Invasive Pneumococcal Disease in Neonates in South Africa: 2000 - 2007

Krishnee Moodley, Yacoob Coovadia


Streptococcus pneumoniae accounts for a small percentage of all reported cases of neonatal sepsis but has been associated with  high mortality rates.  Invasive pneumococcal disease(IPD) is defined “as any condition in which S. pneumoniae is present in blood, cerebrospinal fluid or any other normally sterile body site”.  The high maternal incidence of HIV infection, a predisposing factor for IPD, in South Africa is of concern as a risk factor for IPD in the neonate.  IPD in the neonate in South Africa has not been systematically described, although case reports have been published.  This study aims to describe the epidemiology, clinical features, antimicrobial susceptibility pattern and serotype distribution of IPD in the neonate, and compare this to a non-neonatal group.

Data sources include a database at the National Institute for Communicable diseases(NICD) in South Africa, a source of national clinical, epidemiological and laboratory data, on isolates of S. pneumoniae  from sterile sites.  This study will be limited to neonates(?28 days)  and non-neonates (infants >28 days and < 2years old) for the period 2000 to 2007, inclusive.  The second source of data will be from chart reviews of neonatal cases from six metropolitan hospitals in Kwa-Zulu Natal.

 Analysis and interpretation of these data to ascertain incidence, clinical and laboratory features of IPD  in neonates in South Africa will be performed.  This study also hopes to enable determination of whether our current antimicrobial choices for neonatal sepsis, especially meningitis,  are still appropriate.  In addition, maternal immunization is a safe, cost-effective method of prevention of disease in infants.  This study may indicate whether this measure  warrants further  consideration in our setting.