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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La enfermedad neumoc&#243;cica es una causa frecuente de morbilidad y mortalidad entre la poblaci&#243;n infantil&#46; La reciente autorizaci&#243;n de la vacuna conjugada heptavalente ha incrementado el inter&#233;s cient&#237;fico que suscita esta enfermedad&#46; El objetivo de este estudio es conocer las caracter&#237;sticas epidemiol&#243;gicas y cl&#237;nicas&#44; as&#237; como la evoluci&#243;n de esta enfermedad invasiva en la poblaci&#243;n infantil de la Comunidad Valenciana&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Los datos se han obtenido de las historias cl&#237;nicas de los ni&#241;os menores de 15 a&#241;os&#44; con aislamiento del neumococo&#44; atendidos en todos los hospitales p&#250;blicos de la Comunidad Valenciana durante el per&#237;odo 1996-2000&#46; La evoluci&#243;n de la incidencia se valor&#243; mediante la comparaci&#243;n de tasas&#44; los signos cl&#237;nicos y su evoluci&#243;n &#40;secuelas y letalidad&#41; mediante la evaluaci&#243;n de la frecuencia y su distribuci&#243;n por edades&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se registr&#243; un total de 127 casos&#44; lo que representa un promedio de tasa anual de 3&#44;89&#47;105 habitantes en los menores de 15 a&#241;os y de 20&#44;14 en los menores de 2 a&#241;os&#46; Presentaron antecedentes de problemas de salud un 29&#44;1&#37; de los pacientes&#46; Las manifestaciones cl&#237;nicas predominantes fueron sepsis&#47;bacteriemia &#40;38&#37;&#41;&#44; neumon&#237;a &#40;31&#37;&#41; y meningitis &#40;24&#37;&#41;&#46; Al alta&#44; presentaban secuelas 10 ni&#241;os&#44; de los que el 75&#37; eran menores de 2 a&#241;os&#46; Fallecieron 8 ni&#241;os &#40;letalidad del 6&#44;3&#37;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">En nuestro medio&#44; durante el per&#237;odo estudiado&#44; la infecci&#243;n neumoc&#243;cica se presenta sobre todo en los ni&#241;os menores de 2 a&#241;os&#44; as&#237; como en los mayores de esta edad con antecedentes de problemas de salud&#46; En estos &#250;ltimos se ha encontrado una mayor mortalidad&#46; Ser&#237;a conveniente introducir la enfermedad neumoc&#243;cica en el Sistema de Vigilancia Epidemiol&#243;gica&#44; lo que nos permitir&#237;a disponer de estimaciones m&#225;s precisas de su evoluci&#243;n epidemiol&#243;gica y valorar si la vacuna conjugada es la soluci&#243;n a los problemas que plantea esta bacteria en la actualidad&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Pneumococcal disease is an important cause of morbidity and mortality in children&#46; The recent authorization of the heptavalent conjugate vaccine has increased interest in this disease&#46; The objective of this study was to identify the epidemiological and clinical characteristics of this disease&#44; as well as its outcome in the pediatric population of the Autonomous Community of Valencia&#46;</p> <span class="elsevierStyleSectionTitle">Method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Data were obtained from the medical records of children aged less than 15 years who were positive for pneumococcus isolation on admission to hospital between 1996 and 2000&#46; All the public hospitals of the Autonomous Community of Valencia were included&#46; Changes in incidence were evaluated by comparing rates and outcomes &#40;sequelae and lethality&#41; through frequency and age distribution&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">One hundred twenty-seven cases were registered&#44; giving a mean annual rate of 3&#46;89&#47;105 inhabitants aged less than 15 years&#46; The rate was 20&#46;14 in children aged less than 2 years&#46; A total of 29&#46;1&#37; of the children had previous health problems&#46; The main clinical manifestations included sepsis&#47; bacteremia &#40;38&#37;&#41;&#44; pneumonia &#40;31&#37;&#41; and meningitis &#40;24&#37;&#41;&#46; At discharge sequelae were present in 10 children&#44; 75&#37; of whom were aged less than 2 years&#46; Eight children died &#40;6&#46;3&#37; lethality&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In the period and region studied&#44; pneumococcal infection was present mainly in children aged less than 2 years and in those with previous health problems&#46; In the last few years&#44; mortality has increased&#46; Thus&#44; inclusion of pneumococcal disease in the epidemiological surveillance system would be appropriate to achieve more precise estimations of its epidemiological patterns and to determine whether the conjugate vaccine represents a solution to the problems currently associated with this bacteria&#46;</p>"
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Vol. 17. Núm. 6.
Páginas 458-465 (noviembre - diciembre 2003)
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Vol. 17. Núm. 6.
Páginas 458-465 (noviembre - diciembre 2003)
Open Access
Enfermedad neumocócica invasiva en la población infantil de la Comunidad Valenciana
Invasive pneumococcal disease in children in the Community of Valencia, Spain
Visitas
5237
M. Goicoechea-Sáeza,
Autor para correspondencia
mergoico@terra.es

Correspondencia: Pl. Poeta Eduardo Marquina, 4, pta. 20.a. 46014 Valencia. España.
, A.M. Fullana-Montoroa, P. Momparler-Carrascoa, M.J. Redondo-Gallegoa, J. Brines-Solanesb, F.J. Bueno-Cañigralc
a Servicio de Salud Infantil y de la Mujer. Dirección General para la Salud Pública. Conselleria de Sanitat de la Comunidad Valenciana. Valencia
b Servicio de Pediatría. Hospital Clínico Universitario de Valencia. Valencia
c Concejalía de Sanidad y Consumo. Ayuntamiento de Valencia. Valencia. España
Este artículo ha recibido

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Información del artículo
Resumen
Objetivo

La enfermedad neumocócica es una causa frecuente de morbilidad y mortalidad entre la población infantil. La reciente autorización de la vacuna conjugada heptavalente ha incrementado el interés científico que suscita esta enfermedad. El objetivo de este estudio es conocer las características epidemiológicas y clínicas, así como la evolución de esta enfermedad invasiva en la población infantil de la Comunidad Valenciana.

Método

Los datos se han obtenido de las historias clínicas de los niños menores de 15 años, con aislamiento del neumococo, atendidos en todos los hospitales públicos de la Comunidad Valenciana durante el período 1996-2000. La evolución de la incidencia se valoró mediante la comparación de tasas, los signos clínicos y su evolución (secuelas y letalidad) mediante la evaluación de la frecuencia y su distribución por edades.

Resultados

Se registró un total de 127 casos, lo que representa un promedio de tasa anual de 3,89/105 habitantes en los menores de 15 años y de 20,14 en los menores de 2 años. Presentaron antecedentes de problemas de salud un 29,1% de los pacientes. Las manifestaciones clínicas predominantes fueron sepsis/bacteriemia (38%), neumonía (31%) y meningitis (24%). Al alta, presentaban secuelas 10 niños, de los que el 75% eran menores de 2 años. Fallecieron 8 niños (letalidad del 6,3%).

Conclusiones

En nuestro medio, durante el período estudiado, la infección neumocócica se presenta sobre todo en los niños menores de 2 años, así como en los mayores de esta edad con antecedentes de problemas de salud. En estos últimos se ha encontrado una mayor mortalidad. Sería conveniente introducir la enfermedad neumocócica en el Sistema de Vigilancia Epidemiológica, lo que nos permitiría disponer de estimaciones más precisas de su evolución epidemiológica y valorar si la vacuna conjugada es la solución a los problemas que plantea esta bacteria en la actualidad.

Palabras clave:
Streptococcus pneumoniae
Enfermedad in
Abstract
Objective

Pneumococcal disease is an important cause of morbidity and mortality in children. The recent authorization of the heptavalent conjugate vaccine has increased interest in this disease. The objective of this study was to identify the epidemiological and clinical characteristics of this disease, as well as its outcome in the pediatric population of the Autonomous Community of Valencia.

Method

Data were obtained from the medical records of children aged less than 15 years who were positive for pneumococcus isolation on admission to hospital between 1996 and 2000. All the public hospitals of the Autonomous Community of Valencia were included. Changes in incidence were evaluated by comparing rates and outcomes (sequelae and lethality) through frequency and age distribution.

Results

One hundred twenty-seven cases were registered, giving a mean annual rate of 3.89/105 inhabitants aged less than 15 years. The rate was 20.14 in children aged less than 2 years. A total of 29.1% of the children had previous health problems. The main clinical manifestations included sepsis/ bacteremia (38%), pneumonia (31%) and meningitis (24%). At discharge sequelae were present in 10 children, 75% of whom were aged less than 2 years. Eight children died (6.3% lethality).

Conclusions

In the period and region studied, pneumococcal infection was present mainly in children aged less than 2 years and in those with previous health problems. In the last few years, mortality has increased. Thus, inclusion of pneumococcal disease in the epidemiological surveillance system would be appropriate to achieve more precise estimations of its epidemiological patterns and to determine whether the conjugate vaccine represents a solution to the problems currently associated with this bacteria.

Key words:
Streptococcus pneumoniae
Invasive disease
Infant
Incidence
Mortality
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