BACKGROUND: Because Bangladesh intended to introduce @entity1485 -10 in 2015, we examined the baseline burden of invasive @entity66 (IPD) in order to measure impact of @entity1485 . METHODS: During 2007-2013, we performed blood and cerebrospinal fluid (CSF) cultures in @entity1 <5 years of age with suspected IPD identified through active surveillance at 4 hospitals. Isolates were serotyped by quellung and tested for antibiotic susceptibility by disc diffusion and E-test. Serotyping of culture-negative cases, detected by Binax or PCR, was done by sequential multiplex polymerase chain reaction (PCR). Trends in IPD case numbers were analyzed by serotype and clinical syndrome. RESULTS: The study identified 752 IPD cases; 78% occurred in @entity1 <12 months of age. Serotype information was available for 78% (442/568), including 197 of 323 culture-negative cases available for serotyping. We identified 50 serotypes; the most common serotypes were 2 (16%), 1 (10 %), 6B (7%), 14 (7%) and 5 (7%). @entity1485 -10 and @entity1485 -13 serotypes accounted for 46% (range 29-57% by year) and 50% (range 37-64% by year) of cases, respectively. Potential serotype coverage for @entity693 and @entity693 cases was 45% and 49% for @entity1485 -10, and 48% and 57% for @entity1485 -13, respectively. Eighty two percent of strains were susceptible to all antibiotics except @entity799 . CONCLUSION: The distribution of serotypes causing IPD in Bangladeshi @entity1 is diverse, limiting the proportion of IPD cases @entity1485 can prevent. However, @entity1485 introduction is expected to have major benefits as the country has a high burden of IPD-related mortality, morbidity and disability.

Epidemiology of Invasive Pneumococcal Disease in Bangladeshi XXXX Before Introduction of Pneumococcal Conjugate Vaccine.

@entity1 :: ('9606', 'Species') :: ['children'] @entity66 :: ('MESH:D004194', 'Disease') :: ['pneumococcal disease'] @entity799 :: ('MESH:D015662', 'Chemical') :: ['cotrimoxazole'] @entity693 :: ('MESH:D008581', 'Disease') :: ['non-meningitis', 'meningitis'] @entity1485 :: ('158372', 'Species') :: ['PCV']
@entity1 :: (9606,Species) :: ['Children']
