Surveillance of invasive pneumococcal disease in Colombo, Sri Lanka

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Pediatrics

Background:

• Invasive pneumococcal disease (IPD) remains a significant public health concern, particularly in South Asian countries.
• Surveillance networks are crucial for monitoring disease trends and guiding vaccination strategies.

Purpose of the Study:

• To conduct surveillance of IPD in children admitted to Lady Ridgeway Hospital for Children in Colombo, Sri Lanka.
• To identify prevalent Streptococcus pneumoniae serotypes and assess antimicrobial resistance patterns.

Main Methods:

• Standardized recruitment and laboratory procedures were employed by the South Asian Pneumococcal Surveillance network.
• Blood and cerebrospinal fluid (CSF) cultures were analyzed from children aged 2 months to 5 years presenting with meningitis, pneumonia, or very severe disease.
• Antigen testing on CSF specimens utilized commercially available latex agglutination test kits.

Main Results:

• Twenty-three Streptococcus pneumoniae isolates were identified between January 2005 and March 2007.
• The most common serotypes were 19F, 14, 23F, and 6B, with 60% coverage by the 7-valent pneumococcal conjugate vaccine.
• Over 90% of isolates exhibited penicillin resistance, and high resistance rates to third-generation cephalosporins were also noted.

Conclusions:

• The study highlights the dominant serotypes of Streptococcus pneumoniae circulating in Sri Lanka.
• High levels of antimicrobial resistance, particularly to penicillin, pose a significant challenge for managing IPD in pediatric populations.
• These findings underscore the need for ongoing surveillance and potential vaccine strain updates.