CLINICAL AND MICROBIOLOGICAL CHARACTERIZATION OF INVASIVE PNEUMOCOCCAL PNEUMONIA IN ADULT PATIENTS IN FIVE HEALTHCARE INSTITUTIONS OF BOGOTA, COLOMBIA
- Aura L. Leal, Colombia
- German Camacho Moreno, Colombia
- Anita Montañez, Colombia
- Fabio A. Varon-Vega, Colombia
- José C. Alvarez, Colombia
- Sandra Valderrama, Colombia
- Beatriz E. Ariza, Colombia
- Oscar Pancha, Colombia
- Ana Y. Santana, Colombia
- Nella Sánchez, Colombia
- Patricia Reyes Pabón, Colombia
- Cintia I. Parellada, Brazil
- Jaime Ruiz, Colombia
- Claudia Beltrán, Colombia
- Emilia Prieto, Colombia
- Monica M. Rojas, Colombia
Invasive pneumococcal pneumonia (IPP) is a growing health problem, yet data is scarce on the burden of disease in adults. This study describes the clinical and microbiological characteristics of IPP among adults in Colombia.
A descriptive, observational and retrospective chart review study was conducted in 5 tertiary hospitals in Bogotá, Colombia(2011-2017). Adults ≥18y with IPP defined as pneumonia with pneumococcus isolation in blood/pleural fluid were included. Data on demographics, clinical characteristics, serotypes, and antibiotic susceptibility were collected.
108 IPP cases were identified. The median age was 59y and 55.6% were male. The most frequent comorbidities were: cardiovascular disease(32.4%), chronic pulmonary disease (29%), and malignant neoplasm(23.1%). The most frequent x-ray findings were: lobar consolidation(21.3%), multilobar consolidation(15.5%) and lobar consolidation with pleural effusion(13%). 53.7% of patients required ICU, 52.8% mechanical ventilation and 52.8% inotropics. Case-fatality rate was 37%. The most frequent serotypes were: 3(9.3%), 14(8.3%), 19A(5.6%) and 6C(3.7%). The susceptibility to penicillin was 87.5% and to ceftriaxone 91.7%.
IPP was associated with a substantial ICU admission and lethality. Over one-third of IPP patients had comorbidities. Serotypes not included in the childhood pneumococcal immunization program predominated. It is essential to continue monitoring serotypes to guide vaccine recommendations in Colombia.