1628. Clinical, Epidemiological and Microbiological Characterization of Invasive Streptococcus pneumoniae Disease in Hospitalized Adults from 5 Tertiary Hospitals in Bogotá, Colombia: A Descriptive Study
Autor: | Prieto Emilia, Oscar Pancha, Patricia Reyes Pabón, J Ruiz, Ana Yadira Santana, Aura Lucía Leal Castro, Fabio Varon, Germán Camacho Moreno, Nella Sánchez Flórez, Claudia Ximena Herrera Beltrán, Beatriz Ariza, Sandra Valderrama, Camilo Alvarez Rodríguez, M. Rojas, Anita Montañez Ayala |
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Rok vydání: | 2019 |
Předmět: |
0301 basic medicine
Pneumococcal serotypes Pediatrics medicine.medical_specialty business.industry Invasive Streptococcus pneumoniae disease 030106 microbiology medicine.disease Intensive care unit law.invention Abstracts 03 medical and health sciences Pneumonia 0302 clinical medicine Infectious Diseases Oncology Pneumococcal vaccine law Bacteremia Poster Abstracts Epidemiology Medicine 030212 general & internal medicine business Meningitis |
Zdroj: | Open Forum Infectious Diseases |
ISSN: | 2328-8957 |
Popis: | Background In Colombia, clinical characteristics related to invasive pneumococcal disease (IPD) and circulating pneumococcal serotypes (ST) in adults are scarce. We aimed to describe the clinical and microbiological characteristics of IPD in hospitalized adults ≥18 years old in 5 tertiary hospitals in Colombia from 2011 to 2017. Methods A descriptive, observational, retrospective study was conducted in 5 tertiary care hospitals during a 7-year period. Demographic, clinical data and in-hospital outcomes were collected through chart review from all culture-confirmed invasive S. pneumoniae cases in each hospital. The National Health Institute laboratory database was assessed to obtain information about ST (Quellung) and antimicrobial susceptibility (Broth microdilution). Results 128 cases of IPD were included in this interim analysis, 70(54.7%) were males. The median age was 58 ± 16.7 years. Main underlying conditions were cardiovascular disease (32%), smoking (27.9%), diabetes (20.3%), autoimmune diseases (18.8%), and cancer (18%). The main clinical presentation was bacteremic pneumonia (66.4%), followed by meningitis (14.8%), bacteremia (14.1%) and other (3.1%). Critical care management was required in more than half of the patients: ICU (60.2%), mechanical ventilation (53%) and inotropic support (51.6%). The overall in-hospital mortality rate was 43% and was 39%, 52.6% and 61% for pneumonia, meningitis and bacteremia, respectively. ST was known for 82(64%) cases, most frequent ST were: 3(10.9%), 14(7.3%), 19A(6,1%), 1(4.8%), 4/8/11A/22F (3.65% for each one). ST contained in 13-valent conjugate vaccine (PCV13), 23-valent pneumococcal vaccine (PPVS23) and non-vaccine serotypes accounted for 43.9%, 54.9%, and 40.2% of IPD cases, respectively (Figure 1). 83% and 80.7% strains were susceptible to penicillin and ceftriaxone, respectively. Conclusion Pneumonia is the most common clinical presentation of IPD among adults. The clinical outcome was severe with high mortality rate and need of critical care management. ST contained in PCV13 and PPVS23 accounted for 43.9% and 54.9% of IPD cases. This study highlights the importance to strengthen local surveillance and the implementation of pneumococcal immunization programs in high-risk population. Disclosures All authors: No reported disclosures. |
Databáze: | OpenAIRE |
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