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EPIDEMIOLOGY OF COMMUNITY INVASIVE INFECTIONS IN
CHILDREN AT MARRAKECH CHU


S.OUKKAS1*, J.BELKHAIR1, A.RABII 1,T.ROKNI 1,S.ZOUHAIR 2 ,M.BOUSKRAOUI 3
,N.SORAA1
Page No. 16-25


Abstract

INTRODUCTION: Invasive infections include meningitis, bacteremia, and puncture fluid infections.
These infections are one of the main causes of severe morbidity and mortality in children.
OBJECTIVE: To study the bacteriological profile of documented bacterial invasive infections in
children at Marrakech University Hospital including invasive infections caused by Streptococcus
pneumoniae, Neisseria meningitidis and Haemophilus influenzae b. MATERIAL AND METHODS:
To establish the bacteriological profile of these invasive infections, a surveillance based on data
from the microbiology laboratory was carried out including all strains of pneumococcus,
meningococcus and Haemophilus influenzae isolated from children hospitalized at the Pediatric
Center. Infant from LCS, Hemocultures and pleural fluid during the period January 2010 to
December 2018. RESULTS: During this period, 248 bacteriologically confirmed invasive infections
were recorded at any infectious site. Pneumococcal IIs ranked first with 55% of the germs
responsible for II in children, followed by meningococcus 38% and H.influenzae 7%. The average
age of the children was 3 years with a male predominance and one with sex ratio of 1.2. These II
mainly affected the child under 4 years in 71% of cases. Meningitis and bacteremia were the two
most common infectious sites. Weeds accounted for 13% of these invasive IIs. These invasive
infections were more common in winter and early spring. The evolution between 2010 and 2018
showed an increase in these II from 2015 and that continues until 2018 mainly related to the
increase in pneumococcal II. Regarding meningitis, a stable prevalence of meningococcal
meningitis was found with the predominance of meningococcal serogroup B meningitis (81%), a
significant regression of meningitis to H. influenzae b and an increase in pneumococcal meningitis
between 2015 and 2018 From 2015, a decrease in pneumococcal meningitis of vaccine serotypes
was observed with the progressive increase of pneumococcal meningitis of non-vaccinal serotypes
in all age groups. DISCUSSION / CONCLUSION: This work highlights the problem of II in
children at the University Hospital of Marrakech which arises mainly with meningococcal
serogroup b meningitis and pneumococcal meningitis serotype non-vaccinal. Continuous
surveillance of carriage and pneumococcal infection will be essential to monitor the impact of
PCV10 use in children, including early detection of alternative serotypes, trends in antimicrobial
resistance, and potential indirect effects. . The geographic diversity of pneumococcal serotypes
underscores the importance of ongoing surveillance to guide vaccine design and recommendations.The surveillance of these II is based on clinical, epidemiological and microbiological data, and
clinical and biological collaboration is essential for better management of patients.
Keywords : community invasive infections, Pneumococcal, Meningococcal, Haemophilus
influenzae b.


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