1755. Pediatric Meningococcal Disease In a northern Mexican Hospital: Results of nine years of Active Surveillance
Session: Poster Abstract Session: Pediatric Bacterial Infections
Saturday, October 10, 2015
Room: Poster Hall
Posters
  • meningococo-1024x768.png (151.6 kB)
  • Background: In Mexico, Meningococcal Disease (MeD) is a notifiable condition but considered to be rare. However, we have previously published a binational study showing similar rates between Tijuana, Mexico, and San Diego, CA, and also a 2013-outbreak by N. meningitidis serogroup C (Sequence Type-11).

    Methods: Since October-2005 until September-2014, prospective active surveillance for MeD in children < 16 years old (yo) was performed in the Tijuana, Mexico, General Hospital (TGH). For all N. meningitidis isolates serogroup identification was performed by the Pastorex meningitis kit (Alere, Ltd®, Stockport, UK). Descriptive and comparative analysis was performed using Excel® and VassarStat®. Patients < 16yo during the 2013 outbreak and admitted at TGH (n=6) were not included.

    Results: A total of 38 MeD cases were diagnosed. Median age was 2.5 yo (3 months – 15 yo), two patients had a predisposing condition, one patient had been vaccinated with the 4MCV (developed a serogroup B MeD), all patients lived in Tijuana, however, 10 (26.3%) often crossed the Tijuana-San Diego border. Median days of presentation was 2 (hrs – 14), Purpura was present in 16 (42.1%) and Meningitis in 36 (94.5%). N. meningitidis was the leading cause of culture-confirmed Bacterial Meningitis (63.3%, just followed by S. pneumoniae). Serogroup distribution was as follows: C: 22 (57.9%), Y: 10 (26.3%), B: 4 (10.5%), and Unknown: 2 (5.26%). Overall mortality was of 10 (26.3%).Thrombocytopenia and prolongation of clotting times at admission were significantly associated with mortality. Sequeale was present in 9 patients (32%), mostly neurological. 

    Conclusion: 1. MeD in children is endemic in Tijuana, Mexico. 2. Serogroup C was predominant, and both mortality and sequelae were high. 3. Considering these data, and the fact of having a highly lethal MeD outbreak during 2013, vaccination should be seriously considered in the region.

    Enrique Chacon-Cruz, MD1, Rosa Maria Rivas-Landeros, PhD2 and Maria Luisa Volker-Soberanes, PhD2, (1)Pediatrics, Hospital General de Tijuana, Tijuana, Baja-California, Mexico, (2)Microbiology, Hospital General de Tijuana, Tijuana, Baja-California, Mexico

    Disclosures:

    E. Chacon-Cruz, None

    R. M. Rivas-Landeros, None

    M. L. Volker-Soberanes, None

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