Abstract P-162: PEDIATRIC INTENSIVE CARE UNIT (PICU) ADMISSIONS DUE TO PNEUMONIA COMPLICATED WITH PARAPNEUMONIC EFFUSION (PPE) OR PLEURAL EMPYEMA (PE) AT COSTA RICA’S (CR) NATIONAL CHILDREN’S HOSPITAL

Abstract

Aims & Objectives: In Latin America, few studies analyzing children with pneumonia complicated with PPE or PE requiring PICU admission have been published. We describe the first study in Central America focusing on this subgroup of pts. Methods Retrospective descriptive study of ch <13 years who had a discharge diagnosis of pneumonia with PPE or PE who were admitted to the PICU of the only national pediatric tertiary referral teaching hospital of CR from Jan-1st-2006 to Jan-31st-2014. Results Among 121 pts with pneumonia complicated with PPE or PE, 46(38%) required PICU admission. 27(58.7%) were male; median age was 11(1–166) months. Median length of hospitalization in the PICU was 5(1–30) days, and total days in hospital for this group, 19(2–83) days. Mechanical ventilation was required in 43(93.5%) pts, with a mean duration of 6.9(1–30) days. A bacterial pathogen was identified in 33(71.7%) pts, being the 3 most common: Staphylococcus aureus 17(37%)(100% MRSA), Streptococcus pneumoniae 11(23.9%), and Streptococcus pyogenes 3(6.5%). Inotropic support was required in 23(50%) pts, transfusions in 28(60.9%), thoracocentesis 33(71.7%), chest tube insertion 37(80.4%), and decortication 14(30.4%). Septic shock occurred in 16(34.8%) pts. 3 (6.5%) pts died: 2 due to pneumococcal septic shock and 1 due to a culture-negative necrotizing pneumonia with abscess formation. Conclusions Although PICU admissions due to pneumonia complicated with PE or PPE in CR children is associated with significant morbidity, the mortality rate is low if compared with other countries. Due to the concerning high rates of MRSA isolates, antibiotic therapy against this pathogen should be initiated promptly in these pts.