María Esther Castillo,
Author Of 2 Presentations
INVASIVE PNEUMOCCOCAL DISEASE IN HOSPITALIZED CHILDREN FROM LIMA, PERU AFTER INTRODUCTION OF THE 13-VALENT PNEUMOCOCCAL CONJUGATE VACCINE (PCV13) (ID 1006)
Abstract
Background
The PCV13 vaccine was introduced in 2015. We determined serotypes and antibiotic resistance of pneumococcal strains isolated from children with IPD in Lima, Peru after PCV13 introduction.
Methods
This was a passive surveillance study (Nov-2016 to Dic-2019) in 6 hospitals and 5 private laboratories in Lima, in children <18 years with IPD. Pneumococcus was confirmed by microbiological and lytA gene amplification. Antibiotic resistance was performed by E-test and disc-diffusion. Strains were serotyped by Sequential-multiplex-PCR.
Results
85 pneumococcus strains were isolated from children with IPD. The most prevalent diagnosis was pneumonia 61% and meningitis 19%. Age range was among 2 months and 13 years. 46% were <2 years, 86% were <5 years. 51% were female. High levels of antibiotic resistance to azithromycin 79%, cotrimoxazole 75%, tetracycline 70% and clindamycin 68% was observed. The resistance among Meningeal and Non-meningeal isolates was 40% and 12% for Penicillin; 0% and 1% for ceftriaxone. More common serotype/serogroup were 19A(65.5%), 24(24A/24B/24F)(32.8%), 6(6A/6B/6C/6D)(8.6%) and 15B/15C(6.9%). 19A is decreasing loosely throughout the years [2017(50%), 2018(45%) and 2019 (33%)]. serogroup 24A/24B/24F was the emerging serotype post-PCV13.
Conclusions
Serotype 19A remain circulating in Lima. Serogroup 24A/24B/24F is emerging post-PCV13 introduction. High levels of antibiotic resistance is observed compared to previous studies in Lima
PNEUMOCOCCAL NASOPHARYNGEAL CARRIAGE IN CHILDREN FROM LIMA, PERU AFTER INTRODUCTION OF THE 13-VALENT PNEUMOCOCCAL CONJUGATED VACCINE (ID 950)
Abstract
Background
The aim of this study was to determine the change in serotypes and antibiotic resistance of pneumococcal strains isolated from healthy nasopharyngeal carriers in children from Lima-Perú after introduction of Pneumococcal Conjugate Vaccine (PCV13).
Methods
This was a post-PCV13 observational study (2016 to 2019), in five hospitals in Lima-Perú. Nasopharyngeal swab from 1000 children <2 years was taken. We compare the data with previous pre-PCV13 study (2007 to 2009) in Perú. Pneumococcus was isolated and identified at study laboratory. Antibiotic sensitivity was determined by disc diffusion. Strains were serotyped by Sequential-multiplex-PCR.
Results
Pneumococcal carriers decreases from 27%(573/2123) in pre-PCV13 to 21%(208/1000) in post-PCV13 (p<0.05). The antibiotic resistance increases (p<0.05) for cotrimoxazole(58% to 76%), Oxacillin(52% to 76% non-sensitive), azithromycin(29% to 50%), tetracycline(29% to 39%); and Clindamycin(13% to 29%) in post-PCV13. The most common pre-PCV13 serotype were: 19F(18.1%), 6B(14.3%); 23F(8.9%) and 14(6.5%) and the most common post-PCV13 serotype were: 15B/15C(13.9%), 6A/6B/6C/6D(11.5%) and 19A(5.3%). A positive association (p<0.001) between respiratory symptoms and pneumococcus was observed.
Conclusions
The decrease in pneumococcal nasopharyngeal carrier could be due to use of PCV13 vaccine. The antibiotic resistance is increasing compared to pre-PCV13. 15B/15C represents an emerging non-PCV13 vaccine serotype in our population.