Impact of the pneumococcal conjugate vaccine on pneumococcal parapneumonic XXXX .

@entity1 @entity66 @entity2260 @entity3509 @entity5686 @entity1485 @entity15978 @entity328
BACKGROUND: Pediatric pneumococcal parapneumonic @entity3509 ( @entity15978 ) has become increasingly common. In the last decade, Utah has had one of the highest rates of @entity15978 in the United States, 14/100,000 @entity1 , attributed primarily to @entity328 serotype 1. Our objective was to describe the temporal trends in @entity15978 in Utah before and after the availability of the 7-valent pneumococcal conjugate vaccine ( @entity1485 -7). METHODS: The Intermountain Health Care (IHC) data warehouse was queried for all cases of @entity3509 in @entity1 younger than 18 years, defined as International Classification of Diseases, 9th revision, Clinical Modification code 510.9, for the study period March 1996-June 2005. We also retrieved and serotyped all blood and pleural fluid isolates of @entity2260 from @entity1 younger than 18 years with a diagnosis of @entity15978 at Primary @entity1 's Medical Center (PCMC) between March 1996 and June 2005. The pre- @entity1485 -7 period (PRE) included 57 months (March 1996-December 2000) and the post- @entity1485 -7 period (POST) included 54 months (January 2001-June 2005). RESULTS: We identified 776 cases of pediatric @entity3509 in the IHC system, and 478 (62%) were managed at PCMC. In the years 1996-2000, we managed a mean of 38 cases of @entity3509 per year compared with 71.5 cases per year between 2001 and 2004 (P = 0.006). At PCMC, there were 295 cases of invasive @entity66 (IPD), and 74 (25%) were @entity15978 . During the PRE period, @entity15978 represented 24 of 137 (17.5%) cases of IPD compared with 50 of 158 (32%) in the POST period (P = 0.008). One-half of the @entity1 with @entity15978 required intensive care and 4 died. During the PRE and POST periods, @entity15978 was most often caused by serotype 1 (46 and 34%, respectively), but in the POST period serogroups 3 (20%), and @entity5686 (14%) were also prevalent. @entity15978 in @entity1485 -7-immunized @entity1 was caused exclusively by nonvaccine serotypes. CONCLUSIONS: @entity15978 in the post- @entity1485 -7 era is more common, representing one-third of the IPD in @entity1 in UT. @entity15978 is associated with significant morbidity and mortality. Serotype 1 remains the most common cause of @entity15978 , but serotypes 3 and @entity5686 are emerging.
