Community-acquired Invasive Bacterial Disease in Urban Gambia, 2005-2015: A Hospital-based Surveillance

Saffiatou Darboe; Uduak Okomo; Abdul-Khalie Muhammad; Buntung Ceesay; Mamadou Jallow; Effua Usuf; Sam Tweed; Edem Akpalu; Brenda Kwambana-Adams; Samuel Kariuki; Martin Antonio; Richard S Bradbury; Karen Forrest; Thushan I de Silva; Bolarinde Joseph Lawal; Davis Nwakanma; Ousman Secka; Anna Roca

doi:10.1093/cid/ciz463

Community-acquired Invasive Bacterial Disease in Urban Gambia, 2005-2015: A Hospital-based Surveillance

Saffiatou Darboe^* (Corresponding Author), Uduak Okomo, Abdul-Khalie Muhammad, Buntung Ceesay, Mamadou Jallow, Effua Usuf, Sam Tweed, Edem Akpalu, Brenda Kwambana-Adams, Samuel Kariuki, Martin Antonio, Richard S Bradbury, Karen Forrest, Thushan I de Silva, Bolarinde Joseph Lawal, Davis Nwakanma, Ousman Secka, Anna Roca

^*Corresponding author for this work

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Abstract

BACKGROUND: Invasive bacterial diseases cause significant disease and death in sub-Saharan Africa. Several are vaccine preventable, although the impact of new vaccines and vaccine policies on disease patterns in these communities is poorly understood owing to limited surveillance data.

METHODS: We conducted a hospital-based surveillance of invasive bacterial diseases in The Gambia where blood and cerebrospinal fluid (CSF) samples of hospitalized participants were processed. Three surveillance periods were defined in relation to the introduction of pneumococcal conjugate vaccines (PCVs), before (2005- 2009), during (2010-2011) and after (2012-2015) PCV introduction. We determined the prevalences of commonly isolated bacteria and compared them between the different surveillance periods.

RESULTS: A total of 14 715 blood and 1103 CSF samples were collected over 11 years; overall, 1045 clinically significant organisms were isolated from 957 patients (972 organisms [6.6%] from blood and 73 [6.6%] from CSF). The most common blood culture isolates were Streptococcus pneumoniae (24.9%), Staphylococcus aureus (22.0%), Escherichia coli (10.9%), and nontyphoidal Salmonella (10.0%). Between the pre-PCV and post-PCV eras, the prevalence of S. pneumoniae bacteremia dropped across all age groups (from 32.4% to 16.5%; odds ratio, 0.41; 95% confidence interval, .29-.58) while S. aureus increased in prevalence, becoming the most prevalent bacteria (from 16.9% to 27.2%; 1.75; 1.26-2.44). Overall, S. pneumoniae (53.4%), Neisseria meningitidis (13.7%), and Haemophilus influenzae (12.3%) were the predominant isolates from CSF. Antimicrobial resistance to common antibiotics was low.

CONCLUSIONS: Our findings demonstrate that surveillance data on the predominant pathogens associated with invasive disease is necessary to inform vaccine priorities and appropriate management of patients.

Original language	English
Pages (from-to)	S105-S113
Number of pages	9
Journal	Clinical Infectious Diseases
Volume	69
Issue number	Supplement_2
Early online date	30 Aug 2019
DOIs	https://doi.org/10.1093/cid/ciz463
Publication status	Published - 15 Sept 2019

Bibliographical note

Acknowledgments. The authors thank Ameh James for his comments and suggestions, Kabiro Kanteh and Fatoumata Ceesay for helping retrieve records, and the staff of the Clinical Services Department and Clinical Laboratories.

Financial support. This work was supported by the Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine.

Supplementary Data
Supplementary materials are available at Clinical Infectious Diseases online. Consisting of data provided by the authors to benefit the reader, the posted materials are not copyedited and are the sole responsibility of the authors, so questions or comments should be addressed to the corresponding author.

Keywords

bacteremia
community-acquired infection
invasive bacterial disease
meningitis
vaccine preventable disease
INFECTIONS
POPULATION-BASED-SURVEILLANCE
CONJUGATE VACCINE
ELIMINATION
PNEUMONIA
CHILDREN
AFRICA
MENINGITIS
RESISTANCE

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1093/cid/ciz463Licence: CC BY

Community-acquired Invasive Bacterial Disease in Urban Gambia, 2005–2015: A Hospital-based Surveillance
© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Final published version, 1.85 MBLicence: CC BY

Cite this

Darboe, S., Okomo, U., Muhammad, A.-K., Ceesay, B., Jallow, M., Usuf, E., Tweed, S., Akpalu, E., Kwambana-Adams, B., Kariuki, S., Antonio, M., Bradbury, R. S., Forrest, K., de Silva, T. I., Lawal, B. J., Nwakanma, D., Secka, O., & Roca, A. (2019). Community-acquired Invasive Bacterial Disease in Urban Gambia, 2005-2015: A Hospital-based Surveillance. Clinical Infectious Diseases, 69(Supplement_2), S105-S113. https://doi.org/10.1093/cid/ciz463

Darboe, S, Okomo, U, Muhammad, A-K, Ceesay, B, Jallow, M, Usuf, E, Tweed, S, Akpalu, E, Kwambana-Adams, B, Kariuki, S, Antonio, M, Bradbury, RS, Forrest, K, de Silva, TI, Lawal, BJ, Nwakanma, D, Secka, O & Roca, A 2019, 'Community-acquired Invasive Bacterial Disease in Urban Gambia, 2005-2015: A Hospital-based Surveillance', Clinical Infectious Diseases, vol. 69, no. Supplement_2, pp. S105-S113. https://doi.org/10.1093/cid/ciz463

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title = "Community-acquired Invasive Bacterial Disease in Urban Gambia, 2005-2015: A Hospital-based Surveillance",

abstract = "BACKGROUND: Invasive bacterial diseases cause significant disease and death in sub-Saharan Africa. Several are vaccine preventable, although the impact of new vaccines and vaccine policies on disease patterns in these communities is poorly understood owing to limited surveillance data.METHODS: We conducted a hospital-based surveillance of invasive bacterial diseases in The Gambia where blood and cerebrospinal fluid (CSF) samples of hospitalized participants were processed. Three surveillance periods were defined in relation to the introduction of pneumococcal conjugate vaccines (PCVs), before (2005- 2009), during (2010-2011) and after (2012-2015) PCV introduction. We determined the prevalences of commonly isolated bacteria and compared them between the different surveillance periods.RESULTS: A total of 14 715 blood and 1103 CSF samples were collected over 11 years; overall, 1045 clinically significant organisms were isolated from 957 patients (972 organisms [6.6%] from blood and 73 [6.6%] from CSF). The most common blood culture isolates were Streptococcus pneumoniae (24.9%), Staphylococcus aureus (22.0%), Escherichia coli (10.9%), and nontyphoidal Salmonella (10.0%). Between the pre-PCV and post-PCV eras, the prevalence of S. pneumoniae bacteremia dropped across all age groups (from 32.4% to 16.5%; odds ratio, 0.41; 95% confidence interval, .29-.58) while S. aureus increased in prevalence, becoming the most prevalent bacteria (from 16.9% to 27.2%; 1.75; 1.26-2.44). Overall, S. pneumoniae (53.4%), Neisseria meningitidis (13.7%), and Haemophilus influenzae (12.3%) were the predominant isolates from CSF. Antimicrobial resistance to common antibiotics was low.CONCLUSIONS: Our findings demonstrate that surveillance data on the predominant pathogens associated with invasive disease is necessary to inform vaccine priorities and appropriate management of patients.",

keywords = "bacteremia, community-acquired infection, invasive bacterial disease, meningitis, vaccine preventable disease, INFECTIONS, POPULATION-BASED-SURVEILLANCE, CONJUGATE VACCINE, ELIMINATION, PNEUMONIA, CHILDREN, AFRICA, MENINGITIS, RESISTANCE",

author = "Saffiatou Darboe and Uduak Okomo and Abdul-Khalie Muhammad and Buntung Ceesay and Mamadou Jallow and Effua Usuf and Sam Tweed and Edem Akpalu and Brenda Kwambana-Adams and Samuel Kariuki and Martin Antonio and Bradbury, {Richard S} and Karen Forrest and {de Silva}, {Thushan I} and Lawal, {Bolarinde Joseph} and Davis Nwakanma and Ousman Secka and Anna Roca",

note = "Acknowledgments. The authors thank Ameh James for his comments and suggestions, Kabiro Kanteh and Fatoumata Ceesay for helping retrieve records, and the staff of the Clinical Services Department and Clinical Laboratories. Financial support. This work was supported by the Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine. Supplementary Data Supplementary materials are available at Clinical Infectious Diseases online. Consisting of data provided by the authors to benefit the reader, the posted materials are not copyedited and are the sole responsibility of the authors, so questions or comments should be addressed to the corresponding author.",

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doi = "10.1093/cid/ciz463",

language = "English",

volume = "69",

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journal = "Clinical Infectious Diseases",

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TY - JOUR

T1 - Community-acquired Invasive Bacterial Disease in Urban Gambia, 2005-2015

T2 - A Hospital-based Surveillance

AU - Darboe, Saffiatou

AU - Okomo, Uduak

AU - Muhammad, Abdul-Khalie

AU - Ceesay, Buntung

AU - Jallow, Mamadou

AU - Usuf, Effua

AU - Tweed, Sam

AU - Akpalu, Edem

AU - Kwambana-Adams, Brenda

AU - Kariuki, Samuel

AU - Antonio, Martin

AU - Bradbury, Richard S

AU - Forrest, Karen

AU - de Silva, Thushan I

AU - Lawal, Bolarinde Joseph

AU - Nwakanma, Davis

AU - Secka, Ousman

AU - Roca, Anna

N1 - Acknowledgments. The authors thank Ameh James for his comments and suggestions, Kabiro Kanteh and Fatoumata Ceesay for helping retrieve records, and the staff of the Clinical Services Department and Clinical Laboratories. Financial support. This work was supported by the Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine. Supplementary Data Supplementary materials are available at Clinical Infectious Diseases online. Consisting of data provided by the authors to benefit the reader, the posted materials are not copyedited and are the sole responsibility of the authors, so questions or comments should be addressed to the corresponding author.

PY - 2019/9/15

Y1 - 2019/9/15

N2 - BACKGROUND: Invasive bacterial diseases cause significant disease and death in sub-Saharan Africa. Several are vaccine preventable, although the impact of new vaccines and vaccine policies on disease patterns in these communities is poorly understood owing to limited surveillance data.METHODS: We conducted a hospital-based surveillance of invasive bacterial diseases in The Gambia where blood and cerebrospinal fluid (CSF) samples of hospitalized participants were processed. Three surveillance periods were defined in relation to the introduction of pneumococcal conjugate vaccines (PCVs), before (2005- 2009), during (2010-2011) and after (2012-2015) PCV introduction. We determined the prevalences of commonly isolated bacteria and compared them between the different surveillance periods.RESULTS: A total of 14 715 blood and 1103 CSF samples were collected over 11 years; overall, 1045 clinically significant organisms were isolated from 957 patients (972 organisms [6.6%] from blood and 73 [6.6%] from CSF). The most common blood culture isolates were Streptococcus pneumoniae (24.9%), Staphylococcus aureus (22.0%), Escherichia coli (10.9%), and nontyphoidal Salmonella (10.0%). Between the pre-PCV and post-PCV eras, the prevalence of S. pneumoniae bacteremia dropped across all age groups (from 32.4% to 16.5%; odds ratio, 0.41; 95% confidence interval, .29-.58) while S. aureus increased in prevalence, becoming the most prevalent bacteria (from 16.9% to 27.2%; 1.75; 1.26-2.44). Overall, S. pneumoniae (53.4%), Neisseria meningitidis (13.7%), and Haemophilus influenzae (12.3%) were the predominant isolates from CSF. Antimicrobial resistance to common antibiotics was low.CONCLUSIONS: Our findings demonstrate that surveillance data on the predominant pathogens associated with invasive disease is necessary to inform vaccine priorities and appropriate management of patients.

AB - BACKGROUND: Invasive bacterial diseases cause significant disease and death in sub-Saharan Africa. Several are vaccine preventable, although the impact of new vaccines and vaccine policies on disease patterns in these communities is poorly understood owing to limited surveillance data.METHODS: We conducted a hospital-based surveillance of invasive bacterial diseases in The Gambia where blood and cerebrospinal fluid (CSF) samples of hospitalized participants were processed. Three surveillance periods were defined in relation to the introduction of pneumococcal conjugate vaccines (PCVs), before (2005- 2009), during (2010-2011) and after (2012-2015) PCV introduction. We determined the prevalences of commonly isolated bacteria and compared them between the different surveillance periods.RESULTS: A total of 14 715 blood and 1103 CSF samples were collected over 11 years; overall, 1045 clinically significant organisms were isolated from 957 patients (972 organisms [6.6%] from blood and 73 [6.6%] from CSF). The most common blood culture isolates were Streptococcus pneumoniae (24.9%), Staphylococcus aureus (22.0%), Escherichia coli (10.9%), and nontyphoidal Salmonella (10.0%). Between the pre-PCV and post-PCV eras, the prevalence of S. pneumoniae bacteremia dropped across all age groups (from 32.4% to 16.5%; odds ratio, 0.41; 95% confidence interval, .29-.58) while S. aureus increased in prevalence, becoming the most prevalent bacteria (from 16.9% to 27.2%; 1.75; 1.26-2.44). Overall, S. pneumoniae (53.4%), Neisseria meningitidis (13.7%), and Haemophilus influenzae (12.3%) were the predominant isolates from CSF. Antimicrobial resistance to common antibiotics was low.CONCLUSIONS: Our findings demonstrate that surveillance data on the predominant pathogens associated with invasive disease is necessary to inform vaccine priorities and appropriate management of patients.

KW - bacteremia

KW - community-acquired infection

KW - invasive bacterial disease

KW - meningitis

KW - vaccine preventable disease

KW - INFECTIONS

KW - POPULATION-BASED-SURVEILLANCE

KW - CONJUGATE VACCINE

KW - ELIMINATION

KW - PNEUMONIA

KW - CHILDREN

KW - AFRICA

KW - MENINGITIS

KW - RESISTANCE

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DO - 10.1093/cid/ciz463

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SN - 1058-4838

VL - 69

SP - S105-S113

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

IS - Supplement_2

ER -

Community-acquired Invasive Bacterial Disease in Urban Gambia, 2005-2015: A Hospital-based Surveillance

Abstract

Bibliographical note

Keywords

UN SDGs

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