Clinical course and microbiology of diphtheria in Latvia
Abstract number: P1394
Paberza R., Vingre I., Suvalova M., Arsa F., Storozenko J., Kuse V.
In recent years Latvia still remains the only country in the EU with regulary registered diphtheria cases. Sporadic cases continue to occur, but morbidity has decreased from 20062009.
Objectives and Methods: Using retrospective analysis of case records summarize results of microbiology and imunological examinations, peculiarities of the course and outcomes of diphtheria in 56 patients treated in Infectology Center of Latvia (ICL) during period from 2006 till november 2009. The throat swabs for toxigenic corynebacteria were examined according to our standart protocols and the WHO guidelines. The level of antitoxic IgG antibodies were detected by ELISA.
Results: In period from 2006 till november 2009 at ICL were hospitalized 56 diphtheria patients: in 200624 patients, in 200712, in 200814 and in 20096 patients. Early hospitalisation before 5 days were in 34 cases. Only 13 patients were vaccinated according schemes, partially vaccinated and unvaccinated 43. Toxigenic C. diphtheriae var. gravis were isolated in 54 cases, var.mitis 1 case. The protective level of antitoxic IgG antibodies were insufficient in 35 cases. Course of diphtheria were mild in 26 cases, moderate 7 cases, severe in 22 cases. 7 patients died. Severity criteria were: stridor, oedema of neck, skin petechia, circulatory collapse, acute renal insufficiency, myocarditis, motor paralysis. All patients with severe and those who died had not sufficient antitoxic IgG antibodies level. Because of severe course and clinical indications 12 patients were mehanically ventilated. From them 9 patients had pneumonia. In 3 cases from bronchial lavage and blood Klebsiella pneumoniae and multiresistant Acinetobacter baumannii was obtained.
Conclusions: Most of all diphtheria cases were idetected to unvaccinated, socially deprived adults. Pneumonia to mechanically ventilated patients was caused by gramnegative multiresistant microflora and treatment include broad spectrum antimicrobial. To provide further decrease of diphtheria level it is necessary to continue vaccination of adults.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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