title: Pneumococcal infection among hospitalized Egyptian children.
abstract: OBJECTIVE
  We aimed to describe the detection rate spectrum of clinical manifestations, and outcome of pneumococcal disease in children younger than 5 years admitted to the largest referral pediatric hospital in Egypt.
  
  
  METHODS
  This was a hospital-based study to detect laboratory-confirmed Streptococcus pneumoniae cases among children younger than 5 years. Data on demographic characteristics, clinical diagnosis, comorbidities, diagnostic tests, antibiotic resistance, and clinical outcome were collected during the study years from 2008 to 2011.
  
  
  RESULTS
  During the 4-year study period, 22 018 cases younger than 5 years had cultures performed at Cairo University Pediatric Hospital microbiology laboratory. We estimated the annual detection rate of total Streptococcus pneumonia infection to be 54.5/100 000. The incidence of invasive pneumococcal disease (IPD) was half the incidence of non-IPD (18.2 and 36.4/100 000, respectively). Infants of 1 year or younger were statistically more vulnerable to Streptococcus pneumonia infection compared with children between 1 and 5 years of age (annual rate: 110.5/100 000 and 21.6/100 000, respectively). The overall pneumococcal annual case fatality was 33.3% and was higher in IPD (75%) than in non-IPD (12.5%) cases. There was an obviously increasing trend of the pneumococcal detection rate throughout the 4 years of the study (P<0.0001).
  
  
  CONCLUSIONS
  Our results confirm the substantial and increasing pneumococcal infection, the emerging of multidrug resistant isolates, and the vulnerability of the younger age group and high-risk population, which calls for a national surveillance to inform policy and decision-making before national wide vaccine introduction.
authors.affiliation: Departments of aPediatric bPublic Health cClinical and Chemical Pathology, Cairo University, Cairo, Egypt.
authors.forename: Iman H
authors.initials: IH
authors.lastname: Draz
authors.forename: Eman F
authors.initials: EF
authors.lastname: Halawa
authors.forename: Ghada
authors.initials: G
authors.lastname: Wahby
authors.forename: Dalia K
authors.initials: DK
authors.lastname: Ismail
authors.forename: Bassant S
authors.initials: BS
authors.lastname: Meligy
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015373:Bacterial Typing Techniques; D002669:Child Welfare / Q000706:statistics & numerical data; D002673:Child, Hospitalized / Q000706:statistics & numerical data*; D002675:Child, Preschool; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data; D011008:Pneumococcal Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents