Monica M. Rojas, Colombia

MSD Colombia MSD Colombia

Poster Author Of 2 e-Posters

Author Of 2 Presentations

CLINICAL AND MICROBIOLOGICAL CHARACTERIZATION OF INVASIVE PNEUMOCOCCAL PNEUMONIA IN ADULT PATIENTS IN FIVE HEALTHCARE INSTITUTIONS OF BOGOTA, COLOMBIA (ID 742)

Abstract

Background

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.

Methods

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.

Results

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%.

Conclusions

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.

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CLINICAL OUTCOMES IN ADULTS WITH INVASIVE PNEUMOCOCCAL DISEASE IN FIVE HEALTHCARE INSTITUTIONS OF BOGOTA, COLOMBIA (ID 724)

Abstract

Background

Although invasive pneumococcal disease(IPD) in adults is associated with significant morbidity and mortality, data are yet scarce in low- and middle-income countries. We aimed to characterize clinical outcomes of adults ≥18 years with IPD in Colombia

Methods

A descriptive, observational, and retrospective chart review study was conducted in 5 tertiary hospitals in Bogotá(Colombia) in adults ≥18y with IPD between 2011-2017. Data on demographics, clinical characteristics and serotypes were collected. The main variables analyzed were clinical presentation, length of stay(LOS), UCI admission, case-fatality rate(CFR) and serotype(ST) distribution.

Results

169 cases were included, 48.5%were female and the median age was 58y(IQR:45–70). The main clinical presentation was bacteremic pneumonia (63.3%), followed by bacteremia (19.5%), meningitis (13.6%) and others (3.1%). The median LOS was 12days(IQR:4-20), 58.6% were admitted to UCI(median 5days(IQR:2–13.3)). 53.3% required mechanical ventilation and 50.9% inotropic support. Among 114 cases which had serotyping data, most frequent ST were: 3(11.4%), 14(9.6%), 19A(8.8%), 6C(6.1%), and 6A(5.3%). Table 1 shows CFR per age group, clinical presentation, and main ST.

tabla 1. case-fatality rate in adults with invasive pneumococcal disease in five healthcare.png

Conclusions

IPD was associated with high mortality and UCI admission. Although most cases of deaths were due to pneumonia, higher CFR were seen in adults ≥60y, in bacteremia/meningitis presentations, and ST 3 and 6C.

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