Sentinel surveillance for bacterial pneumonia and meningitis in children under the age of 5 in a tertiary pediatric hospital in Colombia - 2016

Abstract

Introduction: Bacterial pneumonia and meningitis are vaccine-preventable diseases. Sentinel surveillance provides relevant information about their behavior. Objective: To present the data from a sentinel surveillance carried out at the Fundación HOMI in 2016. Materials and methods: Descriptive study. From January 1 to December 31, 2016, daily surveillance was performed on patients under five years, diagnosed with pneumonia or bacterial meningitis, according to the PAHO's definitions. The microorganisms were identified using the automated VITEK TM2 system. Bacterial isolates were sent to the Microbiology Group of the National Health Institute for confirmation, serotyping, phenotypic and genotypic characterization. Antimicrobial susceptibility profiles were established. Results: 1343 suspected cases of bacterial pneumonia; 654(48.7%) were probable, (84%) had complete Hib vaccination schedules, and (87%) had complete pneumococcal vaccination schedules for age. Blood culture was taken in 619(94.6%), 41(6.6%) were positive; S. pneumoniae was isolated in 17(41%) of them. The most frequent serotype was 19A in 5 cases (29.4%), and 4 serotypes 19A were associated with the reference isolate ST320. The incidence rate of probable bacterial pneumonia was 7.3 cases/100 hospitalized patients, and lethality was 2.1%. Concerning bacterial meningitis, 22 suspected cases were reported, 12 (54%) were probable, 4 (33%) were confirmed, 2 by Escherichia coli and 2 by group C N. meningitidis. The incidence of probable bacterial meningitis was 0.14 cases/100 hospitalized patients. Conclusion: Streptococcus pneumoniae serotypes 19A and 3 are the most frequent cause of pneumonia. Spn19A is related to the multi-resistant clone ST320. Strengthening and continuing this strategy will allow understanding the impact of vaccination.