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- Sustained importance of Streptococcus pneumoniae among pediatric complicated Pneumonia in Portugal (2019-22)Publication . Gomes-Silva, J.; Silva-Costa, Catarina; Pinho, Marcos; Friães, Ana; Ramirez, Mário; Melo-Cristino, José; Portuguese Group for the Study of Streptococcal Infections; Portuguese Study Group of Pediatric Invasive Streptococcal DiseaseBackgrounds: To improve the etiological diagnosis of culture-negative pediatric complicated pneumonia (PCP), we expanded our real-time PCR assay to include other bacterial agents and evaluate potential changes in etiology after 7 years of near universal use of 13-valent conjugate pneumococcal vaccine (PCV13). Methods: We collected 156 culture-negative pleural fluid and empyema samples from children (<18 years), in 62 hospitals in Portugal, from January 2019 to December 2022. Our assay included Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus, Mycoplasma pneumoniae, Haemophilus influenzae, Mycobacterium tuberculosis and Streptococcus agalactiae. For S. pneumoniae cases we performed molecular serotyping. Results: Overall, 78 samples were negative for all bacteria tested (50.0%). Among the remaining 78 samples, the majority was positive for S. pneumoniae (n=64, 41.0%). S. pyogenes was found in 7 samples (4.49%), S. aureus in 5 samples (3.20%), H. influenzae in 2 samples (1.28%), and M. pneumoniae in 1 sample (0.64%). We did not detect M. tuberculosis nor S. agalactiae. In 2 samples, we detected the presence of DNA from both S. pneumoniae and another species: S. aureus (n=1) and H. influenzae (n=1). Among the pneumococcal samples, 44 were serotype 3 (56.4%), 5 were serotype 8 (6.41%), 2 were serotype 14 (2.56%) and serotypes 15A, 16F, 19A, 19F and 6C/6D were detected in 1 sample each (1.28% each). The remaining were negative for all serotypes tested (4.49%). Conclusions/Learning Points: After two decades of pneumococcal conjugate vaccine use, S. pneumoniae is still responsible for most culture-negative PCPs, with PCV13 serotype 3 responsible for most cases. Expanding the molecular diagnostic panel to other species allowed the identification of the etiology of only an additional 9.62% of cases, suggesting that bacteria other than S. pneumoniae remain infrequent despite PCV13 use.
- Implementation of a Nationwide Surveillance Network of Respiratory Syncytial Virus in Children < 2 years old in PortugalPublication . Melo, Aryse; Torres, Ana Rita; Lança, Miguel; Gaio, Vânia; Rodrigues, Ana Paula; Guiomar, Raquel; Bandeira, Teresa; Azevedo, Inês; VigiRSV networkHuman respiratory syncytial virus (RSV) is associated with substantial morbidity and mortality in infants, young children and elderly. Monoclonal antibodies (MAb) therapy is the available method to prevent and combat severe disease in infants, nevertheless there is a global effort in the development of vaccines and new generation of MAb. In this sense, RSV surveillance is essential to estimate the burden of RSV infection, evaluate the impact of preventive measures and to support public health decisions. Following European recommendations, a nationwide hospital-based RSV sentinel network denominated VIGIRSV was set up in Portugal. The aim of this work is to describe the implementation of VIGIRSV and report preliminary results obtained in this surveillance. VIGIRSV was implemented in 2021 with the initiative of the National Institute of Health Dr.outor Ricardo Jorge (INSA) and the Portuguese Paediatrics Society (PPS), and in 2023, 20 Hospitals collaborate in the surveillance. The surveillance is based on the recruitment of children <2 years-old hospitalized for, at least, 24 hours, that fulfill the case definition fordue to an RSVAcute Respiratory Infection (ARI). At recruitment, the paediatrician fills an epidemiological clinical questionnaire, and biological samples are collected for laboratorial diagnosis. Positive samples for RSV are forwarded to INSA for complementary virological analyses such as genetic characterization of the virus. Preliminary results from the first 2 years of surveillance are presented in table 1 and show an early RSV activity with high intensity in the 2022/23 season.. The data obtained from VIGIRSV´s results integrate the weekly published “Epidemiological surveillance bulletin of Influenza and other respiratory viruses” which can be foundavailable at https://www.insa.min-saude.pt/category/informacao-e-cultura-cientifica/publicacoes/atividade-gripal/, as well as the surveillance at European level. In addition, epidemiological and virological results are disclosed in scientific publications. The maintenance of such important surveillance is possible due to effort of distinct organizations and professionals, and has impact on the public health service.