to pneumococcal infection on the basis of the white cell count, level of C-reactive protein, isola tion of the S. pneumoniae from either sputum or nasopharingeal aspirat e and failure to identify another responsible pathogen, Of 135 cases w ith a discharge diagnosis of bronchopneumonia or pneumonia (organism u nspecified), two (1%) had S. pneumoniae isolated from blood and a furt her 95 (70%) had clinical or laboratory features consistent with pneum ococcal infection or S. pneumoniae isolated from either sputum or naso pharyngeal aspirate. With the iminent availability of conjugate pneumo coccal vaccines, there is a need for improved diagnostic methods for i dentifying the pathogens responsible for community-aquired pneumonia i n young children.