Abstract

ARANDA, Cinthia; LOVERA, Dolores  and  ARBO, Antonio. Changes in the epidemiological pattern and resistance Bacterial Meningitis Acute Bacterial Children in a referral hospital. Rev. Inst. Med. Trop. [online]. 2014, vol.9, n.2, pp.10-20. ISSN 1996-3696.

Abstract Introduction. Post-introduction of the anti-H. influenzae type b (HIB) vaccine has been observed in Latin America a significant changes in the epidemiological profile and susceptibility of germs that cause acute bacterial meningitis. No similar studies have in Paraguay. Aim: Study the current epidemiological situation of acute bacterial meningitis in a referral hospital after the introduction of Hib vaccine in Paraguay. Materials and methods: observational, retrospective study in which all cases of acute bacterial meningitis in children <15 years and >3 months hospitalized in the IMT from January 1993 to June 2006 included the medical records of patients were analyzed (pts) including demographics, etiologic and clinical outcome. Pts were stratified by year of hospitalization in three periods: Period I (PER I), which included those who were hospitalized between 1993 and 1997, PER II between 1998 and 2002 and PER 2003 to 2006. III CIM was determined penicillin (PEN) and cefotaxime (CFX) isolates of S. pneumoniae (SPN) for the ipsilométrico method (E-test) carried out by the reaction serotyping Quellung. Results: During the study period 394 pts with acute bacterial meningitis were hospitalized. The mean age was 2.9 ± 4 years, with discreet predominance of males (ratio 1.2 / 1). Serotyping performed in 31 strains of Spn (since 2000) it showed that only 50% corresponded to serotypes included in the pneumococcal conjugate vaccine currently available, with 14 (9/31, 29%) the most frequent. Conclusions: The introduction of Hib vaccine has been a major epidemiological change of acute bacterial meningitis in our institution, now constituting the S. pneumoniae the leading cause of acute bacterial meningitis. Are still evident, however, sporadic cases of acute bacterial meningitis HIB. Although a significant increase in resistance of Spn PEN, CTX resistance is observed is still only <10%.

Keywords : H. influenzae; S. pneumoniae; vacuna; H. influenzae; S. pneumoniae; vaccine.

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