Paediatric, invasive pneumococcal disease in Switzerland, 1985–1994

Abstract

Background

Costeffectiveuse of new vaccines against pneumococcal disease in children requires detailed information about the local epideniiology of pneumococcal infections.

Methods

Data on 393 culture-confirmed cases of invasive pneumococcal infection in children (<17 years) hospitalized in Swiss paediatric clinics were collected retrospectively for the years 1985–1994.

Results

Meningitis (42%) was most frequent, followed by pneumonia (28%) and bacteraeniia (26%). The overall annual incidence was 2.7 cases per 100 000 children <17 years old and 11 cases per 100 000 children <2 years old. Annual incidence rates were stable over the study period. Lethality was high for meningitis (8.6%) and bacteraemia (8.9%). A history of basal skull fracture was reported in 3.3% of children with pneurnococcal meningitis. Residence in a rural region was associated with an increased risk of pneumococcal infection (relative risk = 1.45, 95% confidence interval: 1.01–2.00).

Conclusions

Paediatric, invasive pneumococcal disease seems to be less frequent in Switzerland than in other European and non-European countries. This may be due to differences in diagnostic strategies and lower frequency of risk factors such as the use of day care. Children with a history of basal skull fracture are at increased risk for pneurnococcal meningitis. Further investigation of the association of invasive pneumococcal infection with rural residence and the use of antibiotics for upper respiratory tract infections might give new insight into the dynamics of Streptococcus pneumoniae infection and the development of antibiotic resistance.

Streptococcus pneumoniae, epidemiology, surveillance, vaccine, Switzerland