학술논문
Serotype distribution, clinical characteristics, and antimicrobial resistance of pediatric invasive pneumococcal disease in Colombia during PCV10 mass vaccination (2017-2022).
Document Type
Academic Journal
Author
Camacho-Moreno G; Red Neumocolombia, Bogotá, Colombia.; Universidad Nacional de Colombia, Bogotá, Colombia.; HOMI, Fundación Hospital Pediatrico de la Misericordia, Bogotá, Colombia.; Hospital Infantil Universitario de San José, Bogotá, Colombia.; Leal AL; Red Neumocolombia, Bogotá, Colombia.; Universidad Nacional de Colombia, Bogotá, Colombia.; Grupo Para el Control de la Resistencia Bacteriana en Bogotá, GREBO, Bogotá, Colombia.; Patiño-Niño J; Red Neumocolombia, Bogotá, Colombia.; Fundación Valle del Lili, Cali, Colombia.; Vasquez-Hoyos P; Red Neumocolombia, Bogotá, Colombia.; Universidad Nacional de Colombia, Bogotá, Colombia.; Gutiérrez I; Red Neumocolombia, Bogotá, Colombia.; Clínica Infantil Colsubsidio, Bogotá, Colombia.; Clinicas Colsanitas-Clinica Santa Maria del Lago, Bogotá, Colombia.; Beltrán S; Red Neumocolombia, Bogotá, Colombia.; Clínicas Colsanitas-Clínica Reina Sofia pediátrica y Mujer, Bogotá, Colombia.; Álvarez-Olmos MI; Red Neumocolombia, Bogotá, Colombia.; Fundación Cardioinfantil-Instituto de Cardiología, Bogotá, Colombia.; Mariño AC; Red Neumocolombia, Bogotá, Colombia.; Hospital Militar Central, Bogotá, Colombia.; Londoño-Ruiz JP; Red Neumocolombia, Bogotá, Colombia.; Clínica Infantil Colsubsidio, Bogotá, Colombia.; Barrero R; Red Neumocolombia, Bogotá, Colombia.; Hospital Universitario Clínica San Rafael, Bogotá, Colombia.; Unidad de Servicios de Salud Santa Clara, Subred Centro Oriente, Bogotá, Colombia.; Rojas JP; Red Neumocolombia, Bogotá, Colombia.; Fundación Clínica Infantil Club Noel, Cali, Colombia.; Universidad Libre Seccional Cali, Cali, Colombia.; Universidad del Valle, Cali, Colombia.; Espinosa F; Red Neumocolombia, Bogotá, Colombia.; Universidad del Valle, Cali, Colombia.; Arango-Ferreira C; Red Neumocolombia, Bogotá, Colombia.; Hospital Universitario San Vicente Fundación, Medellín, Colombia.; Suarez MA; Red Neumocolombia, Bogotá, Colombia.; Unidad de Servicio de Salud Tunal, Bogotá, Colombia.; Hospital Universitario San Ignacio, Bogotá, Colombia.; Trujillo M; Red Neumocolombia, Bogotá, Colombia.; Hospital Pablo Tobón Uribe, Medellín, Colombia.; López-Medina E; Red Neumocolombia, Bogotá, Colombia.; Universidad del Valle, Cali, Colombia.; Centro Médico Imbanaco, Cali, Colombia.; López P; Red Neumocolombia, Bogotá, Colombia.; Universidad del Valle, Cali, Colombia.; Hospital Universitario del Valle, Cali, Colombia.; Coronell W; Red Neumocolombia, Bogotá, Colombia.; Hospital Infantil Napoleón Franco Pareja, Cartagena, Colombia.; Ramos N; Red Neumocolombia, Bogotá, Colombia.; Clínica el Bosque-Los Cobos Medical Center, Bogotá, Colombia.; Restrepo A; Red Neumocolombia, Bogotá, Colombia.; Montañez A; Red Neumocolombia, Bogotá, Colombia.; Moreno VM; Red Neumocolombia, Bogotá, Colombia.
Source
Publisher: Frontiers Media S.A Country of Publication: Switzerland NLM ID: 101648047 Publication Model: eCollection Cited Medium: Print ISSN: 2296-858X (Print) Linking ISSN: 2296858X NLM ISO Abbreviation: Front Med (Lausanne) Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2296-858X
Abstract
Introduction: Invasive Pneumococcal Disease (IPD) causes significant morbidity and mortality in children under 5 y. Colombia introduced PCV10 vaccination in 2012, and the Neumocolombia network has been monitoring IPD in pediatric patients since 2008.
Materials and Methods: This study is a secondary analysis of a prospective cohort involving pediatric patients with IPD admitted to 17 hospitals in Colombia, from January 1st, 2017, to December 31st, 2022. We present data on serotypes (Spn), clinical characteristics, and resistance patterns.
Results: We report 530 patients, 215 (40.5%) were younger than 24 months. Among these, 344 cases (64.7%) presented with pneumonia, 95 (17.9%) with primary bacteremia, 53 (10%) with meningitis, 6 (1.1%) had pneumonia and meningitis, and 32 (6%) had other IPD diagnosis. The median hospital stay was 12 days (RIQ 8-14 days), and 268 (50.6%) were admitted to the ICU, of whom 60 (11.3%) died. Serotyping was performed in 298 (56.1%). The most frequent serotypes were Spn19A (51.3%), Spn6C (7.7%), Spn3 (6.7%), Spn6A (3.6%), and Spn14 (3.6%). Of 495 (93%) isolates with known susceptibility, 46 (9.2%) were meningeal (M) and 449 (90.7%) non-meningeal (NM). Among M isolates, 41.3% showed resistance to penicillin, and 21.7% decreased susceptibility to ceftriaxone. For NM isolates, 28.2% had decreased susceptibility to penicilin, and 24.2% decreased susceptibility to ceftriaxone. Spn19A showed the highest resistant to penicillin at 47% and was linked to multiresistance.
Conclusion: The prevalence of PCV10-included serotypes decreased, while serotypes 19A and 6C increased, with Spn19A being associated with multiresistance. These findings had played a crucial role in the decision made by Colombia to modify its immunization schedule by switching to PCV13 in July 2022.
Competing Interests: GC-M has received support from Pfizer, MSD (Merck Sharp and Dohme) and Sanofi Pasteur for participation congresses and paid conferences, has participated in advisory boards and has received support from MSD for research. AL has received support from Pfizer and MSD (Merck Sharp and Dohme) for participation in congresses and paid conferences, has participated in advisory boards and has received support from MSD for research. JP-N has received support from Pfizer for participation in congresses. IG has received support from Pfizer for participation in congresses and paid conferences. SB has received support from Pfizer for participation in congresses. MÁ-O has received support from Pfizer for participation in congresses. A-CM has received support from Pfizer for participation in congresses. RB has received support from Pfizer and MSD for participation in congresses. JR has received support from Pfizer for participation in congresses and paid conferences. FE has received support from MSD for research. EL-M has received research support from MSD, GSK, Sanofi Pasteur, Pfizer, Takeda and Janssen. PL has received research support from GSK, Sanofi Pasteur and Takeda. WC has received support from Pfizer, GSK and AstraZeneca for participation in congresses and paid conferences. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2024 Camacho-Moreno, Leal, Patiño-Niño, Vasquez-Hoyos, Gutiérrez, Beltrán, Álvarez-Olmos, Mariño, Londoño-Ruiz, Barrero, Rojas, Espinosa, Arango-Ferreira, Suarez, Trujillo, López-Medina, López, Coronell, Ramos, Restrepo, Montañez and Moreno.)
Materials and Methods: This study is a secondary analysis of a prospective cohort involving pediatric patients with IPD admitted to 17 hospitals in Colombia, from January 1st, 2017, to December 31st, 2022. We present data on serotypes (Spn), clinical characteristics, and resistance patterns.
Results: We report 530 patients, 215 (40.5%) were younger than 24 months. Among these, 344 cases (64.7%) presented with pneumonia, 95 (17.9%) with primary bacteremia, 53 (10%) with meningitis, 6 (1.1%) had pneumonia and meningitis, and 32 (6%) had other IPD diagnosis. The median hospital stay was 12 days (RIQ 8-14 days), and 268 (50.6%) were admitted to the ICU, of whom 60 (11.3%) died. Serotyping was performed in 298 (56.1%). The most frequent serotypes were Spn19A (51.3%), Spn6C (7.7%), Spn3 (6.7%), Spn6A (3.6%), and Spn14 (3.6%). Of 495 (93%) isolates with known susceptibility, 46 (9.2%) were meningeal (M) and 449 (90.7%) non-meningeal (NM). Among M isolates, 41.3% showed resistance to penicillin, and 21.7% decreased susceptibility to ceftriaxone. For NM isolates, 28.2% had decreased susceptibility to penicilin, and 24.2% decreased susceptibility to ceftriaxone. Spn19A showed the highest resistant to penicillin at 47% and was linked to multiresistance.
Conclusion: The prevalence of PCV10-included serotypes decreased, while serotypes 19A and 6C increased, with Spn19A being associated with multiresistance. These findings had played a crucial role in the decision made by Colombia to modify its immunization schedule by switching to PCV13 in July 2022.
Competing Interests: GC-M has received support from Pfizer, MSD (Merck Sharp and Dohme) and Sanofi Pasteur for participation congresses and paid conferences, has participated in advisory boards and has received support from MSD for research. AL has received support from Pfizer and MSD (Merck Sharp and Dohme) for participation in congresses and paid conferences, has participated in advisory boards and has received support from MSD for research. JP-N has received support from Pfizer for participation in congresses. IG has received support from Pfizer for participation in congresses and paid conferences. SB has received support from Pfizer for participation in congresses. MÁ-O has received support from Pfizer for participation in congresses. A-CM has received support from Pfizer for participation in congresses. RB has received support from Pfizer and MSD for participation in congresses. JR has received support from Pfizer for participation in congresses and paid conferences. FE has received support from MSD for research. EL-M has received research support from MSD, GSK, Sanofi Pasteur, Pfizer, Takeda and Janssen. PL has received research support from GSK, Sanofi Pasteur and Takeda. WC has received support from Pfizer, GSK and AstraZeneca for participation in congresses and paid conferences. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2024 Camacho-Moreno, Leal, Patiño-Niño, Vasquez-Hoyos, Gutiérrez, Beltrán, Álvarez-Olmos, Mariño, Londoño-Ruiz, Barrero, Rojas, Espinosa, Arango-Ferreira, Suarez, Trujillo, López-Medina, López, Coronell, Ramos, Restrepo, Montañez and Moreno.)