Características epidemiológicas, clínicas y bacteriológicas de meningitis neumocócica en pacientes pediátricos de Lima, Perú

Davalos, Long; Terrazas, Yessica; Quintana, Ana; Egoavil, Martha; Sedano, Katherine; Castillo, María E.; Reyes, Isabel; Chaparro, Eduardo; Silva, Wilda; Campos, Francisco; Saenz, A.; Hernandez, Roger; Águila, Olguita del; Pinto, Daniel Guillén; Ochoa, Theresa J.

doi:10.17843/rpmesp.2016.333.2349

Cited by 4 publications

(5 citation statements)

References 20 publications

(26 reference statements)

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“…In a previous trial conducted in Peru, the occurrence of nausea and vomiting was found to be strongly associated with the manifestation of viral meningitis. Out of the 30 cases analyzed by Davalos et al 24 in 2016, 21 were identified as viral meningitis cases, suggesting that these symptoms can be indicative of viral rather than bacterial meningitis. Sleepiness and headache are indeed commonly reported signs in patients with meningitis, as observed in other studies.…”

Section: Discussionmentioning

confidence: 98%

“…Although nausea and vomiting can raise suspicion for meningitis, 7,24 it is crucial to investigate further and use additional diagnostic tools to determine the precise cause, as they can be attributed to a range of infectious etiologies. For instance, acute diarrheal disease, which was frequently observed in this study, can be a common cause of nausea and vomiting.…”

Section: Discussionmentioning

confidence: 99%

“…Sleepiness and headache are indeed commonly reported signs in patients with meningitis, as observed in other studies. 7,24 Although it is crucial to be aware of these common signs, such as sleepiness and headache, when evaluating patients for potential meningitis, it is also important to recognize that the absence of additional clinical findings does not rule out the possibility of meningitis, as the presentation of the disease can vary, and some cases may not exhibit overt clinical signs.…”

Section: Discussionmentioning

confidence: 99%

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Characteristics and Risk Factors of Central Nervous System Infection in Children With Febrile Seizures

do Valle,

Costa,

Fregonese

et al. 2024

Pediatr Emer Care

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Objective The aim of the present study is to evaluate the necessity of performing lumbar puncture in patients experiencing febrile seizures, considering the epidemiology specific to Brazil. Methods A retrospective cross-sectional study was performed from January 2017 to December 2021. Results A total of 469 children with seizure and fever were analyzed. The identified event was the first in 65.9% (n = 309). A total of 54.2% (n = 254) of patients had a simple febrile seizure. Infectious focus, excluding previous central nervous system (CNS) infection, was identified in 35.6% (n = 167) patients. Meningitis was identified in 7.7% (n = 36) patients, all of them were viral. Patients with CNS infection had a higher frequency of symptoms such as nausea and vomiting, drowsiness, headache, and higher level of leukocytosis. A longer duration of fever was found to be more strongly associated with CNS infection. Conclusions When considering the use of lumbar puncture in febrile seizure, it is important to conduct a comprehensive evaluation that considers multiple factors, including clinical signs, symptoms, and the overall clinical context. Meningeal signs may be less prominent, and other symptoms such as lethargy, irritability, and vomiting may serve as more reliable indicators. Although clinical examination suggestive of meningitis remains an important factor, the recurrence of febrile seizures and a longer length of fever can provide additional insights and aid in decision-making regarding lumbar puncture.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Characteristics and Risk Factors of Central Nervous System Infection in Children With Febrile Seizures

do Valle,

Costa,

Fregonese

et al. 2024

Pediatr Emer Care

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“…Los serotipos 6C y 24F fueron resistente a la penicilina. La resistencia a penicilina se ha reportado previamente en pacientes con ENI (6,8) , y más en pacientes con meningitis (15) . Asimismo, todos los serotipos aislados fueron resistentes a macrólidos (eritromicina).…”

Section: Discussionunclassified

Enfermedad neumocócica invasiva en pacientes de un hospital pediátrico de Perú, 2017-2020

Marín-Portocarrero

Quispe-Sanchez

Charca-Rodriguez

et al. 2022

Rev Peru Med Exp Salud Publica

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El propósito del presente estudio fue describir las características clínicas, serotipos y susceptibilidad antibiótica en pacientes con enfermedad neumocócica invasiva (ENI). Se revisaron las historias clínicas de los pacientes con ENI hospitalizados en el Instituto Nacional de Salud del Niño-Breña (Lima, Perú). Se evaluaron a 29 pacientes. La mediana de edad fue 1,9 años (rango intercuartílico 1 a 4 años). El 51,7% eran mujeres y la forma clínica de la ENI más frecuente fue la bacteriemia en 18 (62,1%) pacientes. El 65,5% tenía el esquema de vacunación completo, según el Ministerio de Salud de Perú. El 82,8% del aislamiento del germen fue de sangre. La resistencia antibiótica fue más frecuente a la eritromicina (55,2%), trimetoprim-sulfametoxazol (48,3%) y penicilina (24,1%). Los serotipos registrados fueron 6C, 19A, 23A y 24F. Un paciente falleció por meningitis. En conclusión, la ENI fue más frecuente en niñosde uno a cinco años y en la forma clínica de bacteriemia. Se encontraron cinco serotipos reportados en estudios previos con resistencia a penicilina y eritromicina.

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“…Pneumococcal conjugate vaccines (PCVs) are an effective intervention in reducing the incidence of disease caused by macrolide-resistant pneumococcal serotypes covered by the vaccine ( Rodgers and Klugman, 2011 ). In Peru, PCV was introduced to the National Immunization Program as PCV7 in 2009, and was replaced by PCV10 in 2012, and PCV13 in 2015 ( Davalos et al., 2016 ).…”

Section: Introductionmentioning

confidence: 99%

Increase of Macrolide-Resistance in Streptococcus pneumoniae Strains After the Introduction of the 13-Valent Pneumococcal Conjugate Vaccine in Lima, Peru

Gonzales

Mercado

Pinedo-Bardales

et al. 2022

Front. Cell. Infect. Microbiol.

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Streptococcus pneumoniae upper respiratory infections and pneumonia are often treated with macrolides, but recently macrolide resistance is becoming an increasingly important problem. The 13-valent pneumococcal conjugate vaccine (PCV13) was introduced in the National Immunization Program of Peru in 2015. This study aimed to evaluate the temporal evolution of macrolide resistance in S. pneumoniae isolates collected in five cross-sectional studies conducted before and after this vaccine introduction, from 2006 to 2019 in Lima, Peru. A total of 521 and 242 S. pneumoniae isolates recovered from nasopharyngeal swabs from healthy carrier children < 2 years old (2 carriage studies) and samples from normally sterile body areas from pediatric patients with invasive pneumococcal disease (IPD) (3 IPD studies), respectively, were included in this study. Phenotypic macrolide resistance was detected using the Kirby-Bauer method and/or MIC test. We found a significant increase in macrolide resistance over time, from 33.5% to 50.0% in carriage studies, and from 24.8% to 37.5% and 70.8% in IPD studies. Macrolide resistance genes [erm(B) and mef(A/E)] were screened using PCR. In carriage studies, we detected a significant decrease in the frequency of mef(A/E) genes among macrolide-resistant S. pneumoniae strains (from 66.7% to 50.0%) after introduction of PCV13. The most common mechanism of macrolide-resistant among IPD strains was the presence of erm(B) (96.0%, 95.2% and 85.1% in the 3 IPD studies respectively). Macrolide resistance was more common in serotype 19A strains (80% and 90% among carriage and IPD strains, respectively) vs. non-serotype 19A (35.5% and 34.4% among carriage and IPD strains, respectively). In conclusion, S. pneumoniae macrolide resistance rates are very high among Peruvian children. Future studies are needed in order to evaluate macrolide resistance trends among pneumococcal strains, especially now after the COVID-19 pandemic, since azithromycin was vastly used as empiric treatment of COVID-19 in Peru.

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Características epidemiológicas, clínicas y bacteriológicas de meningitis neumocócica en pacientes pediátricos de Lima, Perú

Cited by 4 publications

References 20 publications

Characteristics and Risk Factors of Central Nervous System Infection in Children With Febrile Seizures

Characteristics and Risk Factors of Central Nervous System Infection in Children With Febrile Seizures

Enfermedad neumocócica invasiva en pacientes de un hospital pediátrico de Perú, 2017-2020

Increase of Macrolide-Resistance in Streptococcus pneumoniae Strains After the Introduction of the 13-Valent Pneumococcal Conjugate Vaccine in Lima, Peru

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