Review Article

Prevalence of Invasive Streptococcus pneumoniae Infections among Iranian Children: A Systematic Review and Meta-Analysis

Abstract

Background: Streptococcus pneumoniae is an important pathogen of children, mostly in developing countries. We aimed to investigate the prevalence of invasive S. pneumoniae among Iranian children using a systematic review and meta-analysis.

Methods: A systematic search was carried out to identify papers published by Iranian authors in the Web of Science, PubMed, Scopus, and Google Scholar electronic databases from January of 2010 to December of 2017. Then, seven publications that met our inclusion criteria were selected for data extraction and analysis.

Results: Totally, one study was multicenter, and six were single-center based studies. Meanwhile, all of the included studied performed among hospitalized patients. Seven studies reported the prevalence of invasive S. pneumoniae isolated from children, of these the pooled prevalence of S. pneumoniae was 2.5% (95% CI: 0.7%-9.1%).

Conclusion: The overall prevalence of invasive S. pneumoniae infections among Iranian children is low (2.5%). However, further clinical studies are required to elucidate the burden of infections among Iranian children, especially in eastern regions.

1. Elshafie S, Taj-Aldeen SJ (2016). Emerging resistant serotypes of invasive Streptococcus pneumoniae. Infect Drug Resist, 9:153-60.
2. Motamedifar M, Sedigh Ebrahim-Saraie H, Mansury D, Nikokar I, Hashemizadeh Z (2015). Prevalence of Etiological Agents and Antimicrobial Resistance Patterns of Bacterial Meningitis in Nemazee Hospital, Shiraz, Iran. Arch Clin Infect Dis, 10(2):e22703.
3. Littorin N, Ahl J, Udden F, Resman F, Riesbeck K (2016). Reduction of Streptococcus pneumoniae in upper respiratory tract cultures and a decreased incidence of related acute otitis media following introduction of childhood pneumococcal conjugate vaccines in a Swedish county. BMC Infect Dis, 16(1):407.
4. Sedigh Ebrahim-Saraie H, Motamedifar M, Mansury D, et al (2016). Bacterial Etiology and Antibacterial Susceptibility Patterns of Pediatric Bloodstream Infections: A Two Year Study From Nemazee Hospital, Shiraz, Iran. J Compr Ped, 7(1):e29929.
5. Henriques-Normark B, Tuomanen EI (2013). The pneumococcus: epidemiology, microbiology, and pathogenesis. Cold Spring Harb Perspect Med, 3(7). pii: a010215.
6. O'Brien KL, Wolfson LJ, Watt JP, et al (2009). Burden of disease caused by Streptococcus pneumoniae in children younger than 5 years: global estimates. Lancet, 374(9693):893-902.
7. Feldman C (2004). Clinical relevance of antimicrobial resistance in the management of pneumococcal community-acquired pneumonia. J Lab Clin Med, 143(5):269-83.
8. Rafiei Tabatabaei S, Rahbar M, Nazari Alam A, et al (2017). Detection of pbp2b Gene and Antimicrobial Susceptibility Pattern of Streptococcus pneumoniae Isolates in Tehran Hospitals, Iran. Arch Pediatr Infect Dis, 5(1):e38891.
9. File TM, Jr. (2006). Clinical implications and treatment of multiresistant Streptococcus pneumoniae pneumonia. Clin Microbiol Infect, 12 Suppl 3:31-41.
10. Munita JM, Arias CA (2016). Mechanisms of Antibiotic Resistance. Microbiol Spectr, 4(2). 10.1128/microbiolspec.VMBF-0016-2015.
11. Munn Z, Moola S, Lisy K, Riitano D, Tufanaru C (2015). Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and incidence data. Int J Evid Based Healthc, 13(3):147–53.
12. Rezaeizadeh G, Pourakbari B, Ashtiani MH, Asgari F, Mahmoudi S, Mamishi S (2012). Antimicrobial susceptibility of bacteria isolated from cerebrospinal fluids in an Iranian referral pediatric center, 1998-2008. Maedica (Buchar), 7(2):131-7.
13. Ghotaslou R, Farajnia S, Yeganeh F, et al (2012). Detection of acute childhood meningitis by PCR, culture and agglutination tests in Tabriz, Iran. Acta Med Iran, 50(3):192-6.
14. Mahmoudi S, Zandi H, Pourakbari B, Ashtiani MT, Mamishi S (2013). Acute bacterial meningitis among children admitted into an Iranian referral children's hospital. Jpn J Infect Dis, 66(6):503-6.
15. Abdinia B, Ahangarzadeh Rezaee M, Abdoli Oskouie S (2014). Etiology and antimicrobial resistance patterns of acute bacterial meningitis in children: a 10-year referral hospital-based study in northwest iran. Iran Red Crescent Med J, 16(7):e17616.
16. Amin M, Ghaderpanah M, Navidifar T (2016). Detection of Haemophilus influenzae type b, Streptococcus agalactiae, Streptococcus pneumoniae and Neisseria meningitidis in CSF specimens of children suspicious of Meningitis in Ahvaz, Iran. Kaohsiung J Med Sci, 32(10):501-6.
17. Ahangarzadeh Rezaee M, Abdinia B, Delpak A, Rezamand A (2017). The Microbiologic Pattern in Pediatric Cancer Patients with Febrile Neutropenia and Bacteremia: A Referral Hospital-Based Study in Northwest of Iran. Iran J Pediatr, 27(2):e9452.
18. Houri H, Tabatabaei SR, Saee Y, Fallah F, Rahbar M, Karimi A (2017). Distribution of capsular types and drug resistance patterns of invasive pediatric Streptococcus pneumoniae isolates in Teheran, Iran. Int J Infect Dis, 57:21-6.
19. Tan TQ (2012). Pediatric invasive pneumococcal disease in the United States in the era of pneumococcal conjugate vaccines. Clin Microbiol Rev, 25(3):409-19.
20. Cho HK, Lee H, Kang JH, et al (2010). The causative organisms of bacterial meningitis in Korean children in 1996-2005. J Korean Med Sci, 25(6):895-9.
21. Jiang H, Su M, Kui L, et al (2017). Prevalence and antibiotic resistance profiles of cerebrospinal fluid pathogens in children with acute bacterial meningitis in Yunnan province, China, 2012-2015. PLoS One, 12(6):e0180161.
22. Guo LY, Zhang ZX, Wang X, et al (2016). Clinical and pathogenic analysis of 507 children with bacterial meningitis in Beijing, 2010-2014. Int J Infect Dis, 50:38-43.
23. Bari A, Zeeshan F, Zafar A, Ejaz H, Iftikhar A, Rathore AW (2016). Childhood Acute Bacterial Meningitis: Clinical Spectrum, Bacteriological Profile and Outcome. J Coll Physicians Surg Pak, 26(10):822-6.
24. Ramachandran P, Fitzwater SP, Aneja S, et al (2013). Prospective multi-centre sentinel surveillance for Haemophilus influenzae type b & other bacterial meningitis in Indian children. Indian J Med Res, 137(4):712-20.
25. Ceyhan M, Yildirim I, Balmer P, et al (2008). A prospective study of etiology of childhood acute bacterial meningitis, Turkey. Emerg Infect Dis, 14(7):1089-96.
26. Ceyhan M, Ozsurekci Y, Gurler N, et al (2016). Bacterial agents causing meningitis during 2013-2014 in Turkey: A multi-center hospital-based prospective surveillance study. Hum Vaccin Immunother, 12(11):2940-5.
27. Khan FY, Abu-Khattab M, Almaslamani EA, et al (2017). Acute Bacterial Meningitis in Qatar: A Hospital-Based Study from 2009 to 2013. Biomed Res Int, 2017:2975610.
28. Saadi AT, Garjees NA, Rasool AH (2017). Antibiogram profile of septic meningitis among children in Duhok, Iraq. Saudi Med J, 38(5):517-20.
29. Xiao T, Chen LP, Liu H, Xie S, Luo Y, Wu DC (2017). The Analysis of Etiology and Risk Factors for 192 Cases of Neonatal Sepsis. Biomed Res Int, 2017:8617076.
30. Al-Mazrou KA, Shibl AM, Kandeil W, Pircon JY, Marano C (2014). A prospective, observational, epidemiological evaluation of the aetiology and antimicrobial susceptibility of acute otitis media in Saudi children younger than 5years of age. J Epidemiol Glob Health, 4(3):231-8.
31. Ngo CC, Massa HM, Thornton RB, Cripps AW (2016). Predominant Bacteria Detected from the Middle Ear Fluid of Children Experiencing Otitis Media: A Systematic Review. PLoS One, 11(3):e0150949.
32. Geno KA, Gilbert GL, Song JY, et al (2015). Pneumococcal Capsules and Their Types: Past, Present, and Future. Clin Microbiol Rev, 28(3):871-99.
33. Song JY, Nahm MH, Moseley MA (2013). Clinical implications of pneumococcal serotypes: invasive disease potential, clini-cal presentations, and antibiotic re-sistance. J Korean Med Sci, 28(1):4-15.
Files
IssueVol 50 No 6 (2021) QRcode
SectionReview Article(s)
DOI https://doi.org/10.18502/ijph.v50i6.6412
Keywords
Streptococcus pneumoniae Sepsis Meningitis Children Meta-analysis

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Yousefi Avarvand A, Halaji M, Zare D, Hasannejad-Bibalan M, Sedigh Ebrahim-Saraie H. Prevalence of Invasive Streptococcus pneumoniae Infections among Iranian Children: A Systematic Review and Meta-Analysis. Iran J Public Health. 2021;50(6):1135-1142.