P-2060. Sociodemographic Disparities and Their Possible Impact on the Epidemiology of Pediatric Community Acquired Bacteremia

Abstract Background Data on the influence of sociodemographic characteristics on the epidemiology of community-acquired bacteremia in vaccinated populations remains limited. We aimed to examine the association between sociodemographic characteristics and the epidemiology of pediatric community acquired bacteremia.Rates of Community Acquired Bacteremia in Low and High Socioeconomic Status Populations Methods This retrospective study was conducted in two hospitals serving populations with significant socioeconomic disparities (low socioeconomic status [SES] rank 2/10 vs. high SES: rank 7/10, based on the Central Bureau of Statistics' scale). We included all cases of community-acquired bacteremia in patients< 18 years between 2016-2023. Bacteremia rates were calculated per 1,000 blood cultures drawn. Rates of true bacteremia and the distribution of isolates were compared between hospitals. S.pneumoniae isolates were further analyzed to determine serotype coverage by the Prevenar 13 and Prevenar 20 vaccines. Results We identified 298 cases of community-acquired bacteremia. Bacteremia rates were higher in low- vs. high-SES children < 3 years (10.5 vs. 5.2 cases/1,000 cultures; RR -2, P < 0.01 and 10.06 vs. 4.1 per 1,000 cultures; RR-2.4, P < 0.01, in those aged < 3 months and 3–36 months, respectively). S.pneumoniae was the leading isolate among children aged 3–36 months (n=55, 44.3% in low vs. n=36, 22.3% in high-SES populations). In the low-SES population, S.pyogenes (10.4%) and N.meningitidis (7.0%) were the next most common isolates, while K.kingae (16.0%) and M.catarrhalis (11.7%) followed in the high-SES population. Non-Prevnar 13 S.pneumoniae serotypes accounted for 94.4% of cases in high-SES and 89% in low-SES populations (P = 0.4). Prevnar 20 covered isolates accounted for 50.9% in low-SES and 38.8% in high-SES populations (P = 0.2). Conclusion Low-SES children < 3 years had more than twice the risk of bacteremia compared to high-SES children, with higher rates of S.pyogenes and N.meningitidis. Non–Prevnar 13 S. pneumoniae serotypes accounted for the majority of cases in both populations, with a substantial proportion covered by the recently introduced Prevnar 20 vaccine, highlighting its potential to reduce the burden of invasive pneumococcal disease. Disclosures All Authors: No reported disclosures