Pneumococcal Infection among Children before Introduction of 13-Valent Pneumococcal Conjugate Vaccine, Cambodia

Turner, Paul; Turner, Claudia; Suy, Kuong; Soeng, Sona; Ly, Sokeng; Miliya, Thyl; Day, Nicholas P. J.

doi:10.3201/eid2111.150914

Cited by 21 publications

(31 citation statements)

References 12 publications

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“…We report on invasive pneumococcal disease in children attending a children’s hospital in Siem Reap, Northwestern Cambodia between 2007 and 2012, and describe the antibiotic resistance profiles, serotypes, vaccine coverage and multilocus sequence types on a subset of isolates. This study complements and extends the data from the 2013–4 surveillance study [ 7 ].…”

Section: Introductionsupporting

confidence: 77%

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Characterisation of Invasive Streptococcus pneumoniae Isolated from Cambodian Children between 2007 – 2012

et al. 2016

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BackgroundThe 13-valent pneumococcal vaccine (PCV13) was introduced in Cambodia in January 2015. There are limited data concerning the common serotypes causing invasive pneumococcal disease (IPD). Knowledge of the circulating pneumococcal serotypes is important to monitor epidemiological changes before and after vaccine implementation.MethodsAll episodes of IPD defined by the isolation of Streptococcus pneumoniae from blood, cerebrospinal fluid or other sterile site in Cambodian children admitted to the Angkor Hospital for Children in Siem Reap, Northwestern Cambodia, between 1st January 2007 and 1st July 2012 were retrospectively studied. Streptococcus pneumoniae isolates that could be retrieved underwent phenotypic typing and whole genome sequencing.ResultsThere were 90 Cambodian children hospitalized with IPD with a median (IQR) age of 2.3 years (0.9–6.2). The case fatality was 15.6% (95% CI 8–23). Of 50 Streptococcus pneumoniae isolates available for further testing, 46% were penicillin non-susceptible and 8% were ceftriaxone non-susceptible, 78% were cotrimoxazole resistant, 30% were erythromycin resistant and 30% chloramphenicol resistant. There were no significant changes in resistance levels over the five-year period. The most common serotypes were 1 (11/50; 22%), 23F (8/50; 16%), 14 (6/50; 12%), 5 (5/50; 10%) and 19A (3/50; 6%). Coverage by PCV7, PCV10 and PCV13 was 44%, 76% and 92% respectively. We identified novel multilocus sequence types and resistotypes using whole genome sequencing.ConclusionsThis study suggests IPD is an important disease in Cambodian children and can have a significant mortality. PCV13 coverage of the serotypes determined in studied strains was high and consistent with another recent study. The phenotypic resistance patterns observed were similar to other regional studies. The use of whole genome sequencing in the present study provides additional typing and resistance information together with the description of novel sequence types and resistotypes.

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Section: Introductionsupporting

confidence: 77%

“…In a recent study of S . pneumoniae , 88% of 43 invasive isolates serotypes causing invasive pediatric disease in Cambodia in 2013–14 had a serotype covered by the PCV13 vaccine [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Characterisation of Invasive Streptococcus pneumoniae Isolated from Cambodian Children between 2007 – 2012

et al. 2016

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“…All papers reported resistance rates for penicillin (median 46.6%, IQR 31.8%-58.1%), co-trimoxazole (median 75.2%, IQR 74.5%-79.3%), and 3GC (median 4.8%, IQR 3.4%-8.0%). One of the papers reported isolates from a study of nasopharyngeal carriage of S. pneumoniae in children (Turner et al, 2015), whereas the others reported isolates from unwell patients.…”

Section: Streptococcus Pneumoniaementioning

confidence: 99%

Antimicrobial resistance in Cambodia: a review

Reed

Krang

Miliya

et al. 2019

International Journal of Infectious Diseases

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Objectives: Following the launch of the Global Antimicrobial Resistance Surveillance System (GLASS), antimicrobial resistance (AMR) rates in many countries remain poorly described. This review provides an overview of published AMR data from Cambodia in the context of recently initiated national human and food-animal surveillance. Methods: PubMed and the Cochrane Database of Systematic Reviews were searched for articles published from 2000 to 2018, which reported antimicrobial susceptibility testing (AST) data for GLASS specific organisms isolated from Cambodia. Articles were screened using strict inclusion/exclusion criteria. AST data was extracted, with medians and ranges of resistance rates calculated for specific bug-drug combinations. Results: Twenty-four papers were included for final analysis, with 20 describing isolates from human populations. Escherichia coli was the most commonly described organism, with median resistance rates from human isolates of 92.8% (n = 6 articles), 46.4% (n = 4), 55.4% (n = 8), and 46.4% (n = 5) to ampicillin, 3 rd generation cephalosporins, fluoroquinolones, and gentamicin respectively. Conclusions: Whilst resistance rates are high for several GLASS organisms, there were insufficient data to draw robust conclusions about the AMR situation in Cambodia. The recently implemented national AMR surveillance systems will begin to address this data gap.

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“…AHC is a paediatric hospital located in Siem Reap, a province in Northern Cambodia with a population of around 1 million. Patients admitted to AHC between 1 August 2013 and 31 July 2014, suspected of having meningitis, pneumonia or sepsis and who gave informed consent were enrolled into a prospective study of pneumococcal colonization and disease [ 10 ]. All enrolled patients had NP swabs taken as soon as possible after admission.…”

Section: Methodsmentioning

confidence: 99%

Lack of Utility of Nasopharyngeal Swabs for Diagnosis ofBurkholderia pseudomalleiPneumonia in Paediatric Patients

et al. 2016

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Diagnosis of Burkholderia pseudomallei pneumonia in children is challenging. We investigated the utility of nasopharyngeal swabs taken from 194 paediatric patients on admission with radiologically proven pneumonia. Melioidosis was proven in 0.5% of samples tested and only in a third of those known to be bacteraemic with B. pseudomallei. It appears unlikely that culture of nasopharyngeal secretions is helpful to confirm B. pseudomallei pneumonia in paediatric patients.

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Pneumococcal Infection among Children before Introduction of 13-Valent Pneumococcal Conjugate Vaccine, Cambodia

Cited by 21 publications

References 12 publications

Characterisation of Invasive Streptococcus pneumoniae Isolated from Cambodian Children between 2007 – 2012

Characterisation of Invasive Streptococcus pneumoniae Isolated from Cambodian Children between 2007 – 2012

Antimicrobial resistance in Cambodia: a review

Lack of Utility of Nasopharyngeal Swabs for Diagnosis ofBurkholderia pseudomalleiPneumonia in Paediatric Patients

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