1221. Burden of Invasive Pneumococcal Disease (IPD) in Hospitalized Children Less Than 5 Years Old and Asociated Direct Costs in a Country without Universal Pneumococcal Vaccination Program
Session: Poster Abstract Session: Pneumococcal Epidemiology
Saturday, October 22, 2011
Room: Poster Hall B1
Handouts
  • LOPEZ EL ET AL (1221).pdf (304.9 kB)
  • Background: There is a lack of data of an hospitalized active surveillance of pneumococcal disease in a latin american country without pneumococcal universal immunization program,  where it is estimated that 2% of hospitalization are due to suspected pneumococcal infections Objective: to evaluate burden and associated costs of IPD in hospitalized children <5yr old in Argentina

    Methods: prospective, observational, multicenter study: inclusion criteria: hospitalized children, <5 yr old, isolation of Spneumoniae in ID or segmental or lobar consolidated pneumonia (CP) (according to WHO criteria). Exclusion: identification of other causative pathogen. Pneumococcal serotyping was performed

    Results: 

    In 7 centers across the country 653 pts were enrolled and 18 (2.7%) excluded because of other organism was identified. Female:  341(51.6%); median age: 16 mo; 416(65.3%) <24 mo; 13(1.9%) had received PCV7. Most prevalent risk factors were: smokers at home: 326(51%); moderate or serious asthma 107(16.5%); prematurity/low weight at birth 95(14.6%). Diagnostic of pneumococcal pneumonia was established in 101(15.8%); complicated pneumonia including empyema 103 (16.1%); consolidated pneumonia 336 (51.5%); meningitis 29(4.5%); peritonitis 7(1.1%); arthritis 7(1.1%); cellulitis 2(0.3%). Overall, Spneumoniae was identified as causative in 121 pts (18.5%). The frequency of serotypes was: 14(42.1%); 1(14.9%); 5(11.6%); 6B:7.4%); 3(6.6%); 7F(4.1%); 9(4.1%); 19F(2.5%); 23F(2.5%); 19A(1.7%); 19B(1.8%);18C(0.8%); 12(0.8%).Complications and sequelae occurred in 20.2% of pts <24 mo and 48.5% 25-60mo; most frequent was peel pleural. Mortality rate: 12(1.9%). Required ICU 11.1% (media: 9 days). Hospital stay: media 8.7 days. Direct costs hospitalization by patient: U$S2,115.10

    Conclusion: 

    • Most of hospitalized pts by IPD were <24mo of age
    • More than 82% of children had associated risk factors
    • The pneumococcal immunization rate is very low in our setting
    • According to serotype distribution in pts with IPD the coverage by pneumococcal conjugated vaccines could be: PCV7: 56%; PCV10:87%; PCV13: 95% 

     


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

    Eduardo L. López, MD1, María M. Contrini, MD1, Eduardo Glatstein, MD2, Silvia Gonzalez Ayala, MD3, Cristina Ciriaci, MD4, Gustavo Ezcurra, MD5, Marisa Iacono, MD6, Eduardo Teplitz, MD7, Manuela Gamarra, PhD1, Miryan Vazquez, PhD1, Adriana Procopio, PhD1, Alejandro Cane, MD8 and Gail Rodgers, MD9, (1)Hospital de Niños R. Gutiérrez, Buenos Aires, Argentina, (2)Hospital de Niños SantisimaTrinidad, Cordoba, Buenos Aires, Argentina, (3)Hospital Sor Maria Ludovica, La Plata, Buenos Aires, Argentina, (4)Hospital Interzonal Especializado Materno Infantil, Mar del Plata, Buenos Aires, Argentina, (5)Hospital de Niños Orlando Alasia, Santa Fe, Buenos Aires, Argentina, (6)Hospital Provincial de Neuquèn, Buenos Aires, Argentina, (7)Hospital Italiano, Bahìa Blanca, Buenos Aires, Argentina, (8)Vaccines, Pfizer Vaccines Latin America, Buenos Aires , Argentina, (9)Pfizer Vaccine Research, Philadelphia, PA

    Disclosures:

    E. L. López, None

    M. M. Contrini, None

    E. Glatstein, None

    S. Gonzalez Ayala, None

    C. Ciriaci, None

    G. Ezcurra, None

    M. Iacono, None

    E. Teplitz, None

    M. Gamarra, None

    M. Vazquez, None

    A. Procopio, None

    A. Cane, Pfizer Vaccines Latin America: Employee, Salary

    G. Rodgers, Pfizer Vaccine Research: Member, Research grant

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