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. 2022 Apr 28:3:293-299.
doi: 10.1016/j.ijregi.2022.04.007. eCollection 2022 Jun.

Invasive Pneumococcal Disease Characterization in Adults and Subgroups aged < 60 years and ≥ 60 years in Bogota, Colombia

Aura Lucia Leal Castro  1   2   3 , Germán Camacho-Moreno  1   2   3   4   5 , Anita Montañez-Ayala  2   3 , Fabio Varón-Vega  6 , José Camilo Alvarez-Rodríguez  2   7 , Sandra Valderrama-Beltrán  8   9 , Beatriz Elena Ariza  8 , Oscar Pancha  10 , Ana Yadira Santana  10 , Nella Sánchez Flórez  10 , Patricia Reyes  5 , Jaime Ruiz  11 , Claudia Beltran  11 , Emilia Prieto  11 , Monica Rojas  11 , Juan Urrego-Reyes  11 , Cintia Irene Parellada  12
Affiliations

Invasive Pneumococcal Disease Characterization in Adults and Subgroups aged < 60 years and ≥ 60 years in Bogota, Colombia

Aura Lucia Leal Castro et al. IJID Reg. .

Abstract

Background: There is scarce information on the burden of invasive pneumococcal disease (IPD) among adults in low- and middle-income countries. This study aimed to describe the clinical outcomes and microbiological characteristics associated with IPD in adults and subgroups aged 18-59 years and ≥60 years in Colombia.

Methods: A retrospective chart review study was conducted in five institutions of Bogotá from January 2011 to December 2017. Analyses were carried out for overall population and stratified by age group (18-59; ≥ 60 years).

Results: There were 169 IPD cases; median age was 58 years, 51.5% were male, and 80.5% had at least one comorbidity. Bacteremic pneumonia was the most common presentation (63.9%). The median length of hospital stay was 12 days with high healthcare resource utilization (HCRU): 58.6% required ICU and 53.3% inotropic support. Overall case-fatality rate (CFR) was 41.4%. Clinical outcomes were worse in patients ≥60 years old with significantly higher CFR and HCRU (ICU admission, mechanical ventilation, and inotropic support) compared to those aged 18-59 years. The most frequent serotypes were 3, 6 A/C, 14, and 19A. The sensitivity to penicillin in meningitis and non-meningitis isolates were 75% and 89.1% respectively.

Conclusions: IPD was associated with a substantial burden in adults and worse clinical outcomes and HCRU in older adults in Colombia. Surveillance data combined with clinical outcomes have the potential to inform age-based pneumococcal vaccination policies.

Keywords: Streptococcus pneumoniae, pneumococcal infection, adult, older adult, mortality; healthcare resource utilization, antimicrobial resistance.

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Figures

Figure 1
Figure 1
Serotype coverage by pneumococcal vaccine in adults with invasive pneumococcal disease, in the early and late period after PCV10 childhood introduction in Bogotá, Colombia, 2011-2017.
See this image and copyright information in PMC

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