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  • Crispin, Ana M  (4)
  • 1
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    508. Prevalence of nasopharyngeal colonization by Staphylococcus aureus in adults with chronic diseases in Colombia.
    Oxford University Press (OUP) ; 2022
    In:  Open Forum Infectious Diseases Vol. 9, No. Supplement_2 ( 2022-12-15)
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    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 9, No. Supplement_2 ( 2022-12-15)
    Abstract: Staphylococcus aureus is a significant cause of morbidity and mortality worldwide. It is responsible for many infections, especially soft tissues, and bacteremia. S. aureus is also a commensal microorganism in humans, usually found in the nasopharynx. Colonized subjects, especially adults with comorbidities, have a higher risk of developing clinical infections such as community-acquired pneumonia (CAP). Some researchers have hypothesized that nasopharyngeal colonization is the etiology that could predict the etiology of CAP. Therefore, the objective of this study was to establish the prevalence of nasopharyngeal colonization by S. aureus in adults with comorbidities in a Colombian cohort. Methods This was a multicenter prospective cohort study in 3 centers in Colombia, conducted between December 2020 and March 2021. Patients older than 18 years with a diagnosis of chronic disease were included. Subjects with evidence or diagnosis of CAP before 90 days and subjects admitted to hospitalization during the last seven days were excluded. Nasopharyngeal aspirate (NPA) sampling in each participant according to WHO guidelines. A seeding of 100 ¼L of NPA by counting method on blood agar. The colonies in these cultures were identified by MALDI-TOF. Results NPAs were obtained in 810 subjects. S. aureus was isolated in 16.9% [137/810] of participants, with an average concentration of 148 CFU/100 µL [IQR 1 – 5500] . All the obtained colonies were confirmed by MALDI-TOFF. Patients had a mean age of 61.4 years [IQR 26 – 98], and 48.7% [67/137] were women. All of the subjects presented at least one comorbidity (51,1% [70/137] Arterial hypertension, 21,9% [30/137] chronic kidney disease, 16,8% [23/137] Diabetes and Heart failure). Notably, only 5.8% [8/137] developed pneumonia during the first six months of follow-up. Conclusion Our results confirm that S. aureus is a prevalent microorganism that colonizes the nasopharynx in adults with comorbidities. We will follow up with the patients for two years to determine if the nasopharyngeal colonization due to S. aureus is a risk factor for developing CAP. Disclosures All Authors: No reported disclosures.
    Type of Medium: Online Resource
    ISSN: 2328-8957
    URL: Article
    DOI: 10.1093/ofid/ofac492.564
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
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  • 2
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    2186. Risk Factors to predict one-year Community-Acquired Pneumonia in a Low-Middle Income Country: A Prospective Cohort Study
    Oxford University Press (OUP) ; 2022
    In:  Open Forum Infectious Diseases Vol. 9, No. Supplement_2 ( 2022-12-15)
    Details
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 9, No. Supplement_2 ( 2022-12-15)
    Abstract: Community-acquired pneumonia (CAP) is the principal cause of mortality due to infectious diseases globally. Some risk factors have been identified for CAP, such as age, smoking, environmental exposures, malnutrition, previous CAP, chronic bronchitis/chronic obstructive pulmonary disease (COPD), asthma, functional impairment, poor dental health, and immunosuppressive therapy, among others. However, these studies were conducted in high-income countries and patients without comorbid conditions. Therefore, we aimed to identify the risk factors associated with CAP development within a one-year follow-up in a prospective cohort of patients with comorbid conditions in Colombia. Table 1.Logistic Regression Analysis Methods This prospective cohort of adult patients with chronic comorbidities between 2020-and 2022 in Bogotá, Colombia. Univariate analysis and multivariate logistic regression model were developed to identify the variables associated with CAP development within a one-year follow-up. The logistic regression model included variables with a p-value & lt;0.20 in the univariate analysis. Results A total of 810 patients were included in the program. Median [IQR] age was 63 [53-62] and the most common comorbidities were 52.2% [423/810] arterial hypertension, 21.7% [176/810] coronary disease, and 19.0% [154/810] congestive heart failure. To date, 678 follow-ups have been made. Thirty-four patients died before the 6-month follow-up, and 46 were lost, leaving 598 patients included in the analysis. The cumulative incidence of CAP was 4.3% [26/598] during one year. After adjusting the logistic regression model, the main risk factors associated with pneumonia development were COPD [OR 4.30, 95% CI 1.66-11.11, p & lt; 0.01], and previous antibiotic treatment [OR 4.08, 95% CI 1.08-15.29, p=0.04] (Table 1). Conclusion Patients with a history of COPD or previous antibiotic treatment have a more than 300% higher risk of developing pneumonia within one year. Robust vaccination programs for adults are needed in Colombia. Disclosures All Authors: No reported disclosures.
    Type of Medium: Online Resource
    ISSN: 2328-8957
    URL: Article
    DOI: 10.1093/ofid/ofac492.1805
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
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  • 3
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    122. Streptococcus pneumoniae Nasopharyngeal Colonization in a Colombian Cohort of Patients with Comorbid Conditions
    Oxford University Press (OUP) ; 2022
    In:  Open Forum Infectious Diseases Vol. 9, No. Supplement_2 ( 2022-12-15)
    Details
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 9, No. Supplement_2 ( 2022-12-15)
    Abstract: Community-acquired pneumonia (CAP) remains the first cause of infectious death and morbidity worldwide. Nevertheless, its etiological pathogen is only isolated in almost 30% of cases, and its most representative bacteria is S. pneumoniae. Some researchers have proposed that the nasopharyngeal colonization by S. pneumoniae could risk developing CAP. However, the prevalence of nasopharyngeal colonization in patients with chronic comorbid conditions in Latin America is unknown, where vaccination rates are low. This study aims to determine the rate of S. pneumoniae colonization in a Colombian cohort. Figure 1.Pneumococcal vaccination and colonization in the whole cohort. Methods This is a prospective cohort study in 3 centers in Colombia carried out between 2020 and 2022. According to the world health organization guidelines, the nasopharyngeal aspirate (NPA) samples from each participant were obtained. Samples were incubated with 5% CO2 in blood agar, and MALDI-TOFF identified the colonies obtained. We compared the number of S. pneumoniae isolated and stratified by anti-pneumococcal vaccination status. Results The cohort was composed of 810 patients. The median [IQR] age was 63 [53-62] and the most common comorbidities were 52.2% [423/810] arterial hypertension, 21.7% [176/810] coronary disease, 19.0% [154/810] congestive heart failure, and 17.4% [141/810] chronic kidney disease. Nasopharyngeal colonization by S. pneumonie was only documented in the patients' 2.1% [15/723] (Figure 1). Moreover, 10.7% [87/810] patients from the cohort were vaccinated against S. pneumoniae, and none were colonized. Conclusion Nasopharyngeal colonization by S. pneumoniae in our cohort of adults with chronic comorbidities was low. Notably, all the colonized patients were not vaccinated, at higher risk of developing the invasive pneumococcal disease. More robust vaccination policies should be implemented for adults in Colombia. Disclosures All Authors: No reported disclosures.
    Type of Medium: Online Resource
    ISSN: 2328-8957
    URL: Article
    DOI: 10.1093/ofid/ofac492.200
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2757767-3
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  • 4
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    111. Influenza and Pneumococcal vaccination rate in a cohort of adults with chronic comorbid conditions in Colombia.
    Oxford University Press (OUP) ; 2022
    In:  Open Forum Infectious Diseases Vol. 9, No. Supplement_2 ( 2022-12-15)
    Details
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 9, No. Supplement_2 ( 2022-12-15)
    Abstract: Lower respiratory tract infections (LRTI) are the leading cause of mortality and morbidity worldwide. Elderly and patients with comorbid conditions are at higher risk of developing LRTI and systemic complications. Therefore, the Centers for Disease Control and Prevention (CDC) and the United States National Center for Immunization and Respiratory Diseases (US-NCIRD) recommend that patients older than 19 be vaccinated for influenza annually. Patients older than 65 or with comorbid conditions (of any age) should be vaccinated for the pneumococcal vaccine. Low-middle-income countries like Colombia do not have strong policies for adults to get vaccinated. According to CDC recommendations, this study aims to determine the vaccination rate in a Colombian cohort. Figure 1. Panel A illustrates patients’ distribution of influenza vaccine in the cohort, while Panel B shows the distribution of pneumococcal vaccine Methods This is the description of a prospective cohort of patients with chronic comorbid conditions between 2020-and 2022 in Bogotá, Colombia. We compared the number of patients vaccinated against Influenza and S. pneumoniae, according to CDC recommendations, to determine the adherence to international guidelines. Results The cohort was composed of 810 patients. The median [IQR] age was 63 [53-62] and the most common comorbidities were 52.2% [423/810] arterial hypertension, 21.7% [176/810] coronary disease, 19.0% [154/810] congestive heart failure, and 17.4% [141/810] chronic kidney disease. According to CDC recommendations, 808 patients should have been vaccinated against influenza (Figure 1A), but only 31.7% [256/808] were immunized last year. Also, 17.8% [144/810] of the whole cohort were 65 years old and should have received the quadrivalent flu shot. Moreover, 86.4% [700/810] patients meet the criteria for pneumococcal vaccination (Figure 1B), but only 11.9% [83/700] received at least one shot. Conclusion Vaccination rates in our cohort of adult patients with chronic comorbidities were meager. Therefore, these patients are at higher risk of developing LRTI complications. More robust vaccination programs for adults are required in Colombia. Disclosures All Authors: No reported disclosures.
    Type of Medium: Online Resource
    ISSN: 2328-8957
    URL: Article
    DOI: 10.1093/ofid/ofac492.189
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2757767-3
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