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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
general
Streptococcus pneumoniae serotype-2 childhood meningitis in bangladesh: A newly recognized pneumococcal infection threat
PLoS ONE, Volume 7, No. 3, Article e32134, Year 2012
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Description
Background: Streptococcus pneumoniae is a leading cause of meningitis in countries where pneumococcal conjugate vaccines (PCV) targeting commonly occurring serotypes are not routinely used. However, effectiveness of PCV would be jeopardized by emergence of invasive pneumococcal diseases (IPD) caused by serotypes which are not included in PCV. Systematic hospital based surveillance in Bangladesh was established and progressively improved to determine the pathogens causing childhood sepsis and meningitis. This also provided the foundation for determining the spectrum of serotypes causing IPD. This article reports an unprecedented upsurge of serotype 2, an uncommon pneumococcal serotype, without any known intervention. Methods and Findings: Cases with suspected IPD had blood or cerebrospinal fluid (CSF) collected from the beginning of 2001 till 2009. Pneumococcal serotypes were determined by capsular swelling of isolates or PCR of culture-negative CSF specimens. Multicenter national surveillance, expanded from 2004, identified 45,437 patients with suspected bacteremia who were blood cultured and 10,618 suspected meningitis cases who had a lumber puncture. Pneumococcus accounted for 230 culture positive cases of meningitis in children <5 years. Serotype-2 was the leading cause of pneumococcal meningitis, accounting for 20.4% (45/221; 95% CI 15%-26%) of cases. Ninety eight percent (45/46) of these serotype-2 strains were isolated from meningitis cases, yielding the highest serotype-specific odds ratio for meningitis (29.6; 95% CI 3.4-256.3). The serotype-2 strains had three closely related pulsed field gel electrophoresis types. Conclusions: S. pneumoniae serotype-2 was found to possess an unusually high potential for causing meningitis and was the leading serotype-specific cause of childhood meningitis in Bangladesh over the past decade. Persisting disease occurrence or progressive spread would represent a major potential infection threat since serotype-2 is not included in PCVs currently licensed or under development. © 2012 Saha et al.
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https://efashare.b-cdn.net/share/pmc/articles/PMC3316528/bin/pone.0032134.s003.docx
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https://efashare.b-cdn.net/share/pmc/articles/PMC3316528/bin/pone.0032134.s005.docx
https://efashare.b-cdn.net/share/pmc/articles/PMC3316528/bin/pone.0032134.s006.docx
Authors & Co-Authors
Saha, Samir Kumar
Bangladesh, Dhaka
Dhaka Shishu Hospital
Al-Emran, Hassan M.
Bangladesh, Dhaka
Dhaka Shishu Hospital
Darmstadt, Gary L.
United States, Baltimore
Johns Hopkins University
Saha, Senjuti
Canada, Toronto
University of Toronto
Islam, Maksuda M.
Bangladesh, Dhaka
Dhaka Shishu Hospital
Chowdhury, Atique Iqbal
Bangladesh, Dhaka
International Centre for Diarrhoeal Disease Research Bangladesh
Foster, Dona
United Kingdom, Oxford
University of Oxford
Naheed, Aliya
Bangladesh, Dhaka
International Centre for Diarrhoeal Disease Research Bangladesh
Arifeen, Shams E.
Bangladesh, Dhaka
International Centre for Diarrhoeal Disease Research Bangladesh
Baqui, Abdullah Hel
United States, Baltimore
Johns Hopkins University
Qazi, Shamim Ahmad
Switzerland, Geneva
Organisation Mondiale de la Santé
Luby, Stephen P.
Bangladesh, Dhaka
International Centre for Diarrhoeal Disease Research Bangladesh
United States, Atlanta
Centers for Disease Control and Prevention
Breiman, Robert F.
United States, Atlanta
Centers for Disease Control and Prevention
Santosham, Mathuram
United States, Baltimore
Johns Hopkins University
Black, Robert E.
United States, Baltimore
Johns Hopkins University
Crook, Derrick W.
United Kingdom, Oxford
University of Oxford
Statistics
Citations: 37
Authors: 16
Affiliations: 7
Identifiers
Doi:
10.1371/journal.pone.0032134
ISSN:
19326203
Research Areas
Health System And Policy
Maternal And Child Health
Study Design
Randomised Control Trial
Case-Control Study