Epidemiological profile of invasive bacterial diseases in children in Casablanca, Morocco: antimicrobial susceptibilities and serotype distribution

Abstract

The aim of this prospective study in Morocco was to investigate the causes of invasive bacterial diseases in children in order to inform antibiotic therapy and vaccine choices. Of 238 children aged ≤ 5 years admitted to the Children's Hospital of Casablanca for invasive diseases over a 12-month period, 185 were diagnosed with bacterial infection: 76 had chest-X-ray-confirmed pneumonia, 59 had meningitis and 50 had sepsis. Streptococcus pneumoniae was the most common pathogen identified (n = 24), followed by Neisseria meningitidis (n = 18, all group B) and Haemophilus influenzae (n = 11). The rate of penicillin non-susceptibility was 62.5% among Str. pneumoniae isolates and 11.1% among N. meningitidis and all isolates were ceftriaxone-susceptible. Of the 11 H. influenzae isolates, only 1 produced a beta-lactamase. The 5 predominant Str. pneumoniae serotypes were 19F, 14, 23F, 6B and 19A and the theoretical coverage of the 7, 10 and 13-valent pneumococcal conjugate vaccines was 60%, 78% and 91% respectively.

Epidemiology and antibiotic resistance profile of bacterial meningitis in Morocco from 2015 to 2018

“…Amoxicillin-resistant strains of N. meningitidis in this study were 5.6%. Whereas in previous studies at the local researches, no strains were found to be resistant to amoxicillin, while the N. meningitidis DSPG level is 9.3% in this study, which has changed over time in relation to these researches [19,20]. Thus, the resistance reported here remained less severe than those reported elsewhere [18,20].…”

Antibiotic Usage Prior and During Hospitalization for Clinical Severe Pneumonia in Children under Five Years of Age in Rabat, Morocco

“…Susceptibility from common circulating respiratory bacteria to commonly used antibiotics remains reasonably high, a finding that differs from previous reports in Moroccan ARI isolates [ 24 , 25 ]. A major limitation of this study is that the incidence of invasive bacterial disease detected among recruited patients was low (24/690; 3.5%) and of multiple etiologies, thus not allowing us to investigate susceptibility patterns among invasive isolates.…”

“…Possibly in relation to this, the proportion of total pediatric deaths attributable to pneumonia is believed to have decreased from 18% to 15% in the period of 2000 to 2012 [ 23 ], but the major gaps in knowledge regarding the precise etiology and epidemiology of pneumonia in Morocco remain inadequately addressed. Data on antibiotic susceptibility in Morocco are limited and disaggregated, although have suggested increasing trends of resistance or even multiresistance from S. pneumoniae isolates to penicillin or other commonly used antibiotics [ 24 , 25 , 26 ]. Data on antibiotic usage for respiratory infections are also scarce, although a recent survey conducted by the public health department reports that 56.5% of the approximately 130,000 children seen in primary health care settings with respiratory tract infections received antibiotics [ 27 ].…”

Detection of Streptococcus pneumoniae and Haemophilus influenzae Type B by Real-Time PCR from Dried Blood Spot Samples among Children with Pneumonia: A Useful Approach for Developing Countries

“…No pneumococcal conjugate vaccines were introduced in Mozambique and Morocco during the study period. The burden of Hib invasive disease in Mozambique is well documented and high [16] while very scarce data on its incidence or impact are available in Morocco [17]. …”