Neumonía adquirida en la comunidad e inmunización a Streptococcus pneumoniae en menores de 59 meses. Periodos pre y pandémico
DOI:
https://doi.org/10.31698/ped.52012025004Palabras clave:
Neumonía, Streptococcus pneumoniae, vacuna, niñosResumen
Introducción: La neumonía es una de las principales causas de muerte en menores de 5 años.
Objetivos: Describir las características demográficas, microbiológicas y estado de inmunización contra el Streptococcus pneumoniae, (S.pneumoniae) de pacientes menores de 59 meses, hospitalizados, con los diagnósticos de neumonía adquirida en la comunidad (NAC) probable o confirmada, en el periodo comprendido entre enero del 2017 a agosto del 2022.
Materiales y Métodos: Estudio observacional descriptivo, transversal retrospectivo. A partir de la base de VINUVA, fueron incluidos pacientes menores de 5 años con diagnóstico de NAC probable o confirmada. Variables edad, genero, tipo de NAC, retorno bacteriológico (cultivos y estudio molecular), serotipificación, inmunización con PCV y evolución. Los datos fueron analizados con SPSS. El comité de ética aprobó el protocolo de estudio.
Resultados: Fueron incluidos 593 pacientes, con una mediana edad 22 meses, 52,8% masculino, 72,8% tenían NAC probable y 27,2% NAC confirmada. Tenían vacuna PCV 64,9%. S. pneumoniae se aisló en el 84%, de las NAC confirmadas con predominio de serotipos vacunales. El 9,8% fueron neumonías severas e ingresaron a la unidad de terapia intensiva pediátrica. Durante la pandemia las hospitalizaciones y la inmunización con PCV disminuyeron, acompañado de aumento de las neumonías por S. pneumoniae. La mortalidad total fue 3,4%.
Conclusiones: Hubo predominio de menores de 24 meses, de género masculino. El Streptococcus pneumoniae de serotipo vacunal predominó en los aislamientos. Formas graves de neumonía se observó en el 9,8% y la mortalidad global fue 3,4%. Durante la pandemia disminuyo cobertura vacunal con PCV y aumento la NAC causada por el S.pneumoniae.
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