Pneumococcal conjugate vaccine and changing epidemiology of childhood bacterial meningitis

Madhi, Shabir А.

doi:10.1016/j.jped.2014.11.001

Cited by 6 publications

(6 citation statements)

References 21 publications

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“…Immunization of young children might not only have conferred protection against invasive H . influenzae type b disease, but could also have indirectly provided protection to unvaccinated individuals through interruption of disease transmission thereby reducing risk of acquiring Hib infection [ 14 , 15 ]. There is likelihood for a similar shift in levels of pneumococcal disease in the post-PCV introduction scenario.…”

Section: Discussionmentioning

confidence: 99%

Burden of bacterial meningitis in India: Preliminary data from a hospital based sentinel surveillance network

et al. 2018

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BackgroundWorldwide, acute bacterial meningitis is a major cause of high morbidity and mortality among under five children, particularly in settings where vaccination for H. influenzae type b, S. pneumoniae and N. meningitidis is yet to be introduced in the national immunization programs. Estimation of disease burden of bacterial meningitis associated with these pathogens can guide the policy makers to consider inclusion of these newer vaccines in the immunization programs. A network of hospital based sentinel surveillance was established to generate baseline data on the burden of bacterial meningitis among children aged less than 5 years in India and to provide a platform for impact assessment following introduction of the Pentavalent and Pneumococcal Conjugate Vaccines (PCV).MethodsDuring surveillance carried out in select hospitals across India in 2012–2013, information regarding demographics, immunization history, clinical history, treatment details and laboratory investigations viz. CSF biochemistry, culture, latex agglutination and PCR was collected from children aged 1 to 59 months admitted with suspected bacterial meningitis.ResultsA total of 3104 suspected meningitis cases were enrolled from 19,670 children admitted with fever at the surveillance hospitals. Of these, 257 cases were confirmed as cases of meningitis. They were due to S. pneumoniae (82.9%), H. influenzae type b (14.4%) and N. meningitidis (2.7%). Highest prevalence (55.3%) was observed among children 1 to 11 months. Antimicrobial susceptibility testing revealed considerable resistance among S. pneumoniae isolates against commonly used antibiotics such as cotrimoxazole, erythromycin, penicillin, and cefotaxime. More commonly prevalent serotypes of S. pneumoniae in circulation included 6B, 14, 6A and 19F. More than 90% of serotypes identified were covered by Pneumococcal Conjugate Vaccine 13.ConclusionsWe observed that S. pneumoniae was the commonest cause of bacterial meningitis in hospitalized children under five years of age in India. Continued surveillance is expected to provide valuable information and trends in future, to take an informed decision on introduction of pneumococcal vaccination in Universal Immunization Programme in India and will also eventually help in post-vaccination impact evaluation.

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Section: Discussionmentioning

confidence: 99%

Burden of bacterial meningitis in India: Preliminary data from a hospital based sentinel surveillance network

et al. 2018

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“…Despite the availability of potent newer antibiotics, the mortality rate associated with acute bacterial meningitis remains very high in some developing countries, ranging from 16–32% [16–20]. Meanwhile, according to the results of extensive studies of the etiology of meningitis that have been conducted in Nepal, French Guiana, the North American Arctic and northern Togo, Streptococcus pneumoniae and Haemophilus influenzae type b were the pathogens most frequently isolated from the CSF of pediatric bacterial meningitis cases [6, 17, 21–23]. Nevertheless, a report from Turkey showed that Neisseria meningitides serogroup W135 was the dominant organism isolated from children with bacterial meningitis [24].…”

Section: Discussionmentioning

confidence: 99%

“…Of the Streptococcus pneumoniae isolates, 87.5% were susceptible to chloramphenicol, whereas 68.8% were susceptible to penicillin. Previous studies have, however, documented pneumococcal penicillin resistance rates ranging from 8%-31% and chloramphenicol resistance rates of 5–20.6% [6, 33–35]. In addition, gentamicin may not be chosen as a treatment option against Streptococcus pneumonia infection in children.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, early diagnosis and appropriate antibiotic treatment are necessary to avoid further complications. It has been reported that Streptococcus pneumoniae , Neisseria meningitidis , and Haemophilus influenzae type b were among the most prevalent pathogens causing this disease [3–6]. However, the prevalence and etiologies of meningitis pathogens may vary during different times, in geographical regions, and according to the age of the patients [3, 7–13].…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and antibiotic resistance profiles of cerebrospinal fluid pathogens in children with acute bacterial meningitis in Yunnan province, China, 2012-2015

Jiang

Kui

et al. 2017

PLoS ONE

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Acute bacterial meningitis is still considered one of the most dangerous infectious diseases in children. To investigate the prevalence and antibiotic resistance profiles of cerebrospinal fluid (CSF) pathogens in children with acute bacterial meningitis in Southwest China, CSF samples from 179 meningitis patients (3 days to 12 years old) with positive culture results were collected from 2012 to 2015. Isolated pathogens were identified using the Vitek-32 system. Gram stain results were used to guide subcultures and susceptibility testing. The antimicrobial susceptibility of isolates was determined using the disc diffusion method. Of the isolates, 50.8% were Gram-positive bacteria, and 49.2% were Gram-negative bacteria. The most prevalent pathogens were E. coli (28.5%), Streptococcus pneumoniae (17.8%), Staphylococcus epidermidis (10.0%), Haemophilus influenzae type b (9.5%), and group B streptococcus (7.2%). In young infants aged ≤3 months, E. coli was the organism most frequently isolated from CSF (39/76; 51.3%), followed by group B streptococcus (13/76; 17.1%) and Streptococcus pneumoniae (8/76; 10.5%). However, in young infants aged >3 months, the most frequently isolated organism was Streptococcus pneumoniae (24/103; 23.3%), followed by Staphylococcus epidermidis (18/103; 17.5%) and Haemophilus influenzae type b (16/103; 15.5%). Antimicrobial susceptibility tests indicated that for E. coli isolates, the susceptibility rates to aminoglycosides ranged from 56.8% to 100.0%, among them, amikacin was identified as the most effective against E. coli. As for cephalosporins, the susceptibility rates ranged from 29.4% to 78.4%, and cefoxitin was identified as the most effective cephalosporin. In addition, the susceptibility rates of piperacillin/tazobactam and imipenem against E. coli were 86.3% and 100%. Meanwhile, the susceptibility rates of Streptococcus pneumoniae isolates to penicillin G, erythromycin, chloramphenicol, ceftriaxone and tetracycline were 68.8%, 0.0%, 87.5%, 81.3% and 0.0%, respectively. Gentamycin, ofloxacin, linezolid and vancomycin were identified as the most effective antibiotics for Streptococcus pneumoniae, each with susceptibility rates of 100%. It was notable that other emerging pathogens, such as Listeria monocytogenes and group D streptococcus, cannot be underestimated in meningitis.

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“…In Brazil, with the incorporation of pneumococcal vaccines, particularly 10-valent, since 2010,6 , 7 there is a reduction of pneumococcal diseases, such as meningitis and CAP,8 - 10 in children under two years of age, with a decline in the number of hospitalizations, malnutrition, deaths, and parental work absenteeism, as well as cost reduction, among others 1112 …”

Section: Introductionmentioning

confidence: 99%

Impact of the pneumococcal 10-valent vaccine on reducing hospitalization for community-acquired pneumonia in children

Silva

Mello

Silva

et al. 2016

Revista Paulista de Pediatria (English Edition)

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Objective:To describe and analyze the occurrence of hospitalizations for community-acquired pneumonia in children before and after the pneumococcal 10-valent conjugate vaccine implementation into the National Immunization Program.Methods:This is an ecological study that includes records of children younger than one year old, vaccinated and not vaccinated with the pneumococcal 10-valent conjugate vaccine in the periods pre- and post-inclusion of the vaccine in the National Immunization Program in the area covered by the Regional Health Superintendence of Alfenas, state of Minas Gerais, Brazil. Vaccination was considered as the exposure factor and hospitalization for community-acquired pneumonia as the endpoint, using secondary annual data by municipality. The prevalence ratio and its 95% confidence interval (95%CI) were used to verify the association between variables. The Z test was used to calculate the difference between proportions.Results:Considering the 26 municipalities of the Regional Health Superintendence of Alfenas, there was a significant reduction in hospitalizations for community-acquired pneumonia in children younger than one year of age, with prevalence ratio (PR)=0.81 (95%CI: 0.74-0.89; p<0.05), indicating a 19% lower prevalence of hospitalization for community-acquired pneumonia in the post-vaccination period.Conclusions:The results suggest the effectiveness of the pneumococcal 10-valent conjugate vaccine in preventing severe cases of community-acquired pneumonia in children younger than one year of age.

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Pneumococcal conjugate vaccine and changing epidemiology of childhood bacterial meningitis

Cited by 6 publications

References 21 publications

Burden of bacterial meningitis in India: Preliminary data from a hospital based sentinel surveillance network

Burden of bacterial meningitis in India: Preliminary data from a hospital based sentinel surveillance network

Prevalence and antibiotic resistance profiles of cerebrospinal fluid pathogens in children with acute bacterial meningitis in Yunnan province, China, 2012-2015

Impact of the pneumococcal 10-valent vaccine on reducing hospitalization for community-acquired pneumonia in children

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