Anti infective

Annual Meeting of the European Society for Paediatric Infectious Diseases, May 2015: congress highlights

Advances in the field of bacterial infections: poster highlights from the 2015 Annual Meeting of the European Society for Paediatric Infectious Diseases.

Over 2,000 clinicians, researchers and students came together in Leipzig from 12–16 May, for the 33rd Annual Meeting of the European Society for Paediatric Infectious Diseases.

Delivered by leading experts, the programme covered a breadth of paediatric infectious disease topics over the 4 days in Germany. This summary highlights some of the interesting studies reported at the meeting.

Resistant uropathogens in children

β-lactamase-producing uropathogens pose significant issues in the treatment of urinary tract infections (UTI) in children due to antibiotic resistance. Tsirigotaki and colleagues presented their prevalence findings and characteristics of children affected by these pathogens.

The study showed that the prevalence of β-lactamase-producing strains has increased significantly in recent years; from 1.08% in 1997–1999 to 7.98% in 2012–2014. Non-E. coli pathogens were largely responsible for this increase, with infection associated with antibiotic prophylaxis and permanent scarring. Young children in particular were afflicted with UTIs, with many children also having urinary tract abnormalities. 1

PCV13 decreases pneumococcal pleural empyema

A Mexican study examined the impact of the 13-valent pneumococcal conjugate vaccine (PCV13) on rates of pneumococcal pleural empyema (PPE). Charcon-Cruz and colleagues discovered that following implementation of PCV13, cases of PPE decreased from 14 (in 59 months) to 3 (in 31 months) in one particular hospital setting. 2

First Mexican study describing the effect of PCV13 on PPE rates. 2

Paediatric clinical trials

An obstacle to the design of paediatric clinical trials in infection is the lack of a consensus on the requirements for conducting trials. In a systematic review of clinical trials, Folgori and colleagues encountered wide variations in study design. 3

The authors concluded that collaboration is urgently needed between those involved in new antibiotic development programmes to standardise the design of paediatric clinical trials, so results can inform clinical practice. 3

Formal guidance on clinical trial design for antibiotics in children is required. 3

Necrotising pneumonia

In a retrospective study, Garcia-Mauriño and colleagues analysed features of necrotising pneumonia and lung abscess.

Pneumonia with necrosis or abscesses were commonly associated with pleural effusion, which required draining in most cases. 4 The introduction of the PCV13 vaccine corresponded to a decrease in the number of cases of necrotising pneumonia with a pneumococcal aetiology (14 in 2004–2009 to 2 in 2010–2014).4 All cases of necrotising pneumonia resolved with medical treatment, without a need for open surgery. 4

Fever, cough, vomiting and abdominal pain were the most frequent symptoms. 4

Occult bacteremia rates following introduction of pneumococcal conjugate vaccines

Leibovitz and colleagues presented their findings on the impact of PCVs on occult bacteremia (OB) among children in Israel.

The most common pathogen isolated in OB was S. pneumoniae.5 The PCV13 serotypes were eliminated as a cause of OB during 2011–2012, but there was also a significant increase in non-PCV13 serotypes during this time.5 Overall, the number of OB cases decreased significantly from 0.3% in the pre-vaccination era (2005–2009) to 0.17% following the introduction of the PCV vaccine (2010–2012). 5

The introduction of PCVs corresponded to a significant reduction in the rate of OB. 5

Reference list

1. Bitsori M, Maraki S, Tsirigotaki M, Galanakis E. Beta-lactamase producing uropathogens in children. ESPID 2015. 2015.
   
2. Chacon-Cruz E, Rivas-Landeros RM, Volker-Soberanes ML. Early trends in pediatric pneumococcal pleural empyema following pneumococcal conjugate 13-valent vaccination: 9 years of active surveillance in a Mexican hospital. ESPID 2015. 2015.
   
3. Folgori L, Bielicki J, Ruiz B, Sharland M. Systematic review of paediatric antibiotic clinical trials: wide variation in study design and outcomes suggests an urgent need for harmonisation. ESPID 2015. 2015.
   
4. Garcia-Mauriño C, Barreiro Perez L, Garcia Sanchez P, del Rosal Rabes T, Escosa Garcia L, Aracil Santos FJ, et al. Necrotizing pneumonia and lung abscess as complications of pediatric bacterial pneumonia. ESPID 2015. 2015.
   
5. Leibovitz E, Ribitzky-Eisner H, Minuhin Y, Greenberg D. Occult bacteremia (OB) in febrile children aged 3-36 months at the pediatric emergency room (PER) in Southern Israel, before and after routine anti-pneumococcal immunization (2005-2012). ESPID 2015. 2015.