scholarly journals 1147. Sentinel Surveillance of Bacterial Pneumonia in Children Under 5 years Treated in HOMI - Fundación Hospital pediatrico la Misericordia in Bogotá, Colombia 2016-2020

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S665-S665
Author(s):  
German Camacho Moreno ◽  
Carolina Duarte Valderrama ◽  
Jacqueline Palacios ◽  
Luz Angela Calvo ◽  
Ivy Talavera ◽  
...  
Keyword(s):  
Disease Surveillance ◽  
Bacterial Pneumonia ◽  
Case Fatality ◽  
Community Acquired Pneumonia ◽  
Blood Cultures ◽  
Sentinel Surveillance ◽  
Surveillance Network ◽  
Probable Case ◽  
The Impact ◽  
Children Under 5

Abstract Background Pneumonia is one of the leading causes of hospitalization and death in children under 5y. The main causes of bacterial pneumonia (BP) are Streptococcus pneumoniae (Spn) and Haemophilus influenzae (Hi). Colombia implemented the Hib vaccine in 1997 with a 3 + 0 scheme and the PCV10 vaccine in 2012, using a 2 + 1 scheme. Sentinel surveillance of BP is carried out at HOMI - Fundación Hospital Pediátrico La Misericordia, which is part of the invasive bacterial vaccine preventable disease surveillance network. Methods A daily active search for cases that met the definitions established in the protocol of the Pan American Health Organization was carried out. All hospitalized patients under 5 years of age with a diagnosis of community acquired pneumonia (ICD10 J10 to J22) were classified as suspected cases, while all suspected cases in which chest X-ray showed a radiological pattern compatible with bacterial pneumonia were considered a probable case. Blood cultures were taken from probable cases; if results were positive (Spn, Hi), the samples were sent to the district and national reference laboratories for confirmation and serotyping. The data obtained in the period January 2016 to December 2020 were analyzed. Results 5272 suspected cases of bacterial pneumonia were found, of which 60% were < 2 y. The highest incidence occurred from March to June (Figure 1). Blood cultures were performed in 2223 (92%) of the 2432 (46.1%) probable cases, confirming 127 (5.2%) cases. Spn, Hi, and other bacteria were found in 55, 27, and 28 cases, respectively (Table 1). Serotyping was performed in 85.4% of the Spn isolates and 77.7% of Hi isolates. The most frequent Spn serotypes were Spn19A in 19 cases (40.4%), Spn3 in 12 cases (25.5%), and Spn14 in 4 cases (8.5%). The presence of Spn19A has increased over time (Figure 2). The most frequent Hi was non-typeable in 13 patients (61.9%), followed by serotype b 6 (28.5%) and serotype a 2 (9.5%). The rate of hospitalization for BP was 9/1000 children < 5 years, and 43 patients died. Case fatality rate was 1.7% among probable cases. Graph 1. Trend of suspected bacterial pneumonia cases in children under 5 years old. HOMI. 2016-2020 Table 1. Bacterial pneumonia isolates. HOMI. 2016 - 2020 Graph 2. Bacterial pneumonia serotypes. HOMI. January 2016 - December 2020 Conclusion BP mainly occurs in 2-year-old children. Spn 19A is the most common bacteria. Although the most frequent Hi is non-typeable, cases of Hib are still observed. Sentinel surveillance allows measuring the impact of public health interventions on this disease. Disclosures German Camacho Moreno, n/a, Pfizer and MSD (Research Grant or Support, Speaker’s Bureau, Other Financial or Material Support, Has received support from Pfizer for participation in congresses)

scholarly journals Blood Cultures Versus Respiratory Cultures: 2 Different Views of Pneumonia

2019 ◽  
Vol 71 (7) ◽  
pp. 1604-1612 ◽  
Author(s):  
Sarah Haessler ◽  
Peter K Lindenauer ◽  
Marya D Zilberberg ◽  
Peter B Imrey ◽  
Pei-Chun Yu ◽  
...  
Keyword(s):  
Case Fatality ◽  
Empiric Therapy ◽  
Respiratory Arrest ◽  
Community Acquired Pneumonia ◽  
Blood Cultures ◽  
First Line ◽  
First Line Therapy ◽  
Lengths Of Stay ◽  
Resistance Patterns ◽  
Source Models

Abstract Background Choice of empiric therapy for pneumonia depends on risk for antimicrobial resistance. Models to predict resistance are derived from blood and respiratory culture results. We compared these results to understand if organisms and resistance patterns differed by site. We also compared characteristics and outcomes of patients with positive cultures by site. Methods We studied adult patients discharged from 177 US hospitals from July 2010 through June 2015, with principal diagnoses of pneumonia, or principal diagnoses of respiratory failure, acute respiratory distress syndrome, respiratory arrest, or sepsis with a secondary diagnosis of pneumonia, and who had blood or respiratory cultures performed. Demographics, treatment, microbiologic results, and outcomes were examined. Results Among 138 561 hospitalizations of patients with pneumonia who had blood or respiratory cultures obtained at admission, 12 888 (9.3%) yielded positive cultures: 6438 respiratory cultures, 5992 blood cultures, and 458 both respiratory and blood cultures. Forty-two percent had isolates resistant to first-line therapy for community-acquired pneumonia. Isolates from respiratory samples were more often resistant than were isolates from blood (54.2% vs 26.6%; P < .001). Patients with both culture sites positive had higher case-fatality, longer lengths of stay, and higher costs than patients who had only blood or respiratory cultures positive. Among respiratory cultures, the most common pathogens were Staphylococcus aureus (34%) and Pseudomonas aeruginosa (17%), whereas blood cultures most commonly grew Streptococcus pneumoniae (33%), followed by S. aureus (22%). Conclusions Patients with positive respiratory tract cultures are clinically different from those with positive blood cultures, and resistance patterns differ by source. Models of antibiotic resistance should account for culture source.

scholarly journals Routine blood cultures in the management of community acquired pneumonia; is it necessary?

2013 ◽  
Vol 1 (2) ◽  
pp. 54-57
Author(s):  
TM Ibrahim
Keyword(s):  
Case Fatality ◽  
Length Of Hospital Stay ◽  
Cost Effective ◽  
Antibiotic Use ◽  
Community Acquired Pneumonia ◽  
Blood Cultures ◽  
True Positive ◽  
It Use ◽  
The Cost

INTRODUCTION: The role of blood cultures (BCs) in the management of community acquired pneumonia (CAP) has generated a lot of controversy among clinicians in recent times. The main objectives of this audit were to determine if BC results impact the choice of antibiotics, and hospital outcomes in CAP. MATERIALS AND METHODS: This was a retrospective study of adults with CAP treated in the ED of Goulbourn Valley Base Hospital, Shepparton in Australia from November 2010 to November 2011. RESULTS: Two hundred and twenty five patients were treated for CAP during the period in review with a mean age of 67.09±19.82 yrs and male:female of 1.5:1. 277 sets of BCs were performed and only 2.2% of the cases had true positive BCs .87% of the total cost of performing these BCs was spent on those with negative cultres.15.1% of the cases had their antibiotics changed during their hospitalization but the results of the BCs had no impact on the antibiotic change. Even though not statistically significant true positive BCs was associated with prolong length of hospital stay (7.6 ± 9.39 days vs 4.89 ± 3.24 days, p=0.44), and duration of IV antibiotic use (4.8±3.27 days vs 3.58±1.97 days, p=0.39). But the case fatality rate was much lower in those with positive BCs, (0 vs 5.7%,p< 0.05). Tachycardia (>120.4±12.46 bpm), neutrophilia (15.0± 8.16 /ul), and high CRP (326.4±146.32 ug/l) were predictors of true positive BCs. CONCLUSIONS: Routine BCs in the management of CAP is not cost-effective with large portion of the cost spent on cultures that returned negative result .Therefore it use show be limited to those likely to return positive cultures. DOI: http://dx.doi.org/10.3126/ijim.v1i2.7408 Int J Infect Microbiol 2012;1(1):54-57

scholarly journals Legionnaires’ disease in Europe, 2011 to 2015

2017 ◽  
Vol 22 (27) ◽  
Author(s):  
Julien Beauté ◽  
Keyword(s):  
Disease Surveillance ◽  
Prevention And Control ◽  
Case Fatality ◽  
Average Increase ◽  
Annual Average ◽  
Surveillance Network ◽  
Case Fatality Ratio ◽  
Study Population ◽  
Legionnaires Disease ◽  
And Control

Under the coordination of the European Centre for Disease Prevention and Control (ECDC), the European Legionnaires’ disease Surveillance Network (ELDSNet) conducts surveillance of Legionnaires’ disease (LD) in Europe. Between 2011 and 2015, 29 countries reported 30,532 LD cases to ECDC (28,188 (92.3%) confirmed and 2,344 (7.7%) probable). Four countries (France, Germany, Italy and Spain) accounted for 70.3% of all reported cases, although their combined populations represented only 49.9% of the study population. The age-standardised rate of all cases increased from 0.97 cases/100,000 population in 2011 to 1.30 cases/100,000 population in 2015, corresponding to an annual average increase of 0.09 cases/100,000 population (95%CI 0.02–0.14; p = 0.02). Demographics and infection setting remained unchanged with ca 70% of cases being community-acquired and 80% occurring in people aged 50 years and older. Clinical outcome was known for 23,164 cases, of whom 2,161 (9.3%) died. The overall case fatality ratio decreased steadily from 10.5% in 2011 to 8.1% in 2015, probably reflecting improved reporting completeness. Five countries (Austria, Czech Republic, Germany, Italy, and Norway) had increasing age-standardised LD notification rates over the 2011−15 period, but there was no increase in notification rates in countries where the 2011 rate was below 0.5/100,000 population.

scholarly journals An international outbreak of Vero cytotoxin-producing Escherichia coli O157 infection amongst tourists; a challenge for the European infectious disease surveillance network

1999 ◽  
Vol 123 (2) ◽  
pp. 217-223 ◽  
Author(s):  
R. G. PEBODY ◽  
C. FURTADO ◽  
A. ROJAS ◽  
N. McCARTHY ◽  
G. NYLEN ◽  
...  
Keyword(s):  
Disease Surveillance ◽  
Case Control Study ◽  
Case Control ◽  
Enteric Infection ◽  
Surveillance Network ◽  
Recent Infection ◽  
Probable Case ◽  
E Coli ◽  
Laboratory Confirmation ◽  
Control Study

In March 1997, an outbreak of Vero cytotoxin-producing Escherichi coli O157 (VTEC) infection occurred amongst holidaymakers returning from Fuerteventura, Canary Islands. For the investigation, a confirmed case was an individual staying in Fuerteventura during March 1997, with either E. coli O157 VTEC isolated in stool, HUS or serological evidence of recent infection; a probable case was an individual with bloody diarrhoea without laboratory confirmation. Local and Europe-wide active case finding was undertaken through national centres, Salm-Net and the European Programme of Intervention Epidemiology, followed by a case-control study.Fourteen confirmed and one probable case were identified from England (7), Finland (5), Wales (1), Sweden (1) and Denmark (1) staying in four hotels. Three of the four hotels were supplied with water from a private well which appeared to be the probable vehicle of transmission. The case-control study showed illness was associated with consumption of raw vegetables (OR 8·4, 95% CI 1·5–48·2) which may have been washed in well water. This investigation shows the importance of international collaboration in the detection and investigation of clusters of enteric infection.

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

Biomédica ◽  
2021 ◽  
Vol 41 (Sp. 2) ◽  
pp. 62-75
Author(s):  
Germán Camacho-Moreno ◽  
Carolina Duarte ◽  
Diego García ◽  
Viviana Calderón ◽  
Luz Yanet Maldonado ◽  
...  
Keyword(s):  
Bacterial Meningitis ◽  
Bacterial Pneumonia ◽  
Pneumococcal Vaccination ◽  
Relevant Information ◽  
Sentinel Surveillance ◽  
Vaccine Preventable Diseases ◽  
Reference Isolate ◽  
Meningitis In Children ◽  
Susceptibility Profiles ◽  
The Impact

Introduction: Bacterial pneumonia and meningitis are vaccine-preventable diseases. Sentinel surveillance provides relevant information about their behavior.Objective: To present the data from sentinel surveillance carried out at the Fundación HOMI, Fundación Hospital Pediátrico La Misericordia in 2016.Materials and methods: We conducted a descriptive study from January 1 to December 31, 2016, on the daily surveillance of patients under 5 years of age diagnosed with pneumonia or bacterial meningitis according to PAHO’s definitions. We identified the microorganisms using the automated VITEKTM 2 system. Bacterial isolates were sent to the Microbiology Group at the Colombian Instituto Nacional de Salud for confirmation, serotyping, phenotypic, and genotypic characterization. Antimicrobial susceptibility profiles were established.Results: From 1,343 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%) and 41 (6.6%) were positive while S. pneumoniae was isolated in 17 (41%) of them. The most frequent serotype was 19A in five cases (29.4%), and four 19A serotypes 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%. As for bacterial meningitis, 22 suspected cases were reported, 12 (54%) were probable, four (33%) were confirmed: two by Escherichia coli and two 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 were 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.

scholarly journals Monitoring the Control of Sexually Transmissible Infections and Blood-Borne Viruses: Protocol for the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance (ACCESS) (Preprint)

2018 ◽  
Author(s):  
Denton Callander ◽  
Clarissa Moreira ◽  
Carol El-Hayek ◽  
Jason Asselin ◽  
Caroline van Gemert ◽  
...  
Keyword(s):  
Public Health ◽  
Health Services ◽  
Surveillance System ◽  
Sentinel Surveillance ◽  
World Health ◽  
People Living With Hiv ◽  
Surveillance Network ◽  
Sexually Transmissible Infections ◽  
The World ◽  
The Impact

BACKGROUND New biomedical prevention interventions make the control or elimination of some blood-borne viruses (BBVs) and sexually transmissible infections (STIs) increasingly feasible. In response, the World Health Organization and governments around the world have established elimination targets and associated timelines. To monitor progress toward such targets, enhanced systems of data collection are required. This paper describes the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance (ACCESS). OBJECTIVE This study aims to establish a national surveillance network designed to monitor public health outcomes and evaluate the impact of strategies aimed at controlling BBVs and STIs. METHODS ACCESS is a sentinel surveillance system comprising health services (sexual health clinics, general practice clinics, drug and alcohol services, community-led testing services, and hospital outpatient clinics) and pathology laboratories in each of Australia’s 8 states and territories. Scoping was undertaken in each jurisdiction to identify sites that provide a significant volume of testing or management of BBVs or STIs or to see populations with particular risks for these infections (“priority populations”). Nationally, we identified 115 health services and 24 pathology laboratories as relevant to BBVs or STIs; purposive sampling was undertaken. As of March 2018, we had recruited 92.0% (104/113) of health services and 71% (17/24) of laboratories among those identified as relevant to ACCESS. ACCESS is based on the regular and automated extraction of deidentified patient data using specialized software called GRHANITE, which creates an anonymous unique identifier from patient details. This identifier allows anonymous linkage between and within participating sites, creating a national cohort to facilitate epidemiological monitoring and the evaluation of clinical and public health interventions. RESULTS Between 2009 and 2017, 1,171,658 individual patients attended a health service participating in ACCESS network comprising 7,992,241 consultations. Regarding those with unique BBV and STI-related health needs, ACCESS captured data on 366,441 young heterosexuals, 96,985 gay and bisexual men, and 21,598 people living with HIV. CONCLUSIONS ACCESS is a unique system with the ability to track efforts to control STIs and BBVs—including through the calculation of powerful epidemiological indicators—by identifying response gaps and facilitating the evaluation of programs and interventions. By anonymously linking patients between and within services and over time, ACCESS has exciting potential as a research and evaluation platform. Establishing a national health surveillance system requires close partnerships across the research, government, community, health, and technology sectors. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/11028

scholarly journals Is group C meningococcal disease increasing in Europe? A report of surveillance of meningococcal infection in Europe 1993–6

1999 ◽  
Vol 122 (1) ◽  
pp. 41-49 ◽  
Author(s):  
M. CONNOLLY ◽  
N. NOAH
Keyword(s):  
Meningococcal Disease ◽  
Disease Surveillance ◽  
Communicable Disease ◽  
Age Distribution ◽  
Case Fatality ◽  
European Countries ◽  
Meningococcal Infection ◽  
Slow Increase ◽  
Set Up ◽  
The Impact

A surveillance system to assess the impact and changing epidemiology of invasive meningococcal disease in Europe was set up in 1987. Since about 1991, contributors from national reference laboratories, national communicable disease surveillance centres and institutes of public health in 35 European countries provided information on all reported cases of meningococcal disease in their country. We describe some trends observed over the period 1993–6. The main findings were: the overall incidence of meningococcal disease was 1·1 per 100000 population but there was some evidence of a slow increase over time and with northern European countries tending to have a higher incidence (Kendall correlation 0·5772, P<0·001), an increasing predominance of serogroup C, and a shift in the age distribution towards teenagers and away from younger children (χ2 test for trend 44·56, P<0·0001), although about half of the cases were under 5 years of age. The overall case fatality rate was 8·3% and the most common serosubtypes were B[ratio ]15[ratio ]P1.7,16 and C[ratio ]2a[ratio ]P1.2,5.

scholarly journals Influence of Antibiotics on the Detection of Bacteria by Culture-Based and Culture-Independent Diagnostic Tests in Patients Hospitalized With Community-Acquired Pneumonia

2017 ◽  
Vol 4 (1) ◽  
Author(s):  
Aaron M. Harris ◽  
Anna M. Bramley ◽  
Seema Jain ◽  
Sandra R. Arnold ◽  
Krow Ampofo ◽  
...  
Keyword(s):  
Legionella Pneumophila ◽  
Diagnostic Tests ◽  
Chlamydia Pneumoniae ◽  
Community Acquired Pneumonia ◽  
Blood Cultures ◽  
Antibiotic Administration ◽  
Antibiotic Exposure ◽  
Specimen Collection ◽  
Culture Independent ◽  
The Impact

Abstract Background Specimens collected after antibiotic exposure may reduce culture-based bacterial detections. The impact on culture-independent diagnostic tests is unclear. We assessed the effect of antibiotic exposure on both of these test results among patients hospitalized with community-acquired pneumonia (CAP). Methods Culture-based bacterial testing included blood cultures and high-quality sputum or endotracheal tube (ET) aspirates; culture-independent testing included urinary antigen testing (adults) for Streptococcus pneumoniae and Legionella pneumophila and polymerase chain reaction (PCR) on nasopharyngeal and oropharyngeal (NP/OP) swabs for Mycoplasma pneumoniae and Chlamydia pneumoniae. The proportion of bacterial detections was compared between specimens collected before and after either any antibiotic exposure (prehospital and/or inpatient) or only prehospital antibiotics and increasing time after initiation of inpatient antibiotics. Results Of 4678 CAP patients, 4383 (94%) received antibiotics: 3712 (85%) only inpatient, 642 (15%) both inpatient and prehospital, and 29 (&lt;1%) only prehospital. There were more bacterial detections in specimens collected before antibiotics for blood cultures (5.2% vs 2.6%; P &lt; .01) and sputum/ET cultures (50.0% vs 26.8%; P &lt; .01) but not urine antigen (7.0% vs 5.7%; P = .53) or NP/OP PCR (6.7% vs 5.4%; P = .31). For all diagnostic testing, bacterial detections declined with increasing time between inpatient antibiotic administration and specimen collection. Conclusions Bacteria were less frequently detected in culture-based tests collected after antibiotics and in culture-independent tests that had longer intervals between antibiotic exposure and specimen collection. Bacterial yield could improve if specimens were collected promptly, preferably before antibiotics, providing data for improved antibiotic selection.

scholarly journals Achieving quality primary care data: a description of the Canadian Primary Care Sentinel Surveillance Network data capture, extraction, and processing in Alberta

2019 ◽  
Vol 4 (2) ◽  
Author(s):  
Stephanie Garies ◽  
Michael Cummings ◽  
Brian Forst ◽  
Kerry McBrien ◽  
Boglarka Soos ◽  
...  
Keyword(s):  
Primary Care ◽  
Disease Surveillance ◽  
Data Extraction ◽  
Contextual Information ◽  
Sentinel Surveillance ◽  
Classification Systems ◽  
Data Repository ◽  
Free Text ◽  
Local Data ◽  
Surveillance Network

IntroductionElectronic medical record (EMR) databases have become increasingly popular for secondary purposes, such as health research. The Canadian Primary Care Sentinel Surveillance Network (CPCSSN) is the first and only pan-Canadian primary care EMR data repository, with de-identified health information for almost two million Canadians. Comprehensive and freely available documentation describing the data ‘lifecycle’ is important for assessing potential data quality issues and appropriate interpretation of research findings. Here, we describe the flow and transformation of CPCSSN data in the province of Alberta. ApproachIn Alberta, the data originate from 54 publicly-funded primary care settings, including one community pediatric clinic, with 318 providers contributing de-identified EMR data for 410,951 patients (as of December 2018). Data extraction methods have been developed for five different EMR systems, and include both backend and automated frontend extractions. The raw EMR data are transformed according to specific rules, including trimming implausible values, converting values and free text to standard terminologies or classification systems, and structuring the data into a common CPCSSN format. Following local data extraction and processing, the data are transferred to a central repository and made available for research and disease surveillance. ConclusionThis paper aims to provide important contextual information to future CPCSSN data users.

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