WCIM 2014 SEOUL KOREA 137
Poster Session
The Korean Journal of Internal Medicine Vol. 29, No. 5 (Suppl. 1)
PS 0340 Epidemiology and Public Health Epidemiology of Pneumococcal Community-Acquired Pneumonias in Different Age Groups on Data of the Far East of Russia
Alina MARTYNOVA1
Pacific State Medical University, Russia1, Far Eastern Federal University, Russia2
Background: Despite of the gained results in diagnostics and treatment of communi- ty-acquired pneumonias (CAP) the pneumococcal infection remains one of the leading problems of the modern medicine. Also there are still some discussions in epidemiolog- ical peculiarities of pneumococcal CAP in different age groups. The aim was to defi ne role of S.pneumoniae in ethiology.
Methods: Our patients with confirmed CAP (400 patients) were divided on 4 age groups of 1-5 years, 6-15 years, adults (18-54), aged adults (55Results: pneumococcus was the leading pathogen in all age groups, and it was the most frequent in 1-5 chil- dren (42%), 6-15 (30%), 18-54 (35%), >55 years (60%). In some cases it was defi ned in association with the Chlamydia pneumophilla, Mycoplasma pneumonia and Haemo- philus infl uenzae. The resistance of pneumcoocci to macrolides was in all groups, and it was connected with the spread of the mefE and ermB determinants, and there were only 12 penicilline resistant strains. The isolates were distributed among four major serotypes: 23F, 14, 18C, 6B. MLST (30 isolates) showed the spread of sequence types 90, 189, 240 and some others.
Conclusions: Pneumococci remains the leading pathogen causing CAP in all age groups, and the epidemiological surveillance with molecular epidemiology study should be the fi rst step for preventive measures and the spread of the pneumococcal vaccines (e.g. Prevnar) among population.
PS 0341 Epidemiology and Public Health Serologic Profi le of Chronic Hepatitis B Infection Prev- alence in Rural Areas of Tangerang Regency, Indonesia
Graciella WAHJOEPRAMONO1, Franxicus CLINTON1, Shirley Ivone MONINGKEY1, Wahyuni Lukita ATMODJO1, George MATHEW2
Medical Faculty, Universitas Pelita Harapan, Indonesia1, Mochtar Riady Institute for Nanotechnology, Indonesia2
Background: Hepatitis B viral infection is estimated more than one third of the world’s population and 5% of all carriers develop cirrhosis, and primary hepatocellular carcinoma. Our previous epidemiology study of prevalence Hepatitis B infection in rural areas of Tangerang regency showed about 3.96% were positive to HBsAg test.
Serologic test used for the diagnosis of Hepatitis B virus infection involves of distinct HBV-specifi c antigens and host antibody react to these antigens, however the inter- pretation of these tests was complicated and refl ects multiple possibilities.
Methods: Five hundred patients visited Rural Health Community Centers were recruit- ed with inclusion criteria age 15 - 60 years old male or female, they do not drink alco- hol and they have no history of jaundice. Their plasma was screened for HbsAg using ELISA and Rapid Diagnostic tests; then those blood demonstrated positive to HbsAg, subsequently tested for anti-HBs, anti-HBc, HBeAg, anti-HBe and HBV DNA viral load.
Results: The blood of nineteen (19) patients showed positive to HBsAg. Serologic test for anti-HBs was negative, but all of 19 showed positive to anti-HBc. Only 2 patients were detected HBeAg-positive but anti-HBe react either positive or negative.
Measurement viral load of HBV-DNA demonstrated the number < 1,000 IU/ml for 16 patients and 3 patients the number > 10,000 IU/ml.
Conclusions: Serologic profi les of 19 patients with HBsAg-pos are consistent with carrier state or chronic hepatitis B infection, however only 3 patients with higher HBV DNA levels (>10.000 IU/ml) were diagnosed as Chronic Hepatitis B infection. Mostly patients were diagnosed as carrier state due to their serologic profi le of HBeAg-nega- tive and anti Hbe positive or negative with viral load less than 1000 IU/ml.
PS 0342 Epidemiology and Public Health Survival Curves and Characterization of Patients Who Died with Diagnoses Related with Sepsis in the Univer- sity Clinic Rafael Uribe from Cali Valle Colombia
Angel Ricardo ARENAS VILLAMIZAR1, Hoover LEÓN GIRALDO2, Esteban RODRIGUEZ CARDENAS3, Jenny MUÑOZ LOMBO4
Basic Business Unit Hospitalization, Hospitalization Chief, Colombia1, Subdivision of Teaching and Re- search, Statistical, Colombia2, Emergency, General Doctor, Colombia3, Internal Medicine, General Doctor, Colombia4
Objective: To estimate the survival curves (Kaplan Meier) categorized by risk groups of patients who died of SIRS, sepsis, septic shock or severe sepsis during the year 2011, and carry out their respective characterization
Methods: Sample Size: Totality of patients who died of septicemia diagnoses according to the ICD-10 Criteria for Inclusion: elder 15-year-old patients. Direct cause of death:
Septicemia. To comply with The American College of Chest Physicians and The Society of Critical Care Medicine criteria for diagnosis of Systemic infl ammatory response syn- drome SIRS, sepsis, severe sepsis or septic shock. Exclusion criteria: deceased patients with different diagnoses and Patients Younger than 15 years old.
Statistical Analysis Plan: It was carried out univariate and bivariate analysis. It was cal- culated the categorized survival values: gender, origin of remission, antibiotic treatment and comorbidities. It was used STATA version 10.0
Results: Certifi ed cases of death by SEPSIS (n = 243) 23%, were incorrectly classifi ed.
55.67% of deaths by SEPSIS were of community origin and 44.33% were associated to infections in health care (IAHC). 34,04% of the established treatments were not rele- vant. The fall of the survival curve was faster in patients with community germs died of sepsis. The main germ found in the community was the E. Coli: 11.48%, it was followed by Klebsiella pneumonia: 7.38% For patients with IAHC, the Pseudomona aeruginosa ranked fi rst: 12.12%.
Conclusions: As to the origin of the infection, the pulmonary focus was the further presentation. It was found sepsis diagnoses not justifi ed which alters the epidemiology of the institution. It’s required a greater adherence to the manuals and protocols for the rational use of antibiotics by improving the timeliness and effectiveness of the same.
Studies are suggested to the germs from the community where survival rates fall more dramatically than the germs involved in infections associated with health care.
PS 0343 Epidemiology and Public Health Family Empowerment in Early Detection of Dengue Infection in Surabaya, Indonesia
Dwi Wahyu ASTUTI1, Nasronudin NASRONUDIN4, Siswanto SISWANTO1, Musofa RUSLI2, Bramantono BRAMANTONO2, Maria I. LUSIDA4, Umar F ACHMADI5, Muhammad A. ISFANDIARI6
National Institute of Health Research and Development, Indonesia1, Medical Faculty Airlangga University - Dr Soetomo Hospital, Indonesia2, Medical Faculty Airlangga University, Indonesia3, Airlangga University, Indonesia4, Indonesia University, Indonesia5, Airlangga University, Indonesia6
Background: Dengue is the most rapidly spreading mosquito-borne viral disease in the world, including Indonesia. Dengue virus (DENV) is a small single-stranded RNA virus comprising four distinct serotypes (DENV-1, DENV-2, DENV-3, DENV-4). DENV-3 is a major cause of severe dengue infection in Indonesia. Currently, in several area changes in certain serotype related with severe infection. Family members are expected to take part in prevention, early detection of the morbidity and mortality associated with den- gue infection and as reference source for health worker and researchers.
Methods: A total of 460 patients enrolled this study. Informed consent was obtained prior to recruitment of patients enrolled into the study. During their admission to 5 hospitals and 15 primary health centers, data of characteristics and clinical informa- tion (symptoms, laboratory and severity of dengue infection) were collected during January 2012 to December 2013. The subject is patient with fever on day 1 or 2, suspected Dengue infection according to WHO criteria, and shows positive dengue NS1 and or IgM, IgG anti-dengue using a rapid screening test. The family members and health workers came to the patient’s neighborhood and observed wheter there are same symtoms in radius of 100 meters from the patient’s house.
Results: From 460 patients, DENV-1 has been documented as the most frequent serotype among dengue cases (19,34%), followed by DENV-2 (19,13%). Spontaneous haemorrhagic manifestations occurs on 36 patients (7,8%) of the 460 patients. All patients with haemorrhagic manifestations, 12 (33,33%) and 5 (13,8%) were caused by DENV-2, DENV-1 respectively. All subject discharge from health facility on recovery, undeveloped to DSS or death.
Conclusions: Empowering family members and health worker can give an important contribution in early case detection to zero morbidity, mortality and transmission.