1222. Two Year Survey of Pneumococcal Serotype Distribution in Invasive Pneumococcal Disease among Adults in Belgium
Session: Poster Abstract Session: Pneumococcal Epidemiology
Saturday, October 22, 2011
Room: Poster Hall B1
Handouts
  • Adult-IPD-Poster_1024x576.pdf (2.1 MB)
  • Background: 

    An ongoing IPD surveillance network in Belgium started in 2009 aiming to

    -document the distribution and antibiotic susceptibility of Streptococcus pneumoniae serotypes responsible for IPD in adults 

    -document the mortality and morbidity of IPD in the same population

    -estimate the potential coverage provided by the 13-valent conjugated pneumococcal vaccine.

    Methods: Prospective, active surveillance of IPD in hospitalized adults. Isolation of S. pneumoniae from culture of a normally sterile site by hospital microbiological laboratories. Fifty hospitals (44% of acute hospitals) participated in the surveillance network. The clinical presentation, complications and mortality caused by an IPD were evaluated and documented during hospital stay, at and 1 month after discharge

    Results: 

    In 2009, only patients older than 50 with IPD were targeted and a total of 551 (mean age 71.7 range 50-88) included. In 2010 the study was extended to adults from 18 years of age and 693 patients were included  (mean age 63.6, range 18-98). Of these, 506 patients were evaluable and  79.4% had pneumonia with bacteremia, 7.3% had empyema, 4.2% had meningitis, 6.5% had primary bacteremia. The mean duration of hospitalization was 17.7 days. ICU admission was required for 33% of patients, with a mean duration of 9.1 days. A total of 95 (18.8%) died during hospitalization. Mortality ranged from 8.8% in the 18-49 year old to 29% in the 75+ age group.

    Serotypes 7F, 1, 19A and 3 accounted for 42% of all IPD. The most frequent types were 7F, 1 and 19A in pneumonia and 1 (24.3%) in empyema.  Compared to the 50+ population in 2009, there was an increase in cases with 7F and 1 due to preponderance in the 18 to 49 age group. Penicillin non susceptibility was mainly present in serotype 19A and affected 12% of isolates, similar to the year before.

    60% of the serotypes identified are included in the 13-valent conjugated pneumococcal vaccine.

    Conclusion: This study shows that IPD in Belgium has a high morbidity and mortality with a case fatality rate of 1 in 5.


    Subject Category: C. Clinical studies of bacterial infections and antibacterials including sexually transmitted diseases and mycobacterial infections (surveys, epidemiology, and clinical trials)

    Jan Verhaegen, MD, PhD, Microbiology, University Hospitals Leuven, Leuven, Belgium, Willy E Peetermans, MD, PhD, General Internal Medicine and Infectious Diseases, University Hospitals Leuven, Leuven, Belgium, Johan Flamaing, MD, PhD, Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium, Pierre Van Damme, MD PhD, Ctr. for the Evaluation of Vacc. (WHO Collaborating Ctr.), Univ. of Antwerp, Antwerp, Belgium, Yves Van Laethem, MD, infectiology, University Hospital St Pierre, Brussels, Belgium, Koen Van Herck, MD PhD, Public Health, University of Ghent, Ghent, Belgium and Filip Surmont, MD, Specialty Care, Pfizer, Brussels, Belgium

    Disclosures:

    J. Verhaegen, Pfizer: Investigator and Scientific Advisor, Consulting fee and Research support

    W. E. Peetermans, Pfizer: Investigator and Scientific Advisor, Consulting fee and Research support

    J. Flamaing, Pfizer: Scientific Advisor, Consulting fee

    P. Van Damme, pfizer: Scientific Advisor, Consulting fee

    Y. Van Laethem, pfizer: Scientific Advisor, Consulting fee

    K. Van Herck, Pfizer: Investigator and Scientific Advisor, Consulting fee and Research support

    F. Surmont, Pfizer: Employee, Salary

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.