Paediatric pneumococcal disease in Central Europe.

Streptococcus pneumoniae causes considerable global paediatric morbidity and mortality, despite the availability of safe and effective pneumococcal conjugate vaccines (PCVs). To justify the introduction of PCVs, accurate information on the burden of disease is required. Here, we present an appraisal of the pneumococcal epidemiological situation in 11 Central European countries. The data are based on study findings presented at the 12th Central European Vaccine Advisory Group (CEVAG) meeting, held on 21-22 May 2010 in Sofia, Bulgaria, and a literature review of the PubMed database using the search terms 'pneumococcal' or 'Streptococcus pneumoniae', in combination with 'otitis media', 'pneumonia', 'meningitis' or 'bacteraemia/sepsis', and '[Central European country name]'. The incidence of pneumococcal disease appears to be lower in Central Europe than previously reported for Europe as a whole, with the highest risk in infants aged 0-2 years. The fatality rates in the under fives from invasive infections are up to 40%. A paucity of comprehensive country-specific data on pneumococcal disease burden arises from the lack of homogenous surveillance programmes. Standardised, active surveillance systems are required for the accurate evaluation of the pneumococcal disease burden in the region. Only then can the need for vaccination be addressed.

Microbiological and therapeutical aspects of pneumococcal diseases in the Slovak Republic.

Since 1983, multiresistant pneumococcal strains, mostly 14, 23F, 19A serotypes have been reported in Slovakia. A 15-year cooperation of specialists from various fields and the representatives of different institutions revealed that the pneumococcal infection problem in the Slovak Republic remains an important healthcare task. In the prospective multicentric microbiological and clinical analysis of otitis media acuta in children under 5 years, pneumococci were isolated in 45.9%, where 50.8% of strains were intermediate and fully resistant to penicillin and 47.5% resistant to macrolid antibiotics. Invasive pneumococcal infections, mostly meningitis and bacteremias, were observed in two studies. Penicillin resistance was higher in children under 5 years (52.8%), in comparison with other age groups. The dominant serotypes of childhood were 14, 19A and 6A, while in the age group above 65 there was a broad spectrum of serotypes confirmed. Serotype 14 is the most frequent serotype in physiologically sterile liquids and otitis media liquor in the Slovak Republic (Tab. 3, Fig. 5, Ref. 34).

Rotavirus type profile in nosocomial and community infections in Western Slovakia.

The surveillance study of rotavirus gastroenteritis at the University Teaching Hospital Trencín area, Slovakia, during 2006-2011 confirmed that the genotype profile of circulating rotaviruses was not stable. While G1P[8] dominating genotype dropped from 75 to 7.3 % in the period 2009-2011, genotype G2P[4] that was not detected in 2009 raised to 45.1 % in 2011. Vaccination coverage rose from 4.4 to 22.1 % in the period 2008-2011. Among the community and hospital cases, we observed that the average age of patients with nosocomial infections was significantly less (10.6 months) than in the cases of community rotavirus gastroenteritis (RVGE) cases. Compared to the nosocomial infection cases, the duration of the disease and the duration of hospitalization among the community cases were significantly longer by 0.22 and 3.63 days, respectively, during 2006-2011. Though the vaccination coverage was found to correlate with changes in the type of the circulating rotaviruses, the natural circulation in rotavirus genotypes may not be excluded as important factor contributing to the emergence of G2P[4] strain during the survey period.

[The hypereosinophilic syndrome in a child with endomyocardial fibrosis treated surgically]. / Hypereozinofilný syndróm dietata s endomyokardiálnou fibrózou riesený operacne.

The authors describe the case-history of a 12-year-old patient with hypereosinophil syndrome, endomyocardial fibrosis of the left ventricle and dominating mitral valve insufficiency. By correction of the insufficiency, using a Carpentier ring, the authors achieved substantial improvement of the haemodynamics. One year after operation the patient is cardially compensated.