Invasive pneumococcal disease in Indian adults: 11 years' experience |
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Authors: | Ranjith Jayaraman Rosemol Varghese Jones Lionel Kumar Ayyanraj Neeravi Devika Shanmugasundaram Ravikar Ralph Kurien Thomas Balaji Veeraraghavan |
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Institution: | 1. Department of Clinical Microbiology, Christian Medical College and Hospital, Vellore 632004, India;2. Department of General Medicine, Christian Medical College and Hospital, Vellore 632004, India;3. Department of Biostatistics, National Institute for Research in Environmental Health (ICMR), Bhopal 462001, India |
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Abstract: | PurposeTo investigate the epidemiology of invasive pneumococcal disease (IPD), prevalent serotypes, and pattern of antimicrobial resistance (AMR) in Indian adults.MethodsProspective laboratory based surveillance of IPD was carried out in >18 years age group between January 2007 and July 2017, from a tertiary care hospital in South India. All Streptococcus pneumoniae culture positives from blood, CSF and sterile body fluids were characterized to identify the serotypes and AMR.ResultsA total of 408 IPD cases were characterized in this study. The overall case fatality rate in this study was 17.8% (95% confidence interval (CI): 14.1, 22.4). Pneumonia (39%), meningitis (24.3%), and septicaemia (18.4%) were the most common clinical conditions associated with IPD. Serotypes 1, 3, 5, 19F, 8, 14, 23F, 4, 19A and 6B were the predominant serotypes in this study. Penicillin non-susceptibility was low with 6.4%ConclusionSerotype data from this study helped in accurate estimation of pneumococcal conjugate vaccine-13 and pneumococcal polysaccharide vaccine-23 protective coverage against serotypes causing IPD in India as 58.7% (95% CI: 53.8, 63.4) and 67.4% (95% CI: 62.7, 71.8) respectively. Penicillin non-susceptibility in meningeal IPD cases is 27.4%. Empirical therapy for meningeal IPD must be cephalosporin in combination with vancomycin since cefotaxime non-susceptibility in meningeal IPD is 9.9% |
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Keywords: | Corresponding author Vaccine Preventable Invasive Bacterial Disease Surveillance Department of Clinical Microbiology Christian Medical College and Hospital Vellore 632004 Tamil Nadu India Invasive pneumococcal disease Adults India Vaccine coverage Penicillin resistance |
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