Invasive pneumococcal disease among children younger than 5 years of age before and after introduction of pneumococcal conjugate vaccine in Casablanca, Morocco

Diawara, Idrissa; Zerouali, Khalid; Katfy, Khalid; Zaki, Bahija; Belabbès, Houria; Najib, J.; Elmdaghri, Naima

doi:10.1016/j.ijid.2015.09.019

Cited by 45 publications

(57 citation statements)

References 29 publications

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“…Apesar do fenómeno de substituição observado, a redução importante dos casos vacinais, ultrapassou largamente o aumento dos não vacinais. [12][13][14][15] Em Portugal, a DIP tornou-se uma doença de declaração obrigatória apenas em 2014. 17 Os dados do estudo prospetivo promovido pelo Grupo de Estudo da Doença Invasiva Pneumocócica da Sociedade de Infeciologia Pediátrica da Sociedade Portuguesa de Pediatria (SPP), mostram que a incidência global da doença variou entre 6,3 e 4,6/100 000 crianças e adolescentes, de 2006 a 2014 (Brito MJ, comunicação pessoal).…”

Section: Discussionunclassified

Doença Invasiva Pneumocócica Pediátrica Antes da Vacinação Universal: 1995 - 2015

et al. 2017

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Introduction: Pneumococcal conjugate vaccine was introduced in the private market in Portugal in 2001, reaching over the years a moderately high coverage. In July 2015, it was included in the National Immunisation Program. The aim of this study was to characterize invasive pneumococcal disease in a pediatric hospital before universal use of the vaccine.Material and Methods: Retrospective analysis of medical records of all children with Streptococcus pneumoniae identified by culture and/or molecular biology (available since 2008), in products obtained from sterile sites, from January 1995 to June 2015. We evaluated demographic, clinical and microbiological data. Serotype results are available since 2004.Results: Over those 20 years, 112 invasive pneumococcal disease cases were identified, with a median age of 15 months (1 month - 15 years). The median number of cases /year was 4, the highest between 2001 - 2002 (8/year) and 2007 - 2012 (7 - 11/year). The identification occurred mostly in blood culture (72), cerebrospinal fluid (24), pleural fluid (11) an others (5). The most frequent diagnoses were pneumonia (38%), occult bacteraemia (34%) and meningitis (21%). Over the period under review, there was an increase of pneumonia and slight increase of OB, with meningitis cases remaining relatively unchanged.Discussion: In the last two decades, there was no reduction in the number of cases of invasive pneumococcal disease. There was an increase in isolates from pneumonia and occult bacteraemia that might be due to the introduction of molecular biological methods for Streptococcus pneumoniae detection. Vaccine serotypes were predominant.Conclusion: This retrospective analysis before universal vaccination will contribute to evaluate the impact of vaccination in the Portuguese pediatric population.

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Section: Discussionunclassified

Doença Invasiva Pneumocócica Pediátrica Antes da Vacinação Universal: 1995 - 2015

et al. 2017

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“…Bu durumun, uzun süredir ülkemiz aşı takviminde bulunan ve yaygın şekilde uygulanan pnömokok ve H.influenzae tip b aşılarının etkinliği olduğu düşünülmektedir. Zira bu bakterilerin neden olduğu infeksiyon sayısındaki ciddi azalma çeşitli kaynaklarda da bildirilmiştir (6,9) . Literatürde akut otitis media hastalarının çoğunun çocuk olduğu görülmektedir.…”

Section: Discussionunclassified

Determination of the Causative Agents and Antimicrobial Susceptibility in Otitis Externa and Otitis Media Patients

Borsa¹,

Kaplan²,

Aldağ³

et al. 2016

Ankem Derg

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ÖZET Kulak infeksiyonları, başta çocuklar olmak üzere tüm yaş gruplarını etkileyebilen ve toplumda sık görülen infeksiyonlardır. Otitis eksterna (OE), 4) OE, 44'ü (% 37) OM ön tanılı hastalar oldukları görülmüştür. Ayrıca kültür pozitif OM hastalarının büyük çoğunluğunun (% 81.4) kronikleşmiş vakalar olması dikkat çekmiştir. OE tanısı alan 76 hastada en sık bulgular ağrı (% 97), işitme kaybı (% 96), kulak akıntısı (% 96), dış kulak yolunda ödem ve daralma (% 96) olarak saptanmıştır. OM tanısı alan 42 hastada en sık rastlanan bulgular ise kulak zarında perforasyon (% 100), ağrı (% 94), kulak akıntısı (% 94), ateş (% 69) ve işitme kaybı (% 54) olarak kaydedilmiştir. Kültür pozitif olan 76 OE hastamızdan izole edilen mikroorganizmalardan ikisi Anahtar sözcükler: etken mikroorganizmalar, kulak infeksiyonu, otitis eksterna, otitis media, Pseudomonas aeruginosa SUMMARY Determination of the Causative Agents and Antimicrobial Susceptibility in Otitis Externa and Otitis Media Patients Ear infections may affect almost all age groups, besides being among the most common human infections. Otitis externa (OE) is the inflammation of external auditory canal. Disease is usually seen during summer season, and may cause severe complications if left untreated. The most common causative agents are Pseudomonas aeruginosa and Staphylococcus aureus. Fungi, particularly Aspergillus and Candida species, may also cause the disease. Otitis media (OM) is characterized with pain, inflammation and effusion in the middle ear. Recurrent ear discharge and tympanic membrane perforation are also common findings particularly in patients with chronic infection. The most common causative agents are Streptococcus pneumoniae and Haemophilus influenzae, but the number of cases caused by these strains have been decreasing due to the effective vaccination programmes. P.aeruginosa, S.aureus, and enteric Gram negative bacteria are the most common microorganisms isolated in chronic OM cases.In

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“…Before pneumococcal vaccine implementation in Morocco, the incidence rate of invasive pneumococcal diseases (IPD) in children aged to 2 years was 34.6/100,000 populations. The incidence rates of PCV-7, PCV-10 non-PCV-7 and PCV-13 non-PCV-10 serotypes were 18.0, 5.7 and 5.7/100,000 population in the same age, respectively [11]. In 2010, the use of the pneumococcal conjugate vaccine (PCV-13 and then PCV-10) dramatically reduced the prevalence of vaccine serotypes through active vaccination particularly among children less than 5 years of ages in Casablanca, Morocco.…”

Section: Introductionmentioning

confidence: 99%

“…In 2010, the use of the pneumococcal conjugate vaccine (PCV-13 and then PCV-10) dramatically reduced the prevalence of vaccine serotypes through active vaccination particularly among children less than 5 years of ages in Casablanca, Morocco. However, the introduction of vaccination was associated with a subsequent relative increase in non-vaccine serotypes [11]. This can be attributed to the phenomena of “serotype replacement”, the expansion of preexisting NVT pneumococci, and/or serotype switching [12].…”

Section: Introductionmentioning

confidence: 99%

“…This can be attributed to the phenomena of “serotype replacement”, the expansion of preexisting NVT pneumococci, and/or serotype switching [12]. Vaccination has also reduced the incidence rate of antibiotic resistant serotypes, but we previously reported, a rebound due to the persistence of some vaccine serotypes like 6B and 14 [11]. Although several studies have described the genetic profile of the pbp1a , pbp2b and pbp2x genes in pneumococci from different countries [4, 13], actually, there are no studies on the characteristics of penicillin non- susceptible S. pneumoniae (PNSP) in Morocco.…”

Section: Introductionmentioning

confidence: 99%

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Molecular characterization of penicillin non-susceptible Streptococcus pneumoniae isolated before and after pneumococcal conjugate vaccine implementation in Casablanca, Morocco

Diawara

Barguigua

Katfy

et al. 2017

Ann Clin Microbiol Antimicrob

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Background Streptococcus pneumoniae is a major cause of morbidity and mortality worldwide, especially among children and the elderly. The ability to effectively treat pneumococcal infection has been compromised due to the acquisition of antibiotic resistance, particularly to β-lactam drugs. This study aimed to describe the prevalence and molecular evolution of penicillin non-susceptible S. pneumoniae (PNSP) isolated from invasive diseases before and after pneumococcal conjugate vaccine implementation in Casablanca, Morocco.MethodsIsolates were obtained from the Microbiology Laboratory of Ibn Rochd University Hospital Centre of Casablanca. Serogrouping was done by Pneumotest Kit and serotyping by the Quellung capsular swelling. Antibiotic susceptibility pattern was determined by disk diffusion and E-test methods. The PNSP were analyzed by pulsed-field gel electrophoresis (PFGE) and by genotyping of pbp1a, pbp2b, and pbp2x genes.ResultsA total of 361 S. pneumoniae isolates were collected from 2007 to 2014. Of these isolates, 58.7% were obtained before vaccination (2007–2010) and 41.3% after vaccination (2011–2014). Of the 361 isolates, 80 were PNSP (22.2%). Generally, the proportion of PNSP between pre- and post-vaccination periods were 31 and 13% (p = 0.009), respectively. The proportion of PNSP isolated from pediatric and adult (age > 14 years) patients decreased from 34.5 to 22.9% (p = 0.1) and from 17.7 to 10.2% (p = 0.1) before and after vaccine implementation, respectively. The leading serotypes of PNSP were 14 (33 vs. 57%) and 19A (18 vs. 14%) before and after vaccination among children. For adults, serotypes 19A (53%) and 23F (24%) were the dominant serotypes in the pre-vaccination period, while serotype 14 (22%) was the most prevalent after vaccination. There were 21 pbp genotypes in the pre-vaccination period vs. 12 for post-vaccination period. PFGE clustering showed six clusters of PNSP grouped into three clusters specific to pre-vaccination period (clusters I, II and III), two clusters specific to post-period (clusters V and VI) and a cluster (IV) that contained clones belonging to the two periods of vaccination.ConclusionOur observations demonstrate a high degree of genetic diversity among PNSP. Genetic clustering among PNSP strains showed that they spread mainly by a restricted number of PNSP clones with vaccine serotypes. PFGE clustering combined with pbp genotyping revealed that vaccination can change the population structure of PNSP.

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Invasive pneumococcal disease among children younger than 5 years of age before and after introduction of pneumococcal conjugate vaccine in Casablanca, Morocco

Abstract: Shifts in the distribution of IPD serotypes and reductions in the incidence rate of disease suggest an effective reduction of the burden of IPD in children, but continued high quality surveillance is critical to assess the changes in serotype distributions.

Cited by 45 publications

References 29 publications

Doença Invasiva Pneumocócica Pediátrica Antes da Vacinação Universal: 1995 - 2015

Doença Invasiva Pneumocócica Pediátrica Antes da Vacinação Universal: 1995 - 2015

Determination of the Causative Agents and Antimicrobial Susceptibility in Otitis Externa and Otitis Media Patients

Molecular characterization of penicillin non-susceptible Streptococcus pneumoniae isolated before and after pneumococcal conjugate vaccine implementation in Casablanca, Morocco

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