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Childhood pneumococcal bacteraemia in Riyadh, Saudi Arabia
1Department of Microbiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Insights
This study on pediatric pneumococcal bacteremia found most cases occurred in children under two, with pneumonia being a common infection focus. A significant portion of isolates showed penicillin resistance, highlighting evolving antimicrobial resistance patterns.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Antimicrobial Resistance
Background:
- Pneumococcal bacteremia is a significant cause of childhood illness.
- Understanding epidemiological patterns and antimicrobial resistance is crucial for effective treatment.
Purpose of the Study:
- To investigate the clinical characteristics and antimicrobial susceptibility of pneumococcal bacteremia in children.
- To analyze trends in penicillin resistance and identify predisposing factors.
Main Methods:
- Retrospective study of 49 children with pneumococcal bacteremia from 1991-1995.
- Analysis of infection focus, predisposing conditions, acquisition source, and seasonal variations.
- Antimicrobial susceptibility testing of pneumococcal isolates.
Main Results:
- Majority of cases (61.2%) were in children under 2 years old.
- Pneumonia was the most common infection focus (28.6%).
- 20.4% of isolates exhibited relative penicillin resistance, with 22% showing multiple drug resistance.
Conclusions:
- Pediatric pneumococcal bacteremia in this cohort was associated with high rates of penicillin resistance.
- Early detection of pneumococcal antigens in blood is vital for diagnosis.
- The emergence of resistant strains necessitates ongoing surveillance and treatment strategy evaluation.
Abstract:
Forty-nine children with pneumococcal bacteraemia seen during a 5-year period (1 January 1991 to 31 December 1995) at King Khalid University Hospital were studied. The majority (61.2%) were under 2 years of age. The focus of infection was pneumonia, pharyngitis or undetermined in 28.6%, 18.4% and 20.4%, respectively. Diseases that had probably predisposed them to pneumococcal bacteraemia (mainly nephrotic syndrome) were encountered in 24.5% of cases. Forty-five per cent of the cases occurred during the summer season and in 29% the disease was nosocomially acquired. No death was recorded in this series and the reasons for this are discussed. Detection of pneumococcal antigens from blood taken for culture was successful in 96% of cases; this test is important in the diagnosis of pneumococcal bacteraemia in partially treated patients. Antimicrobial susceptibility testing showed 20.4% of the isolates to be relatively penicillin-resistant. Resistance to other antimicrobial agents was also recorded and multiple resistance was noted in 22% of isolates. There was a significant difference between the ceftriaxone MIC of the relatively penicillin-resistant strains compared with penicillin-sensitive strains. The emergence and the steady increase in the numbers of relatively penicillin-resistant pneumococcal strains in Saudi Arabia during the last 10 years are discussed.