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Published on: February 23, 2014
Pediatric invasive pneumococcal disease in Bolívar, Colombia: a descriptive cross-sectional study
Wilfrido Coronell Rodríguez1, Andrés Felipe Mora-Salamanca2, José Santacruz-Arias2
1Universidad de Cartagena, Cartagena, Bolívar, Colombia.
Insights
Invasive pneumococcal disease (IPD) significantly impacts vulnerable children in Colombia, leading to high intensive care unit admissions and mortality. Emerging carbapenem resistance is a growing concern for pediatric IPD cases.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Microbiology
- Public Health Epidemiology
Background:
- Invasive pneumococcal disease (IPD) remains a significant pediatric health concern in Colombia, despite existing vaccination programs.
- Understanding the characteristics of IPD in children is crucial for targeted public health interventions.
Purpose of the Study:
- To describe the socio-demographic, epidemiological, and clinical features of pediatric IPD cases.
- To identify prevalent *Streptococcus pneumoniae* (Spn) serotypes and antimicrobial resistance patterns in Bolívar, Colombia.
Main Methods:
- A descriptive, cross-sectional study was conducted analyzing pediatric IPD cases from 2016 to 2023.
- Data were retrospectively collected from medical records, including Spn serotyping from the Colombian National Institute of Health.
- Descriptive statistics were used to analyze patient characteristics and outcomes.
Main Results:
- Fifty-four pediatric IPD cases were identified, predominantly in children aged 2-9 years from low socio-economic backgrounds.
- The most frequent serotype was Spn19A (20.4%). Antimicrobial resistance showed vancomycin sensitivity but 34% had decreased meropenem sensitivity.
- High rates of pediatric intensive care unit (PICU) admission (79.6%) and mortality (35.2%) were observed, with a median hospitalization of 13.5 days.
Conclusions:
- IPD disproportionately affects vulnerable children in Bolívar, Colombia, leading to severe clinical outcomes.
- High PICU admission and mortality rates underscore the need for improved prevention and treatment strategies.
- The emergence of carbapenem resistance in *Streptococcus pneumoniae* isolates is a critical concern requiring further monitoring.
Introduction:
Invasive pneumococcal disease (IPD) remains a pediatric health challenge despite national vaccination efforts in Colombia. We described the socio-demographic, epidemiological, and clinical characteristics of children (<18 years of age) with IPD at a pediatric reference center in Bolívar, Colombia.
Methods:
Descriptive cross-sectional study of all pediatric patients (under 18 years of age) diagnosed with IPD between 2016 and 2023. Data was collected retrospectively from medical records. IPD was defined as identifying Streptococcus pneumoniae (Spn) in blood, cerebrospinal, pleural, synovial, peritoneal, or pericardial fluid. Spn serotyping data was provided by the Colombian National Institute of Health. Descriptive statistics were performed to describe all variables.
Results:
Between 2016-2023, we identified fifty-four pediatric IPD cases. Most cases were reported among children in the 2-9 age group (44.4%), male sex (57.4%), low socio-economic strata (100%), and previous medical conditions (61.1%). Half of the patients were vaccinated. Serotyping data were available from 35 (64.8%) isolates. Fifteen Spn serotypes were identified, Spn19A being the most frequent (20.4%). All Spn isolates were vancomycin sensitive, while 34% had meropenem-decreased sensitivity. Three-quarters of the patients (76.0%) were diagnosed with bacteremia (bacteremic pneumonia/meningitis and bacteremia without known focus). The 79.6% of children were admitted to the pediatric intensive care unit (PICU). The median hospitalization days were 13.5 (IQR 5.5-23.5) while the median PICU length of stay was 9.5 (IQR 4-18) days. Nineteen patients died (35.2%).
Conclusion:
IPD disproportionately affects vulnerable children, resulting in high PICU admission and mortality rates and prolonged hospital stay in Bolívar, Colombia. In addition, the emergence of resistance to carbapenems is of concern.
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