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Burden of invasive pneumococcal disease in children in Casablanca, Morocco four years after the introduction of pneumococcal vaccination


Amar Chikhaoui
Néhémie Nzoyikorera
Idrissa Diawara
Zineb Jouhadi
Khalid Zerouali

Abstract

Streptococcus pneumoniae is a common bacterium that can cause several types of infections, including invasive infections especially in children aged <5 years. The aim of this work is to report the different aspects of invasive pneumococcal disease (IPD) in a pediatric hospital in Casablanca, Morocco 4 years after the implementation of pneumococcal vaccination. We conducted a descriptive, retrospective study over a 4-year period from January 2015 to December 2018 in A. Harouchi Pediatric Hospital in Casablanca. This study included hospitalized children aged 0 to 14 years´ old who had an IPD. The data was collected using a data collection sheet from archived patient records and computerized laboratory database; organization of data was done using Microsoft Excel 2016 and analysis was done using SPSS-20. A total of 68 patients were included in this series over the 4-year period. Meningitis was the most common IPD (54.41%) followed by bacteremia (19.17%) and then pneumonia (16.17%). Of the 35 serogrouped strains, 7 were included in the pneumococcal conjugate vaccine (PCV) 10 (20%), 6 were PCV13-nonPCV10 serotypes (17.14%) and 6 were non-vaccine serotypes (17.14%). Among the strains tested for their antibiotic resistance profile, 32.70% were resistant to penicillin, tetracycline (29.78%), erythromycin (20.75%) and cotrimoxazole (17.31%). One strain was intermediate to ceftriaxone. The evolution was unfavorable for 18 patients (26.47%). This study reported high resistance rates to penicillin, tetracyclin and erythromycin. The mortality essentially concerned meningitis patients. Ongoing surveillance of antibiotic susceptibility and serotype distribution is needed by a national surveillance network.


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eISSN: 1937-8688