Vivian M. Moreno Mejia, Colombia

Red Neumocolombia .

Poster Author Of 3 e-Posters

 ePoster
Online Abstracts Clinical Sciences - Disease Burden in Infants, Children/Youth, and Adults B2 Disease Burden in Infants, Children/Youth, and Adults

CLINICAL, EPIDEMIOLOGICAL AND MICROBIOLOGICAL CHARACTERIZATION OF MENINGITIS BY STREPTOCOCCUS PNEUMONIAE IN A PEDIATRIC POPULATION OF COLOMBIA AFTER MASS VACCINATION WITH PCV10

Presenter
Authors
Presentation Type
Abstract_Submission
Presentation Topic
B2 Disease Burden in Infants, Children/Youth, and Adults
Online Abstracts Clinical Sciences - Treatment of Pneumococcal Disease in Infants, Children/Youth, and Adults B5 Treatment of Pneumococcal Disease in Infants, Children/Youth, and Adults

RESISTANCE OF STREPTOCOCCUS PNEUMONIAE ISOLATES CAUSING INVASIVE PNEUMOCOCCAL DISEASE IN 17 HOSPITALS OF COLOMBIA.

Presenter
Authors
Presentation Type
Abstract_Submission
Presentation Topic
B5 Treatment of Pneumococcal Disease in Infants, Children/Youth, and Adults
Online Abstracts Clinical Sciences - Disease Burden in Infants, Children/Youth, and Adults B2 Disease Burden in Infants, Children/Youth, and Adults

FREQUENCY, CLINICAL AND MICROBIOLOGICAL CHARACTERISTICS, AND OUTCOMES OF PRIMARY BACTEREMIA BY STREPTOCOCCUS PNEUMONIAE IN CHILDREN TREATED AT COLOMBIAN TERTIARY CARE CENTERS 2017 - 2019

Presenter
Authors
Presentation Type
Abstract_Submission
Presentation Topic
B2 Disease Burden in Infants, Children/Youth, and Adults

Author Of 5 Presentations

 Conference Calendar

CHARACTERIZATION OF STREPTOCOCCUS PNEUMONIAE SEROTYPE 19A CAUSING INVASIVE PNEUMOCOCCAL DISEASE FROM BOGOTÁ, COLOMBIA (ID 997)

Session Name
Basic Sciences - Conventional and Molecular Microbiology
Presenter
Authors

Abstract

Background

Invasive Pneumococcal Disease (IPDs) is a leading cause of morbidity and mortality. In Colombia, the 7-valent pneumococcal conjugate vaccine was introduced in 2006 and replaced in 2011 by 10-valent. However, the number of S.pneumoniae serotype-19A causing IPDs in Bogotá has considerably increased in the last years. Thus, we characterized all S.pneumoniae serotype-19A isolates received from the Public Health Laboratory Network of Bogotá (PHLNB) in 2017, after Pneumococcal Conjugate Vaccine implementation.

Methods

This study was conducted with all S.pneumoniae serotype-19A isolates received in 2017 from PHLNB. Standard laboratory methods were performed for pneumococcal culture. Identification and antimicrobial susceptibility/resistance were done by automated method (VITEK-BioMérieux). Serotyping results (Quellung Reaction) were received by feedback of the Colombian National Institute of Health. Statistical analysis: Excel/SPSS.

Results

In 2017, 227 S.pneumoniae IPD-isolates were received from PHLNB. The most prevalent serotypes were 19A/3/23A/9N/6C/14/35B. Serotype-19A accounted for 20.3% (46/227) of IPD-isolates. Twenty-two (47.8%) children <5 years were affected by this serotype in 2017 with Pneumonia (39.1%) and Sepsis (34.9%). All 46 serotype-19A were susceptible to vancomycin and chloramphenicol, while reduced susceptibility and/or resistance was observed for erythromycin (100%), penicillin (65.2%) and Trimetoprim-Sulfametoxazol (58.7%).

Conclusions

These results evidence the predominant emergency of S.pneumoniae multidrug-resistant serotype-19A, among children <5 years in Bogotá-Colombia.

Hide

CLINICAL, EPIDEMIOLOGICAL AND MICROBIOLOGICAL CHARACTERIZATION OF MENINGITIS BY STREPTOCOCCUS PNEUMONIAE IN A PEDIATRIC POPULATION OF COLOMBIA AFTER MASS VACCINATION WITH PCV10 (ID 274)

Session Name
Clinical Sciences - Disease Burden in Infants, Children/Youth, and Adults
Presenter
Authors

Abstract

Background

Acute bacterial meningitis caused by Streptococcus pneumoniae is an important pathology for public health because of its high morbidity and mortality. In 2012, Colombia introduced the vaccine in the compulsory vaccination scheme.

Methods

Ambispective case series study conducted in pediatric patients with meningitis admitted to 10 hospitals of Bogotá (2008-2019), and 4 hospitals of Cali, 2 of Medellín, and 1 of Cartagena (2017-2019). Objective:To perform a clinical, epidemiological and microbiological characterization of patients with meningitis caused by Streptococcus pneumoniae in Colombia from 2008 to 2019, in the hospitals included in Neumocolombia network.

Results

58 cases were related to the pathology. The most frequent symptoms in the cohort were fever, hyporexia and somnolence. Epileptic seizures were particularly common between 4 and 12 months of age. Increased resistance to penicillin and third generation cephalosporins was found in the period 2015-2019. The mortality rate was 20.68%, and the most important sequel was cognitive dysfunction, with a frequency of 73.77%, followed by sensorineural hearing loss, motor disorders and epilepsy. Mortality was associated with low blood cell counts and high C-reactive protein, while age was associated with increased complications and sequelae.

Conclusions

Recent immunization schemes have changed the clinical, microbiological and epidemiological characteristics of pneumococcal meningitis in Colombia.

Hide

RESISTANCE OF STREPTOCOCCUS PNEUMONIAE ISOLATES CAUSING INVASIVE PNEUMOCOCCAL DISEASE IN 17 HOSPITALS OF COLOMBIA. (ID 277)

Session Name
Clinical Sciences - Treatment of Pneumococcal Disease in Infants, Children/Youth, and Adults
Presenter
Authors

Abstract

Background

Invasive Pneumococcal Disease (IPD) is a cause of morbidity and mortality in children. Some Streptococcus pneumoniae isolates are resistant to antibiotics used for IPD, such as beta-lactams and macrolides. Increased resistance has been reported in Colombia.

Methods

Ambispective case series study in pediatric patients with IPD admitted in 10 hospitals of Bogotá in 2008-2019, and 4 hospitals of Cali, 2 of Medellin and 1 of Cartagena in 2017-2019 (preliminary data).

Results

651 cases of IPD were found. Susceptibility profile information was obtained for 567(87%) isolates; 494(75.8%) were non-meningeal (NM) and 73(11.2%) meningeal (M). Regarding NM, 16.3% were penicillin-resistant, and 5.8% showed intermediate susceptibility; 5% were resistant to ceftriaxone and 9.5% had intermediate susceptibility. M showed 19.1% resistance to penicillin, 5.4% resistance to ceftriaxone, and 5.4% intermediate susceptibility. Resistance to macrolides was 26.2%, to clindamycin 19.7%, and trimethoprim sulfa 32%. All isolates were susceptible to vancomycin. Only 23.8% of the isolates were susceptible to all antibiotics; 36% were multi-resistant. The serotype most resistant to penicillin was 19A (26.8%), which was associated with multi-resistance.

Conclusions

An increase in antibiotic resistance is observed in relation to previous reports associated with emergence of multiresistant S. pneumoniae serotype 19A.

Hide

MORTALITY ASSOCIATED WITH INVASIVE PNEUMOCOCCAL DISEASE IN A COLOMBIAN PEDIATRIC POPULATION (2008-2019) (ID 279)

Session Name
Clinical Sciences - Disease Burden in Infants, Children/Youth, and Adults
Presenter
Authors

Abstract

Background

Invasive Pneumococcal Disease(IPD) causes high mortality in children under 5 years. Colombia started administering PCV10 in 2012. Neumocolombia network monitors IPD in pediatric patients throughout the country.

Methods

Case series study in 69 deceased pediatric patients with IPD admitted to 10 hospitals of Bogotá in 2008-2019, and 4 hospitals of Cali, 2 of Medellín and 1 of Cartagena in 2017-2019(preliminary data).

Results

The average age of sample was 31 months (0-180 months); 57(82%) were younger than 48 months. The average hospital stay was 7.8 days; 59(85.5%) were admitted to the ICU. 39 cases (56%) presented pneumonia, 14(20%) bacteremia, 13(18.8%) meningitis and 3(4.3%) pneumonia plus meningitis. Case fatality rate was 9%(39/429) for pneumonia, 20%(13/65) for meningitis, 10.9%(14/128) for bacteremia, and 37.5%(3/8) for meningitis plus pneumonia. 41 isolates(59%) were serotyped, and the ones with the highest case fatality rate were serotype 3 with 11.6%(5/43), serotype 14 with 10.7%(7/65), and serotype 19A with 8.9%(10/112). 14 cases(20%) had decreased susceptibility to penicillin.

Conclusions

Mortality from IPD is higher in children under two years. The highest lethality was found in patients with meningitis plus pneumonia, and the most lethal serotype was 3.Permanent monitoring of mortality by IPD after the implementation of mass vaccination with PCV10 is necessary.

Hide

FREQUENCY, CLINICAL AND MICROBIOLOGICAL CHARACTERISTICS, AND OUTCOMES OF PRIMARY BACTEREMIA BY STREPTOCOCCUS PNEUMONIAE IN CHILDREN TREATED AT COLOMBIAN TERTIARY CARE CENTERS 2017 - 2019 (ID 280)

Session Name
Clinical Sciences - Disease Burden in Infants, Children/Youth, and Adults
Presenter
Authors

Abstract

Background

Invasive pneumococcal disease is a common cause of morbidity and mortality among children, with a case fatality rate of about 8% in children under 5 years. The frequency of primary bacteremia is 20% of the IPD in children under 2 years.

Methods

Observational, descriptive, longitudinal study. Data were obtained from 40 medical records of patients under 18 years diagnosed with bacteremia by pneumococcus and treated in Neumocolombia network hospitals in 2017-2019. A univariate analysis was performed using frequency and bivariate tables with non-parametric Kruskal-Wallis.

Results

60% of the patients were male. Median age was 24 months (IQR 10 - 48). 52% of the patients were under the age of 2; lethality was 10% and immunization with PCV was 10 50%. The most frequent serotype was 19A, followed by 23B, and 25A(20%, 7.5% and 5.0%, respectively). Resistance to erythromycin was 37.5%, to clindamycin 32.5%, penicillin 22.5% and ceftriaxone 15%. 30% of the children were admitted to the ICU. The average hospital stay was 11 days, and 2.5 days in the ICU.

Conclusions

Primary bacteremia by S. pneumoniae in Colombia has a 10% case fatality rate in children under 2 years, the most frequent serotype being 19A. Penicillin resistance was found in 22.5%.

Hide