Invasive bacterial infections of children in a rural province in the central Philippines.

Abstract

Abstract. The etiology of invasive bacterial infections was studied among 956 Filipino children less than five years old who fulfilled the World Health Organization criteria for severe or very severe pneumonia or had suspected meningitis or sepsis. The most common invasive infections were due to Streptococcus pneumoniae (12 [1.3%]) and Haemophilus influenzae (12 [1.3%]); including four cases of pneumococcal meningitis and 11 cases of H. influenzae meningitis. Type 1 was the most common (six of the 12 isolates) of the pneumococcal serotypes. Serotypes/groups 1, 6, 14, and 23 accounted for 91.7% of the invasive isolates. The majority of the H. influenzae strains from blood (10 out of 10) and cerebrospinal fluid (6 out of 7) were type b. Almost all of the invasive S. pneumoniae (9 out of 12) and H. influenzae (11 out of 12) infections were seen before one year of age, which stresses the need to investigate early immunization of children for H. influenzae type b and S. pneumoniae, as well as maternal immunization to maximize the potential of immunoprophylaxis.

Carriage of Streptococcus pneumoniae and Other Respiratory Bacterial Pathogens in Low and Lower-Middle Income Countries: A Systematic Review and Meta-Analysis

“…The prevalence of H. influenzae carriage in HIV-infected children was reported for India (24%) [70] and Zambia (29%) [71], two lower-middle income countries. The prevalence of H. influenzae carriage in ill children from three lower-middle income countries ranged between 15.2% and 53.5% [36], [61], [62]. PCR generally yielded higher rates of H. influenzae carriage than microbiology in both healthy (31.4%–70% vs. 1.1%–28.6%) and ill (50%–53.5% vs. 15.2%–36.6%) subjects.…”

Immunogenicity, reactogenicity and safety of three-dose primary and booster vaccination with combined diphtheria-tetanus-whole-cell pertussis-hepatitis B-reduced antigen contentHaemophilus influenzaetype b vaccine in Filipino children

“…6 Studies involving bacterial culture from blood have found that Streptococcus pneumoniae and Haemophilus influenzae are the most common etiological agents for pneumonia and meningitis in children with the pneumococcal serotypes 1, 6, 9, 14, 19, 23 and H. influenzae serotype b as the most prevalent causative agents. 7,8 Although official data on Hib disease in the Philippines is limited, studies have reported that the majority (∼80%) of Hib-related pneumonia and meningitis occur in the first year of life. 9,10 In view of the high global coverage of combined DTP vaccines, the addition of new antigens to existing DTP vaccines is the most effective way to achieve rapid vaccine coverage with the new antigen.…”

Serious community-acquired neonatal infections in rural Southeast Asia (Bohol Island, Philippines)

“…Antimicrobial susceptibility tests were performed as previously reported. 27,28 Radiological investigation Postero-anterior and lateral chest radiographs were obtained for most infants and read by the study radiologist, blinded to clinical information, and classified for the presence and type of infiltrates. A dense infiltrate was defined as fluffy opacities with ill-defined margins, with lobar, segmental or patchy distribution.…”

“…27,28 The study was approved by the Institutional Review Board of the Research Institute for Tropical Medicine. As part of a large prospective study on serious infections in children under 5 years of age, infants below 2 months were enrolled using criteria, partly based on the WHO case management protocol for Acute Respiratory Infections, 29 or our definitions, 28 if they had: (1) clinically defined severe pneumonia (cough or difficult breathing and respiratory rate X60/min or severe lower chest wall indrawing), 29 (2) suspected meningitis indicated by convulsions, abnormal sleepiness or difficulty in waking, or neurologic abnormalities 28 or (3) clinical suspicion of sepsis (any of the following: fever >38.01C or hypothermia <36.01C, poor feeding, distended and tense abdomen, apneic episodes, grunting, central cyanosis and jaundice).…”

“…As part of a large prospective study on serious infections in children under 5 years of age, infants below 2 months were enrolled using criteria, partly based on the WHO case management protocol for Acute Respiratory Infections, 29 or our definitions, 28 if they had: (1) clinically defined severe pneumonia (cough or difficult breathing and respiratory rate X60/min or severe lower chest wall indrawing), 29 (2) suspected meningitis indicated by convulsions, abnormal sleepiness or difficulty in waking, or neurologic abnormalities 28 or (3) clinical suspicion of sepsis (any of the following: fever >38.01C or hypothermia <36.01C, poor feeding, distended and tense abdomen, apneic episodes, grunting, central cyanosis and jaundice). 28 To exclude nosocomial infections and non-infectious conditions related to prematurity, we excluded: (1) premature infants p7 days of age; (2) infants admitted for X3 days in another hospital immediately before evaluation; (3) infants born at Gallares Hospital who developed symptoms of infection at X3 days of life while still in hospital; (4) infants who had invasive procedures (i.v. insertion, intubation, etc.)…”