Epidemiology of invasive pneumococcal infection among hospitalized children aged less than 5 years in Oman.

The objective of this study was to describe the epidemiology of invasive pneumococcal disease (IPD) in Omani children. We retrospectively reviewed cases admitted in children <5 years of age who were admitted in one of 4 tertiary care facilities within the Muscat Governorate. These cases represented nearly 95% of all IPD admissions recorded throughout the country from 1 January 2006 to 31 December 2006. Cases of IPD were identified using the ICD-10 discharge code. Case definition required microbiological confirmation (i.e., isolation of Streptococcus pneumoniae from blood, cerebrospinal fluid or any other normally sterile biological fluid) or clinical diagnosis in the absence of a specimen. A total of 41 cases of IPD were identified. The annual incidence of IPD was 26.1 per 100,000 in children <2 years old and 18.6 per 100,000 in children <5 years old. Among the reported IPD cases, 22 (54%) isolates were resistant to at least one antibiotic and 15 (37%) of patients had a known comorbid medical condition. These results demonstrate that the incidence of IPD in Oman during 2006 was high compared to many of the neighboring countries and provides baseline data on the incidence of IPD in an era before the introduction of the pneumococcal conjugate vaccine (PCV). In light of evidence for a significant incidence of IPD, we recommended that a nationwide surveillance system be put in place to monitor the incidence of IPD in children <5 years of age in Oman and to document the impact of PCV.