Juan Pablo Rojas1, Aura Lucia Leal2, Jaime Patiño3, Anita Montañez4, Germán Camacho5, Sandra Beltrán6, Carolina Bonilla7, Rocio Barrero8, Cristina Mariño9, Nicolás Ramos10. 1. Infectología Pediátrica, Universidad El Bosque, Fundación Cardioinfantil IC , Bogotá, Colombia. Electronic address: juanpa8506@hotmail.com. 2. Universidad Nacional de Colombia, Asociación Colombiana de Infectología (ACIN), Grupo para el Control de la Resistencia Bacteriana en Bogotá, Grupo Neumocolombia, Colombia. 3. Fundación Cardioinfantil, Asociación Colombiana de Infectología ACIN-Sociedad Colombiana de Pediatría, Grupo Neumocolombia, Colombia. 4. Asociación Colombiana de Infectología, Grupo Neumocolombia, Colombia. 5. Hospital de la Misericordia, Universidad Nacional de Colombia. Grupo Neumocolombia, Colombia. 6. Fundación Sanitas-Clínica Colombia, Grupo Neumocolombia, Colombia. 7. Clínica Hospital San Rafael, Grupo Neumocolombia, Colombia. 8. Hospital Santa Clara E.S.E y Hospital el Tunal E.S.E. Grupo Neumocolombia, Colombia. 9. Hospital Militar Central, Grupo Neumocolombia, Sociedad Colombiana de Pediatría, Colombia. 10. Clínica El Bosque, Grupo Neumocolombia, Sociedad Colombiana de Pediatría, Colombia.
Abstract
INTRODUCTION: Streptococcus pneumoniae (S. pneumoniae), also known as pneumococcus, is one of the main bacteria associated with mortality in children under 2 years of age, with a morbidity and mortality incidence that varies according to demographics and exposure to risk, or protective factors. OBJECTIVE: To describe the child mortality due to invasive pneumococcal disease (IPD) between 2008 -2014 (6 years), in 8 Medical Centres in Bogotá, Colombia. PATIENTS AND METHOD: Descriptive observational case series of patients who died of IPD, aged 28 days to 18 years, in 8 tertiary care institutions in Bogota, Colombia. The study period was from 1 January 2008 to 15 January 2014. SAMPLE SIZE: 239 patients. RESULTS: A total of 239 registered cases of IPD were reviewed, showing a mortality of 8% (n 18). The mean age of patients that died was 43.7 months, with an age range from 2 to 176 months (14 years), with 66% of the cases being male. Serotypes were identified in 8 patients, finding: 6A, 6B, 10A, 14, 18C, 23B, 23F, and 35B. The most common clinical presentation of the cases was meningitis with mortality of 33% (6 cases), followed by bacteraemia without focus in 28% (5 cases), and pneumonia with 27% (5 cases). Combined clinical situations were presented, such as pneumonia and meningitis in 11% (2 cases). Two of the patients had clearly documented risk factors for IPD (asplenia and chronic respiratory disease). CONCLUSIONS: IPD mortality is particularly high in children under 2 years in male patients, especially when presented with a meningeal focus (44%). Serotyping was not possible in all patients who died, since no strain isolated was sent to the National Institute of Health. Continuous and systematic vigilance is required to evaluate the impact of vaccination and possible changes in the pattern of presentation of disease.
INTRODUCTION:Streptococcus pneumoniae (S. pneumoniae), also known as pneumococcus, is one of the main bacteria associated with mortality in children under 2 years of age, with a morbidity and mortality incidence that varies according to demographics and exposure to risk, or protective factors. OBJECTIVE: To describe the child mortality due to invasive pneumococcal disease (IPD) between 2008 -2014 (6 years), in 8 Medical Centres in Bogotá, Colombia. PATIENTS AND METHOD: Descriptive observational case series of patients who died of IPD, aged 28 days to 18 years, in 8 tertiary care institutions in Bogota, Colombia. The study period was from 1 January 2008 to 15 January 2014. SAMPLE SIZE: 239 patients. RESULTS: A total of 239 registered cases of IPD were reviewed, showing a mortality of 8% (n 18). The mean age of patients that died was 43.7 months, with an age range from 2 to 176 months (14 years), with 66% of the cases being male. Serotypes were identified in 8 patients, finding: 6A, 6B, 10A, 14, 18C, 23B, 23F, and 35B. The most common clinical presentation of the cases was meningitis with mortality of 33% (6 cases), followed by bacteraemia without focus in 28% (5 cases), and pneumonia with 27% (5 cases). Combined clinical situations were presented, such as pneumonia and meningitis in 11% (2 cases). Two of the patients had clearly documented risk factors for IPD (asplenia and chronic respiratory disease). CONCLUSIONS: IPD mortality is particularly high in children under 2 years in male patients, especially when presented with a meningeal focus (44%). Serotyping was not possible in all patients who died, since no strain isolated was sent to the National Institute of Health. Continuous and systematic vigilance is required to evaluate the impact of vaccination and possible changes in the pattern of presentation of disease.