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

IJID REGIONS(2022)

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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 Bogot & aacute; 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.
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Key words
Streptococcus pneumoniae,pneumococcal infection,adult,older adult,mortality healthcare resource utilization,antimicrobial resistance
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