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Volume 5, Issue 2 (Suppl) J Infect Dis Ther 2017
ISSN: 2332-0877, JIDT an open access journal Infection Congress 2017
May 11-12, 2017
May 11-12, 2017 Barcelona, Spain
4th International Congress on
Infectious Diseases
J Infect Dis Ther 2017, 5:2 (Suppl)
Hospital cost of invasive pneumococcal diseases among children less than 15 year old in Tunisia
Arwa Ben Salah, Sana El Mhamdi, Manel Ben Fredj, Amara Tamboura, Mohamed Tahar Sfar and Mohamed Soussi Soltani
University of Monastir, Tunisia
Statement of the Problem: Invasive pneumococcal disease (IPD) caused by Streptococcus pneumoniae remains a global health
problem and imposes a great burden on society and health care system.
Aim: The objective of this study was to estimate the medical cost of hospitalizations due to IPD (pneumonia and meningitis) among
children under 15 year old in Tunisia, in an effort to provide sufficient data which can help policy makers to assess the need for the
vaccine.
Methodology: A prospective multicenter study was conducted in 15 pediatric departments across different socio-economic areas
of Tunisia from June 2014 to May 2015. All children under 15 years old who were hospitalized for pneumococcal pneumonia or
confirmed bacterial meningitis were enrolled. A case report formwas completed for every eligible case. Activity based costing method
was used to estimate the hospital cost. Data entry and statistical analysis were conducted using SPSS, version 20.0.
Findings: During the study period, 727 children were hospitalized for pneumococcal pneumonia and 60 children were hospitalized
for bacterial meningitis, among them 21(35%) had confirmed pneumococcal meningitis. The median hospital cost for pneumococcal
pneumonia was 353.910 TD and it was 1680.632 TD for pneumococcal meningitis. By overall data extrapolation, we estimated that
nearly 1091 hospitalizations for pneumococcal pneumonia and 69 hospitalizations for pneumococcal meningitis occur each year in
Tunisian children under 15 years of age, incurring total costs of 502 079.408 TD.
Conclusion: The economic burden of pneumococcal infections seems to be major in Tunisia, where a safe and effective vaccine is
available but has not yet been introduced to immunization schedules.
Severe skull base osteomyelitis caused by Pseudomonas aeruginosa with successful outcome after prolonged
outpatient therapy with continuous infusion of ceftazidime and oral ciprofloxacin: A case report
Cristina Conde
Hospital General Universitario de Elche, Spain
Skull base osteomyelitis is anuncommondisease that usually complicates amalignant external otitis with temporal bone involvement.
It affects predominantly diabetic and immuno compromised males and has a high mortality rate. Pseudomonas aeruginosa is the
most common causative organism. Currently, there is no consensus about the best therapeutic option. Here, we describe a case of
severe skull base osteomyelitis caused by Pseudomonas aeruginosa with progressive palsy of cranial nerves that was successfully
managed with prolonged outpatient continuous infusion of ceftazidime plus oral ciprofloxacin. A 69-year-old man presented with
dysphagia, headache and weight loss. He complained of left earache and purulent otorrhea. Over the following weeks, he developed
progressive palsy of IX, X, VI and XII cranial nerves and papilledema. A petrous-bone computed tomography showed a mass in the
left jugular foramen with a strong lytic component that expanded to the cavum. A biopsy was then performed and microbiological
cultures grew Pseudomonas aeruginosa. After six weeks of parenteral antibiotic treatment, the patient was discharged and treatment
was continued with a domiciliary continuous infusion of a beta-lactam through a peripherally inserted central catheter, along with an
oral fluoroquinolone for 10 months. Both radiological and clinical responses were excellent. Skull base osteomyelitis is a life-threating
condition; clinical suspicion and correct microbiological identification are key to achieve an accurate and timely diagnosis. Due to the
poor outcome of Pseudomonas aeruginosa skull base osteomyelitis, prolonged outpatient parenteral antibiotic therapy administered
by continuous infusion could be a valuable option for these patients.