Welcome to the WSPID 2022 Virtual Congress Calendar
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Pre-Congress days – 20-21 February
Main Congress days – 22-24 February
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DIFFERENTIAL IMPACT OF NONPHARMACEUTICAL INTERVENTIONS ON PEDIATRIC INVASIVE BACTERIAL INFECTIONS
Abstract
Background
Invasive bacterial infection (IBI) remains a major burden of mortality and morbidity in children. As coronavirus disease 2019 (COVID-19) emerged, stringent non-pharmaceutical interventions (NPIs) were applied worldwide.
Aims
This study aimed to evaluate the impact of NPIs on the epidemiological change in pediatric IBI in Korea.
Methods
From January 2018 to December 2020, surveillance for pediatric IBIs caused by nine pathogens was maintained at 22 hospitals throughout Korea. Annual incidence rates of the IBIs were compared by pathogen and before and after the COVID-19 pandemic.
Results
A total of 655 cases were identified and the annual incidence was 196.2 cases per 100,000 in-patients in 2018, 170.8 in 2019, and 172.4 in 2020. The median age was 10.0 months (range, 0-226 months). Most common pathogen by age group was S. agalactiae in infants <3 months of age (46.6%), S. aureus in 3 – <24 months of age (36.8%), Salmonella spp. in 24 – <60 months of age (34.3%), S. aureus in children ≥5 years of age (60.4%). Compared to 2018-2019, the incidence rate in 2020 decreased by 55% for invasive pneumococcal disease (26.6 vs. 11.5 per 100,000 in-patients, p=0.014) and by 59% for Salmonella spp. infection (22.8 vs. 9.4 per 100,000 in-patients, p=0.018). In contrast, no significant changes were observed in invasive infections due to S. aureus, S. agalactiae, and E. coli during the study period.
Conclusions
The NPIs implemented during the COVID-19 pandemic reduced invasive diseases caused by S. pneumoniae and Salmonella spp., but not S. aureus, S. agalactiae, and E. coli in children.
TIME TO POSITIVITY OF BLOOD CULTURES IN A PEDIATRIC HOSPITAL: A 6 YEARS’ EXPERIENCE IN BOGOTÁ, COLOMBIA
Abstract
Background
Time to positivity(TTP) is the time between the beginning of incubation and detection of growth in an automated system for blood culture. Some studies have found that TTP are related to prognosis in bacteremia. The diagnostic and prognostic value of TPP in pediatrics are related with high inoculum and small TTP, but few studies describe it.
Aims
To describe the TTP of 6 years of blood cultures in a Pediatric Hospital in Bogotá, Colombia.
Methods
We conducted a retrospective descriptive study of TTP in 6 years(2015-2020) in a Pediatric Hospital in Colombia. We obtained information of time to positivity using BD-Epicenter. We analyzed it with R4.0.3.
Results
We included 1258 blood cultures. Most frequent pathogen was coagulase-negative Staphylococci(CoNS) (409–32,5%), followed by S. aureus (264–20,9%), E. coli (176–14%), K. pneumoniae (68–5,4%), Streptococcus viridans (64-5,1%) and pneumococcus (29–2,3%). CoNS was most common in newborns and infants, and S. aureus in children and adolescents. Median TTP for S. aureus was 15 hours(IQR 12.3–18.6), E. coli 10.1 hours(IQR8.6–11.5), K. pneumoniae 9.5 hours (IQR8.3–10.9), Streptococcus viridans 14.1 hours (IQR12.1–16.1) and pneumococcus was 10.7 hours(IQR8.5-11.6). CoNS have a delayed growth (median 19.6h IQR17.1–23.2) related with contamination. TTP change the proportion of different organisms; <15 hours are frequent for pneumococcus and K. pneumoniae, >50 hours another pathogens (ie.Yeast) and contamination with CoNS are frequent.
Conclusions
TTP in pediatrics related to pathogenic isolates are practically always less that one day and common pathogens in Pediatrics usually growth in the first 14 hours. The TTP could change the probability of obtaining different pathogens.
CAMPYLOBACTER INFECTION: A CROSS SECTIONAL COMPARATIVE STUDY AMONG CHILDREN AGED 2 TO 59 MONTHS IN DAR ES SALAAM, TANZANIA
Abstract
Background
Campylobacter species have been recognized as the leading cause of bacterial enteritis in both developed and developing countries, and the prevalence of Campylobacter infection in children under five years has been reported to be higher than in adults
Aims
This study aimed to determine the prevalence and risk factors for Campylobacter infection in children with diarrhea and those without diarrhea in Dar es Salaam Tanzania.
Methods
A hospital based cross sectional comparative study was conducted from October 2016 to April 2017. A total of 617 children (312 with diarrhea and 305 without diarrhea) at the main hospitals and their respective Reproductive and Child Health (RCH-1) clinics were enrolled. Stool samples were collected and tested for Campylobacter infection, while blood samples were collected and tested for malaria and HIV.
Results
We found no significant difference in the prevalence of Campylobacter infection among children with diarrhea (16.7%) and those without diarrhea (16.4%) (p-value = 0.927). Drinking unboiled water was significantly associated with Campylobacter infection among children with diarrhea (p-value=0.045), while chicken keeping and HIV infection were significantly associated with Campylobacter infection in children without diarrhea (p-value=0.025 and 0.001 respectively)
Conclusions
Campylobacter infection is prevalent in both children with and without diarrhea. Consumption of unboiled water increases the risk of developing diarrhea in children with Campylobacter infection.
EXTENSIVELY DRUG-RESISTANT (XDR) GRAM-NEGATIVE BACTERIAL SEPSIS AMONG NEONATES FROM LMIC: A RETROSPECTIVE COHORT STUDY
Abstract
Background
Extensively drug-resistant (XDR) Gram-negative bacterial (GNB) sepsis is emerging as a new threat among neonates admitted in Neonatal Intensive Care Unit (NICU).
Aims
To determine the proportion of neonates, the pathogen profile and outcome of XDR-GNB neonatal sepsis, in a newly established Level III NICU in Western India.
Methods
The data of all neonates admitted in NICU from July 2016 to June 2021 was retrospectively analyzed from our database. Standard CDC definition was used to define multi-drug resistance (MDR) and XDR.
Results
Of the total of 1230 NICU admissions, 973 were inborn and 257 were outborn neonates. The incidence of total and culture positive sepsis was 31.5% (387/1230) and 11.7% (144/1230) respectively. There were a total of 194 bacterial isolates with 73.2% (142) being GNB. Out of these, 73.2% (104) were MDR and 33.8% (48) were XDR GNB isolates. Fifty eight percent of XDR GNB were isolated from outborn referred neonates. Neonates with XDR GNB sepsis accounted for one third of the total neonates with culture positive sepsis. The distribution of these XDR GNB isolates was: Klebsiella (n=21, 44%), Acinetobacter (n=18, 38%), Escherichia species (n=6, 13%), Enterobacter (n=1; 2%), Citrobacter (n=1, 2%) and Chrysobacterium (n=1, 2%). Among 142 GNB isolates, 58% of Acinetobacter, 44% of Klebsiella and 38% of Escherichia were XDR. The case fatality rate was almost double among neonates with XDR GNB sepsis as compared to non-XDR GNB sepsis (RR 1.97 [95% CI 1.11-3.51; p 0.021]).
Conclusions
XDR-GNB accounted for one-third of the total GNB isolates with almost double case fatality rate.
NON-TUBERCULOUS MYCOBACTERIAL CERVICOFACIAL LYMPHADENITIS IN CHILDREN – 10 YEAR EXPERIENCE IN A TERTIARY PAEDIATRIC CENTRE
Abstract
Background
Non-tuberculous mycobacteria (NTM) lymphadenitis in children is increasingly recognised, and poses diagnostic and therapeutic challenges.
Aims
To describe the epidemiology and clinical features of NTM lymphadenitis, determine sampling diagnostic yield, and review management and outcomes.
Methods
We performed a 10 year retrospective review (2011-2021) of children aged 0-16 years with NTM lymphadenitis. Diagnosis was based on typical clinical features in the presence of positive histological finding of granulomatous inflammation, culture, or direct polymerase chain reaction testing. Data collection included demographics, risk factors, clinical features, investigations, treatment, complications and outcomes.
Results
Forty-five children had 48 episodes of NTM lymphadenitis; 62.2% female, mean age 80 months (range 12-166 months). 43.7% presented with unilateral single node, most commonly parotid (39.6%), and submandibular (29.2%). 20.8% had reported fever. Three patients with disseminated NTM infection had pre-existing (n=2) or newly diagnosed (n=1) immunodeficiency. Sixty-seven sampling procedures were performed; NTM was identified in 23/64 (35.9%) specimens sent, from culture (n=16) or sequencing (n=7). NTM was identified in 22/48 episodes (45.8%). Mycobacterium abscessus was most common (11/23, 47.8%), followed by Mycobacterium haemophilum (6/23, 26.1%). Surgery was performed in 45/48 episodes (98.3%). 38 children (79.2%) received antibiotics; mean duration 4.96 months (range 0.75-19 months). Outcomes for 43 episodes showed 69.8% fully resolved, 27.9% relapsed at a new site, 2.3% recurred. 10/45 (22.2%) had post-surgical complications and 11/38 (28.9%) developed adverse drug reactions.
Conclusions
Mycobacterium abscessus lymphadenitis was most commonly identified. Culture yield was low but molecular sequencing improved diagnosis. About 1/3 had relapse or recurrence, and 1/4 had treatment complications..
EXPOSURE TO INDOOR FUNGAL AEROSOLS AND LOWER RESPIRATORY TRACT INFECTIONS AMONG HOSPITALIZED UNDER-FIVE CHILDREN IN IBADAN, NIGERIA
Abstract
Background
Previous epidemiological studies have documented the household factors associated with childhood lower respiratory tract infections (LRTI), but only very few studies have explored the dose-response relationship between residential microbial diversity and childhood LRTI.
Aims
This study aimed to investigate the association between exposure to diverse indoor fungal aerosols and LRTI among under-five children in Ibadan, Nigeria.
Methods
In-home visits were conducted among 178 under-five children with LRTI matched by age (±3months), sex, and geographical location with 180 community-based under-five children without LRTI in Ibadan, Nigeria. Trained study staff sampled the indoor environment for fungal exposures using active sampling approach. Indoor total fungal count (TFC) was estimated and dichotomized into high (>median) and low (≤median) exposures. Alpha diversity measures including richness (R), Shannon (H), and Simpson (D) indices were also estimated. Conditional logistic regression models were used to test association between exposure to indoor fungal aerosols and LRTI risk among under-five children.
Results
The mean (SD) age of participants was 7.3 (1.35) months with a male preponderance (61.0%). Median TFC was higher in homes of cases (66 cfu/m3) than controls (49cfu/m3). Higher fungal diversities were found in homes of cases (R=2.56; H=0.82; D=2.33) than controls (R=1.89; H=0.55; D=1.88). In the multivariate models, higher categories of exposure to indoor TFC (OR=2.75, 95%CI=1.54–4.89), fungal richness (OR=3.17, 95%CI=1.65–6.07), and fungal diversity (OR=3.00, 95%CI=1.55–5.79) were independently associated with childhood LRTI risk.
Conclusions
Our study suggests an increased risk of LRTI when children under the age of five years are exposed to high levels of indoor fungal aerosols.