Streptococcus pneumoniae serotype-2 childhood meningitis in Bangladesh: a newly recognized pneumococcal infection threat

• Published in: PloS one 2012-03, Vol.7 (3), p.e32134-e32134
• Main Authors: Saha, Samir K, Al Emran, Hassan M, Hossain, Belal, Darmstadt, Gary L, Saha, Senjuti, Islam, Maksuda, Chowdhury, Atique I, Foster, Dona, Naheed, Aliya, El Arifeen, Shams, Baqui, Abdullah H, Qazi, Shamim A, Luby, Stephen P, Breiman, Robert F, Santosham, Mathuram, Black, Robert E, Crook, Derrick W
• Format: Article
• Language: English
• Subjects: Age Distribution; Antigens; Antigens, Bacterial - cerebrospinal fluid; Bacteremia; Bangladesh - epidemiology; Biology; Blood; Blood tests; Cerebrospinal fluid; Child, Preschool; Childhood; Children; Children & youth; Childrens health; Cloning; Disease control; Disease prevention; Disease transmission; DNA, Bacterial - analysis; DNA, Bacterial - genetics; Electrophoresis, Gel, Pulsed-Field; Gel electrophoresis; Geography; Hospitals; Humans; Infant; Infant, Newborn; Infections; Infectious diseases; Laboratories; Lumber; Medical research; Medicine; Meningitis; Meningitis, Pneumococcal - cerebrospinal fluid; Meningitis, Pneumococcal - epidemiology; Meningitis, Pneumococcal - microbiology; Microbiology; Pediatrics; Pneumonia; Polymerase Chain Reaction; Population Surveillance - methods; Prevalence; Proteins; Public health; Sepsis; Serotypes; Serotyping; Species Specificity; Streptococcus infections; Streptococcus pneumoniae; Streptococcus pneumoniae - classification; Streptococcus pneumoniae - genetics; Streptococcus pneumoniae - isolation & purification; Surveillance; Trends; Urban areas; Vaccines
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0032134

Streptococcus pneumoniae is a leading cause of meningitis in countries where pneumococcal conjugate vaccines (PCV) targeting commonly occurring serotypes are not routinely used. However, effectiveness of PCV would be jeopardized by emergence of invasive pneumococcal diseases (IPD) caused by serotypes which are not included in PCV. Systematic hospital based surveillance in Bangladesh was established and progressively improved to determine the pathogens causing childhood sepsis and meningitis. This also provided the foundation for determining the spectrum of serotypes causing IPD. This article reports an unprecedented upsurge of serotype 2, an uncommon pneumococcal serotype, without any known intervention. Cases with suspected IPD had blood or cerebrospinal fluid (CSF) collected from the beginning of 2001 till 2009. Pneumococcal serotypes were determined by capsular swelling of isolates or PCR of culture-negative CSF specimens. Multicenter national surveillance, expanded from 2004, identified 45,437 patients with suspected bacteremia who were blood cultured and 10,618 suspected meningitis cases who had a lumber puncture. Pneumococcus accounted for 230 culture positive cases of meningitis in children