ABSTRACT
BACKGROUND: Streptococcus pneumoniae causes life-threatening infections such as meningitis, pneumonia, and febrile bacteremia, particularly in young children. The increasing number of drug-resistant isolates has highlighted the necessity for intervening and controlling disease. To achieve this, information is needed on serotype distribution and patterns of antibiotic resistance in children. METHODS: All cases of invasive pneumococcal disease (IPD) in children aged less than 15 yr recorded at King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia, were reviewed for serotyping and antibiotic susceptibility. Isolates were collected from 78 consecutive patients with IPD between 2009 and 2012. All collected isolates were subjected to serotyping by co-agglutination, sequential multiplex PCR, and single PCR sequetyping as previously described. RESULTS: The most frequently isolated IPD serotypes were 23F, 6B, 19F, 18C, 4, 14, and 19A, which are listed in decreasing order and cover 77% of total isolates. The serotype coverage for the pneumococcal conjugate vaccine (PCV)7, PCV10, and PCV13 was 77%, 81%, and 90%, respectively. Results from sequential multiplex PCR agreed with co-agglutination results. All serotypes could not be correctly identified using single PCR sequetyping. Minimum inhibitory concentration showed that 50 (64%) isolates were susceptible to penicillin, whereas 70 (90%) isolates were susceptible to cefotaxime. CONCLUSIONS: The most common pneumococcal serotypes occur with frequencies similar to those found in countries where the PCV has been introduced. The most common serotypes in this study are included in the PCVs. Addition of 23A and 15 to the vaccine would improve the PCV performance in IPD prevention.
Subject(s)
Adolescent , Child , Child, Preschool , Humans , Infant , Anti-Bacterial Agents/pharmacology , Bacterial Proteins/genetics , Cefotaxime/pharmacology , DNA, Bacterial/analysis , Meningitis/diagnosis , Microbial Sensitivity Tests , Multiplex Polymerase Chain Reaction , Penicillins/pharmacology , Pneumococcal Vaccines/immunology , Pneumonia/diagnosis , Protein Tyrosine Phosphatases/genetics , Retrospective Studies , Saudi Arabia , Serotyping , Streptococcus pneumoniae/drug effectsABSTRACT
The incidence of sensorineural hearing loss among infants in the neonatal intensive unit [NICU] is higher than in normal infants. This study determined the rate of hearing loss in healthy newborns and in NICU patients before hospital discharge at a single institution in the Eastern region of the United Arab Emirates; 96.5% of all eligible infants were screened. Hearing deficit was diagnosed in 25/13 854 healthy newborns [0.18%; 95% CI: 0.12%-0.27%] and 14/826 infants in the NICU [1.7%; 95% CI: 0.9%-2.8%]. Although hearing impairment was significantly more common in those admitted to the NICU [RR = 9.4; 95% CI: 4.9-17.9], healthy newborns accounted for 25 of the 39 cases with hearing loss. The rate of congenital hearing deficit was comparable to international data. Universal screening is recommended since selective screening of high-risk infants missed two-thirds of newborns with hearing loss