Shally Awasthi, India

King George`s Medical University Paediatrics

Presenter of 2 Presentations

NASOPHARYNGEAL CARRIAGE OF STREPTOCOCCUS PNEUMONIAE SEROTYPES AMONG HEALTHY CHILDREN IN NORTH INDIA (ID 318)

Abstract

Background

Streptococcus pneumonia (SP) causes morbidity and mortality among children worldwide. India introduced 13-valent pneumococcal conjugate vaccine (PCV-13) in 2017. Current study was conducted to isolate SP from nasopharyngeal (NP) swabs of healthy children and assess changes in serotypes among PCV vaccinated and unvaccinated children.

Methods

Cross-sectional study was conducted (July-August 2019) in Lucknow District, North India. Children (2-59 months) who had no clear illness/hospitalization (last one-month) were recruited from vaccination-clinics of hospitals. After NP specimen collection, bacterial culture was done using 5% sheep agar-blood plate containing gentamicin. Pneumococcal isolates were identified by optochin-sensitivity and bile-solubility. Serotyping was done using Quellung Method

Results

Of 300 children, 56.7%(170/300) were males and 52.0%(156/300) were 2-11 months. Overall SP colonization rate was 37.6% (113/300). Vaccine serotypes isolated were 18C,19A,19F,23F,3,4,6A,6B,9V. Among 60% (181/300) PCV vaccinated, SP positivity was 37.5% (68/181) and vaccine serotype were 39.7% (27/68). Among 40% (119/300) non-PCV vaccinated-children, 37.8%(47/119)had NP colonization positive and PCV-13 serotypes were 37.7%(17/47). Non-Vaccine serotypes were 10A,15A,15B,15C,21,34,35B,22F and similar in vaccinated and unvaccinated children.

Conclusions

About 4 of 10 healthy children had NP colonization with SP and around 40% serotypes were covered by PCV-13. Our preliminary data suggests that SP colonization rate and serotype isolates were similar in vaccinated and unvaccinated children

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EFFECT OF PNEUMOCOCCAL CONJUGATE VACCINATION ON RADIOLOGICAL FINDINGS IN CHEST IN INFANTS HOSPITALIZED WITH COMMUNITY ACQUIRED PNEUMONIA IN NORTHERN INDIA: A CASE-CONTROL STUDY (ID 519)

Abstract

Background

Burden of community acquired pneumonia (CAP) among infants is high in India. Pneumococcal Conjugate Vaccination(PCV) has been introduced in India since 2017 in a phased manner. Our aim was to study the effect of PCV on radiological findings of chest in infants hospitalized with WHO-defined CAP.

Methods

Prospective, hospital-based pneumonia surveillance in four districts of North India. Infants(2-11 months) hospitalized with CAP from index districts with<14 days of symptoms were recruited. Clinical data was abstracted. Chest X-rays(CXRs) were interpreted by a panel of three independent blinded radiologists.

Results

From May,2017-October,2018, 282 (22.7% females) infants with PCV vaccination (cases) and 570 (29.8% females) without PCV vaccination (controls) with interpretable CXRs were analyzed. Primary end point pneumonia (PEP)+other infiltrate (OI) were found in 43(15.2%) cases and 140(24.7%) controls (p=0.001); OI in 30(10.6%) cases and 69(12.1%) controls (p=0.5) and normal CXR in 209(74.1%) cases and 361(63.3%) controls (p=0.001). There was one death among cases whose CXR showed OI. There were 22 deaths among controls whose CXRs showed PEP + OI in 12(54.6%); OI in 3(13.6%) and normal 7(31.8%). Crude odds ratio for death (cases) was 0.088 (95 %: CI 0.012-0.66).

Conclusions

Among hospitalized patients of CAP, radiological findings differ by PCV vaccination status in infants.

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Author Of 3 Presentations

EFFECT OF PNEUMOCOCCAL CONJUGATE VACCINATION ON RADIOLOGICAL FINDINGS IN CHEST IN INFANTS HOSPITALIZED WITH COMMUNITY ACQUIRED PNEUMONIA IN NORTHERN INDIA: A CASE-CONTROL STUDY (ID 519)

Abstract

Background

Burden of community acquired pneumonia (CAP) among infants is high in India. Pneumococcal Conjugate Vaccination(PCV) has been introduced in India since 2017 in a phased manner. Our aim was to study the effect of PCV on radiological findings of chest in infants hospitalized with WHO-defined CAP.

Methods

Prospective, hospital-based pneumonia surveillance in four districts of North India. Infants(2-11 months) hospitalized with CAP from index districts with<14 days of symptoms were recruited. Clinical data was abstracted. Chest X-rays(CXRs) were interpreted by a panel of three independent blinded radiologists.

Results

From May,2017-October,2018, 282 (22.7% females) infants with PCV vaccination (cases) and 570 (29.8% females) without PCV vaccination (controls) with interpretable CXRs were analyzed. Primary end point pneumonia (PEP)+other infiltrate (OI) were found in 43(15.2%) cases and 140(24.7%) controls (p=0.001); OI in 30(10.6%) cases and 69(12.1%) controls (p=0.5) and normal CXR in 209(74.1%) cases and 361(63.3%) controls (p=0.001). There was one death among cases whose CXR showed OI. There were 22 deaths among controls whose CXRs showed PEP + OI in 12(54.6%); OI in 3(13.6%) and normal 7(31.8%). Crude odds ratio for death (cases) was 0.088 (95 %: CI 0.012-0.66).

Conclusions

Among hospitalized patients of CAP, radiological findings differ by PCV vaccination status in infants.

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NASOPHARYNGEAL CARRIAGE OF STREPTOCOCCUS PNEUMONIAE SEROTYPES AMONG HEALTHY CHILDREN IN NORTH INDIA (ID 318)

Abstract

Background

Streptococcus pneumonia (SP) causes morbidity and mortality among children worldwide. India introduced 13-valent pneumococcal conjugate vaccine (PCV-13) in 2017. Current study was conducted to isolate SP from nasopharyngeal (NP) swabs of healthy children and assess changes in serotypes among PCV vaccinated and unvaccinated children.

Methods

Cross-sectional study was conducted (July-August 2019) in Lucknow District, North India. Children (2-59 months) who had no clear illness/hospitalization (last one-month) were recruited from vaccination-clinics of hospitals. After NP specimen collection, bacterial culture was done using 5% sheep agar-blood plate containing gentamicin. Pneumococcal isolates were identified by optochin-sensitivity and bile-solubility. Serotyping was done using Quellung Method

Results

Of 300 children, 56.7%(170/300) were males and 52.0%(156/300) were 2-11 months. Overall SP colonization rate was 37.6% (113/300). Vaccine serotypes isolated were 18C,19A,19F,23F,3,4,6A,6B,9V. Among 60% (181/300) PCV vaccinated, SP positivity was 37.5% (68/181) and vaccine serotype were 39.7% (27/68). Among 40% (119/300) non-PCV vaccinated-children, 37.8%(47/119)had NP colonization positive and PCV-13 serotypes were 37.7%(17/47). Non-Vaccine serotypes were 10A,15A,15B,15C,21,34,35B,22F and similar in vaccinated and unvaccinated children.

Conclusions

About 4 of 10 healthy children had NP colonization with SP and around 40% serotypes were covered by PCV-13. Our preliminary data suggests that SP colonization rate and serotype isolates were similar in vaccinated and unvaccinated children

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CHEST-RADIOGRAPH FINDINGS IN CHILDREN (2-59 MONTHS) HOSPITALIZED WITH COMMUNITY-ACQUIRED PNEUMONIA, PRIOR TO INTRODUCTION OF PNEUMOCOCCAL CONJUGATE VACCINE IN INDIA- A PROSPECTIVE OBSERVATIONAL STUDY (ID 364)