Reduction in pediatric hospitalizations for varicella-related invasive group a streptococcal infections in the varicella vaccine era☆
Section snippets
Methods
We performed a retrospective medical record review of all patients with GAS isolated from a sterile site that were admitted to Children's Memorial Hospital, a pediatric tertiary care hospital, between January 1, 1993, and December 31, 2001. Subjects were identified from microbiology laboratory records. Cases were excluded if (1) culture from only a nonsterile site was identified (vaginal, throat, sputum, superficial, etc); (2) source of GAS culture was not well documented; (3) culture yielded
Results
During the 9-year study period, 238 hospitalized patients with GAS thought to be isolated from a normally sterile site were identified. A total of 235 medical records (99%) were available for a preliminary review. Among these, 91 records were excluded, based on our criteria. The primary reason for exclusion was recovery of GAS only from a superficial site, accounting for 59 cases. Twenty-nine cases were excluded for mixed growth without predominance of GAS, and 3 cases were excluded for
Discussion
This retrospective study documented a significant decline in varicella-associated IGAS hospitalizations temporally associated with increasing utilization of varicella vaccine. The proportion of IGAS hospitalizations that were varicella-associated declined from 27% in the prevaccine era (1993 to 1995) to 16% during vaccine implementation (1996 to 1998) and to only 2% with widespread vaccine use in Illinois (1999 to 2001). This finding of a significant reduction in VA-IGAS hospitalizations
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2020, VaccineCitation Excerpt :Meanwhile, universal varicella immunization was first initiated in the United States in 1996 after approval by the US FDA in 1995. Studies conducted in the United States have demonstrated that the varicella vaccine is effective, on the basis of decreases in the numbers of varicella patients, varicella-associated admitted cases, and deaths after implementation of universal vaccination [3–7]. In 2014, Japan initiated a national immunization program in which two doses of Oka/Biken varicella vaccine are given.
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Presented in part at the Pediatric Academic Societies' Meeting, May 3, 2003, Seattle, Washington.