Emmanuel Roilides (Greece)
Aristotle University School of Medicine Infectious Diseases Unit and Research LaboratoryAuthor Of 7 Presentations
Q&A
Expert
Welcome and Introduction
Welcome and introduction
CHARACTERISTICS OF CHILDREN HOSPITALIZED WITH MIS-C DURING THREE PANDEMIC WAVES IN GREECE
Abstract
Backgrounds:
The Multisystem Inflammatory Syndrome in Children (MIS-C) is a rare but potentially severe complication of COVID-19.
Methods
This is a retrospective observational study of children aged <18 years hospitalized with MIS-C in 10 tertiary hospitals in Greece during three pandemic waves characterized by different SARS-CoV-2 variant: i. from August 2020 to January 2021 (EU1-B.1.177), ii. from February 2021 to July 2021 (Alpha-B.1.1.7) and iii. from August 2021 to December 2021 (Delta-B.1.617.2). The aim of the study was to document the incidence over time, clinical characteristics and outcome of children admitted with MIS-C in Greek hospitals during the COVID-19 pandemic.
Results:
In total, 119 patients were included, 91.6% (109/119) met the WHO criteria of MIS-C diagnosis: 26.9% (32/119), 39.5% (47/119) and 33.6% (40/119) were hospitalized during the 1st, 2nd, and 3rd study period, respectively. Demographic and clinical characteristics are shown in Table 1. No cases were found before October 2020. The incidence of MIS-C significantly decreased over the three waves from 3.3/1000 to 0.25/1000 confirmed COVID-19 cases (P <0.0001). No other significant difference was observed in the clinical manifestations and disease severity of children hospitalized with MIS-C over the three waves.
Conclusions/Learning Points:
This study indicates that the incidence of MIS-C may vary according to the predominant variant. Outcome remains favourable regardless of the variant leading to MIS-C. Larger studies are needed to clarify if clinical characteristics and/or disease severity may differ, as well.
PATTERNS AND TRENDS OF ANTIBACTERIAL AND ANTIFUNGAL USE IN A PEDIATRIC ONCOLOGY DEPARTMENT
Abstract
Backgrounds:
Monitoring of antibacterial and antifungal use is essential for antimicrobial stewardship strategies. We studied patterns and time trends of antibacterial and antifungal use in a pediatric oncology department.
Methods
A retrospective analysis of monthly antibacterial and antifungal use was conducted in a 20-bed pediatric oncology department of a tertiary-level hospital from January 2018 to May 2020 (29 months). Data of antimicrobial and antifungal consumption was obtained from the hospital pharmacy and expressed as defined daily doses per 100 bed-days (DDD/100BD). Number of bed-days was obtained from Hospital Office of Statistics.
Results:
During study period there was a median monthly rate of 301 bed-days. Total consumption of antibacterials had a median monthly rate of 108 DDD/100BD and of antifungals 94 DDD/100BD showing significant increases (p=0.015 and p<0.001, respectively). Glycopeptides (vancomycin/teicoplanin) constituted the most common used antibacterial class (29.5 DDD/100BD). Carbapenems were the second most used antibacterial agents (15.2 DDD/100BD) with a significant increase (p=0.009). Consumption of aminoglycosides and combination of piperacillin with tazobactam followed with 13.8 DDD/100BD and 11.7 DDD/100BD, respectively. Consumption of cotrimoxazole was 9.3 DDD/100BD, followed by metronidazole (6.4 DDD/100BD), colistin (4 DDD/100BD) and quinolones (3.8 DDD/100BD). Utilization of 3rd generation cephalosporins was relatively low (3.7 DDD/100BD). Voriconazole constituted the most common used antifungal agent (45 DOT/100BD). Micafungin was the second most commonly used antifungal agent (18 DOT/100BD) with a significant increase (p=0.028).
Conclusions/Learning Points:
High consumption of glycopeptides and carbapenems combined by constant use of colistin is of concern. Emergence of antimicrobial resistance in pediatric oncology patients could explain this pattern. High voriconazole and micafungin use mainly reflects antifungal prophylaxis practices. These results may guide antimicrobial and antifungal stewardship activities.
ANTIFUNGAL USE IN EUROPEAN PEDIATRIC INTENSIVE CARE UNITS (PICUS): A 12-WEEK MULTICENTER MODIFIED POINT PREVALENCE STUDY (CALYPSO)
Abstract
Backgrounds:
Knowledge of antifungal use in PICUs across Europe, while frequently prescribed, is limited. A 12-wk modified point-prevalence study was conducted to record antifungal use in Εuropean PICUs.
Methods
All patients hospitalized in the participating PICUs and receiving systemic antifungals were included. Information about ward demographics was collected once at the beginning; weekly ward and patient data were collected prospectively for the 12-wk study period and entered in REDCap database.
Results:
18 PICUs (15 hospitals), in 10 European countries participated. 8/18 (44%) of PICUs followed prophylactic practices for patients with immunocompromise/neutropenia, long-term parenteral nutrition or central lines, 7/18 (39%) had an antifungal stewardship program implemented and the majority (16/18) used biomarkers (15/16 galactomannan, 12/16 each beta-D-glucan and Cryptococcal antigen). 101 patients with ages ≤90d (14 patients), 3-60mo (44pts) and >5yrs (43pts) were recorded. Malignancy was the most common underlying condition among patients aged >90d (28%) followed by surgery/trauma (25%), whereas all patients ≤90d had previous surgery. Indication for antifungal prescribing was prophylaxis in 38% and treatment in 62% [empirical (57%), preemptive (13%) and targeted (30%)]. Fluconazole was the most common agent both for prophylaxis [45%, median dose: 6 (range 2-9) mg/kg/d] and empirical treatment [53%, median dose: 10 (range 1-12) mg/kg/d], whereas LAMB was the most frequent agent for targeted treatment [37%, median dose: 5 (range 3-6) mg/kg/d] (Table 1). Common reasons for empirical and targeted treatment were persistent fever in high-risk patients (58%) and candidiasis (100%), respectively. For targeted treatment, the most frequent pathogens were Candida albicans (37%) and Candida parapsilosis (32%).
Conclusions/Learning Points:
The majority of antifungal prescriptions across European PICUs were for prophylaxis or empirical treatment. These data will be valueable for guiding antifungal stewardship strategies in PICUs
Presenter of 4 Presentations
Welcome and introduction
Q&A
Expert
Welcome and Introduction
Moderator of 4 Sessions
Session Description:
This symposium will focus on the epidemiology and public health impact of noninvasive pneumococcal disease in children and considerations to optimize prevention with the introduction of new pneumococcal conjugate vaccines.
Facilitator Of
Session Description:
This symposium will focus on the epidemiology and public health impact of noninvasive pneumococcal disease in children and considerations to optimize prevention with the introduction of new pneumococcal conjugate vaccines.
Poster Author Of 14 e-Posters
EP033 - PATTERNS AND TRENDS OF ANTIMICROBIAL USE IN A PEDIATRIC INTENSIVE CARE UNIT (PICU) USING DAYS OF THERAPY (ID 1064)
EP213 - CONSERVATIVE MANAGEMENT OF CEREBROSPINAL FLUID SHUNT INFECTIONS IN SELECTED PEDIATRIC PATIENTS (ID 965)
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EP218 - POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME: A RARE COMPLICATION OF INVASIVE PNEUMONOCOCCAL INFECTION (ID 1080)
EP347 - THE ROLE OF BIOMARKERS IN DIAGNOSTIC APPROACHES IN NEONATES AND CHILDREN SUFFERING FROM VENTILATOR-ASSOCIATED PNEUMONIA (VAP) (ID 1475)
EP371 - CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS (CLABSIS) IN PEDIATRIC ONCOLOGY PATIENTS (ID 1533)
EP380 - VENTILATOR ASSOCIATED EVENTS (VAE) IN PATIENTS HOSPITALIZED IN A PEDIATRIC INTENSIVE CARE UNIT (PICU) DURING 2017-2019: EPIDEMIOLOGY, RISK FACTORS AND OUTCOME (ID 1403)
EP395 - MULTISYSTEM INFLAMMATORY SYNDROME (MIS-C) PRESENTING AS RETROPHARYNGEAL ABSCESS IN A 10-YEAR OLD BOY (ID 1048)
EP574 - CANDIDA GUILLIERMONDII IN A PATIENT WITH WILMS TUMOR AFTER TREATMENT WITH DEXAMETHASONE DUE TO CANCER HEMOPHAGOCYTOSIS (ID 1482)
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PD008 - PERSISTENT STAPHYLOCOCCAL BACTEREMIA AFFECTING MULTIPLE SYSTEMS IN A BOY WITH SURGICALLY CORRECTED CONGENITAL HEART DISEASE (ID 1464)
PD011 - SUBCUTANEOUS DIROFILARIASIS IN A GIRL WITH RHEUMATOID ARTHRITIS (ID 1176)
PD100 - COMPARISON OF ANTIMICROBIAL CONSUMPTION IN CRITICALLY ILL CHILDREN USING DAILY DEFINED DOSES AND DAYS OF THERAPY (ID 1063)
PD116 - STREPTOCOCCUS PNEUMONIAE MENINGITIS AND/OR SEPTICEMIA AND SEROTYPE SURVEILLANCE IN CHILDREN, DURING 2010-2021 IN GREECE (ID 1186)
PD152 - HEMOSTATIC ALTERATIONS IN SEPTIC NEONATES IN CONVENTIONAL COAGULATION TESTS AND ROTEM PARAMETERS (ID 1924)
- Dimitra Gialamprinou (Greece)
- Georgios Mitsiakos (Greece)
- Abraham Pouliakis (Greece)
- Georgios Katsaras (Greece)
- Christos-Georgios Kontovazainitis (Greece)
- Ilias Chatziioannidis (Greece)
- Athanasios Moraitis (Greece)
- Anastasia Banti (Greece)
- Alexandra Fleva (Greece)
- Emmanuel Roilides (Greece)
- Elissavet Diamanti (Greece)
PD168 - MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN (MIS-C): A NATIONWIDE COLLABORATIVE STUDY IN THE GREEK POPULATION (ID 774)
- STAVROULA LAMPIDI (Greece)
- Despoina Maritsi (Greece)
- IRINI ELEFTHERIOU (Greece)
- Evaggelia Farmaki (Greece)
- Nikos SPYRIDIS (Greece)
- KONSTANTINA CHARISI (Greece)
- Petrina Vantsi (Greece)
- Filippos G. Filippatos (Greece)
- Kleopatra Skourti (Greece)
- EFIMIA PAPADOPOULOU-ALATAKI (Greece)
- Kyriaki Papadopoulou-Legbelou (Greece)
- Parthena Kampouridou (Greece)
- Ioanna N. Grivea (Greece)
- Eleni Vergadi (Greece)
- Despoina Gkentzi (Greece)
- Despina Dimou (Greece)
- Patra Koletsi (Greece)
- Lampros Fotis (Greece)
- Vassiliki Papaevangelou (Greece)
- Gabriel Dimitriou (Greece)
- Emmanouil Galanakis (Greece)
- George A. Syrogiannopoulos (Greece)
- Vassiliki Spoulou (Greece)
- Athanasios Michos (Greece)
- Emmanuel Roilides (Greece)
- Maria Tsolia (Greece)