title: Retrospective review of invasive pediatric pneumococcal diseases in a military hospital in the southern region of Saudi Arabia.
abstract: OBJECTIVE
  Invasive pneumococcal disease (IPD) is associated with high case-fatality rates and serious chronic sequelae. The objective of this study was to assess the magnitude of invasive pneumococcal infections in a pediatric population without universal vaccination during childhood in a single hospital.
  
  
  METHODS
  Retrospective review of all pediatric cases of invasive pneumococcal infection during a 7-year period.
  
  
  METHODS
  We reviewed the microbiological and clinical records of cases of IPD in children <13 years of age admitted to the Armed Forces Hospital, Southern Region, Saudi Arabia.
  
  
  RESULTS
  We identified 41 patients with IPD; 27 (66%) were <2 years of age. Four (50%) of those with pneumoccal meningitis were <2 years of age. The case fatality was 3 of 41 (7.3%) due to meningitis and 2 of 41 (5%) due to sepsis, with a case fatality of 5 (12%) due to meningitis and sepsis. Nine patients developed sequelae; of those with meningitis, 5 (73%) developed sequelae. Only 15 (41%) patients had predisposing medical conditions. The overall intermediate and high levels of pneumococcal resistance to penicillin and ceftriaxone were found to be 48.5%, 2.4% and 2.4%, 0%, respectively. None of the pneumococcal isolates were serotyped, and none of the patients had been vaccinated against pneumococcal infections in our hospital.
  
  
  CONCLUSIONS
  Despite the presence of a targeted immunization program, a considerable number of cases of invasive pneumococcal infections were reported among our pediatric population over a period of 7 years. Prospective studies in serotypes and antibiotic resistance from the southern region are needed to provide baseline information for the formulation and evaluation of a national prevention and control program.
authors.affiliation: Pediatric Infectious Diseases Department, Armed Forces Hospital, Khamis Mushayt, Saudi Arabia. drmzayed2000@yahoo.com
authors.forename: Mohammed Saeed
authors.initials: MS
authors.lastname: Al Ayed
authors.forename: Ali Abdullah
authors.initials: AA
authors.lastname: Hawan
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D006772:Hospitals, Military; D006801:Humans; D007223:Infant; D008586:Meningitis, Pneumococcal / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D008826:Microbial Sensitivity Tests; D011008:Pneumococcal Infections / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents