[ XXXX in the era of heptavalent pneumococcal conjugate vaccine].

@entity1 @entity1143 @entity326 @entity3509 @entity1576 @entity1485 @entity2258 @entity582
INTRODUCTION: To describe clinical features, complications, serotypes and antibiotic resistance in @entity2258 in our environment after the generalization of the heptavalent conjugate vaccine ( @entity1485 -7) in paediatrics. MATERIAL AND METHODS: Prospective study of episodes of @entity2258 , with positive cultures in @entity1 treated in the emergency department from January 2006 to February 2010. RESULTS: We studied 346 episodes in 320 @entity1 , 335 belonged to 309 adult @entity1 , 221 (71.5%) males, median age 68 years (range 16-94), and 11 episodes to @entity1 <15 years. Two-hundred and thirty seven (68.5%) episodes were community acquired. @entity582 was present in 130 (37.6%) cases, with a tendency towards an increased risk in @entity1 < 65 years (OR=1.56, 95% CI 0.96- 2.56, P=.07). Thirteen (3.8%) @entity1 developed @entity3509 and 33 (9.5%) @entity326 . The mean age of @entity1 with @entity3509 was lower (P=.03). In the multivariate analysis were related to the presence of @entity582 : a history of chronic @entity1576 (OR=0.45, 95% CI 0.25-0.81, P=.008), positive urinary antigen (OR 2.02, 95% CI 1 13-3.62, P=.01) and @entity1143 (OR=3.86, 95% CI 1.79-8.35, P=.001). Shock was associated with Fine IV-V stage (OR=23.6, 95% CI 4.96-112.82, P<.001), age < 65 years (OR=4.47, 95% CI 1.75-11.39, P=.002) and @entity1143 (OR=4.15, 95% CI 1.65 to 10.41, P=.002). Increased mortality risk was associated with presence of any complication (OR=6.6, 95% CI 1.5-27.2, P=.009) and specifically @entity326 (OR=3.3, 95% CI 1.06-10.3, P=.04). Most serotypes obtained were not included in the VNC-7. CONCLUSIONS: @entity2258 after generalisation of @entity1485 -7 is mainly related to non-vaccine serotypes. Younger @entity1 without @entity1576 are at increased risk of @entity582 , @entity3509 , and @entity326 , the latter being associated with a higher mortality.
