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Introduction: Invasive Bacterial Diseases (IBD) are the major causes of morbidity and mortality in under five children in India. There is difference in the pattern and aetiology of IBD according to the geographical variation and the antimicrobial susceptibility of causative organisms are also variable. There is lack of data on patterns of IBD from central India. Aim: To generate the data on the burden of pneumonia, meningitis and sepsis among under five children in central India and the microorganisms associated with them. Materials and Methods: This prospective observational study was conducted from August 2019 to July 2020 at the Department of Paediatrics at Mahatma Gandhi Memorial Medical College and MY Hospital, indore, on children of 1-59 months of age admitted with Pneumonia, Meningitis and Sepsis. A detailed history was recorded for all the participants and thorough physical examination was done along with chest x-ray, routine laboratory examination and blood cultures were performed. Latex Agglutination Test (LAT) and Antibiotic Susceptibility Testing were performed on Cerebrospinal Fluid (CSF) samples. All the data collected were recorded in Microsoft(MS) excel sheet and frequency(n), percentages(%) and chi-square test for significance level, were calculated to analyse the collected data. Results: Of the total 450 cases enrolled, 283 (62.8%) had confirmed IBD. Out of the confirmed cases, 183 (64.6%) had pneumonia, 52 (18.3%) had meningitis and 48 (16.9%) had sepsis. Highest case fatality rate was seen with sepsis followed by meningitis and pneumonia. The most common organism isolated was Staphylococcus aureus. Overall, gram-negative bacilli were found to be more resistant to the conventional antibiotics than gram positive organisms. An 83% (n=40) of Staphylococcus aureus were susceptible to methicillin whereas only 45% (n=12) of Klebsiella pneumoniae were susceptible to Amikacin. Conclusion: The present study highlights the predominance of staphylococcus aureus and adverse outcomes of IBD in children with Severe Acute Malnutrition (SAM) and incomplete immunisation. Emergence of resistant bacterial strains to conventional antibiotics warrants the need to consider the locally prevailing antimicrobial susceptibility patterns for the effective management of these diseases. [ABSTRACT FROM AUTHOR]

Introduction: Haemophilus influenzae type b, Streptococcus pneumoniae, and Neisseria meningitidis were the leading causative agents of invasive bacterial diseases (IBD) among children of less than 5 years of age prior to the introduction of the Haemophilus influenzae type b (Hib) conjugate vaccine. A significant decrease of invasive Haemophilus influenzae diseases (IHD) occurred in nations that implemented routine Hib vaccination in their national immunization program (NIP). Aim: The goal of this study was to describe the frequency and characteristics of pediatric patients with IBD before and after routine Hib vaccination was implemented into the Croatian national immunization program (NIP). Subjects and methods: A retrospective analysis of patient records from administrative databases for patients aged 0 to 18 with etiologically proven IBD at University Hospital for Infectious Diseases "Dr. Fran Mihaljević". Results: A total of 1.112 pediatric patients were analyzed. The patients were divided into three periods: one prevaccinal (reference) and two postvaccinal periods. During the second period, a statistically significant change in proportion occurred for Neisseria meningitidis (p<0.05), Streptococcus agalactiae (p<0.05) and Haemophilus influenzae (p<0.0001). Haemophilus influenzae (p<0.0001) maintained this trend during the third period as well. Additionally, a decrease in Hib meningitis cases was noted (p<0.0001). Conclusion: The implementation of Hib vaccine in the Croatian NIP led to a significant decrease of IHD. Streptococcus pneumoniae and Neisseria meningitidis are still the leading causative agents of IBD, and thus the introduction of adequate pneumococcal and meningococcal vaccine in Croatian NIP should be considered. [ABSTRACT FROM AUTHOR]

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Background: Invasive bacterial diseases (IBD) are a serious cause of hospitalization, sequelae and mortality. Albeit a low incidence, an increase in cases due to H. influenzae was registered in the past 4 years and, in the Tuscany region, an excess of cases due to N. meningitidis since 2015 is alarming. The purpose of this study is to deepen the knowledge of IBD epidemiology in Tuscany with particular attention to temporal trends.Methods: Tuscan residents hospitalized for IBD from January 1st 2000 to March 18th 2016 were selected from the regional hospital discharge database based on ICD-9-CM codes. Age-specific and standardized hospitalization rates were calculated together with case-fatality rates (CFRs). A time-trend analysis was performed; whereas, prognostic factors of death were investigated through univariable and multivariable analyses.Results: The average standardized hospitalization rates for invasive meningococcal diseases (IMD), invasive pneumococcal diseases and invasive diseases due to H. influenzae from 2000 to 2016 were 0.6, 1.8, and 0.2 per 100,000, respectively. The average CFRs were 10.5%, 14.5% and 11.5% respectively with higher values in the elderly. Older age was significantly associated with higher risk of death from all IBD. A significant reduction in hospitalization rates for IMD was observed after meningococcal C conjugate vaccine introduction. The Annual Percentage Change (APC) was -13.5 (95% confidence interval (CI) -22.3; -3.5) in 2005-2013 but has risen since that period. Furthermore, a significant increasing trend of invasive diseases due to H. influenzae was observed from 2005 onwards in children 1-4 years old (APC 13.3; 95% CI 0; 28.3).Conclusions: This study confirms changes in the epidemiology of invasive diseases due to H. influenzae and IMD. Furthermore, attention is called to the prevention of IBD in the elderly because of the age group's significantly higher rate of hospitalizations and deaths for all types of IBD. [ABSTRACT FROM AUTHOR]