Hospital Surveillance of Childhood Bacterial Meningitis in Senegal and the Introduction of Haemophilus influenzae Type b Conjugate Vaccine

Ba, Osseynou; Fleming, Jessica A.; Dièye, Yakhya; Mutombo, Boniface Mutombo wa; Ba, Mamadou; Cissé, Moussa; Diallo, Astou Coly Niassy; Sow, Iyane; Slack, Mary P. E.; Faye, Pape Coumba; Bâ, Mady; Diallo, Ndiouga; Weiss, Noel S.

doi:10.4269/ajtmh.2010.10-0346

Cited by 14 publications

(11 citation statements)

References 14 publications

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“…In our study the prevalence of confirmed and probable meningitis were 3.3% and 2.1% respectively. Our result is similar to other surveillance (based on cultures) of meningitis in other parts of Africa [ 33 , 34 ]. The prevalence however appears low compared to some reports from the northern part of Ghana.…”

Section: Discussionsupporting

confidence: 92%

Aetiological agents of cerebrospinal meningitis: a retrospective study from a teaching hospital in Ghana

Owusu

Nguah

Boaitey

et al. 2012

Ann Clin Microbiol Antimicrob

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AbstractsBackgroundMeningitis is an important cause of morbidity and mortality in low-resource settings. In sub-Saharan Africa, the meningitis belt has been characterized by particularly high and seasonal incidences of bacterial meningitis extending throughout life. Despite the progress being made in treating the condition, the mortality rates continue to be high, ranging between 2% and 30% globally. In Ghana, the mortality rate of meningitis has been estimated to range from 36% to 50%. However little information is available on the pathogens contributing to meningitis and their antimicrobial susceptibilities. Updated information is essential to adjust the recommendations for empirical treatment or prevention of meningitis which could have immense implications for local and global health.MethodsWe retrospectively reviewed laboratory records of all patients suspected of bacterial meningitis who underwent a lumbar puncture from January 1, 2008 to December 31, 2010. Data were retrieved from laboratory record books and double entered into a Microsoft® excel spreadsheet.ResultsRecords of 4,955 cerebrospinal fluid samples were analysed. Of these, 163 (3.3%, 95%CI: 2.8% to 3.8%) were confirmed meningitis and 106 (2.1%, 95%CI: 1.7% to 2.6%) were probable meningitis cases. Confirmed meningitis cases were made up of 117 (71.8%) culture positive bacteria, 19 (11.7%) culture positive Cryptococcus neoformans and 27(16.6%) Gram positive bacteria with negative culture. The most prevalent bacteria was Streptococcus pneumoniae 91 (77.7%), followed by E.coli 4 (3.4%), Salmonella species 4 (3.4%), Neisseria meningitidis 3 (2.5%), Pseudomonas species 3(2.5%) and others. Pneumococcal isolates susceptibility to penicillin, chloramphenicol and ceftriaxone were 98.9% (95%CI: 94.0% to 100.0%), 83.0% (95%CI: 73.4% to 90.1%) and 100.0% (95%CI: 95.8% to 100.0%) respectively.ConclusionStreptococcus pneumoniae is an important cause of meningitis among all age groups and its susceptibility to penicillin and ceftriaxone still remains very high. Ghanaians of all ages and possibly other developing countries in the meningitis belt could benefit from the use of the pneumococcal vaccine. Other bacterial and fungal pathogens should also be considered in the management of patients presenting with meningitis.

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Section: Discussionsupporting

confidence: 92%

Aetiological agents of cerebrospinal meningitis: a retrospective study from a teaching hospital in Ghana

Owusu

Nguah

Boaitey

et al. 2012

Ann Clin Microbiol Antimicrob

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“…In recent years, two main changes have been observed in the epidemiology of acute bacterial meningitis in children [ 25 ]. The first change was that the prevalence of Streptococcus pneumoniae , Haemophilus influenzae type b and Neisseria meningitides significantly decreased in some developed countries due to the administration of vaccines [ 26 , 27 ]. Similarly, the incidence of acute bacterial meningitis caused by with Streptococcus pneumoniae , Haemophilus influenzae type b and Neisseria meningitides also decreased in Yunnan province, China, where vaccinations were partially performed against these bacteria.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and antibiotic resistance profiles of cerebrospinal fluid pathogens in children with acute bacterial meningitis in Yunnan province, China, 2012-2015

Jiang

Kui

et al. 2017

PLoS ONE

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Acute bacterial meningitis is still considered one of the most dangerous infectious diseases in children. To investigate the prevalence and antibiotic resistance profiles of cerebrospinal fluid (CSF) pathogens in children with acute bacterial meningitis in Southwest China, CSF samples from 179 meningitis patients (3 days to 12 years old) with positive culture results were collected from 2012 to 2015. Isolated pathogens were identified using the Vitek-32 system. Gram stain results were used to guide subcultures and susceptibility testing. The antimicrobial susceptibility of isolates was determined using the disc diffusion method. Of the isolates, 50.8% were Gram-positive bacteria, and 49.2% were Gram-negative bacteria. The most prevalent pathogens were E. coli (28.5%), Streptococcus pneumoniae (17.8%), Staphylococcus epidermidis (10.0%), Haemophilus influenzae type b (9.5%), and group B streptococcus (7.2%). In young infants aged ≤3 months, E. coli was the organism most frequently isolated from CSF (39/76; 51.3%), followed by group B streptococcus (13/76; 17.1%) and Streptococcus pneumoniae (8/76; 10.5%). However, in young infants aged >3 months, the most frequently isolated organism was Streptococcus pneumoniae (24/103; 23.3%), followed by Staphylococcus epidermidis (18/103; 17.5%) and Haemophilus influenzae type b (16/103; 15.5%). Antimicrobial susceptibility tests indicated that for E. coli isolates, the susceptibility rates to aminoglycosides ranged from 56.8% to 100.0%, among them, amikacin was identified as the most effective against E. coli. As for cephalosporins, the susceptibility rates ranged from 29.4% to 78.4%, and cefoxitin was identified as the most effective cephalosporin. In addition, the susceptibility rates of piperacillin/tazobactam and imipenem against E. coli were 86.3% and 100%. Meanwhile, the susceptibility rates of Streptococcus pneumoniae isolates to penicillin G, erythromycin, chloramphenicol, ceftriaxone and tetracycline were 68.8%, 0.0%, 87.5%, 81.3% and 0.0%, respectively. Gentamycin, ofloxacin, linezolid and vancomycin were identified as the most effective antibiotics for Streptococcus pneumoniae, each with susceptibility rates of 100%. It was notable that other emerging pathogens, such as Listeria monocytogenes and group D streptococcus, cannot be underestimated in meningitis.

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“…Among the 29 S. pneumoniae meningitis tested with 28 different antisera, 16 different serotypes were identified, and serotypes 1 (6/29, 20.7%; 95% CI, 5-36%), was the most prevalent followed by 23 F (4/29, 13.8%), and 6B (3/29, 10.3%) (Figure 3 ). Serotype data have been obtained in 3 previous studies on meningitis in Senegal [ 19 ]-[ 21 ]. In the 70s the most frequent serotypes were 5, 6, 23 and 12, although serotype 1 was also detected (4-8%).…”

Section: Discussionmentioning

confidence: 99%

Identifying an appropriate PCV for use in Senegal, recent insights concerning Streptococcus pneumoniaeNP carriage and IPD in Dakar

Seck

et al. 2014

BMC Infect Dis

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BackgroundSince 2000, the Global Alliance for Vaccines and Immunization (GAVI) and WHO have supported the introduction of the Pneumococcal Conjugate Vaccine (PCV) in the immunization programs of developing countries. The highest pneumococcal nasopharyngeal carriage rates have been reported (40-60%) in these countries, and the highest incidence and case fatality rates of pneumococcal infections have been demonstrated in Africa.MethodsStudies concerning nasopharyngeal pneumococcal carriage and pneumococcal infection in children less than 5 years old were conducted in Dakar from 2007 to 2008. Serotype, antibiotic susceptibility and minimum inhibitory concentrations were determined. In addition, among 17 overall publications, 6 manuscripts of the Senegalese literature published from 1972 to 2013 were selected for data comparisons.ResultsAmong the 264 children observed, 132 (50%) children generated a nasopharyngeal (NP) positive culture with Streptococcus pneumoniae. The five most prevalent serotypes, were 6B (9%), 19 F (9%), 23 F (7.6%), 14 (7.6%) and 6A (6.8%). Fifteen percent of the strains (20/132) showed reduced susceptibility to penicillin and 3% (4/132) showed reduced susceptibility to anti-pneumococcal fluoroquinolones. Among the 196 suspected pneumococcal infections, 62 (31.6%) Streptococcus pneumoniae were isolated. Serogroup 1 was the most prevalent serotype (21.3%), followed by 6B (14.9%), 23 F (14.9%) and 5 (8.5%). Vaccine coverage for PCV-7, PCV-10 and PCV-13, were 36.2% (17/47), 66% (31/47) and 70.2% (33/47) respectively. Reduced susceptibility to penicillin and anti-pneumococcal fluoroquinolones was 6.4% and 4.3%, respectively, and the overall lethality was 42.4% (14/33).ConclusionsThis study confirms a high rate of carriage and disease caused by Streptococcus pneumoniae serotypes contained within the current generation of pneumococcal conjugate vaccines and consistent with reports from other countries in sub-Saharan Africa prior to PCV introduction. Antimicrobial resistance in this small unselected sample confirms a low rate of antibiotic resistance. Case-fatality is high. Introduction of a high valency pneumococcal vaccine should be a priority for health planners with the establishment of an effective surveillance system to monitor post vaccine changes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0627-8) contains supplementary material, which is available to authorized users.

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Hospital Surveillance of Childhood Bacterial Meningitis in Senegal and the Introduction of Haemophilus influenzae Type b Conjugate Vaccine

Cited by 14 publications

References 14 publications

Aetiological agents of cerebrospinal meningitis: a retrospective study from a teaching hospital in Ghana

Aetiological agents of cerebrospinal meningitis: a retrospective study from a teaching hospital in Ghana

Prevalence and antibiotic resistance profiles of cerebrospinal fluid pathogens in children with acute bacterial meningitis in Yunnan province, China, 2012-2015

Identifying an appropriate PCV for use in Senegal, recent insights concerning Streptococcus pneumoniaeNP carriage and IPD in Dakar

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