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Streptococcus pneumoniae and Haemophilus influenzae in paediatric meningitis patients at Goroka General Hospital, Papua New Guinea: serotype distribution and antimicrobial susceptibility in the pre-vaccine era
- Source :
- BMC Infectious Diseases
- Publication Year :
- 2015
- Publisher :
- BioMed Central, 2015.
-
Abstract
- Background Bacterial meningitis remains an important infection globally, with the greatest burden in children in low-income settings, including Papua New Guinea (PNG). We present serotype, antimicrobial susceptibility and outcome data from paediatric meningitis patients prior to introduction of Haemophilus influenzae type b (Hib) and pneumococcal conjugate vaccines (PCVs) in PNG, providing a baseline for evaluation of immunisation programs. Methods Cerebrospinal fluid (CSF) was collected from children admitted to Goroka General Hospital with suspected meningitis between 1996 and 2005. Culture and sensitivity was conducted, and pneumococci and H. influenzae were serotyped. Laboratory findings were linked to clinical outcomes. Results We enrolled 1884 children. A recognised pathogen was identified in 375 children (19.9 %). Streptococcus pneumoniae (n = 180) and Hib (n = 153) accounted for 88.8 % of pathogens isolated. 24 different pneumococcal serogroups were identified; non-PCV types 2, 24 and 46 accounted for 31.6 % of pneumococcal meningitis. 10- and 13-valent PCVs would cover 44.1 % and 45.4 % of pneumococcal meningitis respectively. Pneumococcal isolates were commonly resistant to penicillin (21.5 %) and 23 % of Hib isolates were simultaneously resistant to ampicillin, co-trimoxazole and chloramphenicol. The case fatality rate in patients with a recognised bacterial pathogen was 13.4 % compared to 8.5 % in culture-negative patients. Conclusions If implemented in routine expanded programme of immunisation (EPI) with high coverage, current PCVs could prevent almost half of pneumococcal meningitis cases. Given the diversity of circulating serotypes in PNG serotype replacement is of concern. Ongoing surveillance is imperative to monitor the impact of vaccines. In the longer term vaccines providing broader protection against pneumococcal meningitis will be needed. Electronic supplementary material The online version of this article (doi:10.1186/s12879-015-1197-0) contains supplementary material, which is available to authorized users.
- Subjects :
- Serotype
Male
medicine.medical_specialty
Population
Microbial Sensitivity Tests
medicine.disease_cause
Hospitals, General
Pneumococcal conjugate vaccine
Haemophilus influenzae
Meningitis, Bacterial
Pneumococcal Vaccines
Papua New Guinea
Anti-Infective Agents
Ampicillin
Internal medicine
Streptococcus pneumoniae
Trimethoprim, Sulfamethoxazole Drug Combination
Medicine
Humans
Meningitis
education
Antiinfective agent
education.field_of_study
Vaccines, Conjugate
business.industry
Immunization Programs
Meningitis, Pneumococcal
Haemophilus influenzae type b
Low-income
Infant
medicine.disease
Infectious Diseases
Immunology
Female
business
medicine.drug
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 14712334
- Volume :
- 15
- Database :
- OpenAIRE
- Journal :
- BMC Infectious Diseases
- Accession number :
- edsair.doi.dedup.....3990b8c369ac2f2247e38de917e4499f