Cristian C. Serrano Mayorga, Colombia
Universidad de La Sabana Infectious Diseases DepartmentPoster Author Of 3 e-Posters
MAJOR ADVERSE CARDIOVASCULAR EVENTS DURING INVASIVE PNEUMOCOCCAL DISEASE ARE SEROTYPE DEPENDENT
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PATIENTS WITH MENINGITIS DUE TO STREPTOCOCCUS PNEUMONIAE ALSO MIGHT DEVELOP MAJOR ADVERSE CARDIOVASCULAR EVENTS (MACE)
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STREPTOCOCCUS PNEUMONIAE SEROTYPES 19A AND 3 ARE THE MAIN CAUSE OF INVASIVE PNEUMOCOCCAL DISEASE IN ADULTS IN BOGOTÁ, COLOMBIA
Presenter of 1 Presentation
PATIENTS WITH MENINGITIS DUE TO STREPTOCOCCUS PNEUMONIAE ALSO MIGHT DEVELOP MAJOR ADVERSE CARDIOVASCULAR EVENTS (MACE) (ID 716)
Abstract
Background
Streptococcus pneumoniae (Spn) is the leading cause of community-acquired pneumonia (CAP) and bacterial meningitis in adults. Recent studies have shown that up to 30% of patients admitted due to pneumococcal CAP develop major adverse cardiovascular events (MACE, i.e., new/worsening arrhythmia, new/worsening heart failure, and myocardial infarction). However, it is unknown whether MACE could also be identified in patients with pneumococcal meningitis.
Methods
In this observational, multicentric retrospective study. We analyzed medical records from adult patients with invasive pneumococcal disease (IPD) reported in a surveillance program across all hospitals in Bogotá, Colombia, between 2012 and 2019. Pneumococcal meningitis was confirmed by the identification of Spn in blood cultures and/or cerebrospinal fluid cultures and clinical presentation. Adverse cardiac outcomes were blinded evaluated in each case.
Results
From a total of 314 patients with microbiological Spn isolation, 19.7% (62/314) were diagnosed with pneumococcal meningitis. Out of the 62 patients evaluated, 10 (16%) developed MACE, 8.1% (5) new/worsening heart failure, 6.5% (4) new/worsening arrhythmia, and 3.2% (2) myocardial infarction.
Conclusions
To our knowledge, this is the first clinical study showing that patients with pneumococcal meningitis could be at risk of MACE as reported in pneumococcal CAP. Further studies are needed to characterize patients at risk better.
Author Of 3 Presentations
MAJOR ADVERSE CARDIOVASCULAR EVENTS DURING INVASIVE PNEUMOCOCCAL DISEASE ARE SEROTYPE DEPENDENT (ID 700)
Abstract
Background
Worldwide up to 30% of patients admitted to hospitals due to community-acquired pneumonia (CAP) develop major-adverse-cardiovascular events (MACE). Importantly, patients who develop MACE have a higher risk of dying during acute hospitalization and up to 10 years thereafter. Streptococcus pneumoniae (Spn) is the only etiological agent linked independently to MACE. However, there is no data regarding which Spn serotype is more associated with MACE in humans.
Methods
This is an observational, multicentric, retrospective cohort study conducted through the Health Secretary of Bogotá (HSB), Colombia. All patients with the diagnosis of invasive pneumococcal disease (IPD), reported in Bogota to the HIB between 2012 and 2019 were included. Serotyping was carryout at the HIB. MACE were defined as new/worsening heart failure, new/worsening arrhythmias, and/or myocardial infarctions. A multivariate analysis was performed.
Results
A total of 314 patients with IPD were included. 22.6% (71/314) developed MACE. As previously described, patients were older and with more comorbid conditions. However, patients with Spn serotype 3 were independently associated with MACE after adjusting for disease severity and comorbid conditions (OR 2.20; 95%CI 1.02, 4.76).
Conclusions
In patients admitted due to IPD, Spn serotype 3 is independently associated with MACE. Further molecular characterization and experiments are needed to prove causality.
PATIENTS WITH MENINGITIS DUE TO STREPTOCOCCUS PNEUMONIAE ALSO MIGHT DEVELOP MAJOR ADVERSE CARDIOVASCULAR EVENTS (MACE) (ID 716)
Abstract
Background
Streptococcus pneumoniae (Spn) is the leading cause of community-acquired pneumonia (CAP) and bacterial meningitis in adults. Recent studies have shown that up to 30% of patients admitted due to pneumococcal CAP develop major adverse cardiovascular events (MACE, i.e., new/worsening arrhythmia, new/worsening heart failure, and myocardial infarction). However, it is unknown whether MACE could also be identified in patients with pneumococcal meningitis.
Methods
In this observational, multicentric retrospective study. We analyzed medical records from adult patients with invasive pneumococcal disease (IPD) reported in a surveillance program across all hospitals in Bogotá, Colombia, between 2012 and 2019. Pneumococcal meningitis was confirmed by the identification of Spn in blood cultures and/or cerebrospinal fluid cultures and clinical presentation. Adverse cardiac outcomes were blinded evaluated in each case.
Results
From a total of 314 patients with microbiological Spn isolation, 19.7% (62/314) were diagnosed with pneumococcal meningitis. Out of the 62 patients evaluated, 10 (16%) developed MACE, 8.1% (5) new/worsening heart failure, 6.5% (4) new/worsening arrhythmia, and 3.2% (2) myocardial infarction.
Conclusions
To our knowledge, this is the first clinical study showing that patients with pneumococcal meningitis could be at risk of MACE as reported in pneumococcal CAP. Further studies are needed to characterize patients at risk better.
STREPTOCOCCUS PNEUMONIAE SEROTYPES 19A AND 3 ARE THE MAIN CAUSE OF INVASIVE PNEUMOCOCCAL DISEASE IN ADULTS IN BOGOTÁ, COLOMBIA (ID 707)
Abstract
Background
Incidence of Invasive pneumococcal disease (IPD) depends on numerous factors, including vaccine undertake, geographic location, and serotype prevalence. There is limited data about the incidence of Streptococcus pneumoniae (Spn), serotype distribution, and clinical characteristics of adults hospitalized due to IPD in Colombia. Thus, this study will attempt to bridge this gap in the literature.
Methods
This is an observational, retrospective, citywide study conducted between 2012 and 2019 in Bogotá, Colombia. We analyzed, reported positive cases of IPD. Importantly, Bogotá represents approximately 75% of the Colombian population. Strains were isolated in each hospital and typified in a centralized laboratory. The objectives included assessment of Spn serotype distribution, clinical diagnosis, mortality, ICU admission, and need for mechanical ventilation.
Results
A total of 314 patients with IPD were included, 54.8% male. The leading cause of IPD was pneumonia (33%), followed by meningitis and sepsis. The most prevalent serotypes were 19A (13.1%) and 3 (12.4%). The overall hospital mortality was 30%. Moreover, 65.6% were admitted to the ICU, 44.9% required invasive mechanical ventilation, and 5.1% non- invasive mechanical ventilation.
Conclusions
Pneumococcal pneumonia continues to be the most prevalent cause of IPD. Serotypes 19A and 3 are the leading cause of IPD in Colombian adults.