DISTRIBUTION OF CAPSULAR TYPES AND PENICILLIN-RESISTANCE OF STRAINS OF STREPTOCOCCUS-PNEUMONIAE CAUSING SYSTEMIC INFECTIONS IN ARGENTINEAN CHILDREN UNDER 5 YEARS OF AGE

Streptococcus pneumoniae (SPN) is the most common cause of invasive in fections in children, with high levels of mortality in developing coun tries, An increase in frequency of penicillin-resistant strains is rep orted in most parts of the world, A study was undertaken in Argentina and 5 other countries of the region, to determine the type distributio n and penicillin resistance rate of SPN isolated from invasive infecti ons in children less than 5 years old. Between June 1994 and March 199 6, a total of 505 SPN isolated from sterile sites were collected from 15 hospitals located in 9 cities of different geographic areas, Clinic al and epidemiological data from 443 children were analyzed. Sixty fiv e percent SPN were isolated from children less than 2 years old, Pneum onia was the clinical diagnosis in 58% of the cases, meningitis in 22% , and sepsis in 10.6%. Isolates were recovered from blood (51.2%), ple ural fluid (22.7%), CSF (20.7%), and other sterile sites (5.4%). Thirt y different pneumococcal capsular types were identified and the 10 mos t frequent in descending order were: 14, 5, 1, 6A/6B, 7F, 9V, 19F, 19A , 16F y 23F, representing 89.3% of the total, Overall, 13.1% of isolat es showed intermediate resistance to penicillin while 11.3% showed hig h resistance, Lethality was 8.8%, without correlation with penicillin- resistance and/or type, These result should be used in selecting the o ptimal combination of specific types for a conjugate vaccine, useful i n children less than 2 years old and for considering therapeutic strat egies for invasive pneumococcal infections.