Publication: Clinical Profile of Invasive Pneumococcal Disease in Patan Hospital, Nepal
Date
2011
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Pneumococcal infection is one of the leading causes of pneumonia, meningitis and
septicemia in developing countries. It accounts for one million deaths each year in
children.
Objectives
The objective of this study is to see the clinical profile of invasive pneumococcal
disease, antibiotics sensitivity pattern and prevalent serotypes in children admitted
at Patan Hospital.
Methods
This is a retrospective analytical study conducted in the department of Paediatrics,
Patan hospital. The lab data of those children who grew pneumococci in their
blood, cerebrospinal fluid or body fluids over a period of 3 years (January 2007 to
Dec 2009) were collected and the case files were then studied.
Results
Out of 42 cases of invasive pneumococcal diseases studied admitted diagnoses
included pneumonia, febrile seizure, bacteremia or septicemia, meningitis, acute
gastroenteritis and glomerulonephritis. Twenty seven of them were children
under five. The male to female ratio was 1.7:1. On investigation 64%, 52% and 5%
of the patients had leucocytosis, anaemia, and leucopenia respectively. Twenty
six of them had radiological changes suggestive of pneumonia. Streptococcus
pneumoniae grew in 38 blood samples, 5 cerebrospinal fluid and 3 pleural fluids.
Almost all of these isolates were sensitive to penicillin, cefotaxime, amoxycillin,
choloramphenicol, erythromycin and ofloxacin and resistant to cotrimoxazole and
gentamicin.Pneumococcal serotypes found in our study were 1, 14, 5, 23B, 6B, 8,
9A, 9V, 10A, 15 and 23F (11 serotypes).
Conclusions
Penicillin is still the most effective antibiotic for streptococcal infection in our study.
Of the pneumococcal serotypes identified; 36% were covered by the 7-valent
pneumococcal conjugate vaccine, 54% each by PCV-10 and PCV-13, and 72% by the
e 23 valent vaccines.
KEY WORDS
Invasive Pneumococcal Disease, Serotypes, Streptococcus pneumoniae,
Description
Chhetri UD, Shrestha S, Pradhan R, Shrestha A, Adhikari N, Thorson S, Pollard AJ, Murdoch DR, Kelly DF
Department of Pedriatrics Patan Academy of Health Sciences (PAHS), Patan Hospital, Lagankhel, Nepal