ESPID Education. Gómez B. 06/07/11; 7742
Dr. Borja Gómez
Dr. Borja Gómez

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Expected impact of 13-valent pneumococcal conjugate vaccination in invasive bacterial infection rate in the pediatric emergency department

Gómez B *, Herrero M *, Gangoiti I*, Hernández JL **, Benito J *, Sánchez J *, Mintegi S *
* Pediatric Emergency Department. Cruces Hospital
** Microbiology Department. Cruces Hospital

Objective: To study the impact we can expect from the introduction of the 13-valent pneumococcal conjugate vaccine (PCV-13) in the spectrum of invasive bacterial infections (IBI) in the Pediatric Emergency Department (PED)

Methods: Retrospective study of children under 14 years diagnosed with an IBI (bacterial culture/protein chain reaction in blood or cerebrospinal fluid - CSF) in a PED of a tertiary hospital between January 2008 and December 2010.

Results: Among 180,202 episodes, an IBI was diagnosed in 88 patients (36, 40.9%, under 1 year).
The most frequent diagnoses were: sepsis with/without meningitis 28 (31.4%), bacteraemia 21 (23.6%), pneumonia 13 (14.6%), meningitis 9 (10.1%). The most commonly isolated bacteria were S. pneumoniae 33 (37.5%), N. meningitidis 21 (23.9%), E. Coli 9 (10.2%).
The bacterium was isolated from blood in 77 patients (27 pneumococcus, 18 meningococcus), from CSF in 3 (pneumococcus), and from both fluids in 8 (3 pneumococcus, 3 meningococcus, 2 Group B Streptococcus).
29 isolated pneumococcus were serotyped. The distribution of the serotypes related to the different PCV was: 5 were included in the PCV-7 (17.2% CI 95% 7.1-35.0), 15 in the PCV-10 (51.7%, 95% CI 34.4- 68.6) and 25 in the PCV-13 (86.2% CI 95% 68.8-95.1).
None of the patients died. Two patients with invasive pneumococcal infection had sequels.

Conclusions: In the era of 7-valent PCV, pneumococcus is the leading cause of IBI in PED. The introduction of 13-valent PCV may lead to a very significant decrease of IBI rate and meningococcus may become the leading cause of IBI.
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