Invasive pneumococcal disease burden in hospitalized adults in Bogota, Colombia

Paula O Narváez,Julian Lozada-Arcinegas,Luis Felipe Reyes,Sandra Gómez,Cristian C Serrano-Mayorga,Alirio Bastidas,Hernan Vargas,Paula C Ramirez-Valbuena,Salome Gomez-Duque,Juan E Alarcon,Charles Feldman

doi:10.1186/s12879-021-06769-2

Abstract

BackgroundThe incidence of invasive pneumococcal disease (IPD) varies depending on a number of factors, including vaccine uptake, in both children and adults, the geographic location, and local serotype prevalence. There are limited data about the burden of Streptococcus pneumoniae (Spn), serotype distribution, and clinical characteristics of adults hospitalized due to IPD in Colombia. The objectives of this study included assessment of Spn serotype distribution, clinical characteristics, mortality, ICU admission, and the need for mechanical ventilation.MethodsThis was an observational, retrospective, a citywide study conducted between 2012 and 2019 in Bogotá, Colombia. We analyzed reported positive cases of IPD from 55 hospitals in a governmental pneumococcal surveillance program. Pneumococcal strains were isolated in each hospital and typified in a centralized laboratory. This is a descriptive study stratified by age and subtypes of IPD obtained through the analysis of medical records.ResultsA total of 310 patients with IPD were included, of whom 45.5% were female. The leading cause of IPD was pneumonia (60%, 186/310), followed by meningitis. The most frequent serotypes isolated were 19A (13.87%, 43/310) and 3 (11.94%, 37/310). The overall hospital mortality rate was 30.3% (94/310). Moreover, 52.6% (163/310 patients) were admitted to the ICU, 45.5% (141/310) required invasive mechanical ventilation and 5.1% (16/310) non-invasive mechanical ventilation.ConclusionPneumococcal pneumonia is the most prevalent cause of IPD, with serotypes 19A and 3 being the leading cause of IPD in Colombian adults. Mortality due to IPD in adults continues to be very high.

Highlights

Lower respiratory tract infections are the leading cause of death in developing countries
A total of 310 patients with invasive pneumococcal disease were included in the study; of whom 45.5% (141/310) were female
Results from this study indicate that adult patients hospitalized due to invasive pneumococcal disease (IPD) in Bogotá, Colombia are more frequently infected by pneumococcal serotypes included in the conjugate vaccine PCV13 and the unconjugated vaccine PPV23

Summary

Introduction

Lower respiratory tract infections are the leading cause of death in developing countries. Invasive pneumococcal disease (IPD) is an important cause of morbidity and mortality [1, 2]. The burden of CAP and associated invasive diseases represent annual costs exceeding $17 billion in the United States and more than €10 billion in Europe [8,9,10]. It is essential to highlight that after the widespread usage of pneumococcal vaccines in children, the adult population presents the highest incidence of IPD, and its mortality. The incidence of invasive pneumococcal disease (IPD) varies depending on a number of factors, including vaccine uptake, in both children and adults, the geographic location, and local serotype prevalence. There are limited data about the burden of Streptococcus pneumoniae (Spn), serotype distribution, and clinical characteristics of adults hospitalized due to IPD in Colombia. The objectives of this study included assessment of Spn serotype distri‐ bution, clinical characteristics, mortality, ICU admission, and the need for mechanical ventilation

Methods

Results

Conclusion