von Kries R, Siedler A, Schmitt HJ, Reinert RR (2000): Proportion of invasive pneumococcal infections in German children preventable by pneumococcal conjugate vaccines
Clin. Infect. Dis. 31: 482-487.

The incidence and serotype distribution of Streptococcus pneumoniae as a cause of invasive diseases are unknown with regard to most European countries. From January 1997 through December 1998, population-based nationwide prospective surveillance was undertaken for invasive pneumococcal disease (IPD) in children in Germany, based on monthly independent reports from all pediatric hospitals and from clinical microbiology laboratories. On the basis of 896 reported IPD cases (including 404 with meningitis), the incidences per 10 (5) children in different age groups were as follows: children aged <1 year, 18.9 (9.7 for meningitis), children aged <2 years, 16.0 (7.2 for meningitis), for children aged <5 years, 8.9 (3.9 for meningitis), and for children aged <16 years, 3.2 (1.4 for meningitis). The proportions of cases involving strains (304 serotyped) included in conjugate vaccines were as follows: for the 7-valent vaccine, 52%, for the 9-valent, 62%, and for the 11-valent, 71%. None of the isolates were resistant to penicillin or cefotaxime. Although the rate for meningitis is similar, other manifestations of IPD are less commonly diagnosed in Germany than in other countries. The serotype distribution only partially matched that used in the recent development of pneumococcal conjugate vaccines.