Streptococcus pneumoniae in children in Spain: 1990-1999

This study analyses the serogroups/types (SGTs) and resistance to penicilli n and erythromycin of 3921 strains isolated from 1990 to 1999 in children a ged 0-14 y in Spanish hospitals of all the autonomous communities. Based on the age of the children, strains have been divided into five groups: 0-6 m o, >6-1 y, >1-2 y, >2-5 y and >5 y. While only eight SGTs were responsible for 80% of the infections in children from 6 mo to 2 y of age, this number increased to 11 and 16 for the groups > 2-5 y and >5-14 y, respectively. SG Ts 6, 14 and 19 were prevalent in blood and otic exudates. SGTs 1, 4, 5, 12 and 18 were more frequent in invasive disease but serotype 3 was clearly a ssociated with otitis. Serotypes 1 and 5 were quite significant in children of over 2 y of age, and this should be taken into account in future vaccin e formulations. Conclusion: Although high, the rate of penicillin resistance in the paediat ric population has remained stable in recent years. Conversely, erythromyci n resistance is still increasing in our country. Coverage by the 7-valent v accine was 78 and 81% for blood and otic isolates, respectively. These cove rage levels would be increased by 9% and 3% if 9-valent (plus 1+5 serotypes ) were used and by an additional 2.6% and 7.6% using the 11-valent (plus 37) formulation.