The aetiology of paediatric @entity281 changes after pneumococcal vaccination and group B XXXX prophylaxis.

@entity1 @entity295 @entity4008 @entity794 @entity2348 @entity281 @entity328
AIM: This study explored the incidence and aetiology of @entity281 after @entity1 received the pneumococcal conjugate vaccination and a risk-based intrapartum antibiotic prophylaxis against early onset @entity295 caused by group B @entity328 . We also monitored clinically relevant antimicrobial resistance. METHOD: We studied 3986 positive blood cultures from @entity1 up to 17  years of age at a paediatric hospital in Stockholm, Sweden, using data from medical records before and after the initiatives, to reduce early onset @entity295 , were introduced in 2007 and 2008. RESULTS: Bloodstream infections caused by @entity328 declined by 42% overall (5.6 to 3.2/100  000) and by 62% in previously healthy @entity1 under 36  months of age (24.2 to 9.2/100  000). Early onset @entity295 caused by group B @entity328 declined by 60% (0.5 to 0.2/1000 live born @entity1 ). @entity4008 caused by these bacteria decreased by 70%. @entity794 and various Gram-negative bacteria became the dominant pathogens, in both previously healthy @entity1 and those with underlying disease. Overall, antimicrobial resistance remained low between the two 5-year study periods. CONCLUSION: Pneumococcal conjugate vaccination and risk-based intrapartum antibiotic prophylaxis against group B @entity328 effectively decreased the incidence of @entity281 . Empirical antibiotic therapy should target @entity794 in  both community and hospital-acquired invasive @entity2348 .
