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

BMC Infectious Diseases

Deborah Lehmann⁴  William Pomat²  Peter Siba²  John Reeder⁵  Christopher Blyth⁷  Denise Murphy³  Helen Smith³  Tilda Orami²  Mition Yoannes²  Suparat Phuanukoonnon⁶  Andrew R. Greenhill¹ 

[1]School of Applied and Biomedical Sciences, Federation University, Churchill, Australia

[2]Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea

[3]Queensland Department of Health, Forensic and Scientific Services, Coopers Plains, Australia

[4]Telethon Kids Institute, The University of Western Australia, Perth, Australia

[5]Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia

[6]The Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia

[7]PathWest Laboratory Medicine, Perth, Western Australia, Australia

关键词: Pneumococcal conjugate vaccine;    Low-income;    Meningitis;   

Others  :  1232747
DOI  :  10.1186/s12879-015-1197-0

 received in 2015-06-18, accepted in 2015-10-08,  发布年份 2015

【 摘 要 】

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.

【 授权许可】

   
2015 Greenhill et al.

【 图 表 】

Fig. 1.

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