Invasive Pneumococcal Disease in Neonates Prior to Pneumococcal Conjugate Vaccine Use in South Africa: 2003-2008

被引:1
|
作者
Moodley, Krishnee [1 ,2 ]
Coovadia, Yacoob Mahomed [3 ]
Cohen, Cheryl [4 ,5 ]
Meiring, Susan [6 ]
Lengana, Sarona [5 ]
De Gouveia, Linda [5 ]
von Mollendorf, Claire [4 ,5 ]
Crowther-Gibson, Penny [6 ]
Quan, Vanessa [6 ]
Eley, Brian [7 ]
Reubenson, Gary [8 ]
Nana, Trusha [9 ]
von Gottberg, Anne [5 ,10 ]
机构
[1] Lancet Labs, Microbiol, Kwa Zulu Natal, South Africa
[2] Univ KwaZulu Natal, Coll Hlth Sci, Antimicrobial Res Unit, Durban, South Africa
[3] Univ KwaZulu Natal, Dept Med Microbiol, Nelson R Mandela Sch Med, Durban, South Africa
[4] Univ Witwatersrand, Sch Publ Hlth, Fac Hlth Sci, Johannesburg, South Africa
[5] Natl Hlth & Aboratory Serv, Natl Inst Communicable Dis, Ctr Resp Dis & Meningitis, Johannesburg, South Africa
[6] Natl Hlth Lab Serv, Natl Inst Communicable Dis, Div Publ Hlth Surveillance & Response, Johannesburg, South Africa
[7] Univ Cape Town, Dept Pediat & Child Hlth, Pediat Infect Dis Unit, Red Cross War Mem Childrens Hosp, Cape Town, South Africa
[8] Univ Witwatersrand, Rahima Moosa Mother & Child Hosp, Fac Hlth Sci, Dept Pediat & Child Hlth, Johannesburg, Gauteng, South Africa
[9] Natl Hlth Lab Serv, Dept Microbiol, Charlotte Maxeke Johannesburg Acad Hosp, Johannesburg, South Africa
[10] Univ Witwatersrand, Sch Pathol, Fac Hlth Sci, Johannesburg, South Africa
关键词
neonates; invasive pneumococcal disease; South Africa; INFLUENZAE TYPE-B; STREPTOCOCCUS-PNEUMONIAE; INFANTS YOUNGER; EPIDEMIOLOGY; SURVEILLANCE; INFECTION; CHILDREN; SEROTYPE-1; BURDEN; DEATH;
D O I
10.1097/INF.0000000000002096
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background: Neonatal invasive pneumococcal disease (IPD) in developing countries is poorly described. We provide a baseline description of neonatal IPD in South Africa, before implementation of the 7-valent pneumococcal conjugate vaccine (PCV7) in 2009. Methods: Data from children (age <= 2 years) with IPD (pneumococcus identified from a normally sterile specimen) from January 2003 to December 2008 were extracted from a national laboratory-based surveillance database. Clinical and laboratory characteristics of IPD among neonates (0-27 days old) was compared with IPD among young children (>= 28 days <= 2 years). Early-onset IPD (0-6 days old) was compared with late-onset IPD (>= 7-27 days old). Isolates were serotyped using the Quellung reaction. Results: Overall 27,630 IPD cases were reported. Of the 26,277 (95%) with known ages, 6583 (25%) were <= 2 years of age, of which 4.5% (294/6583) were neonates. The estimated annual incidence of neonatal IPD in 2008 was 5 per 100,000 live births. Fifty-one percent of neonates with IPD presented with early-onset IPD. Case fatality ratios (CFRs) were high in both groups, 31% (28/89) in neonatal IPD versus 26% (614/2383) in non-neonatal IPD (P = 0.18). Among neonates, the meningitis cases (15/37, 41%) were associated with the highest CFR. The 13-valent pneumococcal conjugate vaccine (PCV13) serotypes accounted for 69% (134/194) of neonatal IPD isolates. Conclusions: Pneumococcal neonatal disease in South Africa was not uncommon before PCV introduction and is associated with a high CFR. The indirect effect on neonatal IPD of PCV rollout requires further evaluation.
引用
收藏
页码:424 / 430
页数:7
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