2294. Continuous Pneumococcal Invasive Disease reduction, high impact on pneumococcal empyemas and meningitis, and serotype 19A disappearance following PCV-13 vaccination in children: eleven and a half years of Active Surveillance in a Mexican hospital on the U.S. border
Session: Poster Abstract Session: Pediatric Bacterial Infections: From A to Z
Saturday, October 7, 2017
Room: Poster Hall CD
Posters
  • Poster IDSA 2017.pdf (2.1 MB)
  • <>Background:The Tijuana, Mexico and San Diego, California, is the world’s most transited frontier. We have previously published pneumococcal serotype replacement following PCV-7 introduction, especially by serotypes 19-A, 3 and 6A/C. Since May/2012 universal vaccination with PCV-13 was introduced for all children. This study analyzes the effectiveness of PCV-13 after its implementation in the region.

    <>Methods: Since October/2005 until March/2017 (11.5 years) we underwent an active surveillance for all Invasive Pneumococcal Diseases (IPD) in children < 16 years admitted at the Tijuana General Hospital. Only culture-confirmed cases were included. Following identification, serotyping was performed using the Quellung Reaction (Statens Serum Institute® Copenhagen, Denmark). Descriptive analysis was performed using Excel®.

    <>Results: Fifty seven cases of confirmed IPD were found. Clinical diagnosis were pleural empyemas (PPE) (45.6%), meningitis (PM) (28%), otomastoiditis (15.7%), only sepsis (7%), and bacteremic pneumonia (3.5%). Median age was of 3.9 years (2 days – 15.9 years), median hospitalization days was of 14 (1-90). Overall mortality was of 6 (10.5%). Following PCV13 introduction there was a decreased on overall IPD mortality by 73.29%, overall IPD by 68%, PPE by 68.1%, and PM by 55.4%. However, during 2015-16, we had three PM cases, two of which were immunocompromised patients, and none vaccinated with PCV13. From an average of 1.75 yearly cases due to pneumococcal serotype 19-A before PCV13 implementation, there had been no patients with IPD’s caused by this serotype. (See Figure 1). After PCV13 vaccination, serotypes associated with IPD cases had been as follow: Two 22F, and one each by 6A, 18C, 3, 7F, 15, 7B, 35B, 24F and 33F.

    <>Conclusion: This is the first Mexican study based on active surveillance that shows consistent effectiveness of PCV-13 on reduction of overall IPD, disappearance of pneumococcal serotype 19-A, and strong impact on PPE in children. Effectiveness on PM is still above 50%, however, during 2015-16 there had been three cases, but with particular conditions (immunodeficiencies and no vaccination). Continuous active surveillance is mandatory.

    <>

    Enrique Chacon-Cruz, MD1, Jorge Arturo Alvelais-Palacios, MD, PhD2, Erika Zoe Lopatynsky-Reyes, MD3, Maria Luisa Volker-Soberanes, PhD4 and Rosa Maria Rivas-Landeros, PhD4, (1)Pediatrics, Hospital General de Tijuana, Tijuana, Baja-California, Mexico, (2)School of Medicine, Universidad Autonoma de Baja California, ECISALUD, Tijuana, Mexico, (3)School of Public Health, University of California-San Diego, San Diego, CA, (4)Microbiology, Hospital General de Tijuana, Tijuana, Baja-California, Mexico

    Disclosures:

    E. Chacon-Cruz, None

    J. A. Alvelais-Palacios, None

    E. Z. Lopatynsky-Reyes, None

    M. L. Volker-Soberanes, None

    R. M. Rivas-Landeros, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 4th with the exception of research findings presented at the IDWeek press conferences.