Conjugated pneumococcal vaccine for children in Saudi Arabia: following the footsteps of Hib vaccine

This study was conducted to assess the impact of Hib vaccination on the Haemophilus influenzae type b incidence and occurrence of Streptococcus pneumoniae in the University Hospital of Riyadh, Saudi Arabia. The study also meant to consider the need for the introduction of routine conjugated pneumococcal vaccine for children. It was a retrospective study during the period of January 1996 to July 2007 reviewing all positive blood and CSF in children up to 18 years of age who were admitted to the hospital with a diagnosis of invasive disease with Haemophilus influenzae type b and Streptococcus pneumoniae. Eighty cases with invasive disease due to Haemophilus influenzae were admitted between 1996 and 2000. Hib conjugated vaccine has become routine in Saudi Arabia since the year 2000 and since then a significant steady drop of Haemophilus influenzae type b cases was observed with only 36 cases occurring between June 2001 and July 2007. On the other hand, no change was observed in the incidence of Streptococcus pneumoniae invasive disease. This study suggests that the prevention of invasive pneumococcal disease by immunization may be an attractive proposition. These results should initiate health authorities to encourage similar local and nation wide studies to support this suggestion

Pencillin resistance in serogroups/serotypes of streptococcus pneumoniae causing invasive infections in central Saudi Arabia

To determine the minimum inhibitory concentrations [MICs] of penicillin, ceftriaxone and vancomycin of serogroups/serotypes of Streptococcus pneumoniae [S. pneumoniae] from invasive diseases in all age groups from major hospitals in Riyadh, Kingdom of Saudi Arabia [KSA]. All isolates of S. pneumoniae from patients with invasive pneumococcal infections between February 2000 and November 2001 were prospectively collected from 8 major hospitals in Riyadh, KSA. The isolates were confirmed as S. pneumoniae at the King Khalid University Hospitals, Riyadh, KSA and then serogrouped/serotyped using the agglutination method. The MICs for penicillin, ceftriaxone and vancomycin were carried out using the E-test. Forty-three% of the isolates were resistant to penicillin mostly of the intermediate type [97%]. The resistant strains were mainly confined to serogroups/serotypes 6, 23, 19 and 15 and the 7-valent conjugate vaccine covers 76% of the penicillin-resistant strains. Only one isolate was resistant to ceftriaxone. In view of the rather insignificant level of highly resistant-penicillin strains and the virtual absence of resistance to ceftriaxone we would like to suggest using ceftriaxone for treating invasive pneumococcal infections outside the central nervous system. We recommend that the conjugate vaccine would be a useful adjunct to penicillin prophylaxis in patients at risk in our community

Serogroups and antimicrobial susceptibility of non-typhoidal salmonellas in children

To update knowledge regarding the pattern of Serogroups and antimicrobial susceptibility of Salmonellas causing gastroenteritis in children at the King Khalid University Hospital in Riyadh, Saudi Arabia during the period of 1st April 1996 to 30th September 1999. The case records of 416 children, from whom Salmonella species were isolated from stool cultures between April 1996 and September 1999 were reviewed. The isolates and susceptibility of these Salmonella were carried out accordingly to standard microbiological methods. During a period of 3 and 1/2 years a total of 412 non-typhoidal Salmonellas were isolated from stool cultures of 416 children who presented to King Khalid University Hospital complaining of gastroenteritis. The majority of these children [70%] belonged to the age group 0-4 years. Eighty seven% of the Salmonella isolates were Serogroup D1, B and C1. The Serogroups and antimicrobial susceptibility of these Salmonellas differed from those previously reported from this country and other parts of the world. Salmonella gastroenteritis is an important clinical condition in infants and children in the Kingdom of Saudi Arabia. Salmonella Serogroups D1, B and C predominate as causative agents of this condition. Most of the salmonella serogroups isolated in this study were highly susceptible to commonly used antimicrobial agents but ampicillin showed a rising resistance pattern. This may make it unsuitable therapy for Salmonella gastroenteritis