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

Incidence of intussusception in children less than 2 years

Surveillance of baseline incidence of intussusception [IS] in children less than 2 years of age is important for the safety monitoring of second-generation rotavirus vaccines. To estimate the incidence of IS in children aged less than two years, before the implementation of rotavirus vaccination as part of the routine immunization program in Bahrain. Salmaniya Medical Complex [SMC], Kingdom of Bahrain. Retrospective Study. Children aged <2 years with definite IS were identified by daily reviews of the medical records at Salmaniya Medical Complex. The annual incidence of IS was calculated for children aged <1 year and 1-2 years, using the number of subjects with definite IS residing in the study area as numerator and the study area population aged <1 year and 1-2 years, respectively, as the denominator. Twenty-one children, 10 males and 11 females, were diagnosed with definite IS [2004-2006]. The incidence of IS ranged from 35.4-56.3 per 100,000 children aged <1 year and from 6.7-21.7 per 100,000 in children aged 1-2 years [overall 23.4-39.2 per 100,000 children aged <2 years]. Sixteen [76.2%] IS cases occurred in children aged <1 year; incidence peaked between 5-8 months of age. IS cases demonstrated no seasonality. Twenty [95.2%] children had abdominal pain and 17 [81%] had vomiting. No deaths were reported. Incidence of IS in Bahrain reveals a decreasing trend from 2004 to 2006. The incidence was high in the first year of life. These baseline data on IS incidence will facilitate the risk/benefit assessment of rotavirus vaccination once it is routinely used for immunizing infants in Bahrain