1460. Community-acquired Bacteremic Pneumonia in Post-Pneumococcal Vaccination Era in a Pediatric Hospital.
Session: Poster Abstract Session: Respiratory Infections: CAP
Friday, October 5, 2018
Room: S Poster Hall
Posters
  • Poster 1460.pdf (805.7 kB)
  • Background: From January 2012 PCV13 was introduced into immunization program in Argentina, 2+1 schedule for <2 years. The aims of this study were to describe epidemiological-clinical pattern of community-acquired bacteremic pneumonia (CABP) in the post-Vaccination period and the risks factors of CABP occurrence, complications and lethality.

    Methods: Cross-sectional study was performed in children with CABP diagnosis, hospitalized in Ricardo Gutierrez Children’s Hospital from January 2012 to December 2017.

    Results: A total of 135 CABP cases were included; 63% male; 31.1% <2 years; 75% of <5 years received PCV13; 30.4% had underlying diseases. The pathogens isolated were (n=136): Streptococcus pneumoniae (Sp) 44.9% (all susceptible to Penicillin), Staphylococcus aureus (Sa) 37,5% (Methicillin-Resistant 90,2%), Haemophilus influenzae (Hi) 15.4% (33.3% non-typable Hi), Beta-hemolytic Streptococci Group A 1.5% and Neisseria meningitidis 0,7%. Seventy one percent of cases had complications (pleural effusion 63%, necrotizing pneumonia 11.1%, pneumothorax 8.1%, lung abscess 3,7%, atelectasis 0.7%). Other clinical manifestations combined with CABP were: sepsis 20%, cellulitis/abscess 9.6%, arthritis 6.7%, meningitis 5.9% and osteomyelitis 3.7%. Condensation was the predominant radiological pattern for all agents in 88.1%. Lethality rate was 3%. Sp was more associated with age ≥24 months [OR 2.78 (1.18-6.64)] and Hi was more associated with age <24 months [OR 4.76 (1.62-14.31)]. Complications were significantly higher among Sa pneumonia cases. Children with CABP and sepsis or arthritis had higher lethality [OR 13.38 (1.14-355.45) and OR 17.71 (1.46-223.73)] respectively.

    Conclusion: After PCV13 introduction Sp was still the most common organism causing CABP, mainly in ≥24 months of age. Sa followed in frequency with high morbility. CABP combined with other clinical manifestations were more associated with lethality.

    Angela Gentile, MD, Julia Bakir, MD, Maria Florencia Lucion, MD, Maria Del Valle Juarez, MD, Solana Rapaport, MD and Maria Soledad Areso, MD, Epidemiology, Hospital de Niños "Ricardo Gutiérrez", Buenos Aires, Argentina

    Disclosures:

    A. Gentile, None

    J. Bakir, None

    M. F. Lucion, None

    M. D. V. Juarez, None

    S. Rapaport, None

    M. S. Areso, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.