Infectio (Jul 2022)
Perfil clínico y microbiológico de bacteremia primaria por Streptococcus pneumoniae en pacientes pediatricos hospitalizados a la red de atención terciaria Neumocolombia. 2017 – 2019
Abstract
Objective: To describe the clinical and microbiological characteristics and outcomes of primary S. pneumoniae bacteremia in pediatric patients hospitalized in tertiary care centers belonging to the Red Neumocolombia (2017-2019).Materials and methods:Observational, descriptive, longitudinal, exploratory study with an analytical scope. Information was obtained from clinical records reporting positive blood cultures for S. pneumoniae, without other infectious foci, performed in pediatric hospitals of the Red Neumocolombia (2017-2019).Results: Information from 51 clinical records was analyzed. 62.7% of the patients were males with a median age of 25 months (IQR 9-49). The most common symptom was fever (78.4%). Immunization with PCV-10 was reported in 47% of the cases. The most frequent serotype was 19A (39.4%) and S. pneumoniae showed non-susceptibility to erythromycin (3%), penicillin (5.4%), and cefotaxime (1.7%). Factors related to admission to the pediatric intensive care unit (PICU) were: pleuritic pain (OR: 27.9; 95%CI: 3.13 - 248.16; p = 0.03), cough (OR:6.04; 95%CI: 1.46-24.88; p=0.013), abdominal pain (OR:6.5; 95%CI: 1.85-22.80; p=0.003), respiratory distress (OR:12; 95%CI: 2.95-48.77; p=0.001), intercostal retraction (OR:22.71; 95%CI: 4.65-141.90; p=0.001), cyanosis (OR:8.69; 95%CI: 1.95-38.65; p=0.004), hypothermia (OR:42.62; 95%CI: 4.77-380.74; p=0.001), and sero-type 19A (OR:3.9; 95%CI:1.10-13.81: p=0.035). Mortality rate was 11.7%.Conclusion: Epidemiology changes have been reported after the introduction of the PCV10 vaccine in Colombia in 2012, with a decrease in vaccine serotypes and an increase in serotype 19A, which is one of the risk factors for admission to the PICU due to primary bacteremia. Increased resistance to erythromycin, penicillin and cefotaxime is also reported.
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