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Acta Médica Costarricense

On-line version ISSN 0001-6002Print version ISSN 0001-6012


ARGUEDAS, Adriano et al. Prospective epidemiologic surveillance of invasive pneumococcal disease and pneumonia in children in San José, Costa Rica. Acta méd. costarric [online]. 2012, vol.54, n.4, pp.252-261. ISSN 0001-6002.

Background and aim: Streptococcus pneumoniae is globally the leading cause of vaccine-preventable death in children below 5 years of age. Methods: Between 2007 and 2009, a prospective, population-based surveillance was conducted in children aged 28 days to 36 months in San José, Costa Rica. Incidence of invasive pneumococcal disease as well as clinically- and chest X ray-confirmed pneumonia were determined, as well as serotype distribution and antibiotic susceptibility. Results: 8801 subjects were enrolled (median age: 14.5 months). Invasive pneumococcal disease was detected in 25 children by isolation from cultures (22) or by PCR and a clinical picture consistent with invasive pneumococcal disease (3). For culture-positive only cases in children aged 28 days to <36 months, the invasive pneumococcal disease incidence rate was 33.7/100,000 per year for years 1 and 2 combined. Consideration of additional PCR-positive cases increased the incidence of invasive pneumococcal disease to 46.0/100,000. The most common serotype was 14 (28.6%), followed by 3, 4, 6A, 19A, and 22F. 42.9% of isolates were penicillin- and cotrimoxazole-nonsusceptible. Incidences of clinical pneumonia and chest X-ray-confirmed pneumonia were 1968/100,000 and 551/100,000, respectively. Conclusion: There is a considerable burden of invasive pneumococcal disease and pneumonia in children in San José. These epidemiologic data serve as a baseline to evaluate the effectiveness of new conjugate pneumococcal vaccines.

Keywords : Streptococcus pneumoniae; Invasive pneumococcal disease; pneumococcal conjugate vaccine; pneumonia; population-based incidence.

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