Epidemiology of invasive pneumococcal disease in Saudi Arabian children younger than 5 years of age

This study evaluated the incidence, serotype distribution, and antimicrobial susceptibility of invasive pneumococcal disease [IPD] in Saudi Arabian children. This multicenter, prospective, clinical surveillance study included children under 5 years of age, residents of one of the seven study health areas, who were brought to a study hospital with suspicion of IPD. Bacterial isolates from sterile site samples, collected less than 24 h after hospital visit/admission, were identified, serotyped, and tested for antibiotic susceptibility. Between June 2007 and January 2009, 631 episodes of suspected IPD were recorded, and 623 were included in the analysis. One child [0.2%] had previously received one dose of a pneumococcal vaccine. Forty-seven episodes were positive for Streptococcus pneumoniae and three for Haemophilus influenzae. The incidence of confirmed IPD cases was estimated to be 2.5-21.6 per 100,000 children [<5 years]. Among the 46 S. pneumoniae isolates serotyped and tested for antibiotic susceptibility, the most common serotypes were 5 and 23F [20% each], 6B [17%], and 1 and 14 [11% each]. Sixty-three percent of isolates were multidrug-resistant. Vaccination of Saudi Arabian children with expanded-coverage conjugate pneumococcal vaccines containing serotypes 1 and 5 could have a substantial impact to prevent IPD in this population

prospective, observational, epidemiological evaluation of the aetiology and antimicrobial susceptibility of acute otitis media in Saudi children younger than 5 years of age

Information regarding acute otitis media [AOM] aetiology is important for developing effective vaccines. Here, bacterial aetiology and antimicrobial susceptibility of AOM were determined in young Saudi children. Children aged 3-60 months with a new episode of AOM, who had not received antibiotics or had received antibiotics for 48-72 h but remained symptomatic, were enrolled in this prospective, observational, epidemiological study in Riyadh. Middle ear fluid [MEF] samples were collected by tympanocentesis or from spontaneous otorrhea, and tested for the presence of Streptococcus pneumoniae, Haemophilus influenzae, Streptococcus pyogenes and Moraxella catarrhalis. Antimicrobial susceptibility of the identified pathogens was assessed using E-tests. Between June 2009 and May 2011, 66 children were enrolled. S. pneumonia was detected in 6 episodes and non-typeable H. influenza [NTHi] in 8 episodes. Moreover, Staphylococcus aureus, which is an uncommon cause of AOM, was detected in 17 episodes. Pneumococcal serotypes were 7F [n = 2], 23F [n = 2], 19F [n = 1] and 15F [n = 1]. Susceptibility to cefotaxime was observed in all pneumococcal and H. influenza isolates, to cefuroxime in 4/6 pneumococcal and 8/8 H. influenza isolates, and to penicillin in 5/6 pneumococcal isolates. S. pneumonia and NTHi were major bacterial contributors for AOM in Saudi children