Clinical and epidemiologic studies of pneumococcal infection in children.

Streptococcus pneumoniae was isolated from 1310 children in a 5-year period from 1979 through 1984. There were 44 cases of meningitis, 172 bacteremic infections, 787 cases of otitis media and 307 respiratory and miscellaneous isolates. The majority of infections could be accounted for by a small number of serotypes, with types 3, 6, 14, 19 and 23 predominating. Most infections (70%) occurred in infants younger than 2 years of age. However, nearly one-fourth of those suffering systemic illness had some underlying condition which may have contributed to their risk for infection, even beyond 2 years of age. Ten of the 12 deaths occurred in patients with altered host defenses. Characteristics of pneumococcal disease and the distribution of serotypes are discussed in relation to the work of other investigators over the past 50 years.