64. Invasive Bacterial Infections in Thailand: Finding from Population-based Surveillance in Two Provinces, 2010-2013
Session: Oral Abstract Session: Bacterial Diseases
Thursday, October 8, 2015: 9:00 AM
Room: 25--ABC
Background: Invasive bacterial infections cause substantial morbidity and mortality in Thailand, but population-based data are lacking to estimate disease burden. As part of the Thailand Invasive Bacterial Infection Surveillance network, we describe incidence and in-hospital mortality of invasive bacterial pathogens in two Thai provinces.

Methods: Surveillance was conducted in Sa Kaeo (SK) in eastern and Nakhon Phanom (NP) in northeastern Thailand during 2010 – 2013. Cases were confirmed in residents of SK or NP by the isolation of Haemophilus influenzae, Streptococcus suis, Streptococcus pyogenes, Streptococcus pneumoniae, Streptococcus agalactiae or Salmonella species from a normally sterile site; or isolation of Burkholderia pseudomallei from any site.

Results:

A total of 1,035 cases were identified:  21 H. influenzae, 59 S. suis, 86 S. pyogenes, 99 S. pneumoniae, 171 S. agalactiae, 132 Salmonella spp. and 467 B. pseudomallei (418 from blood, 49 from non-sterile sites). Pathogen-specific incidences overall ranged from 0.6 to 13.8 per 100,000 persons per year and differed by province, most notably a higher incidence of S. agalactiae. S. suis and B. pseudomallei in NP (Table 1). Mortality in NP ranged between 0% for S. suis to 2.6% for B. pseudomallei. Except S. agalactiae. and B. pseudomallei; for each pathogen, mortality was higher in SK than in NP and ranged from 0.1% for H. influenzae to 1.9% for B. pseudomallei.     

Table 1 Average annual incidence and mortality rate per 100,000 persons

 

 

SK

NP

Cases

Death

Incidence

Mortality

Cases

Death

Incidence

Mortality

B. pseudomallei 

88 

32

5.2

1.9

379

45

22

2.6

S. agalactiae

27

6

1.6

0.4

144

11

8.4

0.6

Salmonella spp.

72

16

4.3

1.0

60

7

3.5

0.4

S. pneumoniae

46

16

2.8

1.0

53

5

3.1

0.3

S. pyogenes

52

15

3.1

0.9

34

5

1.9

0.3

S. suis

22

3

1.3

0.2

37

0

2.1

0

H. influenzae

12

2

0.7

0.1

9

1

0.5

0.1

Total

319

90

19.2

5.4

716

74

41.5

4.3

   Conclusion: Our findings demonstrate the value of population-based surveillance to estimate disease burden of invasive bacterial infections, including at the sub-national level. Despite the higher disease burden in NP, mortality from invasive bacterial pathogens in SK was higher; these differences demonstrate province-specific strategies may be needed for prevention, early diagnosis and optimal treatment.

Saithip Bhengsri, PhD1, Christopher Gregory, MD, MPH1,2, Somsak Thamthitiwat, MD1, Toni Whistler, PhD1,2, Surang Dejsirilert, MSc3, Sathapana Naorat, MSc1, Anchalee Jatapai, PhD1, Sayomporn Sirinavin, MD4, Wantana Paweenkittiporn, PhD5, Henry C. Baggett, MD, MPH1 and for the Invasive Bacterial Infections Study Group, (1)Global Disease Detection Center, Thailand MoPH-US CDC Collaboration, Nonthaburi, Thailand, (2)Division of Global Health Protection, CDC, Atlanta, GA, (3)Thailand National Institute of Health, Nonthaburi, Thailand, (4)Ramathibordi Hospital, Mahidol University, Bangkok, Thailand, (5)Thailand National Institution of Health, Nonthaburi, Thailand

Disclosures:

S. Bhengsri, None

C. Gregory, None

S. Thamthitiwat, None

T. Whistler, None

S. Dejsirilert, None

S. Naorat, None

A. Jatapai, None

S. Sirinavin, None

W. Paweenkittiporn, None

H. C. Baggett, None

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