PO-0261 Clinical Application Of Biomarkers For Children With Severe Enterovirus 71 Infection

Abstract

Pertussis (whooping cough) is a highly contagious, life-threatening, vaccine-preventable respiratory infection. Adults can infect infants who have not completed their primary immunization schedule. Besides, the infection can be asymptomatic among adults so that the reported cases of pertussis reflect only a fraction of the actual number of the patients in Turkey. The aim of this study is to determine the antibody levels against B. pertussis toxin (PT) and filamentous heamagglutinin (FHA) in ages from 6 months to ≥60 years in Izmir, Turkey. The study population consisted of 400 healthy subjects. A cluster of sample design developed by EPI of the World Health Organization was carried out for the selection of the study population. Anti-PT and anti-FHA levels were tested by in-house ELISA in Public Health Institution of Turkey. Anti-PT IgG levels of <10 EU/ml, ≥10 EU/ml and ≥100 EU/ml were accepted as non-immun, immune and possible acute/recent infection, respectively. Of the study population 8.5% had <10 EU/ml, 68.2% had 10-100 EU/ml, and 23.3% had ≥100 EU/ml anti-PT IgG antibodies. According to anti-PT IgG antibody levels 23.7% of the cases were correlated with possible acute/recent infection. The incidence of possible acute/recent infection (≥ 100 EU/ml anti-PT antibodies) was highest among 10-14 and 20-29 years old. The incidence was lowest (18.9%) among 5-6 years old and increased in the school age and was highest (34.3%) among 15-19 years old. Although high infant pertussis vaccination coverage in Turkey, our results showed that, pertussis is endemic, particularly in adolescent and adults. Adolescent and adults can be a major reservoir for the disease who haven't completed their primary immunization. Background and aims Antimicrobial drug resistance is a serious threat to public health worldwide. Antimicrobial stewardship program (ASP) information related to the paediatric population is scarce. This study assesses the usefulness of ASP instituted in 2005 in our centre. Methods Retrospective study in a 214 bed-tertiary care paediatric hospital (52% patients in high-complexity areas), from 2005 to 2012. Variation in admissions, hospital complexity index, mortality rate, bacterial resistance and invasive fungal filamentous infection (IFFI) episodes were recorded. Rates of systemic antibiotics (glycopeptides, aminoglycosides, carbapenems) and intravenous antifungal drugs consumption in admitted patients were assessed, calculated by drug units and related cost. Results A significant decrease in the number of admissions (-27%) was observe but complexity index and number of transplants increased significantly (+206% and +14%, respectively), as episodes of proven and probable IFFI (+88%). ESBL E.coli and K.pneumoniae increased (5 to 7.6% and 13.8 to 20%) while AmpC hiperproduced Enterobacter cloacae remained stable (29.2 to 29.5%). Multiresistant P. aeruginosa (1.1 to 5%) and MRSA (6.5 to 12.2%) increased moderatelely. Mortality rate showed a decrease of 8%. PO-0260d THE USEFULNESS OF AN ANTIMICROBIAL STEWARDSHIP PROG...