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
<>Background:The Tijuana, Mexico
and San Diego, California, is the worlds most transited frontier. We havepreviouslypublishedpneumococcalserotypereplacementfollowing PCV-7introduction, especiallybyserotypes 19-A, 3 and 6A/C.
Since May/2012 universal vaccinationwith PCV-13 wasintroducedfor all children. This
study analyzes the effectiveness of PCV-13 after its implementation in theregion.
untilMarch/2017 (11.5 years) weunderwent 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 wasperformedusing Excel®.
<>Results:Fiftyseven 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 introductiontherewas a decreasedon overall IPD mortalityby 73.29%,overall
IPD by 68%, PPE by68.1%, and PM by 55.4%. However, during 2015-16, wehadthreePM cases,
two of which
wereimmunocompromisedpatients, and nonevaccinatedwith PCV13. From an average
of 1.75 yearly cases due to pneumococcalserotype 19-Abefore PCV13 implementation, therehadbeen no patientswithIPDscausedbythisserotype. (See
Figure 1). After PCV13 vaccination,serotypesassociatedwith IPD cases hadbeen as follow: Two 22F, and oneeach by 6A, 18C, 3, 7F, 15, 7B, 35B, 24F and 33F.
of PCV-13 onreduction of overall IPD, disappearance of pneumococcalserotype 19-A, and strongimpactonPPE 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
J. A. Alvelais-Palacios,
None E. Z. Lopatynsky-Reyes,
None M. L. Volker-Soberanes,
None R. M. Rivas-Landeros,