Resumo

Vigilancia epidemiológica centinela de Haemophilus influenzae y Streptococcus pneumoniae en menores de 5 años en el Perú. Rev. perú. med. exp. salud publica [online]. 2003, vol.20, n.3, pp.150-155. ISSN 1726-4634.

Objective: To determine the frequency, serotypes and antimicrobial resistance of H. influenzae (Hi) and S. pneumoniae (Spn) in Peruvian children under 5 years old with meningitis and pneumonia. Materials and methods: Between October 2000 and December 2001 sentinel surveillance por Hi and Spn was implemented in 5 hospitals in Peru. Serotype identification and antimicrobial resitance were performed at the Peruvian National Institute of Health in Lima. Antimicrobial resitance using minimal inhibitory concentration (MIC) was assessed using the plate microdilution method, according to NCCLS standards. Results: 1283 cases were included. 59 strains (31 of Hi and 28 of Spn) were found. Bacterias were detected in 2,3% of pneumonia patients and in 42,5% of meningitis patients. 10/1210 (0,8%) had Hi pneumonia and 18/1210 Spn pneumonia. 21/73 (28,8%) had Hi meningitis and 10/73 (13,7%) Spn meningitis. The following Spn serotypes: 1, 5, 6A, 11, 14, 19, 19F and 20 were identified. Only the serotype b of Hi was identified. We found Spn strains highly resistant to penicillin (3/13), cotrimoxazole (3/13), erithromycin (1/13), chloramphenicol (1/13) and ceftriaxone (1/13). Hi strains highly resistant to cotrimoxazole (4/20) and ampicillin (1/20) were also detected. Conclusions: The frequency of Spn and Hi infection in children under 5 years old with pneumonia and meningitis was very low. We found serotypes already identified in Latin America and some antibiotic used in the standardized treatment of pneumonia and meningitis highly-resistant strains of Spn and Hi. Follow-up of this surveillance system in selected hospitals is recommended.

Palavras-chave : Haemophilus influenzae; Streptococcus pneumoniae; Surveillance; Epidemiologic surveillance; Child; Peru ..

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