Epidemiology of invasive childhood pneumococcal infections in Israel. The Israeli Pediatric Bacteremia and Meningitis Group

JAMA. 1992 Dec 16;268(23):3328-32.


Objective: To study the epidemiology of childhood pneumococcal invasive infections in Israel as a background for immunization programs.

Design: A 2-year (October 1988 through September 1990) prospective, nationwide surveillance of all invasive pediatric pneumococcal infections.

Setting: All 25 medical centers hospitalizing children in Israel, including all laboratories performing blood cultures from pediatric patients.

Patients: Infants and children aged 0 to 12 years visiting the pediatric emergency department or hospitalized in pediatric departments were included if Streptococcus pneumoniae was isolated from blood or cerebrospinal fluid.

Results: Four hundred sixty-nine invasive infections were diagnosed. Pneumonia, bacteremia without apparent focus, meningitis, and cellulitis were found in 39%, 37%, 17%, and 3%, respectively. The annual incidence was 42 per 100,000 for children younger than 5 years of age (104 per 100,000 for those < 12 months old). The two most common serotypes were 1 and 5, which are rare in Western Europe and North America. Eight groups comprised 82% of all invasive infections. Extrapolated to a population in which 100,000 live births occur yearly, the total annual hospitalizations for pneumococci infections was calculated to be 1928 days. The overall case-fatality rate was 2.2%, but it was 30% during the first month of life.

Conclusions: Pneumococcal invasive infections are common in children in Israel and carry considerable morbidity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adolescent
  • Age Factors
  • Bacteremia / epidemiology
  • Child
  • Child, Preschool
  • Ethnic Groups
  • Female
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Israel / epidemiology
  • Male
  • Meningitis, Pneumococcal / epidemiology
  • Pneumococcal Infections / epidemiology*
  • Pneumococcal Infections / microbiology
  • Pneumonia, Pneumococcal / epidemiology
  • Prospective Studies
  • Seasons
  • Serotyping
  • Streptococcus pneumoniae / classification
  • Survival Rate