Loc Thuy Ho Nguyen, Viet Nam

Pasteur Institute Ho Chi Minh City Microbiology and Immunology

Presenter of 1 Presentation

BACTERIAL MENINGITIS SURVEILLANCE OF CHILDREN UNDER 5 YEARS OF AGE IN SOUTHERN – VIET NAM, 2018-2019 (ID 313)

Abstract

Background

In Vietnam, the Invasive Bacterial Vaccine Preventable Diseases (IB-VPD) Surveillance network of World Health Organization which identifies major pathogens causing bacterial meningitis has been implemented since 2012. This program utilizes realtime PCR for detection of Streptococcus pneumoniae (Spn), Neisseria meningitidis (Nm) and Haemophilus influenzae (Hi) in children under 5 years of age suspected for bacterial meningitis. This work presents the positive rate and serotypes distribution of Spn from this program between 2018 and 2019.

Methods

540 cerebrospinal fluid (CSF) specimens of probable bacterial meningitis cases from 1 month to 59 months old were collected for identification of Spn, Nm and Hi by triplex direct rt-PCR. Positive samples for Spn were serotyped for 21 serotypes.

Results

Total positivity rate of three pathogens was 6.5%, among which Spn was predominant (94.3%, n= 33), following by Nm (5.7%, n=2), and there was no Hi detected. PCV13-types account for 94.0%, of which 6A/B was the most prevalent serotype (54.5%, n=18).

Conclusions

Spn was the most common cause of pediatric bacterial meningitis in Southern Vietnam from 2018-2019. Majority of serotypes found are included in pneumococcal conjugate vaccines, which are not yet introduced in the national immunization schedule in Vietnam.

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Author Of 3 Presentations

BACTERIAL MENINGITIS SURVEILLANCE OF CHILDREN UNDER 5 YEARS OF AGE IN SOUTHERN – VIET NAM, 2018-2019 (ID 313)

Abstract

Background

In Vietnam, the Invasive Bacterial Vaccine Preventable Diseases (IB-VPD) Surveillance network of World Health Organization which identifies major pathogens causing bacterial meningitis has been implemented since 2012. This program utilizes realtime PCR for detection of Streptococcus pneumoniae (Spn), Neisseria meningitidis (Nm) and Haemophilus influenzae (Hi) in children under 5 years of age suspected for bacterial meningitis. This work presents the positive rate and serotypes distribution of Spn from this program between 2018 and 2019.

Methods

540 cerebrospinal fluid (CSF) specimens of probable bacterial meningitis cases from 1 month to 59 months old were collected for identification of Spn, Nm and Hi by triplex direct rt-PCR. Positive samples for Spn were serotyped for 21 serotypes.

Results

Total positivity rate of three pathogens was 6.5%, among which Spn was predominant (94.3%, n= 33), following by Nm (5.7%, n=2), and there was no Hi detected. PCV13-types account for 94.0%, of which 6A/B was the most prevalent serotype (54.5%, n=18).

Conclusions

Spn was the most common cause of pediatric bacterial meningitis in Southern Vietnam from 2018-2019. Majority of serotypes found are included in pneumococcal conjugate vaccines, which are not yet introduced in the national immunization schedule in Vietnam.

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IMPACT OF A SINGLE DOSE OF PCV10 OR PCV13 ON NASOPHARYNGEAL PNEUMOCOCCAL CARRIAGE IN VIETNAMESE CHILDREN DURING THE FIRST YEAR OF LIFE (ID 696)

Abstract

Background

Reduced-dose schedules of pneumococcal conjugate vaccine (PCV) could increase the accessibility and use of PCV in low and middle-income countries.

Methods

Groups within the Vietnam Pneumococcal Trial II receive PCV10 and PCV13 in a 1+1 schedule at 2 and 12 months of age, or no vaccine. Nasopharyngeal swabs were collected at 6 and 12 months of age to show the impact of the 2-month dose on pneumococcal carriage.

Results

Based on analysis to date of 1152 of 3200 swabs, vaccine-type carriage was low. In unvaccinated participants, PCV10 and PCV13-type carriage were 5.1% and 10.4% at 6 months, and 8.3% and 12.0% at 12 months, respectively. A dose of PCV10 transiently reduced vaccine-type carriage at 6 months of age (3/178 [1.7%] versus 18/355 [5.1%]).

Conclusions

With the exception of the PCV10 group at 6 months of age, both vaccine-type and non-vaccine-type carriage rates were similar among PCV10-vaccinated participants, PCV13-vaccinated participants and unvaccinated controls at 6 and 12 months of age. Based on preliminary data, a single dose of PCV at 2 months of age does not appear to reduce pneumococcal carriage during the first year of life in this population.

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ANTIBIOTIC SUSCEPTIBILITY OF STREPTOCOCCUS PNEUMONIAE IN SOUTHERN VIETNAM (ID 855)

Session Name
Clinical Sciences - Disease Burden in Infants, Children/Youth, and Adults

Abstract

Background

Streptococcus pneumoniae is a bacterial pathogen responsible for severe infections in children, especially meningitis. The emergence of multidrug-resistant S.pneumoniae, likely due to indiscriminate antibiotic use, is a serious public health problem in Vietnam. The aim of this study was to survey antimicrobial susceptibility of invasive S. pneumoniae isolates.

Methods

Twenty-five isolates from children <5 years old with meningitis in Southern Vietnam from 2012-2018 were serotyped by realtime PCR and Quellung reaction. Antimicrobial susceptibility was determined by Kirby Bauer (erythromycin, clindamycin, tetracycline, trimethoprim-sulfamethoxazole, chloramphenicol, levofloxacin, rifampin, vancomycin) and MIC methods (penicillin and ceftriaxone) with the data interpreted by CLSI, 2018.

Results

All pneumococcal isolates were non-susceptible to penicillin, erythromycin, clindamycin, and tetracycline, with 92%, 48%, and 20% non-susceptible to trimethoprim-sulfamethoxazole, ceftriaxone, and chloramphenicol, respectively. All isolates were susceptible to levofloxacin, rifampin, and vancomycin. All isolates were non-susceptible to multiple antibiotic classes (at least three classes of antibiotic) with serotype 6A and 6B isolates non-susceptible to most antibiotics tested. Furthermore, higher resistance rates were observed in this study compared to Southern Vietnam in previous periods.

Conclusions

Antibiotic resistance of invasive S. pneumoniae isolates from pediatric patients with meningitis in Southern Vietnam is alarmingly high. Strategies to combat pneumococcal antibiotic resistance are urgently needed.

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