Serotype distribution of invasive Pneumococcal disease in a tertiary children's hospital in Vietnam.

Abstract

Background: Invasive pneumococcal disease (IPD) is a leading cause of morbidity and mortality among children worldwide. However, this evidence from Vietnam is rare.

Methods: This retrospective cross-sectional study was conducted at a tertiary children's hospital in Vietnam by analysing data of all patients under 18 years old admitted the hospital for IPD from 2019 to 2022. S. pneumoniae isolates or DNA extract from blood or other normally sterile fluids were serotyped. Clinical characteristics, antibiotic susceptibility, serotype distribution, and patient outcomes were analyzed and reported.

Results: Among total of 274 children with IPD identified, 232 children under 5 years old accounted for 84.7%. S. pneumoniae serotyping revealed 18 different serotypes, with 6A/B, 19A, 23F, 19F, and 14 being the most prevalent. The coverage rates for PCV7/PCV10, PCV13 and PCV20 were 66.0%, 83.0%, and 87.2%, respectively. Antibiotic resistance rates were high, with nearly 100% resistance to erythromycin and clindamycin, and a 75.3% resistance rate to third-generation cephalosporins. Amongst 24 death cases, 25% of the confirmed deaths attributed to serotype 19F.

Conclusion: Paediatric IPD in Vietnam primarily affects children under 5 years old, with high rates of antibiotic resistance. The high pneumococcal conjugate vaccine (PCV) coverage emphasizes the need for universal PCV vaccination in children to enhance IPD prevention. Continued and enhanced surveillance of IPD is essential for better understanding and management.

Clinical trial number: not applicable.