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O085 - CLINICAL AND MICROBIOLOGICAL PROFILE OF IPD IN HOSPITALIZED PATIENTS IN A TERTIARY BRAZILIAN HOSPITAL, 2000-2021 (ID 507)
Abstract
Background
A pneumococcal conjugate vaccine was introduced in Brazilian National Vaccination Program in 2010. This ongoing prospective study evaluates the effect of PCV10 use on the clinical and microbiological characteristics of IPD in all ages over the last 21 years in a single tertiary hospital in Sao Paulo, Brazil.
Methods
In our ongoing hospital-based surveillance study, all culture-positive IPD cases groups were evaluated from January 1, 2000, through December 31, 2021, in all ages. Serotypes, clinical characteristics, and outcomes were analyzed according to the pre-vaccination period (2000-2009) and post-vaccination period (2010-2021)
Results
701 isolates were recovered, of which 81.6% were serotyped. Nearly 71% of the pre-vaccination strains were PCV10 serotypes and declined to 38.8% in the post-vaccine era. Conversely, serotypes 3, 6A e 19A altogether increased from 7.6% to 15.5%; unique PPSV23 serotypes increased from 12.7% to 23.3% and non-vaccine serotypes (NVT) increased from 9% to 21.3%. Smoking (22.5%), alcohol and substance misuse (20.7%), cardiovascular diseases (18%), neoplastic diseases (13.5%), chronic respiratory disease (10.2%), HIV (9%), and homelessness (8.7%) are the leading risk factors in the post-vaccine period – driven largely by adults. Approximately 43% required intensive care; Overall, CFR was 24.5%, increased with age, and peaked among those with comorbidities (range: 19-47%).
Conclusions
Contrasting with the pre-vaccine era, IPD has turned into a disease affecting adults with comorbidities. The relative significance of non-PCV10 serotypes has almost doubled in the post-PCV10 period. ICU need and CFR remained high and varied widely across age groups, increased-risk conditions, and period studied.