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Sample records for early pneumococcal carriage

  1. Impact of the Hajj on pneumococcal carriage and the effect of various pneumococcal vaccines.

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    Edouard, Sophie; Al-Tawfiq, Jaffar A; Memish, Ziad A; Yezli, Saber; Gautret, Philippe

    2017-08-07

    The Islamic Hajj pilgrimage is the largest annual mass gathering in the world. The overcrowding of people promotes the acquisition, spread and transmission of respiratory pathogens, including Streptococcus pneumoniae. It is estimated that about 33% of pilgrims are at risk of invasive pneumococcal disease. We conducted a methodological review according to the Preferred Reporting Items for Systematic Reviews and meta-Analysis guidelines. The objective was to summarize the available data regarding the prevalence of pneumococcal carriage among Hajj pilgrims and about carriage acquisition and circulation of S. pneumoniae among pilgrims before and after participating in the Hajj according to their vaccination status. Five articles met eligibility criteria for pneumococcal carriage and impact of pneumococcal vaccination on carriage. All five studies showed a significant increase in nasopharyngeal carriage of pneumococci following the pilgrimage, with acquisition rates ranging from 18% to 36%. Serotypes 3, 19F and 34 are the most common. A significant increase in at least one antibiotic and multiple antibiotic non-susceptible strains was observed following participation in the Hajj. A lower prevalence was found in pilgrims treated with antibiotics, those who used a hand sanitizer, or those who washed their hands more frequently than usual. An increased carriage of pneumococcal serotypes included in pneumococcal vaccines (10-valent pneumococcal conjugate vaccine (PCV10), 13-valent pneumococcal conjugate vaccine (PCV13), 23-valent pneumococcal polysaccharide vaccine (PPV23) was observed following participation in the Hajj. To date, no study has shown a significant reduction in pneumococcal carriage among pilgrims after vaccination with PPV23 or PCVs. In fact, no significant difference was currently observed in the prevalence ratio of pneumococcal carriage between vaccinated and unvaccinated pilgrims. The studies analyzed in this review showed an increased carriage of

  2. Experimental human pneumococcal carriage models for vaccine research.

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    Ferreira, Daniela M; Jambo, Kondwani C; Gordon, Stephen B

    2011-09-01

    Pneumococcal conjugate vaccines have had unprecedented success in controlling vaccine-type invasive pneumococcal disease. As serotype replacement and the complexity of designing vaccines to multiple capsular polysaccharides ultimately pose a threat to these vaccines, the development of alternative protein vaccines is important. Protein vaccines offer the promise of extended serotype coverage, reduced cost, and improved protection against otitis media and pneumococcal pneumonia. As placebo-controlled trials are not currently ethically justifiable, human pneumococcal challenge models using prevention of carriage as a test endpoint offer an attractive link between preclinical studies and clinical efficacy trials. Experimental human pneumococcal carriage studies offer a means of describing mechanisms of protection against carriage and a clinical tool to choose between vaccine candidates. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. Dynamics of pneumococcal acquisition and carriage in young adults during training in confined settings in Israel.

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    Hagai Levine

    Full Text Available BACKGROUND: Outbreaks and sporadic cases of pneumococcal illness occur among young adults in confined settings. Our aim was to characterize pneumococcal acquisition and carriage among healthy young adults in Israel during military training in confined settings. METHODS: During the years 2007-2008, an observational longitudinal study was conducted in three cohorts of healthy soldiers, during a 7-month basic training period. Epidemiological data, oropharyngeal and nasopharyngeal cultures were sampled on 5 occasions: before and 3, 6, 12 and 24 weeks after start of training. Samples were processed within 2-18 hours. Relatedness of isolates was investigated by capsular typing of all isolates and pulsed-field gel electrophoresis to determine acquisition and transmission. Carriage and acquisition patterns were analyzed and multivariable logistic regression analysis was performed to assess the impact of time on acquisition after mixing, controlling for other covariates. RESULTS: Pneumococci were recovered on 202 of 1872 visits among 742 individuals, including 40 different serotypes. Mean carriage prevalence increased in all visits following training initiation. Acquisition during training was high, as 36.9% of individuals acquired pneumococci at least once during training, and for almost one fourth of the whole population this occurred during the first 6 weeks. Significant clustering was noted. Sharing drinking glass/bottle was found to be a significant and common risk factor for pneumococcal acquisition. CONCLUSIONS: Pneumococcal acquisition is highly frequent when young adults live in close contact in confined settings, especially early after mixing.

  4. Using Pneumococcal Carriage Data to Monitor Postvaccination Changes in the Incidence of Pneumococcal Otitis Media.

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    Flasche, Stefan; Givon-Lavi, Noga; Dagan, Ron

    2016-11-01

    Pneumococcal conjugate vaccines (PCVs) have substantially reduced the burden of pneumococcal disease, including the incidence of otitis media (OM). However, in most countries, no surveillance exists to monitor the change in pneumococcal OM incidence after the introduction of PCVs. We explored whether measuring pneumococcal carriage was a useful surrogate for monitoring postvaccination changes in the incidence of pneumococcal OM. The 7-valent PCV was introduced to Israel's national immunization program in July 2009 and gradually replaced by the 13-valent PCV starting in November 2010. Each day since 2009, nasopharyngeal swabs have been obtained from the first 4 Bedouin children and the first 4 Jewish children who were younger than 5 years old and attended a pediatric emergency room in southern Israel. During the same time, OM surveillance in southern Israel included all children younger than 2 years of age who were diagnosed with OM and had undergone a middle-ear fluid culture. The relative change in the prevalence of vaccine-serotype (VT) pneumococcal carriage was predictive of the relative change in incidence of OM due to VT pneumococcus. However, the serotype replacement observed in non-VT carriage is not paralleled in the incidence of OM due to non-VT pneumococcus. This could indicate that there are more complex mechanisms of the immune response involved in preventing initial and consecutive episodes of OM, which has been changed through declining prevalence of the most virulent serotypes as a result of vaccination. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Pneumococcal Carriage in Children under Five Years in Uganda-Will Present Pneumococcal Conjugate Vaccines Be Appropriate?

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    Ann Lindstrand

    Full Text Available Pneumonia is the major cause of death in children globally, with more than 900,000 deaths annually in children under five years of age. Streptococcus pneumoniae causes most deaths, most often in the form of community acquired pneumonia. Pneumococcal conjugate vaccines (PCVs are currently being implemented in many low-income countries. PCVs decrease vaccine-type pneumococcal carriage, a prerequisite for invasive pneumococcal disease, and thereby affects pneumococcal disease and transmission. In Uganda, PCV was launched in 2014, but baseline data is lacking for pneumococcal serotypes in carriage.To study pneumococcal nasopharyngeal carriage and serotype distribution in children under 5 years of age prior to PCV introduction in Uganda.Three cross-sectional pneumococcal carriage surveys were conducted in 2008, 2009 and 2011, comprising respectively 150, 587 and 1024 randomly selected children aged less than five years from the Iganga/Mayuge Health and Demographic Surveillance Site. The caretakers were interviewed about illness history of the child and 1723 nasopharyngeal specimens were collected. From these, 927 isolates of S. pneumoniae were serotyped.Overall, the carriage rate of S. pneumoniae was 56% (957/1723. Pneumococcal carriage was associated with illness on the day of the interview (OR = 1.50, p = 0.04. The most common pneumococcal serotypes were in descending order 19F (16%, 23F (9%, 6A (8%, 29 (7% and 6B (7%. One percent of the strains were non-typeable. The potential serotype coverage rate for PCV10 was 42% and 54% for PCV13.About half of circulating pneumococcal serotypes in carriage in the Ugandan under-five population studied was covered by available PCVs.

  6. [Pneumococcal carriage in mothers and children of the Panare Amerindians from the State of Bolivar, Venezuela].

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    Bello Gonzalez, T.; Rivera-Olivero, I.A.; Pocaterra, L.; Spadola, E.; Araque, M.; Hermans, P.W.M.; Waard, J.H. de

    2010-01-01

    In North America, the indigenous groups have been identified as a population with increased risk of pneumococcal colonization and pneumococcal invasive disease. However, little information is available from South American natives. In the present study we evaluated the nasopharyngeal carriage and

  7. Immunogenicity of a 7-valent pneumococcal conjugate vaccine (PCV7) and impact on carriage in Venezuelan children at risk of invasive pneumococcal diseases

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    Rivera-Olivero, I.A.; Nogal, B. del; Fuentes, M.; Cortez, R.; Bogaert, D.; Hermans, P.W.M.; Waard, J.H. de

    2014-01-01

    BACKGROUND AND AIMS: We evaluated the immunogenicity of the 7-valent pneumococcal conjugate vaccine (PCV7), and its impact on pneumococcal carriage in Venezuelan children at high risk for invasive pneumococcal disease (IPD). METHODS: 82 children (age 2-59 months) with sickle cell anemia (n=22),

  8. PNEUMOCOCCAL CARRIAGE RATE IN CHILDREN AND THEIR ANTIMICROBIAL SUSCEPTIBILITY PATTERNS IN AN URBAN S ET UP

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    Nandan; Jagadeesh; Anjana

    2013-01-01

    ABSTRACT: INTRODUCTION: S.pneumoniae is the major cause of morbidity and mor tality in India and abroad and carriage is the key to invasiv e disease. Carriage (20-60%) and invasive disease are more prevalent in children and in the el derly. Increased case fatality is due to the emergence of Penicillin and Multidrug Resistant S.pn eumoniae worldwide. Penicillin has been the drug of choice for treatment of pneumococcal inf ections but the increasing number of re...

  9. Pre-vaccination nasopharyngeal pneumococcal carriage in a Nigerian population: epidemiology and population biology.

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    Ifedayo M O Adetifa

    Full Text Available BACKGROUND: Introduction of pneumococcal vaccines in Nigeria is a priority as part of the Accelerated Vaccine Introduction Initiative (AVI of the Global Alliance for Vaccines and Immunisation (GAVI. However, country data on the burden of pneumococcal disease (IPD is limited and coverage by available conjugate vaccines is unknown. This study was carried out to describe the pre vaccination epidemiology and population biology of pneumococcal carriage in Nigeria. METHODS: This was a cross sectional survey. Nasopharyngeal swabs (NPS were obtained from a population sample in 14 contiguous peri-urban Nigerian communities. Data on demographic characteristics and risk factor for carriage were obtained from all study participants. Pneumococci isolated from NPS were characterised by serotyping, antimicrobial susceptibility and Multi Locus Sequencing Typing (MLST. RESULTS: The prevalence of pneumococcal carriage was 52.5%. Carriage was higher in children compared to adults (67.4% vs. 26%, highest (≈90% in infants aged <9 months and reduced significantly with increasing age (P<0.001. Serotypes 19F (18.6% and 6A (14.4% were most predominant. Potential vaccine coverage was 43.8%, 45.0% and 62% for PCV-7, PCV-10 and PCV-13 respectively. There were 16 novel alleles, 72 different sequence types (STs from the isolates and 3 Sequence Types (280, 310 and 5543 were associated with isolates of more than one serotype indicative of serotype switching. Antimicrobial resistance was high for cotrimoxazole (93% and tetracycline (84%, a third of isolates had intermediate resistance to penicillin. Young age was the only risk factor significantly associated with carriage. CONCLUSIONS: Pneumococcal carriage and serotype diversity is highly prevalent in Nigeria especially in infants. Based on the coverage of serotypes in this study, PCV-13 is the obvious choice to reduce disease burden and prevalence of drug resistant pneumococci. However, its use will require careful

  10. Dynamics of Nasopharyngeal Pneumococcal Carriage During the Course of Viral Bronchiolitis

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    Faber, Tina E.; Schuurs, Theo A.; Veeger, Nic J. G. M.; Hennus, Marije P.; Bont, Louis J.

    The effect of viral infection on nasopharyngeal carriage of Streptococcus pneumoniae during childhood is not well known. We studied dynamics of pneumococcal colonization by quantitative PCR during the natural course of viral bronchiolitis. At time of admission, 47(47%) of 100 patients with

  11. Dynamics of nasopharyngeal pneumococcal carriage during the course of viral bronchiolitis

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    Faber, Tina E.; Schuurs, Theo A.; Veeger, Nic J G M; Hennus, Marije P.; Bont, Louis J.

    2016-01-01

    The effect of viral infection on nasopharyngeal carriage of Streptococcus pneumoniae during childhood is not well known. We studied dynamics of pneumococcal colonization by quantitative PCR during the natural course of viral bronchiolitis. At time of admission, 47 (47%) of 100 patients with

  12. Effect of Reduced-Dose Schedules With 7-Valent Pneumococcal Conjugate Vaccine on Nasopharyngeal Pneumococcal Carriage in Children A Randomized Controlled Trial

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    van Gils, Elske J. M.; Veenhoven, Reinier H.; Hak, Eelko; Rodenburg, Gerwin D.; Bogaert, Debby; IJzerman, Ed P. F.; Bruin, Jacob P.; van Alphen, Loek; Sanders, Elisabeth A. M.

    2009-01-01

    Context The effects of reduced-dose schedules of 7-valent pneumococcal conjugate vaccine (PCV-7) on pneumococcal carriage in children are largely unknown, although highly relevant in the context of subsequent herd effects. Objective To examine the effects of a 2-dose and 2 + 1-dose PCV-7 schedule on

  13. Emerging pneumococcal carriage serotypes in a high-risk population receiving universal 7-valent pneumococcal conjugate vaccine and 23-valent polysaccharide vaccine since 2001

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    Stubbs Liz

    2009-08-01

    Full Text Available Abstract Background In Australia in June 2001, a unique pneumococcal vaccine schedule commenced for Indigenous infants; seven-valent pneumococcal conjugate vaccine (7PCV given at 2, 4, and 6 months of age and 23-valent pneumococcal polysaccharide vaccine (23PPV at 18 months of age. This study presents carriage serotypes following this schedule. Methods We conducted cross sectional surveys of pneumococcal carriage in Aboriginal children 0 to 6 years of age living in remote Aboriginal communities (RACs in 2003 and 2005. Nasal secretions were collected and processed according to published methods. Results 902 children (mean age 25 months living in 29 communities in 2003 and 818 children (mean age 35 months in 17 communities in 2005 were enrolled. 87% children in 2003 and 96% in 2005 had received two or more doses of 7PCV. From 2003 to 2005, pneumococcal carriage was reduced from 82% to 76% and reductions were apparent in all age groups; 7PCV-type carriage was reduced from 11% to 8%, and 23PPV-non-7PCV-type carriage from 31% to 25% respectively. Thus non-23PPV-type carriage increased from 57% to 67%. All these changes were statistically significant, as were changes for some specific serotypes. Shifts could not be attributed to vaccination alone. The top 10 of 40 serotypes identified were (in descending order 16F, 19A, 11A, 6C, 23B, 19F, 6A, 35B, 6B, 10A and 35B. Carriage of penicillin non-susceptible (MIC > = 0.12 μg/mL strains (15% overall was detected in serotypes (descending order 19A, 19F, 6B, 16F, 11A, 9V, 23B, and in 4 additional serotypes. Carriage of azithromycin resistant (MIC > = 2 μg/mL strains (5% overall, was detected in serotypes (descending order 23B, 17F, 9N, 6B, 6A, 11A, 23F, and in 10 additional serotypes including 6C. Conclusion Pneumococcal carriage remains high (~80% in this vaccinated population. Uptake of both pneumococcal vaccines increased, and carriage was reduced between 2003 and 2005. Predominant serotypes in combined

  14. New Pneumococcal Carriage Acquired in Association with Acute Respiratory Infection Is Prone to Cause Otitis Media.

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    Auranen, Kari; Syrjänen, Ritva; Leino, Tuija; Kilpi, Terhi

    2016-01-01

    For considering vaccine-prevention of pneumococcal acute otitis media (PncAOM), relationships between pneumococcal carriage, respiratory infection and PncAOM need to be understood. We analyzed nasopharyngeal samples collected from 329 unvaccinated Finnish children aged 2-24 months at scheduled visits and at visits during respiratory infection in 1994-97. We assessed temporal associations of respiratory infection with pneumococcal acquisition and whether PncAOM hazard depends on the relative timing of acquisition and the infection onset. The data comprised 607 person-years of risk-time for acquisition, 245 person-months of concurrent respiratory infection and carriage, and 119 episodes of PncAOM. The acquisition hazard was 3-fold in the month preceding respiratory sickness (hazard ratio, HR 3.5, 90% credible interval CI 2.9, 4.1) as compared to acquisition in healthy children. Moreover, the PncAOM hazard was markedly higher (HR 3.7, 90% CI 2.4, 5.3) during the first month of carriage acquired around the acute phase of respiratory infection (between 1 month before and 1 week after the sickness onset), as compared to carriage acquired later during sickness. The high proportion (76%) of PncAOM events occurring within 1 month of acquisition was due to frequent acquisition being associated with respiratory infection as well as the susceptibility of such acquisition to cause otitis media.

  15. Dynamic models of pneumococcal carriage and the impact of the Heptavalent Pneumococcal Conjugate Vaccine on invasive pneumococcal disease

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    Edmunds W John

    2010-04-01

    Full Text Available Abstract Background The 7-valent pneumococcal conjugate vaccine has been introduced in national immunisation programmes of most industrialised countries and recently in two African GAVI eligible countries (Rwanda and The Gambia. However the long term effects of PCV are still unclear, as beneficial direct and herd immunity effects might be countered by serotype replacement. Method A dynamic, age-structured, compartmental model of Streptococcus pneumoniae transmission was developed to predict the potential impact of PCV7 on the incidence of invasive disease accounting for both herd immunity and serotype replacement effects. The model was parameterised using epidemiological data from England and Wales and pre and post-vaccination surveillance data from the US. Results Model projections showed that serotype replacement plays a crucial role in determining the overall effect of a PCV7 vaccination programme and could reduce, negate or outweigh its beneficial impact. However, using the estimate of the competition parameter derived from the US post-vaccination experience, an infant vaccination programme would prevent 39,000 IPD cases in the 20 years after PCV7 introduction in the UK. Adding a catch-up campaign for under 2 or under 5 year olds would provide a further reduction of 1,200 or 3,300 IPD cases respectively, mostly in the first few years of the programme. Conclusions This analysis suggests that a PCV vaccination programme would eradicate vaccine serotypes from circulation. However, the increase in carriage of non-vaccine serotypes, and the consequent increase in invasive disease, could reduce, negate or outweigh the benefit. These results are sensitive to changes in the protective effect of the vaccine, and, most importantly, to the level of competition between vaccine and non-vaccine types. The techniques developed here can be used to assess the introduction of vaccination programmes in developing countries and provide the basis for cost

  16. Agglutination by anti-capsular polysaccharide antibody is associated with protection against experimental human pneumococcal carriage.

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    Mitsi, E; Roche, A M; Reiné, J; Zangari, T; Owugha, J T; Pennington, S H; Gritzfeld, J F; Wright, A D; Collins, A M; van Selm, S; de Jonge, M I; Gordon, S B; Weiser, J N; Ferreira, D M

    2017-03-01

    The ability of pneumococcal conjugate vaccine (PCV) to decrease transmission by blocking the acquisition of colonization has been attributed to herd immunity. We describe the role of mucosal immunoglobulin G (IgG) to capsular polysaccharide (CPS) in mediating protection from carriage, translating our findings from a murine model to humans. We used a flow cytometric assay to quantify antibody-mediated agglutination demonstrating that hyperimmune sera generated against an unencapsulated mutant was poorly agglutinating. Passive immunization with this antiserum was ineffective to block acquisition of colonization compared to agglutinating antisera raised against the encapsulated parent strain. In the human challenge model, samples were collected from PCV and control-vaccinated adults. In PCV-vaccinated subjects, IgG levels to CPS were increased in serum and nasal wash (NW). IgG to the inoculated strain CPS dropped in NW samples after inoculation suggesting its sequestration by colonizing pneumococci. In post-vaccination NW samples pneumococci were heavily agglutinated compared with pre-vaccination samples in subjects protected against carriage. Our results indicate that pneumococcal agglutination mediated by CPS-specific antibodies is a key mechanism of protection against acquisition of carriage. Capsule may be the only vaccine target that can elicit strong agglutinating antibody responses, leading to protection against carriage acquisition and generation of herd immunity.

  17. Multi-serotype pneumococcal nasopharyngeal carriage prevalence in vaccine naïve Nepalese children, assessed using molecular serotyping.

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    Rama Kandasamy

    Full Text Available Invasive pneumococcal disease is one of the major causes of death in young children in resource poor countries. Nasopharyngeal carriage studies provide insight into the local prevalence of circulating pneumococcal serotypes. There are very few data on the concurrent carriage of multiple pneumococcal serotypes. This study aimed to identify the prevalence and serotype distribution of pneumococci carried in the nasopharynx of young healthy Nepalese children prior to the introduction of a pneumococcal conjugate vaccine using a microarray-based molecular serotyping method capable of detecting multi-serotype carriage. We conducted a cross-sectional study of healthy children aged 6 weeks to 24 months from the Kathmandu Valley, Nepal between May and October 2012. Nasopharyngeal swabs were frozen and subsequently plated on selective culture media. DNA extracts of plate sweeps of pneumococcal colonies from these cultures were analysed using a molecular serotyping microarray capable of detecting relative abundance of multiple pneumococcal serotypes. 600 children were enrolled into the study: 199 aged 6 weeks to <6 months, 202 aged 6 months to < 12 months, and 199 aged 12 month to 24 months. Typeable pneumococci were identified in 297/600 (49.5% of samples with more than one serotype being found in 67/297 (20.2% of these samples. The serotypes covered by the thirteen-valent pneumococcal conjugate vaccine were identified in 44.4% of samples containing typeable pneumococci. Application of a molecular serotyping approach to identification of multiple pneumococcal carriage demonstrates a substantial prevalence of co-colonisation. Continued surveillance utilising this approach following the introduction of routine use of pneumococcal conjugate vaccinates in infants will provide a more accurate understanding of vaccine efficacy against carriage and a better understanding of the dynamics of subsequent serotype and genotype replacement.

  18. Effect of the 13-valent pneumococcal conjugate vaccine on nasopharyngeal carriage by respiratory pathogens among Greenlandic children

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    Navne, Johan Emdal; Koch, Anders; Slotved, Hans-Christian

    2017-01-01

    BACKGROUND: In 2010, Greenland introduced the 13-valent pneumococcal conjugate vaccine (Prevnar 13®- PCV-13) in the childhood immunisation program. The authors aimed to evaluate the impact of PCV-13 on nasopharyngeal carriage of bacteria frequently associated with respiratory infections in children....... Overall carriage rate of S. pneumoniae remained unchanged from 2011 to 2013 (51% and 56%, p=0.13), but significant serotype shifts were observed among both vaccinated and unvaccinated children with marked reductions in carriage of vaccine-type pneumococci, counterbalanced by increasing carriage of non-vaccine...... types. Carriage rate of S. aureus decreased significantly among vaccinated children whereas that of M. catarrhalis increased. CONCLUSION: PCV-13 introduction in Greenland is associated with significant changes in nasopharyngeal bacterial carriage. Continued surveillance is warranted to clarify whether...

  19. Kinetics of antibodies against pneumococcal proteins and their relationship to nasopharyngeal carriage in the first two months of life.

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    Awa L Mendy

    Full Text Available The currently used Streptococcus pneumoniae vaccines have had a significant impact on the pneumococcal diseases caused by the serotypes they cover. Their limitations have stimulated a search for alternate vaccines that will cover all serotypes, be affordable and effective in young children. Pneumococcal protein antigens are potential vaccine candidates that may meet some of the shortfalls of the current vaccines. Thus, this study aimed to determine the relationship between antibodies against pneumococcal protein antigens and nasopharyngeal carriage in infants.One hundred and twenty mother-infant pairs were enrolled into the study. They had nasopharyngeal swabs(NPS taken at birth and every two weeks for the first eight weeks after delivery, and blood samples were obtained at birth and every four weeks for the first eight weeks after delivery. Nasopharyngeal carriage of S. pneumoniae was determined from the NPS and antibodies against the pneumococcal proteins CbpA, PspA and rPly were measured in the blood samples.The S. pneumoniae carriage rate in infants increased to that of mothers by eight weeks of age. The odds of carriage in infants was 6.2 times (95% CI: 2.0-18.9 higher when their mothers were also carriers. Bacterial density in infants was lower at birth compared to their mothers (p = 0.004, but increased with age and became higher than that of their mothers at weeks 4 (p = 0.009, 6 (p = 0.002 and 8 (p<0.0001. At birth, the infants' antibodies against CbpA, and rPly pneumococcal protein antigens were similar, but that of PspA was lower (p<0.0001, compared to their mothers. Higher antibody concentrations to CbpA [OR (95% CI: 0.49 (0.26-0.92, p = 0.03], but not PspA and rPly, were associated with protection against carriage in the infants.Naturally induced antibodies against the three pneumococcal protein antigens were transferred from mother to child. The proportion of infants with nasopharyngeal carriage and the bacterial density of S

  20. Impact of PCV13 on Serotype 3 Invasive Pneumococcal Disease and Nasopharyngeal Carriage in Massachusetts’ Children

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    Lapidot, Rotem; Shea, Kimberly M; Little, Brent A; Yildirim, Inci; Pelton, Stephen I

    2017-01-01

    Abstract Background Although a substantial decline in overall vaccine serotype invasive pneumococcal disease (IPD) incidence has been observed following immunization with PCV7 and subsequently PCV13, the reported effectiveness for individual vaccine serotypes has varied. Reported effectiveness of PCV13 for serotype 3 (ST3) disease has differed by study design and geography, with a wide range of estimates including zero. We assessed the impact of PCV13 on ST3 IPD cases and nasopharyngeal (NP) carriage in Massachusetts’ children. Methods Cases of ST3 IPD in children Pelton, Pfizer: Board Member and Grant Investigator, Consulting fee, Research grant and Speaker honorarium; Merck vaccines: Board Member, Consulting fee and Speaker honorarium; GSK: Board Member, Consulting fee and Speaker honorarium; Sequiris: Board Member, Consulting fee and Speaker honorarium

  1. Immunogenicity of a 7-valent pneumococcal conjugate vaccine (PCV7) and impact on carriage in Venezuelan children at risk of invasive pneumococcal diseases.

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    Rivera-Olivero, Ismar A; Del Nogal, Berenice; Fuentes, Mariana; Cortez, Rossana; Bogaert, Debby; Hermans, Peter W M; Waard, Jacobus H de

    2014-06-30

    We evaluated the immunogenicity of the 7-valent pneumococcal conjugate vaccine (PCV7), and its impact on pneumococcal carriage in Venezuelan children at high risk for invasive pneumococcal disease (IPD). 82 children (age 2-59 months) with sickle cell anemia (n=22), chronic heart disease (n=19), HIV infection (n=12), immune-suppressive therapy (n=11) and other IPD-predisposing conditions (n=18) were vaccinated with PCV7 according to CDC-recommended age-related immunization schedules. Blood samples were taken to determine the concentration of IgG antibody, and nasopharyngeal swabs were obtained to isolate Streptococcus pneumoniae, before the first vaccine dose and 1 month after completion of the vaccination schedule. Pneumococcal carriage prior to the first immunization was 27% (n=22), with the most frequently carried serotypes being vaccine serotypes 6B (22%) and 14 (13%). One month after completion of the vaccination scheme pneumococcal carriage was 22% (n=17), dominated by non-vaccine serotypes 19A (24%) and 7F (12%). Before immunization, 65% of the subjects had IgG antibody titers >0.35 μg/mL for five serotypes tested. Post-vaccination, 100% of the subjects showed titers >1.0 μg/mL for all PCV7 serotypes with geometric mean concentrations (GMC) ranging from 1.75 μg/mL (serotype 23F) to 17.16 μg/mL (serotype 14). Children previously colonized with serotype 6B had a significantly lower GMC to this serotype following immunization than children not carrying 6B prior to the first PCV dose (p<0.05). PCV7 is highly immunogenic in Venezuelan children at high-risk for IPD. Vaccination was associated with an immediate shift in nasopharyngeal carriage toward non-PCV7 serotypes. Finally, we observed serotype-specific hyporesponsiveness to immunization after natural carriage with the same serotype in high-risk children. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Nasopharyngeal Pneumococcal Carriage among Healthy Children in Cyprus Post Widespread Simultaneous Implementation of PCV10 and PCV13 Vaccines.

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    Adamos Hadjipanayis

    Full Text Available The objective of the study was to describe the incidence of pneumococcal nasopharyngeal carriage, serotype distribution and antibiotic resistance profile of pneumococcal nasopharyngeal isolates in healthy children aged 6 to 36 months following the implementation of conjugate vaccines. A nasopharyngeal swab was collected from 1105 healthy children following a stratified random sampling between September 2013 and April 2014. Demographics, vaccination status and data on possible risk factors were recorded. Isolates were serotyped and tested for antibiotic susceptibility. The nasopharyngeal carriage rate was 25.3%. Among 1105 children enrolled, 393 had received PCV13 and 685 PCV10. The prevailing isolated serotypes were: 23A (14.3%, 15A (8.9%, 6C (8.6%, 23B (7.5%, 19A (5.4% and 15B (5%. The proportion of non-vaccine serotypes, PCV10 serotypes, PCV13 additional serotypes (3, 6A, 19A was 76.8%, 2.1% and 10.4% respectively. Although children, who were fully or partially vaccinated with PCV13, were 63% less likely to be colonized with additional PCV13 serotypes compared to those vaccinated with PCV10, the difference is not significant (95%Cl = 0.14-1.02, p = 0.053. The highest antibiotic non-susceptible rates were found for erythromycin (28.2% and penicillin (27.9%. The overall multidrug resistance rate was 13.2%, with serotypes 24F (4/6, 15A (14/25 and 19A (6/15 being the main contributors. Carriage rate was similar between children vaccinated with PCV10 or PCV13. The high incidence of 15A serotype which is also multidrug resistant should be underlined. Ongoing surveillance is needed to monitor the dynamics on nasopharyngeal carriage.

  3. Pneumococcal carriage in young children one year after introduction of the 13-valent conjugate vaccine in Italy.

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    Romina Camilli

    Full Text Available In mid 2010, the 7-valent pneumococcal conjugate vaccine (PCV7 was replaced by the 13-valent conjugate vaccine (PCV13 for childhood immunization in Italy. Our objective in this study was to obtain a snapshot of pneumococcal carriage frequency, colonizing serotypes, and antibiotic resistance in healthy children in two Italian cities one year after PCV13 was introduced.Nasopharyngeal swabs were obtained from 571 children aged 0-5 years from November 2011-April 2012. Pneumococcal isolates were serotyped and tested for antimicrobial susceptibility. Penicillin and/or erythromycin non-susceptible isolates were analyzed by Multi Locus Sequence Typing (MLST.Among the children examined, 81.2% had received at least one dose of PCV7 or PCV13 and 74.9% had completed the recommended vaccination schedule for their age. Among the latter, 57.3% of children had received PCV7, 27.1% PCV13, and 15.6% a combination of the two vaccines. The overall carriage rate was 32.9%, with children aged 6-35 months the most prone to pneumococcal colonization (6-23 months OR: 3.75; 95% CI: 2.19-6.43 and 24-35 months OR: 3.15, 95%CI: 2.36-4.22. A total of 184 pneumococcal isolates were serotyped and divided into PCV7 (5.4%, PCV13 (18.0%, and non-PCV13 (82.0% serotypes. Serotypes 6C, 24F, and 19A were the most prevalent (10.3%, 8.6%, and 8.1%, respectively. The proportion of penicillin non-susceptible (MIC >0.6 mg/L isolates was 30.9%, while 42.3% were erythromycin resistant. Non-PCV13 serotypes accounted for 75.4% and 70.8% of the penicillin and erythromycin non-susceptible isolates, respectively.Our results revealed low rates of PCV7 and PCV13 serotypes in Italian children, potentially due to the effects of vaccination. As the use of PCV13 continues, its potential impact on vaccine serotypes such as 19A and cross-reactive serotypes such as 6C will be assessed, with this study providing a baseline for further analysis of surveillance isolates.

  4. Low prevalence of pneumococcal carriage and high serotype and genotype diversity among adults over 60 years of age living in Portugal.

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    Sónia T Almeida

    Full Text Available Pneumococcal disease is frequent at the extremes of age. While several studies have looked at colonization among young children, much less is known among the elderly. We aimed to evaluate pneumococcal carriage among elderly adults living in Portugal. Between April 2010 and December 2012, nasopharyngeal and oropharyngeal swabs of adults over 60 years of age, living in an urban area (n = 1,945 or in a rural area (n = 1,416, were obtained. Pneumococci were isolated by culture-based standard procedures, identified by optochin susceptibility, bile solubility and PCR screening for lytA and cpsA, and characterized by antibiotype, serotype, and MLST. Associations between pneumococcal carriage, socio-demographic and clinical characteristics were evaluated by univariate analysis and multiple logistic regression. The global prevalence of carriage was 2.3% (95% CI: 1.8-2.8. In the multiple logistic regression analysis, smoking, being at a retirement home, and living in a rural area increased the odds of being a pneumococcal carrier by 4.4-fold (95% CI: 1.9-9.2, 2.0-fold (95% CI: 1.1-3.6 and 2.0-fold (95% CI: 1.2-3.5, respectively. Among the 77 pneumococcal isolates, 26 serotypes and 40 STs were identified. The most prevalent serotypes were (in decreasing order 19A, 6C, 22F, 23A, 35F, 11A, and 23B, which accounted, in total, for 60.0% of the isolates. Most isolates (93.5% had STs previously described in the MLST database. Resistance to macrolides, non-susceptibility to penicillin and multidrug resistance were found in 19.5%, 11.7%, and 15.6% of the isolates, respectively. We conclude that the prevalence of pneumococcal carriage in the elderly, in Portugal, as determined by culture-based methods, is low. Serotype and genotype diversity is high. Living in a rural area, in a retirement home, and being a smoker increased the risk of pneumococcal carriage. This study contributes to the establishment of a baseline that may be used to monitor how novel

  5. Emergence of antibiotic-resistant non-vaccine serotype pneumococci in nasopharyngeal carriage in children after the use of extended-valency pneumococcal conjugate vaccines in Korea.

    Science.gov (United States)

    Choe, Young June; Lee, Hoan Jong; Lee, Hyunju; Oh, Chi Eun; Cho, Eun Young; Choi, Jae Hong; Kang, Hyun Mi; Yoon, In Ae; Jung, Hyun Joo; Choi, Eun Hwa

    2016-09-14

    This study was performed to assess the serotype distribution and antibiotic nonsusceptibility of pneumococcal carriage isolates from children in Korea following the introduction of extended-valency pneumococcal conjugate vaccines (PCVs). From April to June 2014, nasopharyngeal swabs were collected from children who were attending daycare centers in Korea. The collection was conducted in accordance with the World Health Organization Pneumococcal Carriage Working Group standards. Isolates were identified based on colony morphology, the presence of alpha-hemolysis, and inhibition by optochin test. Serotype was determined by Quellung reaction and sequencing analysis (for serogroup 6). The E-test was performed to determine antibiotic susceptibility. A total of 267 pneumococcal isolates were collected from 734 children. Non-PCV13 serotypes accounted for 88.3% and 23A (12.6%), 15B (10.4%), and 15C (9.5%) were most common. Younger age was associated with higher carriage (65.6% vs. 31.2%, Pvaccination was associated with lower carriage caused by PCV13 serotypes (7.4% vs. 20.8%, P=0.007). Overall, nonsusceptibility rates were 86.0% to penicillin and 90.5% to erythromycin, with a multidrug resistance rate of 81.5%. Among penicillin-nonsusceptible isolates, those caused by PCV13 serotypes were 11% and non-PCV13 serotypes were 89%. Frequent non-PCV13 serotypes (23A, 15B, and 15C) were all nonsusceptible to both penicillin and erythromycin except one. High rates of carriage caused by non-PCV13 serotypes such as 23A, 15B, and 15C that show nonsusceptibilities to penicillin and erythromycin were noted following the introduction of extended-valency PCVs in Korea. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Prevalence of Pneumococcal Nasopharyngeal Carriage Among Children 2-18 Months of Age: Baseline Study Pre Introduction of Pneumococcal Vaccination in Cuba.

    Science.gov (United States)

    Toledo, María E; Casanova, Maria F; Linares-Pérez, Nivaldo; García-Rivera, Dagmar; Toraño Peraza, Gilda; Barcos Pina, Indira; Montes de Oca, Martha; Rodriguez-Noda, Laura M; Mirabal, Mayelín; Paredes, Beatriz; Chávez Amaro, Dunia M; Santana Mederos, Darielys; Valdés-Balbín, Yury; Verez-Bencomo, Vicente

    2017-01-01

    A new vaccine candidate against pneumococcus is being developed in Cuba, and it is a priority of the national health system. There is limited information on nasopharyngeal colonization burden, though it is essential for monitoring the impact of the vaccine. The study aims to estimate the prevalence of nasopharyngeal colonization in children 2-18 months of age and identify circulating serotypes, antimicrobial resistance and its association with selected risk factors. A cross-sectional study was conducted between October and December 2013 in Cienfuegos municipality. Inclusion criteria were evaluated, and informed consent was obtained from the parents. Clinical and epidemiologic data were collected through a semistructured questionnaire. Nasopharyngeal swabs according to established protocols were taken. Data analysis included frequency distributions and comparison of proportions. The association between colonization and selected risk factors was assessed by multivariate analysis. A total of 984 children (87.2% living in urban areas) were included. The overall prevalence of colonization was 21.6%. The most frequent serotypes isolated were 6A (23.1%), 23F (10.8%), 6B (10.3%), 19F (8.5%) and 14 (3.3%). We found no resistance to β-lactamases in circulating serotypes. Living with sibling younger than 5 years, previous respiratory infections, previous hospitalization and day-care attendance were determinants of nasopharyngeal carriage. The findings suggest that the burden of pneumococcal disease and colonization in Cuba could be significantly affected after vaccine introduction.

  7. Diet as a risk factor for pneumococcal carriage and otitis media: a cross-sectional study among children in day care centers.

    Directory of Open Access Journals (Sweden)

    Terhi Tapiainen

    Full Text Available BACKGROUND: Pharyngeal bacteria are exposed to different sugar conditions depending on the diet of the child. We hypothesized that dietary factors such as daily intake of carbohydrates could be associated with pneumococcal carriage and the occurrence of otitis media in children. METHODS: Our study design was a cross-sectional study among 1006 children attending child day care centers. Parents filled in a food frequency questionnaire. Oropharyngeal swabs were collected from each child. The primary outcome was the occurrence of pneumococcal carriage and the secondary outcome the number of acute otitis media episodes during life. Principal component analysis was used to group dietary intake into nine factors. The models were adjusted for age, gender of the child and educational level of the mother. RESULTS: The dietary factor which included high consumption of sweet pastries and jam was associated with an increased risk of pneumococcal carriage (OR 1.17, 95% CI 1.01 to 1.36, P-value 0.04. The factor including frequent consumption of fruit and berries was associated with a decreased risk of acute otitis (regression coefficient -0.51, 95% CI -0.98 to -0.03, P=0.04. A high intake of consumption of sweets and snacks (OR 1.36, 95% CI 1.03 to 1.80, P=0.03 was associated with an increased risk of caries. CONCLUSIONS: Diet was associated with a risk of pneumococcal carriage and the occurrence of otitis media. Diet may thus be a modifiable risk factor for the occurrence of acute otitis media.

  8. Effect of early measles vaccine on pneumococcal colonization

    DEFF Research Database (Denmark)

    Hansen, Nadja Skadkær; Byberg, Stine; Hervig Jacobsen, Lars

    2017-01-01

    BACKGROUND: Measles vaccine (MV) may have non-specific beneficial effects for child health and particularly seems to prevent respiratory infections. Streptococcus pneumoniae is the leading cause of bacterial pneumonia among children worldwide, and nasopharyngeal colonization precedes infection....... OBJECTIVE: We investigated whether providing early MV at 18 weeks of age reduced pneumococcal colonization and/or density up to 9 months of age. METHOD: The study was conducted in 2013-2014 in Guinea-Bissau. Pneumococcal vaccine was not part of the vaccination program. Infants aged 18 weeks were block...

  9. General health, otitis media, nasopharyngeal carriage and middle ear microbiology in Northern Territory Aboriginal children vaccinated during consecutive periods of 10-valent or 13-valent pneumococcal conjugate vaccines.

    Science.gov (United States)

    Leach, Amanda J; Wigger, Christine; Beissbarth, Jemima; Woltring, Donna; Andrews, Ross; Chatfield, Mark D; Smith-Vaughan, Heidi; Morris, Peter S

    2016-07-01

    This study aims to monitor the prevalence of suppurative otitis media in remote Indigenous communities after introduction of 13-valent pneumococcal conjugate vaccine (PCV13) in October 2011. We previously reported a decline in suppurative OM following replacement of PCV7 by 10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10) in October 2009. We continued regular surveillance in remote Indigenous communities between February 2010 and August 2013. This analysis reports the general health, otitis media (OM), nasopharyngeal (NP) carriage and middle ear microbiology in children less than 36 months of age who received a primary course of at least two doses of PHiD-CV10 or PCV13, and not more than one dose of another pneumococcal vaccine. Mean ages of 511 PHiD-CV10- and 140 PCV13-vaccinated children were 19 and 13 months, respectively. Most children received 3-dose non-mixed PCV schedules. At the time of assessment, general health was poor and prevalence of risk factors was high in both groups: overall, around 14% of children had scabies, 20% had impetigo, 59% had runny nose and 39% had cough. Average household size was 8 persons, and 60% of the mothers smoked. Bilaterally normal middle ears were detected in 10% and 7%, respectively. OM with effusion (OME), almost all bilateral, was diagnosed in 52% and 50%, any suppurative OM (acute OM or any tympanic membrane perforation [TMP]) in 37% and 41%, and TMP in 14% and 12%, respectively. Children in the PCV13 group had significantly less NP carriage of combined Streptococcus pneumoniae (Spn) and non-typeable Haemophilus influenzae (NTHi) (62% versus 51%) but significantly more polymicrobial (Spn and NTHi) middle ear cultures (12% versus 43%), and significantly less Staphylococcus aureus-positive middle ears (40% versus 7%). Although NP carriage of pneumococcal serotype 19A was low in the PCV13 group, serotypes 19F and 23F persist. The general health, particularly ear health, of little children

  10. The adult nasopharyngeal microbiome as a determinant of pneumococcal acquisition

    NARCIS (Netherlands)

    Cremers, Amelieke Jh; Zomer, Aldert L; Gritzfeld, Jenna F; Ferwerda, Gerben; van Hijum, Sacha Aft; Ferreira, Daniela M; Shak, Joshua R; Klugman, Keith P; Boekhorst, Jos; Timmerman, Harro M; de Jonge, Marien I; Gordon, Stephen B; Hermans, Peter Wm

    2014-01-01

    BACKGROUND: Several cohort studies have indicated associations between S. pneumoniae and other microbes in the nasopharynx. To study causal relationships between the nasopharyngeal microbiome and pneumococcal carriage, we employed an experimental human pneumococcal carriage model. Healthy adult

  11. Pre-vaccine serotype composition within a lineage signposts its serotype replacement - a carriage study over 7 years following pneumococcal conjugate vaccine use in the UK.

    Science.gov (United States)

    Gladstone, Rebecca A; Devine, Vanessa; Jones, Jessica; Cleary, David; Jefferies, Johanna M; Bentley, Stephen D; Faust, Saul N; Clarke, Stuart C

    2017-06-30

    Serotype replacement has been reported in carriage and disease after pneumococcal conjugate vaccine (PCV) introductions in the UK and globally. We previously described concurrent expansion and decline of sequence types associated with serotype replacement over 5 years following PCV introductions in the UK. Here we use whole-genome sequencing to fully characterise the population structure of pneumococcal isolates collected over seven winters encompassing PCV7 and PCV13 introductions in the UK, investigating the importance of lineages in serotype replacement. We analysed 672 pneumococcal genomes from colonised children of 4 years old or less. The temporal prevalence of 20 lineages, defined by hierarchical Bayesian analysis of population structure (BAPS), was assessed in the context of serotype replacement. Multiple serotypes were detected in the primary winter of sampling within three vaccine-type (VT) lineages BAPS4, BAPS10 and BAPS11, in which serotype replacement were observed. In contrast, serotype replacement was not seen in the remaining three VT lineages (BAPS1, BAPS13 and BAPS14), that expressed a single serotype (6B, 6A and 3, respectively) in the primary winter. One lineage, BAPS1 serotype 6B was undetectable in the population towards the end of the study period. The dynamics of serotype replacement, in this UK population, was preceded by the presence or absence of multiple serotypes within VT lineages, in the pre-PCV population. This observation could help predict which non-vaccine types (NVTs) may be involved in replacement in future PCV introductions here and elsewhere. It could further indicate whether any antibiotic resistance associated with the lineages is likely to be affected by replacement.

  12. Effectiveness of the 10-Valent Pneumococcal Nontypeable Haemophilus influenzae Protein D-Conjugated Vaccine (PHiD-CV) Against Carriage and Acute Otitis Media-A Double-Blind Randomized Clinical Trial in Finland.

    Science.gov (United States)

    Vesikari, Timo; Forsten, Aino; Seppä, Ilkka; Kaijalainen, Tarja; Puumalainen, Taneli; Soininen, Anu; Traskine, Magali; Lommel, Patricia; Schoonbroodt, Sonia; Hezareh, Marjan; Moreira, Marta; Borys, Dorota; Schuerman, Lode

    2016-09-01

    After administering the 10-valent pneumococcal polysaccharide nontypeable Haemophilus influenzae protein D-conjugated vaccine (PHiD-CV) to children aged 2-18 months, we observed a reduction in vaccine-type nasopharyngeal carriage, resulting in a reduction of overall pneumococcal nasopharyngeal carriage, which may be important for indirect vaccine effects. We noted a trend toward reduction of acute otitis media. This trial (ClinicalTrials.gov identifier NCT00839254), nested within a cluster-randomized double-blind invasive pneumococcal disease effectiveness study in Finland (ClinicalTrials.gov identifier NCT00861380), assessed the effectiveness of the 10-valent pneumococcal polysaccharide nontypeable Haemophilus influenzae protein D-conjugated vaccine (PHiD-CV or PCV10) against bacterial nasopharyngeal carriage and acute otitis media (AOM). Infants (aged 6 weeks to 6 months) received the PHiD-CV or a control vaccine (hepatitis B) (schedule 3+1 or 2+1). Nasopharyngeal swabs were collected at 4 time points post-vaccination from all of the infants and at pre-vaccination from a subset. Parent-reported physician-diagnosed AOM was assessed from first vaccination until last contact (mean follow-up, 18 months). Vaccine effectiveness (VE) was derived as (1 - relative risk)*100, accounting for cluster design in AOM analysis. Significant VE was assessed descriptively (positive lower limit of the non-adjusted 95% confidence interval [CI]). The vaccinated cohort included 5093 infants for carriage assessment and 4117 infants for AOM assessment. Both schedules decreased vaccine-serotype carriage, with a trend toward a lesser effect from the 2+1 schedule ( VE across timpoints 19%-56% [3+1] and 1%-38% [2+1]). Trends toward reduced pneumococcal carriage (predominantly vaccine serotypes 6B, 14, 19F, and 23F), decreased carriage of vaccine-related serotype 19A, and small increases at later time points (ages 14-15 months) in non-vaccine-serotype carriage were observed. No effects on

  13. Improving Capture of Vaccine History: Case Study from an Evaluation of 10-Valent Pneumococcal Conjugate Vaccine Introduction in Kenya

    National Research Council Canada - National Science Library

    Harris, Aaron M; Aol, George; Ouma, Dominic; Bigogo, Godfrey; Montgomery, Joel M; Whitney, Cynthia G; Breiman, Robert F; Kim, Lindsay

    2016-01-01

    .... We sought to improve immunization history acquisition from Ministry of Health vaccination cards during a vaccine impact study of 10-valent pneumococcal conjugate vaccine on pneumococcal carriage...

  14. Antibody response to pneumococcal vaccine in patients with early stage Hodgkin's disease

    DEFF Research Database (Denmark)

    Frederiksen, B; Specht, L; Henrichsen, J

    1989-01-01

    response to pneumococcal type antigens was similar in healthy adults and in patients with early stage HD before therapy. After treatment, postvaccination antibody response became negligible. Even up to 7 years after cessation of therapy patients were not able to raise a significant antibody response.......Antibody response to pneumococcal vaccination was studied in 76 patients with Hodgkin's disease (HD) before, during and at different time intervals after cessation of therapy. All patients were in pathological stage I and II following explorative laparatomy with splenectomy. The increase...

  15. Pneumococcal Disease

    Science.gov (United States)

    ... Pneumococcal disease is a very serious infection that causes pneumonia, meningitis, and bloodstream infection (sepsis). About one million ... when someone gets pneumococcal disease? Pneumococcal disease can cause pneumonia, meningitis, or bloodstream infection. People with pneumococcal disease ...

  16. Epidemiology of Otitis Media with Spontaneous Perforation of the Tympanic Membrane in Young Children and Association with Bacterial Nasopharyngeal Carriage, Recurrences and Pneumococcal Vaccination in Catalonia, Spain - The Prospective HERMES Study.

    Directory of Open Access Journals (Sweden)

    Robert Cilveti

    Full Text Available The Epidemiology of otitis media with spontaneous perforation of the tympanic membrane and associated nasopharyngeal carriage of bacterial otopathogens was analysed in a county in Catalonia (Spain with pneumococcal conjugate vaccines (PCVs not included in the immunization programme at study time. A prospective, multicentre study was performed in 10 primary care centres and 2 hospitals (June 2011-June 2014, including all otherwise healthy children ≥2 months ≤8 years with otitis media presenting spontaneous tympanic perforation within 48h. Up to 521 otitis episodes in 487 children were included, showing by culture/PCR in middle ear fluid (MEF: Haemophilus influenzae [24.2%], both Streptococcus pneumoniae and H. influenzae [24.0%], S. pneumoniae [15.9%], Streptococcus pyogenes [13.6%], and Staphylococcus aureus [6.7%]. Culture-negative/PCR-positive otitis accounted for 31.3% (S. pneumoniae, 30.2% (H. influenzae and 89.6% (mixed S. pneumoniae/H. influenzae infections. Overall, incidence decreased over the 3-year study period, with significant decreases in otitis by S. pneumoniae and by H. influenzae, but no decreases for mixed S. pneumoniae/H. influenzae infections. Concordance between species in nasopharynx and MEF was found in 58.3% of cases, with maximal rates for S. pyogenes (71.8%, and with identical pneumococcal serotype in 40.5% of cases. Most patients (66.6% had past episodes. PCV13 serotypes were significantly more frequent in first episodes, in otitis by S. pneumoniae as single agent, and among MEF than nasopharyngeal isolates. All non-PCV13 serotypes separately accounted for <5% in MEF. Up to 73.9% children had received ≥1 dose of PCV, with lower carriage of PCV13 serotypes than among non-vaccinated children. Pooling pneumococcal isolates from MEF and nasopharynx, 30% were multidrug resistant, primarily belonging to serotypes 19A [29.8%], 24A [14.3%], 19F [8.3%] and 15A [6.0%]. Our results suggest that increasing PCV13 vaccination

  17. Epidemiology of Otitis Media with Spontaneous Perforation of the Tympanic Membrane in Young Children and Association with Bacterial Nasopharyngeal Carriage, Recurrences and Pneumococcal Vaccination in Catalonia, Spain - The Prospective HERMES Study.

    Science.gov (United States)

    Cilveti, Robert; Olmo, Montserrat; Pérez-Jove, Josefa; Picazo, Juan-José; Arimany, Josep-Lluis; Mora, Emiliano; Pérez-Porcuna, Tomás M; Aguilar, Ignacio; Alonso, Aurora; Molina, Francesc; Del Amo, María; Mendez, Cristina

    2017-01-01

    The Epidemiology of otitis media with spontaneous perforation of the tympanic membrane and associated nasopharyngeal carriage of bacterial otopathogens was analysed in a county in Catalonia (Spain) with pneumococcal conjugate vaccines (PCVs) not included in the immunization programme at study time. A prospective, multicentre study was performed in 10 primary care centres and 2 hospitals (June 2011-June 2014), including all otherwise healthy children ≥2 months ≤8 years with otitis media presenting spontaneous tympanic perforation within 48h. Up to 521 otitis episodes in 487 children were included, showing by culture/PCR in middle ear fluid (MEF): Haemophilus influenzae [24.2%], both Streptococcus pneumoniae and H. influenzae [24.0%], S. pneumoniae [15.9%], Streptococcus pyogenes [13.6%], and Staphylococcus aureus [6.7%]. Culture-negative/PCR-positive otitis accounted for 31.3% (S. pneumoniae), 30.2% (H. influenzae) and 89.6% (mixed S. pneumoniae/H. influenzae infections). Overall, incidence decreased over the 3-year study period, with significant decreases in otitis by S. pneumoniae and by H. influenzae, but no decreases for mixed S. pneumoniae/H. influenzae infections. Concordance between species in nasopharynx and MEF was found in 58.3% of cases, with maximal rates for S. pyogenes (71.8%), and with identical pneumococcal serotype in 40.5% of cases. Most patients (66.6%) had past episodes. PCV13 serotypes were significantly more frequent in first episodes, in otitis by S. pneumoniae as single agent, and among MEF than nasopharyngeal isolates. All non-PCV13 serotypes separately accounted for <5% in MEF. Up to 73.9% children had received ≥1 dose of PCV, with lower carriage of PCV13 serotypes than among non-vaccinated children. Pooling pneumococcal isolates from MEF and nasopharynx, 30% were multidrug resistant, primarily belonging to serotypes 19A [29.8%], 24A [14.3%], 19F [8.3%] and 15A [6.0%]. Our results suggest that increasing PCV13 vaccination would

  18. Early effectiveness of heptavalent conjugate pneumococcal vaccination on invasive pneumococcal disease after the introduction in the Danish Childhood Immunization Programme

    DEFF Research Database (Denmark)

    Harboe, Zitta B.; Valentiner-Branth, Palle; Benfield, Thomas

    2010-01-01

    We evaluated the effectiveness of the heptavalent pneumococcal conjugate vaccine (PCV7) on invasive pneumococcal disease (IPD) 1 year after PCV7's introduction in the childhood immunization programme through a nationwide cohort study based on laboratory surveillance data. There was a decline......, the incidence decreased from 54 to 23 cases per 100,000 (IRR 0.43; 95% CI [0.29-0.62]) and for vaccine-serotypes from 36.7 to 7.7 (IRR 0.20; 95% CI [0.09-0.38]). The incidence of IPD declined approximately 10% (IRR 0.90; 95% CI [0.84-0.97]) in patients aged >or=2 years. The case fatality was 17% in both periods....... The administration of PCV7 was followed by a marked decline in the incidence of IPD in both vaccinated and non-vaccinated individuals....

  19. Candida albicans Carriage in Children with Severe Early Childhood Caries (S-ECC) and Maternal Relatedness.

    Science.gov (United States)

    Xiao, Jin; Moon, Yonghwi; Li, Lihua; Rustchenko, Elena; Wakabayashi, Hironao; Zhao, Xiaoyi; Feng, Changyong; Gill, Steven R; McLaren, Sean; Malmstrom, Hans; Ren, Yanfang; Quivey, Robert; Koo, Hyun; Kopycka-Kedzierawski, Dorota T

    2016-01-01

    Candida albicans has been detected together with Streptococcus mutans in high numbers in plaque-biofilm from children with early childhood caries (ECC). The goal of this study was to examine the C. albicans carriage in children with severe early childhood caries (S-ECC) and the maternal relatedness. Subjects in this pilot cross-sectional study were recruited based on a convenient sample. DMFT(S)/dmft(s) caries and plaque scores were assessed during a comprehensive oral exam. Social-demographic and related background information was collected through a questionnaire. Saliva and plaque sample from all children and mother subjects were collected. C. albicans were isolated by BBL™ CHROMagar™ and also identified using germ tube test. S. mutans was isolated using Mitis Salivarius with Bacitracin selective medium and identified by colony morphology. Genetic relatedness was examined using restriction endonuclease analysis of the C. albicans genome using BssHII (REAG-B). Multilocus sequence typing was used to examine the clustering information of isolated C. albicans. Spot assay was performed to examine the C. albicans Caspofungin susceptibility between S-ECC children and their mothers. All statistical analyses (power analysis for sample size, Spearman's correlation coefficient and multiple regression analyses) were implemented with SAS 9.4. A total of 18 S-ECC child-mother pairs and 17 caries free child-mother pairs were enrolled in the study. Results indicated high C. albicans carriage rate in the oral cavity (saliva and plaque) of both S-ECC children and their mothers (>80%). Spearman's correlation coefficient also indicated a significant correlation between salivary and plaque C. albicans and S. mutans carriage (pseverity (pchildren were 1.3 ± 4.5 x104 cfu/ml and 1.2 ± 3.5 x104 cfu/ml (~3-log higher vs. caries-free children). Among 18 child-mother pairs, >60% of them demonstrated identical C. albicans REAG-B pattern. C. albicans isolated from >65% of child

  20. Meningitis - pneumococcal

    Science.gov (United States)

    Pneumococcal meningitis; Pneumococcus - meningitis ... Pneumococcal meningitis is caused by Streptococcus pneumoniae bacteria (also called pneumococcus, or S pneumoniae ). This type of bacteria is the ...

  1. The role of pneumococcal infection in development of exacerbations in children with bronchial asthma and obstructive bronchitis

    Directory of Open Access Journals (Sweden)

    N.V. Kukhtinova

    2011-01-01

    Full Text Available Pneumococcal infection remains the key cause of severe diseases of lower airways and deaths in children. The objective: to study the role of pneumococcal infection in pathogenesis of exacerbations of recurrent obstructive pulmonary diseases. Methods: etiological structure of lower airways infections was evaluated in 125 patients 1–15 years old with bronchial asthma or recurrent bronchitis. Results: etiologic role of Streptococcus pneumoniae in development of low airways infections was detected in 48% of patients with atopic asthma, 85% — with asthma without atopy, 97% — with recurrent bronchitis. Repeated microbiological examination confirmed chronic carriage of S. рneumoniae in nasopharinx in 31% of patients. Conclusion: early active prophylaxis with vaccine against pneumococcal infection including conjugated vaccines is able to prevent further progression of a disease.Key words: children, bronchial asthma, obstructive bronchitis, exacerbation, pneumococcal infection.

  2. Pneumococcal nasopharyngeal carriage among children in Brazil prior to the introduction of the 10-valent conjugate vaccine: a culture- and PCR-based survey.

    Science.gov (United States)

    Rodrigues, H G; Pinto, T C A; Barros, R R; Teixeira, L M; Neves, F P G

    2017-06-01

    We performed two different approaches (broth enrichment step prior to culture (BEC) and PCR (BEPCR)) for detecting Streptococcus pneumoniae from nasopharyngeal specimens collected from 242 children aged Brazil. These specimens were collected immediately before the introduction of the 10-valent pneumococcal conjugate vaccine (PCV10) and the 13-valent vaccine (PCV13) for routine use in Brazil. Results were compared with previous findings obtained with direct culture (DC) on a selective medium. Colonisation prevalence was 58·3% (n = 141), being higher among children attending the childcare centre (62·7% vs. 55%). The culture-based methods (DC and BEC) enabled the detection of S. pneumoniae in 119 (49·2%) and 115 (47·5%) children, respectively. The PCR-based method (BEPCR) was more sensitive and 137 (56·6%) carriers were identified. Twenty-six serogroups/serotypes were identified, predominantly 6B, 19F, 14, 6A, 15C and 23F. Multiple colonisation was observed in 13 (5·4%) children. The estimated serotypes coverage of available PCVs was 40·4% for the 10-valent (included in the Brazilian immunisation programme) and 55·8% for the 13-valent (only available in private clinics). The use of robust approaches to obtain a more realistic insight about the asymptomatic carrier status is of paramount importance to estimate and assess the impact of vaccine implementation. The combination between culture-based and molecular methods constitutes a suitable strategy.

  3. Clonal distribution of pneumococcal serotype 19F isolates from Ghana

    DEFF Research Database (Denmark)

    Sparding, Nadja; Dayie, Nicholas Tete Kwaku Dzifa; Mills, Richael O.

    2015-01-01

    Streptococcus pneumoniae is a major cause of morbidity and mortality worldwide. Pneumococcal strains are classified according to their capsular polysaccharide and more than 90 different serotypes are currently known. In this project, three distinct groups of pneumococcal carriage isolates from Gh...

  4. Fatal early-onset neonatal sepsis due to Streptococcus pneumoniae.

    Science.gov (United States)

    Nallusamy, R

    1998-12-01

    Two cases of invasive early-onset neonatal pneumococcal sepsis are reported. One neonate was born at term with no risk factors and the other preterm at 35 weeks. Sepsis was not detected at birth for either of these babies and diagnosis was made at the stage of severe sepsis. A fatal outcome resulted despite treatment. Pneumococcal sepsis was confirmed after death in both these cases. Although maternal carriage was not documented in either case, the ages at presentation and progression suggested perinatal acquisition of infection. Early onset neonatal pneumococcal sepsis presents similarly as early onset neonatal Group B streptococcal (GBS) sepsis. Vaginal carriage of pneumococcus is rare but the micro-organism may have a higher invasion to colonisation ratio (attack rate) than GBS. Risk factors for invasive disease are similar to GBS.

  5. Antibody response to pneumococcal vaccine in patients with early stage Hodgkin's disease

    DEFF Research Database (Denmark)

    Frederiksen, B.; Specht, L.; Henrichsen, J.

    1989-01-01

    Antibody response to pneumococcal vaccination was studied in 76 patients with Hodgkin's disease (HD) before, during and at different time intervals after cessation of therapy. All patients were in pathological stage I and II following explorative laparatomy with splenectomy. The increase in antib......Antibody response to pneumococcal vaccination was studied in 76 patients with Hodgkin's disease (HD) before, during and at different time intervals after cessation of therapy. All patients were in pathological stage I and II following explorative laparatomy with splenectomy. The increase...

  6. The rise and fall of pneumococcal serotypes carried in the PCV era.

    Science.gov (United States)

    Devine, Vanessa T; Cleary, David W; Jefferies, Johanna M C; Anderson, Rebecca; Morris, Denise E; Tuck, Andrew C; Gladstone, Rebecca A; O'Doherty, Grace; Kuruparan, Priyasharmila; Bentley, Stephen D; Faust, Saul N; Clarke, Stuart C

    2017-03-01

    Streptococcus pneumoniae is a major cause of meningitis, sepsis and pneumonia worldwide. Vaccination using pneumococcal conjugate vaccines (PCV) has therefore been part of the UK's childhood immunisation programme since 2006. Here we describe pneumococcal carriage rates in children under five years of age attending the paediatric department of a large UK hospital in response to vaccine implementation over seven winter seasons from 2006 to 2013. S. pneumoniae (n=696) were isolated from nasopharyngeal swabs (n=2267) collected during seven consecutive winters, October to March, 2006/7 to 2012/13. This includes the period immediately following the introduction of the seven-valent pneumococcal conjugate vaccine (PCV7) in 2006 in addition to pre- and post-PCV13 introduction in 2010. We show a decrease in PCV13 vaccine serotypes (VT) in the three years following PCV13 vaccine implementation (2010/11 to 2012/13). Serotype 6A represented the only observed VT following PCV13 implementation with all others (including PCV7 serotypes) absent from carriage. Overall pneumococcal carriage, attributable to non-VT (NVT), was consistent across all sampling years with a mean of 31·1%. The ten most frequently isolated NVTs were 6C, 11A, 15B, 23B, 15A, 21, 22F, 35F, 23A and 15C. Fluctuations in the prevalence of each were however noted. Comparing prevalence at 2006/07 with 2012/13 only 15A was shown to have increased significantly (p value of 0·003) during the course of PCV implementation. These data support the increasing evidence that the primary effect of PCVs is due to population immunity by reducing or eliminating the carriage of invasive VT serotypes. With IPD being increasingly attributed to non-vaccine serotypes, surveillance of carriage data continues to act as an early warning system for vaccine design and public health policy that require continual data of both carried pneumococcal serotypes and IPD attributed serotype data. Copyright © 2017 Elsevier Ltd. All rights

  7. Epidemiology of Otitis Media with Spontaneous Perforation of the Tympanic Membrane in Young Children and Association with Bacterial Nasopharyngeal Carriage, Recurrences and Pneumococcal Vaccination in Catalonia, Spain - The Prospective HERMES Study

    National Research Council Canada - National Science Library

    Robert Cilveti; Montserrat Olmo; Josefa Pérez-Jove; Juan-José Picazo; Josep-Lluis Arimany; Emiliano Mora; Tomás M Pérez-Porcuna; Ignacio Aguilar; Aurora Alonso; Francesc Molina; María del Amo; Cristina Mendez; the HERMES Study Group

    2017-01-01

      The Epidemiology of otitis media with spontaneous perforation of the tympanic membrane and associated nasopharyngeal carriage of bacterial otopathogens was analysed in a county in Catalonia (Spain...

  8. Trivalent pneumococcal protein recombinant vaccine protects against lethal Streptococcus pneumoniae pneumonia and correlates with phagocytosis by neutrophils during early pathogenesis.

    Science.gov (United States)

    Xu, Qingfu; Surendran, Naveen; Verhoeven, David; Klapa, Jessica; Ochs, Martina; Pichichero, Michael E

    2015-02-18

    Due to the fact that current polysaccharide-based pneumococcal vaccines have limited serotype coverage, protein-based vaccine candidates have been sought for over a decade to replace or complement current vaccines. We previously reported that a trivalent Pneumococcal Protein recombinant Vaccine (PPrV), showed protection against pneumonia and sepsis in an infant murine model. Here we investigated immunological correlates of protection of PPrV in the same model. C57BL/6J infant mice were intramuscularly vaccinated at age 1-3 weeks with 3 doses of PPrV, containing pneumococcal histidine triad protein D (PhtD), pneumococcal choline binding protein A (PcpA), and detoxified pneumolysin mutant PlyD1. 3-4 weeks after last vaccination, serum and lung antibody levels to PPrV components were measured, and mice were intranasally challenged with a lethal dose of Streptococcus pneumoniae (Spn) serotype 6A. Lung Spn bacterial burden, number of neutrophils and alveolar macrophages, phagocytosed Spn by granulocytes, and levels of cytokines and chemokines were determined at 6, 12, 24, and 48h after challenge. PPrV vaccination conferred 83% protection against Spn challenge. Vaccinated mice had significantly elevated serum and lung antibody levels to three PPrV components. In the first stage of pathogenesis of Spn induced pneumonia (6-24h after challenge), vaccinated mice had lower Spn bacterial lung burdens and more phagocytosed Spn in the granulocytes. PPrV vaccination led to lower levels of pro-inflammatory cytokines IL-6, IL-1β, and TFN-α, and other cytokines and chemokines (IL-12, IL-17, IFN-γ, MIP-1b, MIP-2 and KC, and G-CSF), presumably due to a lower lung bacterial burden. Trivalent PPrV vaccination results in increased serum and lung antibody levels to the vaccine components, a reduction in Spn induced lethality, enhanced early clearance of Spn in lungs due to more rapid and thorough phagocytosis of Spn by neutrophils, and correspondingly a reduction in lung inflammation

  9. Impact of the Hajj on pneumococcal transmission.

    Science.gov (United States)

    Memish, Z A; Assiri, A; Almasri, M; Alhakeem, R F; Turkestani, A; Al Rabeeah, A A; Akkad, N; Yezli, S; Klugman, K P; O'Brien, K L; van der Linden, M; Gessner, B D

    2015-01-01

    Over two million Muslim pilgrims assemble annually in Mecca and Medina, Saudi Arabia, to complete the Hajj. The large number of people in a crowded environment increases the potential for pneumococcal carriage amplification. We evaluated pneumococcal carriage prevalence with four cross-sectional studies conducted at beginning-Hajj (Mecca) and end-Hajj (Mina) during 2011 and 2012. A questionnaire was administered and a nasopharyngeal swab was collected. The swab was tested for pneumococcus, serotype and antibiotic resistance. A total of 3203 subjects (1590 at beginning-Hajj and 1613 at end-Hajj) originating from 18 countries in Africa or Asia were enrolled. The overall pneumococcal carriage prevalence was 6.0%. There was an increase in carriage between beginning-Hajj and end-Hajj cohorts for: overall carriage (4.4% versus 7.5%, prevalence ratio (PR) 1.7, 95% CI 1.3-2.3), and carriage of 23-valent pneumococcal polysaccharide vaccine serotypes (2.3% versus 4.1%, PR 1.8, 95% CI 1.2-2.7), 13-valent pneumococcal conjugate vaccine (PCV) serotypes (1.1% versus 3.6%, PR 3.2, 95% CI 1.9-5.6), 10-valent PCV serotypes (0.6% versus 1.6%, PR 2.6, 95% CI 1.2-5.3), antibiotic non-susceptible isolates (2.5% versus 6.1%, PR 2.5, 95% CI 1.7-3.6) and multiple non-susceptible isolates (0.6% versus 2.2%, PR 3.8, 95% CI 1.8-7.9). Fifty-two different serotypes were identified, most commonly serotypes 3 (17%), 19F (5%) and 34 (5%). These results suggest that the Hajj may increase pneumococcal carriage-particularly conjugate vaccine serotypes and antibiotic non-susceptible strains, although the exact mechanism remains unknown. The Hajj may therefore provide a mechanism for the global distribution of pneumococci. Copyright © 2014 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  10. Pneumococcal Serotypes Colonise the Nasopharynx in Children at Different Densities.

    Directory of Open Access Journals (Sweden)

    Fernanda Rodrigues

    Full Text Available Prevalence of pneumococcal serotypes in carriage and disease has been described but absolute serotype colonisation densities have not been reported. 515 paediatric nasal swab DNA extracts were subjected to lytA qPCR and molecular serotyping by microarray. Absolute serotype densities were derived from total pneumococcal density (qPCR cycle threshold and standard curve and relative abundance (microarray and varied widely. Compared to all serotype densities observed, the strongest evidence of differences was seen for serotypes 21 and 35B (higher and 3, 38 and non-typeables (lower (p<0.05 with a similar hierarchy when only a single serotype carriage was assessed. There was no evidence of any overall density differences between children with single or multiple serotypes detected but serotypes with mid-range densities were more prevalent. The hierarchy of distinct pneumococcal serotype carriage densities described here for the first time, may help explain the dynamics of transmission between children.

  11. Pneumococcal Transmission and Disease In Silico: A Microsimulation Model of the Indirect Effects of Vaccination

    Science.gov (United States)

    Nurhonen, Markku; Cheng, Allen C.; Auranen, Kari

    2013-01-01

    Background The degree and time frame of indirect effects of vaccination (serotype replacement and herd immunity) are key determinants in assessing the net effectiveness of vaccination with pneumococcal conjugate vaccines (PCV) in control of pneumococcal disease. Using modelling, we aimed to quantify these effects and their dependence on coverage of vaccination and the vaccine's efficacy against susceptibility to pneumococcal carriage. Methods and Findings We constructed an individual-based simulation model that explores the effects of large-scale PCV programmes and applied it in a developed country setting (Finland). A population structure with transmission of carriage taking place within relevant mixing groups (families, day care groups, schools and neighbourhoods) was considered in order to properly assess the dependency of herd immunity on coverage of vaccination and vaccine efficacy against carriage. Issues regarding potential serotype replacement were addressed by employing a novel competition structure between multiple pneumococcal serotypes. Model parameters were calibrated from pre-vaccination data about the age-specific carriage prevalence and serotype distribution. The model predicts that elimination of vaccine-type carriage and disease among those vaccinated and, due to a substantial herd effect, also among the general population takes place within 5–10 years since the onset of a PCV programme with high (90%) coverage of vaccination and moderate (50%) vaccine efficacy against acquisition of carriage. A near-complete replacement of vaccine-type carriage by non-vaccine-type carriage occurs within the same time frame. Conclusions The changed patterns in pneumococcal carriage after PCV vaccination predicted by the model are unequivocal. The overall effect on disease incidence depends crucially on the magnitude of age- and serotype-specific case-to-carrier ratios of the remaining serotypes relative to those of the vaccine types. Thus the availability of

  12. Molecular epidemiology of pneumococcal isolates from children in China

    OpenAIRE

    Kang, Li-Hua; Liu, Meng-Juan; Xu, Wen-Chun; Cui, Jing-Jing; Zhang, Xue-Mei; Wu, Kai-Feng; Zhang, Qun

    2016-01-01

    Objectives: To investigate the molecular epidemiology of pneumococcal isolates in Chongqing, China. Methods: In this cross-sectional study, 51 invasive Streptococcus pneumoniae (S. pneumoniae) strains were from children with invasive pneumococcal disease (IPD) and 32 carriage strains from healthy children from January 2010 to December 2013 at the Children’s Hospital of Chongqing Medical University, Chongqing, China. Multilocus sequence typing was used to identify the sequence types (STs)...

  13. Carriage burden, multiple colonization and antibiotic pressure promote emergence of resistant vaccine escape pneumococci.

    Science.gov (United States)

    Mitchell, Patrick K; Lipsitch, Marc; Hanage, William P

    2015-06-05

    Pneumococcal conjugate vaccines target the limited subset of the more than 90 known serotypes of Streptococcus pneumoniae responsible for the greatest burden of pneumococcal disease and antibiotic resistance. Following the introduction of these vaccines, serotypes not targeted were able to expand and resistance became more common within these types. Here we use a stochastic dynamic model of pediatric pneumococcal carriage to evaluate potential influences on the emergence of new resistant lineages following the introduction of a vaccine targeting more common resistant types. Antibiotic pressure was the strongest driver, with no emergence at low levels and universal emergence at high levels. At intermediate levels of antibiotic pressure, higher carriage burden and a greater degree of dual carriage promoted emergence. This may have implications for current plans to introduce childhood pneumococcal vaccination in several high-burden countries.

  14. Streptococcus pneumoniae carriage in the Gaza strip.

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    Gili Regev-Yochay

    Full Text Available BACKGROUND: Pneumococcal infections cause major morbidity and mortality in developing countries. We report the epidemiology of S. pneumoniae carriage in a developing region, the Gaza strip, and evaluate the theoretical coverage of carriage strains by pneumococcal conjugate vaccines (PCVs. METHODOLOGY: In 2009 we conducted a cross-sectional survey of S. pneumoniae carriage in healthy children and their parents, living throughout the Gaza strip. Data were collected and nasopharyngeal swabs were obtained. Antibiotic susceptibilities were determined by Vitek-2 and serotypes by the Quellung reaction. PRINCIPAL FINDINGS: S. pneumoniae carriage was detected in 189/379 (50% of children and 30/376 (8% of parents. Carriage prevalence was highest in children <6 months of age (63%. Significant predictors for child carriage were number of household members and DCC attendance. The proportion of pediatric and adults isolates with serotypes included in PCV7 were 32% and 20% respectively, and 46% and 33% in PCV13 respectively. The most prominent non-vaccine serotypes (NVT were 35B, 15B/C and 23B. Penicillin-nonsusceptible strains were carried by 70% of carriers, penicillin-resistant strains (PRSP by 13% and Multi-drug-resistant (MDR by 30%. Of all PRSP isolates 54% belonged to serotypes included in PCV7 and 71% in the PCV13. Similarly, 59% and 73% of MDR-SP isolates, would theoretically be covered by PCV7 and PCV13, respectively. CONCLUSIONS: This study demonstrates that, PCV13-included strains were carried by 46% and 33% of pediatric and adult subjects respectively. In the absence of definitive data regarding the virulence of the NVT strains, it is difficult to predict the effect of PCVs on IPD in this region.

  15. Nasopharyngeal Carriage and Antimicrobial Susceptibility Pattern of Streptococcus Pneumoniae among Pediatric Outpatients at Gondar University Hospital, North West Ethiopia

    Directory of Open Access Journals (Sweden)

    Abate Assefa

    2013-10-01

    Conclusion: The S. pneumoniae carriage rate was higher among younger children. High antimicrobial resistance of S. pneumoniae against erythromycin, tetracycline, and cotrimoxazole was observed. Being in the young age group and living with younger children are risk factors for pneumococcal carriage.

  16. Pneumococcal antibody concentrations of subjects in communities fully or partially vaccinated with a seven-valent pneumococcal conjugate vaccine.

    Directory of Open Access Journals (Sweden)

    Martin O C Ota

    Full Text Available A recent trial with PCV-7 in a rural Gambian community showed reduced vaccine-type pneumococcal carriage in fully vaccinated compared with control communities. We measured pneumococcal polysaccharide antibody concentrations in this trial to understand further the mechanisms underlying the observed changes.A single-blind, cluster-randomized (by village trial was conducted in 21 Gambian villages. In 11 villages, all residents received PCV-7 (Vaccine group; in 10 control villages only children 5.0 µg/mL for all but serotype 9V of the PCV-7 serotypes in the older group, but not in the younger age group.Higher antibodies in vaccinated communities provide an explanation for the lower pneumococcal carriage rates in fully vaccinated compared to control communities.Controlled-Trials.com ISRCTN51695599 51695599.

  17. Outbreaks of Streptococcus pneumoniae carriage in day care cohorts in Finland – implications for elimination of transmission

    Directory of Open Access Journals (Sweden)

    Auranen Kari

    2009-06-01

    Full Text Available Abstract Background Day care centre (DCC attendees play a central role in maintaining the circulation of Streptococcus pneumoniae (pneumococcus in the population. Exposure within families and within DCCs are the main risk factors for colonisation with pneumococcal serotypes in DCC attendees. Methods Transmission of serotype specific carriage was analysed with a continuous time event history model, based on longitudinal data from day care attendees and their family members. Rates of acquisition, conditional on exposure, were estimated in a Bayesian framework utilising latent processes of carriage. To ensure a correct level of exposure, non-participating day care attendees and their family members were included in the analysis. Posterior predictive simulations were used to quantify transmission patterns within day care cohorts, to estimate the basic reproduction number for pneumococcal carriage in a population of day care cohorts, and to assess the critical vaccine efficacy against carriage to eliminate pneumococcal transmission. Results The model, validated by posterior predictive sampling, was successful in capturing the strong temporal clustering of pneumococcal serotypes in the day care cohorts. In average 2.7 new outbreaks of pneumococcal carriage initiate in a day care cohort each month. While 39% of outbreaks were of size one, the mean outbreak size was 7.6 individuals and the mean length of an outbreak was 2.8 months. The role of families in creating and maintaining transmission was minimal, as only 10% of acquisitions in day care attendees were from family members. Considering a population of day care cohorts, a child-to-child basic reproduction number was estimated as 1.4 and the critical vaccine efficacy against acquisition of carriage as 0.3. Conclusion Pneumococcal transmission occurs in serotype specific outbreaks of carriage, driven by within-day-care transmission and between-serotype competition. An amplifying effect of the day

  18. Molecular epidemiology of pneumococcal isolates from children in China.

    Science.gov (United States)

    Kang, Li-Hua; Liu, Meng-Juan; Xu, Wen-Chun; Cui, Jing-Jing; Zhang, Xue-Mei; Wu, Kai-Feng; Zhang, Qun

    2016-04-01

    To investigate the molecular epidemiology of pneumococcal isolates in Chongqing, China. In this cross-sectional study, 51 invasive Streptococcus pneumoniae (S. pneumoniae) strains were from children with invasive pneumococcal disease (IPD) and 32 carriage strains from healthy children from January 2010 to December 2013 at the Children's Hospital of Chongqing Medical University, Chongqing, China. Multilocus sequence typing was used to identify the sequence types (STs). Capsular serotypes were determined by multiplex polymerase chain reaction. Drug susceptibility and resistance was determined by minimum inhibitory concentrations. In this study, 11 serotypes were identified among the 83 S. pneumoniae clinical isolates tested. Prevalent serotypes were 19A (20.4%), 6A/B (20.4%), 19F (15.7%), 14 (14.5%), and 23F (10.8%). Serotype 19F was the most frequent carriage strain, and serotype 19A was the most frequent invasive strain. The ST983 was the most prevalent ST for carriage strains, and ST320 was the most prevalent ST for invasive strains. For gene analysis, psaA (99.5%) and piaA (98.6%) were present and much conserved in all pneumococci tested. The cps2A and pcsB genes were more frequent in invasive isolates than carriage strains. Antimicrobial resistance rates of invasive pneumococcal isolates to erythromycin, penicillin, meropenem, cefotaxime, and clindamycin were higher than the carriage isolates from children. Our epidemiological evidence shows that 19A, 6A/B, 19F, 14, and 23F remain the most prevalent serotypes, which can be targeted by PCV13. Genotypes and drug resistance varied between carriage and invasive strains. The PsaA and PiaA may be good protein vaccine candidates.

  19. Molecular epidemiology of pneumococcal isolates from children in China

    Directory of Open Access Journals (Sweden)

    Li-Hua Kang

    2016-04-01

    Full Text Available Objectives: To investigate the molecular epidemiology of pneumococcal isolates in Chongqing, China. Methods: In this cross-sectional study, 51 invasive Streptococcus pneumoniae (S. pneumoniae strains were from children with invasive pneumococcal disease (IPD and 32 carriage strains from healthy children from January 2010 to December 2013 at the Children’s Hospital of Chongqing Medical University, Chongqing, China. Multilocus sequence typing was used to identify the sequence types (STs. Capsular serotypes were determined by multiplex polymerase chain reaction. Drug susceptibility and resistance was determined by minimum inhibitory concentrations. Results: In this study, 11 serotypes were identified among the 83 S. pneumoniae clinical isolates tested. Prevalent serotypes were 19A (20.4%, 6A/B (20.4%, 19F (15.7%, 14 (14.5%, and 23F (10.8%. Serotype 19F was the most frequent carriage strain, and serotype 19A was the most frequent invasive strain. The ST983 was the most prevalent ST for carriage strains, and ST320 was the most prevalent ST for invasive strains. For gene analysis, psaA (99.5% and piaA (98.6% were present and much conserved in all pneumococci tested. The cps2A and pcsB genes were more frequent in invasive isolates than carriage strains. Antimicrobial resistance rates of invasive pneumococcal isolates to erythromycin, penicillin, meropenem, cefotaxime, and clindamycin were higher than the carriage isolates from children. Conclusion: Our epidemiological evidence shows that 19A, 6A/B, 19F, 14, and 23F remain the most prevalent serotypes, which can be targeted by PCV13. Genotypes and drug resistance varied between carriage and invasive strains. The PsaA and PiaA may be good protein vaccine candidates.

  20. Estado de portador nasofaríngeo de Streptococcus pneumoniae en madres e hijos de la población indígena Panare del estado Bolívar, Venezuela Pneumococcal carriage in mothers and children of the Panare Amerindians from the State of Bolivar, Venezuela

    Directory of Open Access Journals (Sweden)

    T Bello González

    2010-02-01

    carriage and serotype distribution of Streptococcus pneumoniae in mothers and children of the Panare people from Venezuela. In May 2008, in 8 distinct geographically isolated communities, 148 nasopharyngeal samples were obtained from 64 healthy mothers and 84 healthy Panare children under 5 years of age. S. pneumoniae was isolated and identified by standard techniques. Strains were typified by multiplex PCR and resistance patterns were determined by the disk diffusion method. A total of 65 strains were isolated; 11% of the mothers and 69% of the children carried S. pneumoniae. Serotypes 6B (48%, 33F (21,5%, 6A (6%, 19A (3,1% and 23F (1,5% were the most predominant. Of the 6 colonized mother-child pairs, 3 pairs (2 with 6B, were colonized with the same serotype. All strains were sensitive to penicillin and 13,7% were resistant to macrolides. The high colonization rates in the Panare people suggest that the children are at increased risk of pneumococcal invasive disease and could benefit from vaccination. Four conjugate vaccine serotypes (6B, 6A, 19A and 23F representing 58 % of all strains were present in the population at the moment of sampling. Resistance to antibiotics is (still not a problem.

  1. Carriage and invasive isolates of Streptococcus pneumoniae in Caracas, Venezuela: the relative invasiveness of serotypes and vaccine coverage.

    Science.gov (United States)

    Rivera-Olivero, I A; del Nogal, B; Sisco, M C; Bogaert, D; Hermans, P W M; de Waard, J H

    2011-12-01

    The introduction of a pneumococcal conjugate vaccine in Venezuela needs previous studies to assess vaccine efficiency. We conducted a survey of nasopharyngeal pneumococcal carriage in urban children in Caracas and studied the distribution of serotypes. We compared these data with survey data available for invasive strains isolated in the same area and in the same time period. An overall pneumococcal carriage rate of 27% was observed. The most predominant capsular serotypes among carriage isolates were 6B (29%), 19A (13.8%), 23F (10%), 14 (8.3%), 6A (8.3%) and 15B/C (3.3%) and among invasive isolates 6B (25%), 14 (15%), and 19A, 6A, 7F, and 18 (7.5% each). The serotypes/groups 1, 5, 7F and 18, jointly covering 30% of the invasive strains, represented less than 0.7% of the carrier strains. The theoretical coverage of the pneumococcal conjugate vaccine PCV13 for carriage and invasive strains was calculated to be 74% and 90%, respectively. Our study demonstrates important differences for the serotype distribution in disease and carriage isolates and provides a key baseline for future studies addressing the prevalence and replacement of invasive and carriage serotypes after the introduction of the PCV 13 vaccine in Venezuela in the year 2010.

  2. Streptococcus pneumoniae carriage prevalence in Nepal: evaluation of a method for delayed transport of samples from remote regions and implications for vaccine implementation.

    Directory of Open Access Journals (Sweden)

    Sarah Hanieh

    Full Text Available Pneumococcal disease is a significant cause of morbidity and mortality in young children in Nepal, and currently available pneumococcal conjugate vaccines offer moderate coverage of invasive disease isolates.A prevalence study of children aged 1.5 to 24 months in urban and rural Nepal was conducted. In the urban group, nasopharyngeal swabs (NPS were transported using silica desiccant packages (SDP with delayed processing (2 weeks, or skim-milk-tryptone-glucose-glycerin (STGG with immediate processing (within 8 hours. Pneumococcal nasopharyngeal carriage prevalence, serogroup/type distribution and isolate genotypes (as defined by multilocus sequence typing were determined.1101 children were enrolled into the study: 574 in the urban group and 527 in the rural group. Overall carriage prevalence based on culture from specimens transported and stored in STGG was 58.7% (337/574, compared to 40.9% (235/574 in SDP. There was concordance of detection of pneumococcus in 67% of samples. Using the SDP method, pneumococcal carriage prevalence was higher in the rural population (69.2%; 364/526 compared to the urban population (40.9%; 235/574. Serogroup/type distribution varied with geographical location. Over half of the genotypes identified in both the urban and rural pneumococcal populations were novel.The combination of delayed culture and transport using SDP underestimates the prevalence of pneumococcal carriage; however, in remote areas, this method could still provide a useful estimate of carriage prevalence and serogroup/type distribution. Vaccine impact is unpredictable in a setting with novel genotypes and limited serotype coverage as described here. Consequently, continued surveillance of pneumococcal isolates from carriage and disease in Nepali children following the planned introduction of pneumococcal conjugate vaccines introduction will be essential.

  3. An easy method for detection of nasopharyngeal carriage of multiple Streptococcus pneumoniae serotypes

    DEFF Research Database (Denmark)

    Kaltoft, Margit S.; Sørensen, Uffe; Slotved, Hans-Christian

    2008-01-01

    In this paper, a simplified method for detection of pneumococcal carriage and for revealing the presence of several serotypes in a nasopharyngeal sample is evaluated. Enrichment broth was used for transportation and for the initial culturing of samples. All specimens were examined directly by the...

  4. Clonal Expansion of the Macrolide Resistant ST386 within Pneumococcal Serotype 6C in France

    Science.gov (United States)

    Janoir, Claire; Cohen, Robert; Levy, Corinne; Bingen, Edouard; Lepoutre, Agnès; Gutmann, Laurent; Varon, Emmanuelle

    2014-01-01

    In France, the use of the 7-valent pneumococcal conjugate vaccine (PCV7) lead to an overall significant decrease in PCV7 invasive pneumococcal disease (IPD) incidence. However, the decrease in vaccine serotype prevalence was partially counterbalanced by the serotype replacement phenomenon. In this study, we analyzed the role of the newly described serotype 6C as one of the replacement serotypes. This work was conducted on a large time scale from the early PCV7 era (2002–2003) to the PCV13 era (2010–2011), both on IPD strains recovered from the whole population and nasopharyngeal colonizing strains isolated in infant less than two years, who are known to be the main reservoir for pneumococci. Serotype 6C took advantage over 6A and 6B serotypes, which both decreased over time. A continuous and significant increase in 6C IPD was observed in adults along the study period; in contrast, in children less than two years, only an increase in 6C nasopharyngeal carriage was found, the prevalence of serotype 6C in IPD remaining very low over time. Among 101 6C invasive and colonizing strains studied by MLST, 24 STs were found to be related to three major clonal complexes, CC395, CC176, and CC315. STs related to CC176 tend to disappear after 2009 and were essentially replaced by ST386 (CC315), which dramatically increased over time. This clonal expansion may be explained by the erythromycin and tetracycline resistances associated with this clone. Finally, the decrease observed in nasopharyngeal 6C carriage since 2010, likely related to the PCV13 introduction in the French immunization schedule, is expected to lead to a decrease in 6C IPD in adults thereafter. PMID:24603763

  5. Epidemiological Markers for Interactions Among Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus in Upper Respiratory Tract Carriage.

    Science.gov (United States)

    Lewnard, Joseph A; Givon-Lavi, Noga; Huppert, Amit; Pettigrew, Melinda M; Regev-Yochay, Gili; Dagan, Ron; Weinberger, Daniel M

    2016-05-15

    Cocolonization by Streptococcus pneumoniae and Haemophilus influenzae among children has been noted in numerous studies, as has an inverse relationship involving colonization with these species and Staphylococcus aureus. Interactions among these pathogens could mediate unanticipated outcomes of clinical interventions, including changes in H. influenzae and S. aureus disease incidence following pneumococcal vaccine introduction. However, it remains unclear whether cocolonization patterns represent true interspecies interactions or whether they result from confounding factors. We investigated polymicrobial carriage using longitudinal data from 369 Bedouin children and 400 Jewish children in Israel who were enrolled in a 7-valent pneumococcal conjugate vaccine (PCV7) trial. Children were swabbed 10 times between 2 and 30 months of age. The pathogens followed distinct age and seasonal distributions, but polymicrobial carriage associations persisted after controlling for these and other confounding factors. Receipt of PCV7 resulted in pneumococcal serotype replacement but did not influence total carriage of S. pneumoniae, H. influenzae, or S. aureus. The fact that S. pneumoniae, H. influenzae, and S. aureus polymicrobial carriage patterns do not result from confounding by age and season supports the idea of active interspecies interactions. However, pneumococcal serotype replacement may prevent changes in H. influenzae and S. aureus carriage among PCV7 recipients. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  6. Pneumococcal vaccination and chronic respiratory diseases

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    Froes F

    2017-12-01

    Full Text Available Filipe Froes,1 Nicolas Roche,2 Francesco Blasi3,4 1Chest Department, Hospital Pulido Valente, North Lisbon Hospital Center, Lisbon, Portugal; 2Department of Respiratory and Intensive Care Medicine, Cochin Hospital, Paris Descartes University, Paris, France; 3Department of Pathophysiology and Transplantation, University of Milan, 4Internal Medicine Department, Respiratory Unit and Adult Cystic Fibrosis Center, Fondazione IRCCS ca Granda Ospedale Maggiore Policlinico, Milan, Italy Abstract: Patients with COPD and other chronic respiratory diseases are especially vulnerable to viral and bacterial pulmonary infections, which are major causes of exacerbations, hospitalization, disease progression, and mortality in COPD patients. Effective vaccines could reduce the burden of respiratory infections and acute exacerbations in COPD patients, but what is the evidence for this? This article reviews and discusses the existing evidence for pneumococcal vaccination efficacy and its changing role in patients with chronic respiratory diseases, especially COPD. Specifically, the recent Community-Acquired Pneumonia Immunization Trial in Adults (CAPITA showed the efficacy of pneumococcal conjugate vaccine in older adults, many of whom had additional risk factors for pneumococcal disease, including chronic lung diseases. Taken together, the evidence suggests that pneumococcal and influenza vaccinations can prevent community-acquired pneumonia and acute exacerbations in COPD patients, while pneumococcal vaccination early in the course of COPD could help maintain stable health status. Despite the need to prevent pulmonary infections in patients with chronic respiratory diseases and evidence for the efficacy of pneumococcal conjugate vaccine, pneumococcal vaccine coverage and awareness are low and need to be improved. Respiratory physicians need to communicate the benefits of vaccination more effectively to their patients who suffer from chronic respiratory diseases

  7. Performance of a Pneumolysin Enzyme-Linked Immunosorbent Assay for Diagnosis of Pneumococcal Infections▿

    Science.gov (United States)

    del Mar García-Suárez, María; Cima-Cabal, María Dolores; Villaverde, Roberto; Espinosa, Emma; Falguera, Miquel; de Los Toyos, Juan R.; Vázquez, Fernando; Méndez, Francisco J.

    2007-01-01

    A pneumolysin-specific enzyme-linked immunosorbent assay (PLY-ELISA) for the detection of pneumolysin in urine was developed and evaluated in comparison with the commercially available Binax Now Streptococcus pneumoniae test (Binax, Portland, ME) for the diagnosis of pneumococcal infections. Assay sensitivity was evaluated using urine from 108 patients with culture-confirmed pneumococcal infections. In adults, the sensitivity and specificity of the PLY-ELISA were 56.6% and 92.2%, respectively. In children with nasopharyngeal pneumococcal carriage, PLY-ELISA and Binax Now S. pneumoniae test sensitivities were 62.5% and 87.5%, respectively, while specificities were 94.4% and 27.8%, respectively. In children with nonnasopharyngeal pneumococcal carriage, PLY-ELISA and Binax Now S. pneumoniae test sensitivities were 68.7% and 93.7%, respectively, and test specificities were 94.1% and 41.2%, respectively. The persistence of pneumolysin in urine of pneumococcal pneumonia patients decreased significantly after 4 to 6 days of treatment. Our data suggest that combining the high specificity of the PLY-ELISA with the high sensitivity of the Binax Now S. pneumoniae test would enable pneumococcal infections to be accurately diagnosed in children. PMID:17728474

  8. Pneumococcal disease: Closing the gap

    Directory of Open Access Journals (Sweden)

    Ashfaq Hasan

    2015-01-01

    Full Text Available oday, India is home to 99 million elderly people. By 2050, the number of elderly in this country will have gone up to 300 million1. With an increase in life expectancy from 32 years at the time of independence to 67.14 years in 20121, 10% of the population finds itself labeled as ‘senior citizen’. Inevitably, age brings with it comorbidities, immune senescence and pneumococcal disease. Pneumonia, in deference to its considerable morbidity and mortality, was exalted by Sir William Osler to its dubious pedestal of “Captain of all these Men of Death”. Unsurprisingly, immune debility and in several regions of the planet increasing antibiotic resistance, have ensured that pneumococcal pneumonia continues to take a large toll of senior citizens. Death rates have hardly budged over the last three decades. In India, pneumonia accounts for 25-30% deaths in the elderly3, a fatality rate almost unrivalled by most other terminal diseases. Among 15 high-burden countries, India has the dubious distinction of ranking third from last in the Global Action Plan for Pneumonia and Diarrhea (GAPPD4. During the World Immunization Week 2015 (April 24th to 30th, the ‘Close the Immunization Gap’ campaign gains crucial importance. Immunization, long vaunted as one of the most successful and cost-effective health interventions there is, prevent 2 to 3 million deaths every year, and saves enor-mous hospitalization costs and prevents loss of productivity. The recently published CAPiTA study (Community Acquired Pneumonia Immunization Trial in Adults, evaluated the efficacy of a novel 13-valent conju-gate vaccine for Pneumococcal pneumonia a vac-cine proven for its efficacy in children for the first time in older adults over 85,000 of them. Childhood vaccination with ‘PCV-13’, of course, was instrumental in reducing nasopharyngeal carriage of Strep pneumonia and decreasing the prevalence of Pneumococcal disease in the community at large. Altogether, the idea

  9. The remaining challenges of pneumococcal disease in adults

    Directory of Open Access Journals (Sweden)

    E. Ludwig

    2012-03-01

    Full Text Available Pneumococcal disease can be divided into invasive disease, i.e. when bacteria are detected in normally sterile body fluids, and noninvasive disease. Pneumococcal disease occurs more frequently in younger children and older adults. It is estimated that, in 2050, 30.3% of the European population will be ≥65 yrs old, compared with 15.7% in 2000. Preventive medicine, including vaccination, is essential for the promotion of healthy ageing. Uptake rates for influenza vaccination in the elderly are generally low, despite recommendations in many countries. In addition, it has been reported that influenza infections can make people more susceptible to pneumococcal infections. Despite pneumococcal vaccination, case fatality rates for patients hospitalised with invasive pneumococcal disease have remained at around 12% since the 1950s. Even when effective antibiotic therapy is administered, mortality can be high amongst immunocompetent patients in intensive care. Timely and accurate diagnosis of pneumococcal disease and identification of patients at high risk of poor outcome is essential to ensure that adequate treatment, including hospitalisation when necessary, is implemented as early as possible. Improved diagnostic techniques and more efficacious treatments may help to reduce the burden of pneumococcal disease, but preventive measures, such as influenza and pneumococcal vaccination, should be promoted in order to avoid preventable disease, particularly in the elderly.

  10. Outpatient-based pneumococcal vaccine campaign and survey of perceptions about pneumococcal vaccination in patients and doctors.

    Science.gov (United States)

    Song, Joon Young; Cheong, Hee Jin; Heo, Jung Yeon; Noh, Ji Yun; Seo, Yu Bin; Kim, In Seon; Choi, Won Suk; Kim, Woo Joo

    2013-03-01

    Despite the ready availability of pneumococcal vaccine, vaccination rates are quite low in South Korea. This study was designed to assess perceptions and awareness about pneumococcal vaccines among subjects at risk and find strategies to increases vaccine coverage rates. A cross sectional, community-based survey was conducted to assess perceptions about the pneumococcal vaccine at a local public health center. In a tertiary hospital, an outpatient- based pneumococcal vaccine campaign was carried out for the elderly and individuals with chronic co-morbidities from May to July of 2007. Based on the survey, only 7.6% were ever informed about pneumococcal vaccination. The coverage rates of the pneumococcal vaccine before and after the hospital campaign showed an increased annual rate from 3.39% to 5.91%. The most common reason for vaccination was "doctor's advice" (53.3%). As for the reasons for not receiving vaccination, about 75% of high risk patients were not aware of the pneumococcal vaccine, which was the most important barrier to vaccination. Negative clinician's attitude was the second most common cause of non-vaccination. Annual outpatient-based campaigns early in the influenza season may improve pneumococcal vaccine coverage rates. Doctor's advice was the most important encouraging factor for vaccination.

  11. Pneumococcal Vaccines (PCV, PPSV)

    Science.gov (United States)

    ... Term Complications of Diabetes Your Child's Immunizations: Pneumococcal Vaccines (PCV, PPSV) KidsHealth > For Parents > Your Child's Immunizations: ... or HIV infection); or cochlear implants. Why the Vaccines Are Recommended Children younger than 2 years old, ...

  12. Effect of Serotype on Pneumococcal Competition in a Mouse Colonization Model.

    Science.gov (United States)

    Trzciński, Krzysztof; Li, Yuan; Weinberger, Daniel M; Thompson, Claudette M; Cordy, Derrick; Bessolo, Andrew; Malley, Richard; Lipsitch, Marc

    2015-09-15

    Competitive interactions between Streptococcus pneumoniae strains during host colonization could influence the serotype distribution in nasopharyngeal carriage and pneumococcal disease. We evaluated the competitive fitness of strains of serotypes 6B, 14, 19A, 19F, 23F, and 35B in a mouse model of multiserotype carriage. Isogenic variants were constructed using clinical strains as the capsule gene donors. Animals were intranasally inoculated with a mixture of up to six pneumococcal strains of different serotypes, with separate experiments involving either clinical isolates or isogenic capsule-switch variants of clinical strain TIGR4. Upper-respiratory-tract samples were repeatedly collected from animals in order to monitor changes in the serotype ratios using quantitative PCR. A reproducible hierarchy of capsular types developed in the airways of mice inoculated with multiple strains. Serotype ranks in this hierarchy were similar among pneumococcal strains of different genetic backgrounds in different strains of mice and were not altered when tested under a range of host conditions. This rank correlated with the measure of the metabolic cost of capsule synthesis and in vitro measure of pneumococcal cell surface charge, both parameters considered to be predictors of serotype-specific fitness in carriage. This study demonstrates the presence of a robust competitive hierarchy of pneumococcal serotypes in vivo that is driven mainly, but not exclusively, by the capsule itself. Streptococcus pneumoniae (pneumococcus) is the leading cause of death due to respiratory bacterial infections but also a commensal frequently carried in upper airways. Available vaccines induce immune responses against polysaccharides coating pneumococcal cells, but with over 90 different capsular types (serotypes) identified, they can only target strains of the selected few serotypes most prevalent in disease. Vaccines not only protect vaccinated individuals against disease but also protect by

  13. Nasopharyngeal Bacterial Carriage in the Conjugate Vaccine Era with a Focus on Pneumococci

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    V. T. Devine

    2015-01-01

    Full Text Available Seven-valent pneumococcal conjugate vaccine (PCV7 was included in the UK national immunisation program in 2006, and this was replaced by thirteen-valent PCV in 2010. During this time, the carriage of vaccine-type Streptococcus pneumoniae decreased but pneumococcal carriage remained stable due to increases in non-vaccine-type S. pneumoniae. Carriage studies have been undertaken in various countries to monitor vaccine-type replacement and to help predict the serotypes, which may cause invasive disease. There has been less focus on how conjugate vaccines indirectly affect colonization of other nasopharyngeal bacteria. If the nasopharynx is treated as a niche, then bacterial dynamics are accepted to occur. Alterations in these dynamics have been shown due to seasonal changes, antibiotic use, and sibling/day care interaction. It has been shown that, following PCV7 introduction, an eradication of pneumococcal vaccine types has resulted in increases in the abundance of other respiratory pathogens including Haemophilus influenzae and Staphylococcus aureus. These changes are difficult to attribute to PCV7 introduction alone and these studies do not account for further changes due to PCV13 implementation. This review aims to describe nasopharyngeal cocarriage of respiratory pathogens in the PCV era.

  14. Streptococcus pneumoniae and Staphylococcus aureus carriage in healthy school-age children and adolescents.

    Science.gov (United States)

    Esposito, Susanna; Terranova, Leonardo; Ruggiero, Luca; Ascolese, Beatrice; Montinaro, Valentina; Rios, Walter Peves; Galeone, Carlotta; Principi, Nicola

    2015-04-01

    Streptococcus pneumoniae and Staphylococcus aureus are common commensals of the upper respiratory tract in children and adolescents. Understanding the relationship between these two pathogens, including their potential for mutual interference, is needed to evaluate the epidemiology of the diseases they cause, the factors that condition acquisition and carriage, and the impact of related preventative measures. We obtained oropharyngeal and nasal swabs from 497 healthy subjects aged 6-17 years. S. pneumoniae detection and serotyping were performed using a real-time PCR and S. aureus detection was performed using the RIDAGENE MRSA system. We found that 136 (27.3%) of the children were carriers of both species, 121 (24.3%) of the children carried S. pneumoniae alone and 128 (25.7%) of the children carried S. aureus alone. S. aureus carriage was similar between children who carried S. pneumoniae (136/257, 52.9 %, 95% confidence interval [CI]: 46.8-58.9%) vs those who did not (128/240, 53.3%, 95% CI: 47.0 -59.5%) and was independent of age and vaccination with 7-valent pneumococcal conjugate vaccine (PCV7). Vaccination with PCV7 did not affect S. aureus carriage [S. pneumoniae: 84/143 (58.7%, 95% CI: 50.5 -66.5%) vaccinated children vs 171/351 (48.7%, 95% CI: 43.5 -53.9%) unvaccinated children; S. aureus: 67/143 (46.9%, 95% CI: 38.9-55.0 %) vaccinated children vs 195/351 (55.6%, 95% CI: 50.3 -60.7%) unvaccinated children]. Pneumococcal serotype also did not appear to affect S. aureus carriage. These findings suggested that the carriage of S. pneumoniae did not affect that of S. aureus in older children and adolescents, regardless of age, PCV7 vaccination and pneumococcal serotype. © 2015 The Authors.

  15. Nasopharyngeal colonization of Gambian infants by Staphylococcus aureus and Streptococcus pneumoniae before the introduction of pneumococcal conjugate vaccines.

    Science.gov (United States)

    Usuf, E; Bojang, A; Hill, P C; Bottomley, C; Greenwood, B; Roca, A

    2016-03-01

    Staphylococcus aureus and Streptococcus pneumoniae commonly colonize the upper respiratory tract and can cause invasive disease. Several studies suggest an inverse relationship between these two bacteria in the nasopharynx. This association is of particular concern as the introduction of pneumococcal conjugate vaccines (PCVs) that affect pneumococcal nasopharyngeal carriage become widespread. A cohort of children in rural Gambia were recruited at birth and followed for 1 year, before the introduction of PCV into the routine immunization program. Nasopharyngeal swabs were taken immediately after birth, every 2 weeks for the first 6 months and then every other month. The presence of S. aureus and S. pneumoniae was determined using conventional microbiologic methods. Prevalence of S. aureus carriage was 71.6% at birth, decreasing with age to reach a plateau at approximately 20% between 10 to 20 weeks of age. Carriage with any S. pneumoniae increased during the first 10 weeks of life to peak at approximately 90%, mostly of PCV13 serotypes. Although in the crude analysis S. aureus carriage was inversely associated with carriage of any S. pneumoniae and PCV13 serotypes, after adjusting by age and season, there was a positive association with any carriage (odds ratio 1.32; 95% confidence interval 1.07-1.64; p 0.009) and no association with carriage of PCV13 serotypes (odds ratio 0.99; 95% confidence interval 0.70-1.41; p 0.973). Among Gambian infants, S. aureus and S. pneumoniae are not inversely associated in nasopharyngeal carriage after adjustment for age. Further carriage studies following the introduction of PCV are needed to better understand the relationship between the two bacteria.

  16. Dried Saliva Spots: A Robust Method for Detecting Streptococcus pneumoniae Carriage by PCR

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    Cassandra L. Krone

    2016-03-01

    Full Text Available The earliest studies in the late 19th century on Streptococcus pneumoniae (S. pneumoniae carriage used saliva as the primary specimen. However, interest in saliva declined after the sensitive mouse inoculation method was replaced by conventional culture, which made isolation of pneumococci from the highly polymicrobial oral cavity virtually impossible. Here, we tested the feasibility of using dried saliva spots (DSS for studies on pneumococcal carriage. Saliva samples from children and pneumococcus-spiked saliva samples from healthy adults were applied to paper, dried, and stored, with and without desiccant, at temperatures ranging from −20 to 37 °C for up to 35 days. DNA extracted from DSS was tested with quantitative-PCR (qPCR specifically for S. pneumoniae. When processed immediately after drying, the quantity of pneumococcal DNA detected in spiked DSS from adults matched the levels in freshly spiked raw saliva. Furthermore, pneumococcal DNA was stable in DSS stored with desiccant for up to one month over a broad range of temperatures. There were no differences in the results when spiking saliva with varied pneumococcal strains. The collection of saliva can be a particularly useful in surveillance studies conducted in remote settings, as it does not require trained personnel, and DSS are resilient to various transportation conditions.

  17. Functional polymorphisms of macrophage migration inhibitory factor as predictors of morbidity and mortality of pneumococcal meningitis

    Science.gov (United States)

    Savva, Athina; Brouwer, Matthijs C.; Valls Serón, Mercedes; Le Roy, Didier; Ferwerda, Bart; van der Ende, Arie; Bochud, Pierre-Yves; van de Beek, Diederik; Calandra, Thierry

    2016-01-01

    Pneumococcal meningitis is the most frequent and critical type of bacterial meningitis. Because cytokines play an important role in the pathogenesis of bacterial meningitis, we examined whether functional polymorphisms of the proinflammatory cytokine macrophage migration inhibitory factor (MIF) were associated with morbidity and mortality of pneumococcal meningitis. Two functional MIF promoter polymorphisms, a microsatellite (−794 CATT5–8; rs5844572) and a single-nucleotide polymorphism (−173 G/C; rs755622) were genotyped in a prospective, nationwide cohort of 405 patients with pneumococcal meningitis and in 329 controls matched for age, gender, and ethnicity. Carriages of the CATT7 and −173 C high-expression MIF alleles were associated with unfavorable outcome (P = 0.005 and 0.003) and death (P = 0.03 and 0.01). In a multivariate logistic regression model, shock [odds ratio (OR) 26.0, P = 0.02] and carriage of the CATT7 allele (OR 5.12, P = 0.04) were the main predictors of mortality. MIF levels in the cerebrospinal fluid were associated with systemic complications and death (P = 0.0002). Streptococcus pneumoniae strongly up-regulated MIF production in whole blood and transcription activity of high-expression MIF promoter Luciferase reporter constructs in THP-1 monocytes. Consistent with these findings, treatment with anti-MIF immunoglogulin G (IgG) antibodies reduced bacterial loads and improved survival in a mouse model of pneumococcal pneumonia and sepsis. The present study provides strong evidence that carriage of high-expression MIF alleles is a genetic marker of morbidity and mortality of pneumococcal meningitis and also suggests a potential role for MIF as a target of immune-modulating adjunctive therapy. PMID:26976591

  18. PNEUMOCOCCAL INFECTION: MODERN VIEW ON THE ISSUE AND PREVENTION

    Directory of Open Access Journals (Sweden)

    V.К. Tatochenko

    2007-01-01

    Full Text Available Pneumococci are spread everywhere and they are very often a component of the microflora of the upper respiratory tracts. The level of the pneumococcus carriage is correlated with age. Among children the highest frequency is observed at the age of 4,5 years (up to 90% of cases, among adults it is 5–10%. According to international and Russian data, pneumococcal infection causes up to 76% of all the aetiologically deciphered cases of community cacquired pneumonia among adults and up to 94% (aggravated cases among children. The most frequent clinical forms of pneumococcal infection among children are acute otitis media (over 30%, pneumonia and meningitis (about 5–20% of all purulent bacterial meningitis, among adults — meningitis and sepsis. In 1998, in Russia was registered the first and still the only vaccine for the prevention of pneumococcal infection — Pneumo 23 (Sanofi Pasteur. The vaccine consists of 23 antic gens of the most dangerous pneumococcus serotypes and is used for the prevention of all the forms of pneumococcal infection. The composition of Pneumo 23 corresponds to 85% of pneumococcus serotypes circulating across Europe and to 90% serotypes resistant to penicillin. According to Russian data Pneumo 23 consists of about 80% of pneumococcus serotypes isolated in healthy carriers and ill with acute respiratory diseases and of 92% of serotypes in those suffering from acute bronchitis and pneumonia. The results of the clinical studies allow us to recommend the use of the given vaccine in a complex therapy of children, suffering from latent TB infection, often recurrent episodes of bronchopulmonary pathologies, ENT diseases, bronchial asthma and other chronic diseases.Key words: therapy, pediatrics, pneumonia, bronchial asthma, chronic obstructive lungs disease, prevention, treatment, pneumococcal infection.

  19. Nasopharyngeal carriage of Streptococcus pneumonia in pneumonia-prone age groups in Semarang, Java Island, Indonesia.

    Science.gov (United States)

    Farida, Helmia; Severin, Juliëtte A; Gasem, M Hussein; Keuter, Monique; Wahyono, Hendro; van den Broek, Peterhans; Hermans, Peter W M; Verbrugh, Henri A

    2014-01-01

    Streptococcus pneumoniae is a worldwide occurring pathogen Nasopharyngeal carriage of Streptococcus pneumoniae precedes pneumonia and other pneumococcal diseases in the community. Little is known about S. pneumoniae carriage in Indonesia, complicating strategies to control pneumococcal diseases. We investigated nasopharyngeal carriage of S. pneumoniae in Semarang, Indonesia. A population-based survey was performed in Semarang, Indonesia. Nasopharyngeal swabs and questionnaires were taken from 496 healthy young (6-60 month-old) children and 45-70 year-old adults. Forty-three percent of children aged 6-60 months and 11% of adults aged 45-75 years carried S. pneumoniae. Determinants of carriage were being a child (OR 7.7; 95% CI = 4.5-13.0), passive smoking (OR 2.1; 95% CI = 1.3-3.4), and contact with toddler(s) at home (OR 3.0; 95% CI = 1.9-4.7). The most frequent serotypes found were 6A/B and 15B/C. The current commercially available vaccines cover <50% serotypes found in children. Twenty-four percent of S. pneumoniae strains were penicillin non-susceptible, and 45% were resistant to cotrimoxazol. The limited coverage of commercially available vaccines against the serotypes found in this population, and the high proportion of non-susceptibility to penicillin and cotrimoxazol suggest the need for region-specific information and strategies to control S. pneumoniae.

  20. Prevalence and risk factors of early fecal carriage of Enterococcus faecalis and Staphylococcus spp and their antimicrobial resistant patterns among healthy neonates born in a hospital setting in central Saudi Arabia.

    Science.gov (United States)

    El-Kersh, Talat A; Marie, Mohammed A; Al-Sheikh, Yazeed A; Al-Agamy, Mohamed H; Al Bloushy, Ahmad A

    2016-03-01

    To investigate the prevalence, antibiotic resistant profiles, and risk factors of early fecal carriage of Enterococcus faecalis (E. faecalis) and staphylococci among 150 healthy Saudi neonates born in a hospital setting in central Saudi Arabia. This prospective study was conducted in Al-Bukayriyah General Hospital, Qassim, Saudi Arabia, between June 2012 and January 2013. The E. faecalis and Staphylococcus spp. isolates were identified manually, and Vitek2 system was used for identity confirmation at the species level and minimum inhibitory concentration-susceptibility testing. Enterococcus faecalis (n=73) and Staphylococcus spp. (n=18) were recovered. Unlike staphylococci, E. faecalis colonization did not significantly vary from day one up to 7 days of life, regardless of the type of feeding, but it was relatively higher among vaginally versus cesarean delivery. Both Staphylococcus epidermidis (S. epidermidis) and Staphylococcus aureus (S. aureus) carriage increase as the body weight increases, and this difference was significant (p=0.025) for S. epidermidis. High-level resistance in Gentamycin among E. faecalis isolates was 25% and 11% to Streptomycin. Thirty percent of S. epidermidis were resistant to oxacillin and exhibited multidrug-resistant (MDR) patterns of 5 resistant markers, which were also observed among 2/5 (40%) of Methicillin-resistant Staphylococcus aureus isolates. Enterococcus faecalis did not significantly vary in relation to type of delivery, age up to 7 days, and type of feeding. The neonatal fecal carriage of MDR isolates should be considered as a crucial reservoir to the further spread of antimicrobial resistance genes among hospitals, cross infections, and the community.

  1. ADULT PNEUMOCOCCAL VACCINATION GUIDELINE

    African Journals Online (AJOL)

    Vaccine description. A highly purified vaccine containing 2~. Ilg of each of 23 capsular polysaccharides representing;;, 85% of the serotypes causing pneumonia and invasive pneumococcal disease in the community. Polysaccharide a.rltigens induce type-specific antibodies that enhance opsonisation, phagocytosis and ...

  2. ADULT PNEUMOCOCCAL VACCINATION GUIDELINE

    African Journals Online (AJOL)

    of the most common causes of pneumonia, meningitis, and otitis media. Since pneumococcal infections are not notifiable in. South Africa, the true incidence of these infections is uncertain. evertheless, based on estimated disease rates in the USA, it has been suggested that>150 million cases occur annually. worldvJide.

  3. Dynamics and Determinants of Pneumococcal Antibodies Specific against 13 Vaccine Serotypes in the Pre-Vaccination Era.

    Directory of Open Access Journals (Sweden)

    Annemarijn C Prins-van Ginkel

    Full Text Available Introduction of pneumococcal conjugate vaccines (PCVs for infants decreased overall invasive pneumococcal disease (IPD, while non-vaccine serotype IPD increased. To fully understand this serotype replacement, knowledge about serotype dynamics in the pre-vaccine era is needed. In addition to IPD surveillance and carriage studies, the serotype replacement can be investigated by serosurveillance studies. The current study compared the results of two Dutch serosurveillance studies conducted in 1995-1996 (PIENTER1 and 2006-2007 (PIENTER2.Participants in these studies donated a blood sample and completed a questionnaire. Pneumococcal antibodies of serotypes included in PCV13 were measured with a fluorescent-bead based multiplex immunoassay. Geometric mean antibody concentrations (GMCs and determinants of pneumococcal antibody levels were investigated.GMCs were higher in PIENTER2 for serotypes 1, 6A, 6B, 9V, 18C, 19F and 23F and lower for 3 and 5. Age, day care attendance, household size, vaccination coverage, and urbanisation rate were associated with pneumococcal antibodies in children. Education level, ethnicity, age, low vaccination coverage sample, urbanisation rate, and asthma/COPD were associated with pneumococcal antibodies in elderly. The determinants significantly associated with pneumococcal IgG were slightly different for the elderly in PIENTER1 compared to the elderly in PIENTER2.Although most of the serotype antibody levels remained stable, some of the serotype-specific antibody levels varied during the pre-vaccine era, indicating that exposure of certain serotypes changes without interference of PCVs.

  4. [Acute rhabdomyolysis during pneumococcal pneumonia: two cases].

    Science.gov (United States)

    Aouina, H; Aïssa, I; Baccar, M A; Gharbi, L; Azzabi, S; Bouacha, H

    2007-04-01

    Acute rhabdomyolysis is a clinical and biological syndrome generally with a toxic or traumatic cause. Only 5% of cases are infectious, and rarely in relation to a pneumococcal infection. We report two cases of acute rhabdomyolysis which developed in patients with severe Streptococcus pneumoniae pneumonia. No other cause could be identified in these two patients aged 32 and 37 years. Rhabdomyolysis was discovered in the first patient because of acute kidney failure and elevated serum transaminase levels. The second patient presented an inflammatory edema affecting the soft tissues. Blood cultures isolated a pneumococcus in both patients. The rhabdomyolysis regressed favorably in both patients despite the transient renal failure in the first patient. Prognosis is generally poor for rhabdomyolysis during the course of pneumococcal pneumonia, with increased morbidity and mortality for these infections. Early detection of bacteriemia enables rapid and adequate treatment and prevention of renal failure.

  5. NASOPHARYNGEAL CARRIAGE OF STREPTOCOCCUS PNEUMONIAE IN ORPHANS, PRESCHOOL CHILDREN AND UNORGANIZED CHILDREN UNDER 5 YEARS

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    M. A. Lazareva

    2015-01-01

    Full Text Available Nasopharyngeal colonization with Streptococcus pneumoniae is a source of respiratory mucosal and invasive infections. For effective vaccine prophylaxis of these diseases the national monitoring of the circulating serotypes and antimicrobial resistance of Streptococcus pneumoniae is required. Objective: To analyze serotype diversity and antimicrobial resistance of S. pneumoniae in the nasopharyngeal carriage in children under 5 years. Methods and patients: The study included orphanage, nursery and children not attending preschool institutions (unorganized children without respiratory infections and not receiving antibiotic therapy. Conducted microbiological analysis of nasopharyngeal flora, serotyping of pneumococcus, assess their sensitivity to antibiotics. Results: Nasopharyngeal carriage of S. pneumoniae was found in 23%, Moraxella catarrhalis - in 23%, Haemophilus influenzae - 16% of the 246 children included in the study. Serotype was determined in 54 pneumococcal isolates: predominant serotypes 19F (21%, 6B (15%, 23F (14%, 14 (8%. The coincidence of the spectrum obtained with serotypes members of the PCV7 pneumococcal conjugate vaccines and PKV10, was 81% in PKV13 - 90%. The proportion of strains sensitive to clindamycin, 31%, to macrolides - 40% to trimethoprim / sulfamethoxazole - 60%. Multiple resistance was observed in 37% of the identified pneumococcal serotypes. In erythromycin-resistant strains resistance was caused by the presence of ermB-gene (in 74% of cases or mef-dependent efflux pump as the sole determinant (9%, in 17% of cases – with its association. Maximum antibiotic resistance is observed in pneumococcal vaccine serotypes. Conclusions: The results of the study comparing with previously obtained data shows stability over the past decades the spectrum of pneumococci circulating in the Russian population of children. A substantial increase in pneumococcal resistance to (especially vaccine serotypes antibiotic penicillin

  6. Incomplete recovery of pneumococcal CD4 T cell immunity after initiation of antiretroviral therapy in HIV-infected malawian adults.

    Directory of Open Access Journals (Sweden)

    Enoch Sepako

    Full Text Available HIV-infected African adults are at a considerably increased risk of life-threatening invasive pneumococcal disease (IPD which persists despite antiretroviral therapy (ART. Defects in naturally acquired pneumococcal-specific T-cell immunity have been identified in HIV-infected adults. We have therefore determined the extent and nature of pneumococcal antigen-specific immune recovery following ART. HIV-infected adults were followed up at 3, 6 and 12 months after initiating ART. Nasopharyngeal swabs were cultured to determine carriage rates. Pneumococcal-specific CD4 T-cell immunity was assessed by IFN-γ ELISpot, proliferation assay, CD154 expression and intracellular cytokine assay. S. pneumoniae colonization was detected in 27% (13/48 of HIV-infected patients prior to ART. The rates remained elevated after 12 months ART, 41% (16/39 (p = 0.17 and significantly higher than in HIV-uninfected individuals (HIVneg 14%(4/29; p = 0.0147. CD4+ T-cell proliferative responses to pneumococcal antigens increased significantly to levels comparable with HIV-negative individuals at 12 months ART (p = 0.0799. However, recovery of the pneumococcal-specific CD154 expression was incomplete (p = 0.0015 as were IFN-γ ELISpot responses (p = 0.0040 and polyfunctional CD4+ T-cell responses (TNF-α, IL-2 and IFN-γ expression (p = 0.0040 to a pneumolysin-deficient mutant strain. Impaired control of pneumococcal colonisation and incomplete restoration of pneumococcal-specific immunity may explain the persistently higher risk of IPD amongst HIV-infected adults on ART. Whether vaccination and prolonged ART can overcome this immunological defect and reduce the high levels of pneumococcal colonisation requires further evaluation.

  7. Carriage of Streptococcus pneumoniae and other respiratory bacterial pathogens in low and lower-middle income countries: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Richard A Adegbola

    Full Text Available Infection with Streptococcus pneumoniae is a major cause of childhood morbidity and mortality worldwide, especially in low income countries where pneumococcal conjugate vaccines (PCVs are still underused. In countries where PCVs have been introduced, much of their efficacy has resulted from their impact on nasopharyngeal carriage in vaccinated children. Understanding the epidemiology of carriage for S. pneumoniae and other common respiratory bacteria in developing countries is crucial for implementing appropriate vaccination strategies and evaluating their impact.We have systematically reviewed published studies reporting nasopharyngeal or oropharyngeal carriage of S. pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, and Neisseria meningitidis in children and adults in low and lower-middle income countries. Studies reporting pneumococcal carriage for healthy children <5 years of age were selected for a meta-analysis. The prevalences of carriage for S. pneumoniae, H. influenzae, and M. catarrhalis were generally higher in low income than in lower-middle income countries and were higher in young children than in adults. The prevalence of S. aureus was high in neonates. Meta-analysis of data from young children before the introduction of PCVs showed a pooled prevalence estimate of 64.8% (95% confidence interval, 49.8%-76.1% in low income countries and 47.8% (95% confidence interval, 44.7%-50.8% in lower-middle income countries. The most frequent serotypes were 6A, 6B, 19A, 19F, and 23F.In low and lower-middle income countries, pneumococcal carriage is frequent, especially in children, and the spectrum of serotypes is wide. However, because data are limited, additional studies are needed to adequately assess the impact of PCV introduction on carriage of respiratory bacteria in these countries.

  8. A cohort study of the impact and acquisition of naspharyngeal carriage of Streptococcus pneumoniae during the Hajj.

    Science.gov (United States)

    Memish, Ziad A; Al-Tawfiq, Jaffar A; Almasri, Malak; Akkad, Nadia; Yezli, Saber; Turkestani, Abdulhafeez; van der Linden, Mark; Assiri, Abdullah

    2016-01-01

    The annual Muslim pilgrimage attracts over two million pilgrims who gather in a limited time and space. The pilgrimage carries the potential risk of increase risk of the acquisition of Streptococcus pneumonia. In this cohort study, we evaluate the effect of the Hajj on the prevalence of pneumococcal serotype nasopharyngeal carriage in the Hajj pilgrim population. The secondary objective is to evaluate the effects of the mass gathering on carriage of invasive pneumococcal serotypes. This is a prospective cohort study with two data collection periods: at the beginning and at the end of the Hajj. Nasopharyngeal samples were taken via a standardized swabbing method. A total of 1175 pilgrims were enrolled at the beginning of the study and 1155 (98.3%) were included at the second part of the study. The pre-Hajj samples were obtained at a mean of 0 days and the post-Hajj sampling occurred at a mean of 15 days after arrival to Saudi Arabia. The overall carriage rate of Streptococcus pneumoniae in the pre- and post-Hajj was 1.8% and 7.1% (P = 0.0016). The potential coverage of the 7-valent pneumococcal conjugate vaccine (PCV7), PCV10 and PCV13 were 15.5%, 19.1%; and 35.5%, respectively. The coverage for the 23-valent pneumococcal polysaccharide vaccine (PPV23) was 40%. Although there was an increase in the acquisition of S. pneumoniae, its magnitude is low which does not support public health recommendations for general pneumococcal vaccination of pilgrims except those at risk. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Can the success of pneumococcal conjugate vaccines for the prevention of pneumococcal diseases in children be extrapolated to adults?

    Science.gov (United States)

    Weil-Olivier, Catherine; Gaillat, Jacques

    2014-04-11

    Before conjugate pneumococcal vaccines (PCVs) were introduced it was estimated that Streptococcus pneumoniae caused 500,000 cases of pneumonia, 50,000 cases of bacteremia and 3000 cases of meningitis annually in the United States in both children and adults. After 10 years of routine use of the 7-valent pneumococcal conjugate vaccine (PCV7) the incidence of vaccine-type pneumococcal diseases (PDs) had significantly decreased in vaccinated children (direct effect) and unvaccinated subjects of all ages (indirect effect). Second generation, higher-valent PCVs, especially 13-valent (PCV13), routinely implemented since 2010, have reduced the incidence of PDs caused by the six additional non-PCV7 serotypes, in both vaccinated and unvaccinated subjects. The licence for this vaccine has recently been extended to include adults aged 18 to 49 in Europe. Although PCV13 has an indirect effect on IPD in adults, this will probably not achieve the same level of disease control in adults and the elderly (especially those at high risk) as that obtained in vaccinated children. As highlighted in this paper, differences exist between children and adults for PD manifestations (incidence, morbidity and mortality) and serotypes isolated in nasopharyngeal carriage and diseases, so benefits from adult vaccination must be considered in this light. PCV13 induces an immune response in adults that is non-inferior for all serotypes common with the 23-valent plain polysaccharide vaccine that is currently recommended for adults and even superior for many serotypes. Although there is no evidence that this immune response translates to clinical efficacy in adults as seen in children, the results from a randomised trial in The Netherlands, expected in 2014, should provide the missing evidence. This evidence and efficient surveillance systems should provide the necessary data, essential for policy makers in their decisions on adult pneumococcal vaccination policies. Copyright © 2014 Elsevier Ltd

  10. Recombination in Streptococcus pneumoniae Lineages Increase with Carriage Duration and Size of the Polysaccharide Capsule

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    Chrispin Chaguza

    2016-09-01

    Full Text Available Streptococcus pneumoniae causes a high burden of invasive pneumococcal disease (IPD globally, especially in children from resource-poor settings. Like many bacteria, the pneumococcus can import DNA from other strains or even species by transformation and homologous recombination, which has allowed the pneumococcus to evade clinical interventions such as antibiotics and pneumococcal conjugate vaccines (PCVs. Pneumococci are enclosed in a complex polysaccharide capsule that determines the serotype; the capsule varies in size and is associated with properties including carriage prevalence and virulence. We determined and quantified the association between capsule and recombination events using genomic data from a diverse collection of serotypes sampled in Malawi. We determined both the amount of variation introduced by recombination relative to mutation (the relative rate and how many individual recombination events occur per isolate (the frequency. Using univariate analyses, we found an association between both recombination measures and multiple factors associated with the capsule, including duration and prevalence of carriage. Because many capsular factors are correlated, we used multivariate analysis to correct for collinearity. Capsule size and carriage duration remained positively associated with recombination, although with a reduced P value, and this effect may be mediated through some unassayed additional property associated with larger capsules. This work describes an important impact of serotype on recombination that has been previously overlooked. While the details of how this effect is achieved remain to be determined, it may have important consequences for the serotype-specific response to vaccines and other interventions.

  11. Risk factors for nasopharyngeal carriage of drug-resistant Streptococcus pneumoniae: data from a nation-wide surveillance study in Greece

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    Samonis Georgios

    2009-07-01

    Full Text Available Abstract Background A nation-wide surveillance study was conducted in Greece in order to provide a representative depiction of pneumococcal carriage in the pre-vaccination era and to evaluate potential risk factors for carriage of resistant strains in healthy preschool children attending daycare centers. Methods A study group was organized with the responsibility to collect nasopharyngeal samples from children. Questionnaires provided demographic data, data on antibiotic consumption, family and household data, and medical history data. Pneumococcal isolates were tested for their susceptibility to various antimicrobial agents and resistant strains were serotyped. Results Between February and May 2004, from a total population of 2536 healthy children, a yield of 746 pneumococci was isolated (carriage rate 29.41%. Resistance rates differed among geographic regions. Recent antibiotic use in the last month was strongly associated with the isolation of resistant pneumococci to a single or multiple antibiotics. Serotypes 19F, 14, 9V, 23F and 6B formed 70.6% of the total number of resistant strains serotyped. Conclusion Recent antibiotic use is a significant risk factor for the colonization of otherwise healthy children's nasopharynx by resistant strains of S pneumoniae. The heptavalent pneumococcal conjugate vaccine could provide coverage for a significant proportion of resistant strains in the Greek community. A combined strategy of vaccination and prudent antibiotic use could provide a means for combating pneumococcal resistance.

  12. Multiple colonization with S. pneumoniae before and after introduction of the seven-valent conjugated pneumococcal polysaccharide vaccine.

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    Silvio D Brugger

    2010-07-01

    Full Text Available Simultaneous carriage of more than one strain of Streptococcus pneumoniae promotes horizontal gene transfer events and may lead to capsule switch and acquisition of antibiotic resistance. We studied the epidemiology of cocolonization with S. pneumoniae before and after introduction of the seven-valent conjugated pneumococcal vaccine (PCV7.Nasopharyngeal swabs (n 1120 were collected from outpatients between 2004 and 2009 within an ongoing nationwide surveillance program. Cocolonization was detected directly from swabs by restriction fragment length polymorphism (RFLP analysis. Serotypes were identified by agglutination, multiplex PCR and microarray.Rate of multiple colonization remained stable up to three years after PCV7 introduction. Cocolonization was associated with serotypes of low carriage prevalence in the prevaccine era. Pneumococcal colonization density was higher in cocolonized samples and cocolonizing strains were present in a balanced ratio (median 1.38. Other characteristics of cocolonization were a higher frequency at young age, but no association with recurrent acute otitis media, recent antibiotic exposure, day care usage and PCV7 vaccination status.Pneumococcal cocolonization is dominated by serotypes of low carriage prevalence in the prevaccine era, which coexist in the nasopharynx. Emergence of such previously rare serotypes under vaccine selection pressure may promote cocolonization in the future.

  13. PCV13-vaccinated children still carrying PCV13 additional serotypes show similar carriage density to a control group of PCV7-vaccinated children.

    Science.gov (United States)

    Dagan, Ron; Juergens, Christine; Trammel, James; Patterson, Scott; Greenberg, David; Givon-Lavi, Noga; Porat, Nurith; Gruber, William C; Scott, Daniel A

    2017-02-07

    In addition to reducing vaccine-type nasopharyngeal carriage rates, pneumococcal conjugate vaccines (PCVs) may decrease carriage density in vaccinated individuals still carrying vaccine serotypes. However, reduction of carriage density has not been systematically studied. This study compared the effect of PCV13 versus PCV7 on carriage density of the serotypes in PCV13 that are not included in PCV7. This randomized, double-blind study was conducted in southern Israel and included Jewish and Bedouin subjects. Per protocol, 881 and 873 infants received PCV13 and PCV7, respectively, at ages 2, 4, 6, and 12months. Nasopharyngeal cultures at ages 7, 12, 13, 18, and 24months were plated using the 4-quadrant semiquantitative method and graded 0 (negative) to 4 (growth in all plate quadrants). In this post hoc analysis, the least squares means of cumulative colonization densities per serotype and serotype combination of the total population and each ethnic subpopulation in each vaccine group were calculated, and differences between vaccine groups derived from a linear model. PCV13-vaccinated children still carrying the 6 additional PCV13 serotypes unique to PCV13 showed no significant differences in carriage density compared with the PCV7-vaccinated control group. No differences in carriage density were shown between Jewish and Bedouin subpopulations despite higher carriage rates among Bedouin subjects. Although PCV13 vaccination reduces vaccine-type carriage compared with PCV7 vaccination by reducing nasopharyngeal acquisition of the additional PCV13 serotypes as previously reported, the current study lacks evidence of a decrease in carriage density of these serotypes when acquired in vaccinated children. Despite the lack of effect on carriage density observed, surveillance data suggest a dramatic decrease in disease rates after PCV implementation. Thus, the current analysis suggests that PCV's impact on carriage density has minimal or no impact on vaccine success. (www

  14. Leukocyte attraction by CCL20 and its receptor CCR6 in humans and mice with pneumococcal meningitis.

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    Matthias Klein

    Full Text Available We previously identified CCL20 as an early chemokine in the cerebrospinal fluid (CSF of patients with pneumococcal meningitis but its functional relevance was unknown. Here we studied the role of CCL20 and its receptor CCR6 in pneumococcal meningitis. In a prospective nationwide study, CCL20 levels were significantly elevated in the CSF of patients with pneumococcal meningitis and correlated with CSF leukocyte counts. CCR6-deficient mice with pneumococcal meningitis and WT mice with pneumococcal meningitis treated with anti-CCL20 antibodies both had reduced CSF white blood cell counts. The reduction in CSF pleocytosis was also accompanied by an increase in brain bacterial titers. Additional in vitro experiments showed direct chemoattractant activity of CCL20 for granulocytes. In summary, our results identify the CCL20-CCR6 axis as an essential component of the innate immune defense against pneumococcal meningitis, controlling granulocyte recruitment.

  15. [Pneumococcal septic arthritis in a Spanish university hospital (1993- 2003)].

    Science.gov (United States)

    Barahona, Lucía; Soriano, Francisco; Fernández-Robles, Ricardo; Granizo, Juan José; López-Durán, Juan Carlos

    2005-01-01

    Cases of pneumococcal septic arthritis treated in the Fundación Jiménez Díaz (Madrid, Spain) were reviewed. A retrospective record review was conducted for all patients presenting with pneumococcal septic arthritis between January 1993 and August 2003. Four patients out of a total of 267 reviewed had a clinical and microbiological diagnosis of septic arthritis caused by Streptococcus pneumoniae. The most frequent locations were the knee, ankle and tarsus. Three of the four patients had underlying diseases and one patient died. Pneumococcal septic arthritis, a very rare clinical entity diagnosed by clinical and microbiological findings, should be suspected in patients with underlying disease. Early antibiotic therapy focussed on the most common microorganisms causing septic arthritis is necessary for optimal outcome.

  16. Impact of bacteremia on the pathogenesis of experimental pneumococcal meningitis

    DEFF Research Database (Denmark)

    Brandt, Christian; Peters, David Alberg; Liptrot, Matthew George

    2008-01-01

    Background. Bacteremia plays a major role in the outcome of pneumococcal meningitis. This experimental study investigated how bacteremia influences the pathophysiologic profile of the brain. Methods. Rats with Streptococcus pneumoniae meningitis were randomized to 1 of 3 groups of infected study...... rats: (1) rats with attenuated bacteremia resulting from intravenous injection of serotype-specific pneumococcal antibody, (2) rats with early-onset bacteremia resulting from concomitant intravenous infection, or (3) a meningitis control group. The blood-brain barrier (BBB) breakdown, ventricle size......, brain water distribution, and brain pathologic findings were analyzed using magnetic resonance morphological and functional imaging. Laboratory data and clinical disease scores were obtained. Results. Attenuation of the bacteremic component of pneumococcal meningitis improved clinical disease symptoms...

  17. Age-dependent prevalence of nasopharyngeal carriage of streptococcus pneumoniae before conjugate vaccine introduction: a prediction model based on a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Olivier Le Polain de Waroux

    Full Text Available INTRODUCTION: Data on the prevalence of nasopharyngeal carriage of S.pneumoniae in all age groups are important to help predict the impact of introducing pneumococcal conjugate vaccines (PCV into routine infant immunization, given the important indirect effect of the vaccine. Yet most carriage studies are limited to children under five years of age. We here explore the association between carriage prevalence and serotype distribution in children aged ≥5 years and in adults compared to children. METHODS: We conducted a systematic review of studies providing carriage estimates across age groups in healthy populations not previously exposed to PCV, using MEDLINE and Embase. We used Bayesian linear meta-regression models to predict the overall carriage prevalence as well as the prevalence and distribution of vaccine and nonvaccine type (VT and NVT serotypes in older age groups as a function of that in <5 y olds. RESULTS: Twenty-nine studies compromising of 20,391 individuals were included in the analysis. In all studies nasopharyngeal carriage decreased with increasing age. We found a strong positive linear association between the carriage prevalence in pre-school childen (<5 y and both that in school aged children (5-17 y olds and in adults. The proportion of VT serotypes isolated from carriers was consistently lower in older age groups and on average about 73% that of children <5 y among 5-17 y olds and adults respectively. We provide a prediction model to infer the carriage prevalence and serotype distribution in 5-17 y olds and adults as a function of that in children <5 years of age. CONCLUSION: Such predictions are helpful for assessing the potential population-wide effects of vaccination programmes, e.g. via transmission models, and thus assist in the design of future pneumococcal conjugate vaccination strategies.

  18. Pneumococcal Conjugate Vaccine (PCV13)

    Science.gov (United States)

    ... the United States.Treatment of pneumococcal infections with penicillin and other drugs is not as effective as ... Anyone who has ever had a life-threatening allergic reaction to a dose of this vaccine, to an ...

  19. Age-dependent prevalence of nasopharyngeal carriage of streptococcus pneumoniae before conjugate vaccine introduction: a prediction model based on a meta-analysis.

    Science.gov (United States)

    Le Polain de Waroux, Olivier; Flasche, Stefan; Prieto-Merino, David; Edmunds, W John

    2014-01-01

    Data on the prevalence of nasopharyngeal carriage of S.pneumoniae in all age groups are important to help predict the impact of introducing pneumococcal conjugate vaccines (PCV) into routine infant immunization, given the important indirect effect of the vaccine. Yet most carriage studies are limited to children under five years of age. We here explore the association between carriage prevalence and serotype distribution in children aged ≥5 years and in adults compared to children. We conducted a systematic review of studies providing carriage estimates across age groups in healthy populations not previously exposed to PCV, using MEDLINE and Embase. We used Bayesian linear meta-regression models to predict the overall carriage prevalence as well as the prevalence and distribution of vaccine and nonvaccine type (VT and NVT) serotypes in older age groups as a function of that in helpful for assessing the potential population-wide effects of vaccination programmes, e.g. via transmission models, and thus assist in the design of future pneumococcal conjugate vaccination strategies.

  20. Leukocyte attraction by CCL20 and its receptor CCR6 in humans and mice with pneumococcal meningitis

    NARCIS (Netherlands)

    Klein, Matthias; Brouwer, Matthijs C.; Angele, Barbara; Geldhoff, Madelijn; Marquez, Gabriel; Varona, Rosa; Häcker, Georg; Schmetzer, Helga; Häcker, Hans; Hammerschmidt, Sven; van der Ende, Arie; Pfister, Hans-Walter; van de Beek, Diederik; Koedel, Uwe

    2014-01-01

    We previously identified CCL20 as an early chemokine in the cerebrospinal fluid (CSF) of patients with pneumococcal meningitis but its functional relevance was unknown. Here we studied the role of CCL20 and its receptor CCR6 in pneumococcal meningitis. In a prospective nationwide study, CCL20 levels

  1. Pneumococcal Infections: MedlinePlus Health Topic

    Science.gov (United States)

    ... Prevention, Immunization Action Coalition) - PDF Also in Spanish Topic Image MedlinePlus Email Updates Get Pneumococcal Infections updates ... ray Meningitis - pneumococcal Sputum gram stain Related Health Topics Meningitis Pneumonia Sepsis Sinusitis Streptococcal Infections National Institutes ...

  2. Pneumococcal infection in adults: burden of disease

    NARCIS (Netherlands)

    Drijkoningen, J.J.; Rohde, G.G.

    2014-01-01

    To overview the present global burden of pneumococcal disease is important because new preventive measures such as the pneumococcal conjugate vaccine 13 are currently being evaluated. Pneumococcal disease is roughly divided into non-invasive and invasive disease. The burden of non-invasive

  3. Nasal carriage of Streptococcus pneumoniae serotypes and Staphylococcus aureus in Streptococcus pneumoniae-vaccinated and non-vaccinated young children.

    Science.gov (United States)

    Dukers-Muijrers, N H T M; Stobberingh, E; Beisser, P; Boesten, R C H; Jacobs, P; Hoebe, C J P A

    2013-03-01

    Since the implementation of Streptococcus pneumoniae (SPn) conjugate vaccination (PCV), non-vaccine types have prevailed in invasive pneumococcal disease (IPD), and an increase in Staphylococcus aureus (SA) burden has been suggested. Here, we assess the epidemiology of SA and SPn nasal carriage in 620 children at day-care centres; 141 of these children had received 1-4 PCV7 doses. A higher vaccine dosage was associated with non-vaccine-type SPn carriage. Of all SPn isolates, 45% were PCV7 types, 1% were additional PCV10 types and 22% were the three additional PCV13 types. SA carriage was inversely associated with vaccine-type SPn carriage. SPn serotype 19A showed higher SA co-carriage rates compared to other SPn serotypes. PCV7 implementation does not prevent children from being part of the IPD-related SPn transmission chain. These results contribute to the monitoring of SA- and SPn-related disease and add to the debate on the current national vaccination policy that recently included a change from PCV7 to PCV10.

  4. Nasopharyngeal pneumococcal colonization and impact of a single dose of 13-valent pneumococcal conjugate vaccine in Indian children with HIV and their unvaccinated parents.

    Science.gov (United States)

    Arya, Bikas K; Bhattacharya, Sangeeta Das; Sutcliffe, Catherine G; Ganaie, Feroze; Bhaskar, Arun; Bhattacharyya, Subhasish; Niyogi, Swapan Kumar; Moss, William J; Panda, Samiran; Ravikumar, K L; Das, Ranjan Saurav; Mandal, Sutapa

    2017-09-27

    HIV infection increases risk of invasive disease from Streptococcus pneumoniae. Pneumococcal conjugate vaccines (PCV) prevent invasive disease and acquisition of vaccine type (VT) pneumococcus in the nasopharynx. To look at the safety and impact of one dose of PCV13 on acquisition of VT pneumococcal carriage in Indian children with HIV. We conducted a cohort study in families of HIV-infected children (CLH) and families of HIV-uninfected children (HUC) in West Bengal. All children received one dose of PCV13. Nasopharyngeal swabs were collected from children and parents at baseline and two months after vaccination. 115 CLH and 47 HUC received one dose of PCV13. 58% of CLH were on antiretroviral therapy (ART), the median nadir CD4 count was 287. There were no significant adverse events in either group. HUC had more VT colonization than CLH-- 55% vs. 23% of all isolates. HIV infection doubled the risk of non-vaccine serotype colonization (NVT) (p=0.03). There was no difference in acquisition of VT isolates in CLH (4.4%) and HUC (4.5%) post PCV13, however older CLH (>5 years) had decreased clearance of VT strains. ART made no difference in pneumococcal colonization at baseline or after PCV13; however, CLH with higher nadir CD4 counts before starting ART were less likely to have VT colonization post-PCV13 (PR 0.2; 95%CI 0.1-0.5). While there was no difference in acquisition of VT nasopharyngeal carriage of pneumococcus in CLH and HUC after one dose of PCV13, earlier access to ART may impact response to PCV13 in CLH. This study was registered with the Clinical Trial Registry-India hosted at National Institute of Medical Statistics, New Delhi (CTRI/2012/03/002515 and CTRI/2013/04/003535).

  5. PECULIARITIES OF THE PNEUMOCOCCAL PNEUMONIAE IN CHILDREN

    Directory of Open Access Journals (Sweden)

    T. A. Daminov

    2013-01-01

    Full Text Available 147 children with community-acquired pneumococcal pneumonia aged from 6 months to 14 years old were hospitalized in Children’s Lung Disease Department of the Clinic of Tashkent Medical Academy and in City Clinical Children’s Hospital of Tashkent. The analysis of their anamnesis, clinical and laboratory data, which characterized the main clinical symptoms of the disease, blood picture, chest X-ray at has been performed. The analysis showed the prevalence of lobar pneumonia with frequent right-hand lesion of lungs and in rare cases it was accompanied by bacterial destruction of lungs and purulent pleurisy which proceeded with complications. The Immunochromatography BinaxNOW test and latex agglutination test allow to identify a pneumococcal etiology of pneumonia at early stages of the illness. Antibacterial therapy at a pre-hospital stage reduces efficiency of various diagnostic methods in the hospitalized patients, which makes it more rational to use of the method at a pre-hospital stage at a wider scale. 

  6. Pneumococcal Disease: Diagnosis and Treatment

    Science.gov (United States)

    ... Diseases Sepsis Diagnosis and Treatment Recommend on Facebook Tweet Share Compartir Doctors use a lumbar puncture to collect a sample of cerebrospinal fluid. Larger image . Doctors consider some pneumococcal infections “invasive.” Invasive disease means that germs invade parts of the body that ...

  7. Evaluation of impact of 23 valent pneumococcal polysaccharide vaccine following 7 valent pneumococcal conjugate vaccine in Australian Indigenous children.

    Science.gov (United States)

    Jayasinghe, Sanjay; Chiu, Clayton; Menzies, Rob; Lehmann, Deborah; Cook, Heather; Giele, Carolien; Krause, Vicki; McIntyre, Peter

    2015-11-27

    High incidence and serotype diversity of invasive pneumococcal disease (IPD) in Indigenous children in remote Australia led to rapid introduction of 7-valent conjugate pneumococcal vaccine (7vPCV) at 2, 4 and 6 months in 2001, followed by 23-valent polysaccharide pneumococcal vaccine (23vPPV) in the second year of life. All other Australian children were offered 3 doses of 7vPCV without a booster from 2005. This study evaluated the impact of the unique pneumococcal vaccine schedule of 7vPCV followed by the 23vPPV booster among Indigenous Australian children. Changes in IPD incidence derived from population-based passive laboratory surveillance in Indigenous children vaccine introduction period (Indigenous 1994-2000; non-Indigenous 2002-2004) to the post-vaccine period (2008-2010 in both groups) using incidence rate ratios (IRRs) stratified by age into serotype groupings of vaccine (7v and 13vPCV and 23vPPV) and non-vaccine types. Vaccine coverage was assessed from the Australian Childhood Immunisation Register. At baseline, total IPD incidence per 100,000 was 216 (n=230) in Indigenous versus 55 (n=1993) in non-Indigenous children. In 2008-2010, IRRs for 7vPCV type IPD were 0.03 in both groups, but for 23v-non7v type IPD 1.2 (95% CI 0.8-1.8) in Indigenous versus 3.1 (95% CI 2.5-3.7) in non-Indigenous, difference driven primarily by serotype 19A IPD (IRR 0.6 in Indigenous versus 4.3 in non-Indigenous). For non-7vPCV type IPD overall, IRR was significantly higher in those age-eligible for 23vPPV booster compared to those younger, but in both age groups was lower than for non-Indigenous children. These ecologic data suggest a possible "serotype replacement sparing" effect of 23vPPV following 7vPCV priming, especially for serotype 19A with supportive evidence from other immunogenicity and carriage studies. Applicability post 10vPCV or 13v PCV priming in similar settings would depend on local serotype distribution of IPD. Copyright © 2015 Elsevier Ltd. All rights

  8. The prevalence and risk factors for pneumococcal colonization of the nasopharynx among children in Kilifi District, Kenya.

    Science.gov (United States)

    Abdullahi, Osman; Karani, Angela; Tigoi, Caroline C; Mugo, Daisy; Kungu, Stella; Wanjiru, Eva; Jomo, Jane; Musyimi, Robert; Lipsitch, Marc; Scott, J Anthony G

    2012-01-01

    Pneumococcal conjugate vaccines (PCV) reduce nasopharyngeal carriage of vaccine-serotype pneumococci but increase in the carriage of non-vaccine serotypes. We studied the epidemiology of carriage among children 3-59 months old before vaccine introduction in Kilifi, Kenya. In a rolling cross-sectional study from October 2006 to December 2008 we approached 3570 healthy children selected at random from the population register of the Kilifi Health and Demographic Surveillance System and 134 HIV-infected children registered at a specialist clinic. A single nasopharyngeal swab was transported in STGG and cultured on gentamicin blood agar. A single colony of pneumococcus was serotyped by Quellung reaction. Families of 2840 children in the population-based sample and 99 in the HIV-infected sample consented to participate; carriage prevalence was 65.8% (95% CI, 64.0-67.5%) and 76% (95% CI, 66-84%) in the two samples, respectively. Carriage prevalence declined progressively with age from 79% at 6-11 months to 51% at 54-59 months (p<0.0005). Carriage was positively associated with coryza (Odds ratio 2.63, 95%CI 2.12-3.25) and cough (1.55, 95%CI 1.26-1.91) and negatively associated with recent antibiotic use (0.53 95%CI 0.34-0.81). 53 different serotypes were identified and 42% of isolates were of serotypes contained in the 10-valent PCV. Common serotypes declined in prevalence with age while less common serotypes did not. Carriage prevalence in children was high, serotypes were diverse, and the majority of strains were of serotypes not represented in the 10-valent PCV. Vaccine introduction in Kenya will provide a natural test of virulence for the many circulating non-vaccine serotypes.

  9. The prevalence and risk factors for pneumococcal colonization of the nasopharynx among children in Kilifi District, Kenya.

    Directory of Open Access Journals (Sweden)

    Osman Abdullahi

    Full Text Available Pneumococcal conjugate vaccines (PCV reduce nasopharyngeal carriage of vaccine-serotype pneumococci but increase in the carriage of non-vaccine serotypes. We studied the epidemiology of carriage among children 3-59 months old before vaccine introduction in Kilifi, Kenya.In a rolling cross-sectional study from October 2006 to December 2008 we approached 3570 healthy children selected at random from the population register of the Kilifi Health and Demographic Surveillance System and 134 HIV-infected children registered at a specialist clinic. A single nasopharyngeal swab was transported in STGG and cultured on gentamicin blood agar. A single colony of pneumococcus was serotyped by Quellung reaction.Families of 2840 children in the population-based sample and 99 in the HIV-infected sample consented to participate; carriage prevalence was 65.8% (95% CI, 64.0-67.5% and 76% (95% CI, 66-84% in the two samples, respectively. Carriage prevalence declined progressively with age from 79% at 6-11 months to 51% at 54-59 months (p<0.0005. Carriage was positively associated with coryza (Odds ratio 2.63, 95%CI 2.12-3.25 and cough (1.55, 95%CI 1.26-1.91 and negatively associated with recent antibiotic use (0.53 95%CI 0.34-0.81. 53 different serotypes were identified and 42% of isolates were of serotypes contained in the 10-valent PCV. Common serotypes declined in prevalence with age while less common serotypes did not.Carriage prevalence in children was high, serotypes were diverse, and the majority of strains were of serotypes not represented in the 10-valent PCV. Vaccine introduction in Kenya will provide a natural test of virulence for the many circulating non-vaccine serotypes.

  10. Carriage rate and serotypes of Streptococcus pneumoniae amongst children in Thika Hospital, Kenya

    Directory of Open Access Journals (Sweden)

    Susan Githii

    2013-03-01

    Full Text Available Streptococcus pneumoniae is a major cause of morbidity and mortality worldwide. Rates of carriage are highest in infants and the elderly. The objectives of this study were to determine the rate of nasopharyngeal colonization by S. pneumoniae, and to describe the antibiotic resistant patterns and the serotypes of the carried isolates. A cross-sectional study design was used. Nasopharyngeal swabs were collected from 315 children in the months of Octoberand November 2010 and processed to isolate S. pneumoniae. The isolates were serotyped by the Quellung reaction and their antibiotic susceptibilities assessed by the disc diffusion method. The overall nasopharyngeal carriage rate for S. pneumoniae was 17%. Seventeen serotypes were detected amongst 55 strains analysed: 6A, 23F, 19F, 13, 6B, 14A, 20, 7C, 1,15B, 35B, 19A, 11A, 34, 5, 3 and 23A. Susceptibility testing revealed that nearly all (98% were resistant to cotrimoxazole, 9% were resistant to penicillin and 7% to cefotaxime. Resistance to chloramphenicol and erythromycin was 2% and 4%, respectively. All isolates were fully sensitive to tetracycline. High levels of cotrimoxazole resistance and some resistance to other antimicrobial agents commonly used in Thika District Hospital shows that there is need to revise antimicrobial policy in this region in the treatment of invasive pneumococcal infections. The frequent serotypes found in this study have previously been associated with pneumococcal infectionsin children. Several of these serotypes are included in the ten-valent vaccine and therefore useof this vaccine will help reduce pneumococcal infections in Thika.

  11. PNEUMOCOCCAL CAPSULAR ANTIGEN-DETECTION AND PNEUMOCOCCAL SEROLOGY IN PATIENTS WITH COMMUNITY ACQUIRED PNEUMONIA

    NARCIS (Netherlands)

    BOERSMA, WG; LOWENBERG, A; HOLLOWAY, Y; KUTTSCHRUTTER, H; SNIJDER, JAM; KOETER, GH

    1991-01-01

    Background Methods to determine the microbial cause of community acquired pneumonia include detection of pneumococcal antigen and measurement of pneumococcal capsular antibody response. Their usefulness compared with conventional microbiological techniques was investigated in patients with

  12. Hearing loss in adults surviving pneumococcal meningitis is associated with otitis and pneumococcal serotype

    NARCIS (Netherlands)

    Heckenberg, S.; Brouwer, M.; van den Ende, A.; Hensen, E.F.; van de Beek, D.

    2012-01-01

    Clin Microbiol Infect 2012; 18: 849-855 We assessed the incidence of hearing loss and its relationship with clinical characteristics and pneumococcal serotypes in adults surviving pneumococcal meningitis. We analysed hearing loss in 531 adults surviving pneumococcal meningitis included in two

  13. Surveillance of Australian Hajj pilgrims for carriage of potentially pathogenic bacteria: Data from two pilot studies.

    Science.gov (United States)

    Azeem, Mohammad Irfan; Tashani, Mohamed; Badahdah, Al-Mamoon; Heron, Leon; Pedersen, Kristen; Jeoffreys, Neisha; Kok, Jen; Haworth, Elizabeth; Dwyer, Dominic E; Hill-Cawthorne, Grant; Rashid, Harunor; Booy, Robert

    2017-03-16

    To estimate the pharyngeal carriage rate of Neisseria meningitidis (N. meningitidis), Streptococcus pneumoniae (S. pneumoniae) and Staphylococcus aureus (S. aureus) among Australian Hajj pilgrims. In 2014, surveillance was conducted in two phases among Australian Hajj pilgrims: The first phase during Hajj in Mina, and the second phase soon after returning home to Australia. Nasopharyngeal or oropharyngeal swabs were taken from participants then tested, firstly by nucleic acid testing, and also by standard culture. Of 183 participants recruited in the first phase, 26 (14.2%) tested positive for S. pneumoniae; 4 had received pneumococcal conjugate vaccine (PCV13). Only one tested positive for N. meningitidis (W). Of 93 2nd phase samples cultured, 17 (18.3%) grew S. aureus, all methicillin sensitive, 2 (2.2%) grew N. meningitidis (on subculture; one serotype B, one negative), and 1 (1%), from an unvaccinated pilgrim, grew S. pneumoniae. Relatively high carriage of S. pneumoniae and little meningococcal carriage was found. This indicates the importance of a larger study for improved infection surveillance and possible vaccine evaluation.

  14. Nasopharyngeal Pneumococcal Colonization among Children after Pneumococcal Conjugate Vaccine Introduction

    OpenAIRE

    Manoochehr Karami; Zeinab Berangi; Younes Mohammadi; Seyed Mohsen Zahraei

    2017-01-01

    World Health Organization has recommended all countries to introduction of Pneumococcal Conjugate Vaccine (PCV) in routine immunization schedule, especially those countries with higher rate of mortality in children. However, Islamic Republic of Iran and more than 50 other countries including Algeria, Antigua and Barbuda, Belarus, Belize, Bhutan, Bosnia and Herzegovina, Brunei Darussalam, Cabo Verde, Chad, China, Comoros, Cook Islands, Croatia, Cuba, Czech Republic, Democratic People's Republi...

  15. Pneumococcal vaccines: the impact of conjugate vaccine

    National Research Council Canada - National Science Library

    Mäkelä, P. Helena; Siber, George R; Klugman, Keith P

    2008-01-01

    ... of Streptococcus pneumoniae with Complement Proteins 83 Margaret K. Hostetter III. Clinical Disease and Epidemiology 8 Epidemiology, Diagnosis, and Treatment of Serious Pneumococcal Infections in Chi...

  16. Pneumococcal infections at Hajj: current knowledge gaps.

    Science.gov (United States)

    Ridda, Iman; King, Catherine; Rashid, Harunor

    2014-01-01

    Hajj attendance increases the risk of respiratory infections including pneumonia. Streptococcus pneumoniae is a frequently identified pathogen, found in about 10% of respiratory tract samples of symptomatic Hajj pilgrims; and at least 20% of these isolates are penicillin resistant. However, the burden of pneumococcal disease at Hajj is not precisely defined at serotypic level, and it is postulated that due to intense mixing of pilgrims the distribution of pneumococcal serotypes at Hajj could be different from pilgrims' country of origin or of Saudi Arabia. In Saudi Arabia, the most prevalent pneumococcal serotypes are 23F, 6B, 19F, 18C, 4, 14, and 19A, and 90% of the serotypes are covered by 13-valent pneumococcal conjugate vaccine (PCV-13) as well as 23-valent pneumococcal polysaccharide vaccine (PPV-23). However, due to lack of Hajj-specific data, the Saudi Arabian Ministry of Health has not yet recommended pneumococcal vaccine for pilgrims, and the immunisation recommendation and uptake vary greatly across countries. As at least one third of Hajj pilgrims are 'at risk' of pneumococcal disease either by virtue of age or pre-existing medical conditions, consideration should be given to vaccinating high risk pilgrims against pneumococcal disease. Other preventive measures such as smoking cessation, pollution reduction and vaccinations against influenza and pertussis should also be considered. Precisely defining the epidemiology of pneumococcal disease to identify an optimum vaccination schedule for Hajj pilgrims is a current research priority.

  17. Nasopharyngeal colonization and penicillin resistance among pneumococcal strains: a Worldwide 2004 update

    Directory of Open Access Journals (Sweden)

    Déa M. Cardozo

    Full Text Available Surveillance of nasopharyngeal pneumococcus has proven to be a valuable tool for the monitoring of antibiotic resistance. We reviewed the latest information on colonization rate and penicillin resistance by making a MEDLINE search, using the terms "nasopharyngeal carriage" and "Streptococcus pneumoniae". Out of 225 articles found, data from 109 recent publications (89% from 1996-2003 were analyzed. Data were reported from 41 countries of six continents. Individuals under the age of five (64.3% or 10 years (85.7% were enrolled, including children attending day-care centers (32.1% or orphanages (3.6%, and healthy individuals (78.6% or sick patients (43.6%; biological samples were collected mainly by nasopharyngeal swabs (89.3%. The highest colonization rates were reported from Africa (85-87.2%, where several authors did not find high rates of penicillin resistance. On the other hand, studies conducted in North and Central America reported high-level penicillin resistance at rates of approximately 20-30%. Great variation in the rates of pneumococcal colonization and penicillin resistance were observed within regions or continents. There were also considerable differences in similar populations located in different areas of the same country. Data regarding pneumococcal colonization and penicillin resistance are not available from most countries. We also examined the use of antibiotics to treat pneumococcal infections.

  18. Cocolonization of Pneumococcal Serotypes in Healthy Children Attending Day Care Centers: Molecular Versus Conventional Methods.

    Science.gov (United States)

    Hjálmarsdóttir, Martha Á; Gumundsdóttir, Pálína Fanney; Erlendsdóttir, Helga; Kristinsson, Karl G; Haraldsson, Gunnsteinn

    2016-05-01

    Pneumococci are common colonizer, especially of children, and cocolonization of different serotypes is an important factor for intraspecies genetic exchange. The aim of this study was to analyze pneumococcal carriage and serotype distribution in unvaccinated healthy children in Iceland and compare conventional culture methods and molecular methods using DNA extracted directly from the samples. Nasopharyngeal swabs were obtained from 514 children aged 2-6 year attending day care centers in Reykjavik in 2009. The swabs were selectively cultured for pneumococci and the isolates serotyped using latex agglutination. DNA was also extracted directly from the swabs and serotyped using a multiplex PCR panel designed to detect vaccine serotypes and the most commonly carried non-vaccine serotypes. Pneumococcal carriage was detected in 391 (76.1%) of the children using polymerase chain reaction (PCR) and in 371 (72.2%) using conventional methods. Cocolonization was detected in 92 (23.5%) of the carriers when PCR method was used and in 30 (8.1%) when conventional methods were used, detecting 500 and 401 strains, respectively (P < 0.0001). The most common serotypes were 23F, 19A, 6B, 6A and 19F, rates 13-8%. The number of isolates of serotypes included in the 10-valent and 13-valent vaccines and detected by PCR were 234 (58.4%) and 363 (90.5%), respectively and by conventional methods 186 (46.4%) and 293 (73.1%), respectively. Cocolonization was detected in a fourth of the children carrying pneumococci using DNA extracted directly from nasopharyngeal swabs. The rate of carriage was very high, but no serotype dominated, and the children were commonly colonized by vaccine serotypes, especially cocolonized children.

  19. Production of latex agglutination reagents for pneumococcal serotyping.

    Science.gov (United States)

    Ortika, Belinda D; Habib, Maha; Dunne, Eileen M; Porter, Barbara D; Satzke, Catherine

    2013-02-05

    The current 'gold standard' for serotyping pneumococci is the Quellung test. This technique is laborious and requires a certain level of training to correctly perform. Commercial pneumococcal latex agglutination serotyping reagents are available, but these are expensive. In-house production of latex agglutination reagents can be a cost-effective alternative to using commercially available reagents. This paper describes a method for the production and quality control (QC) of latex reagents, including problem solving recommendations, for pneumococcal serotyping. Here we describe a method for the production of latex agglutination reagents based on the passive adsorption of antibodies to latex particles. Sixty-five latex agglutination reagents were made using the PneuCarriage Project (PCP) method, of which 35 passed QC. The other 30 reagents failed QC due to auto-agglutination (n=2), no reactivity with target serotypes (n=8) or cross-reactivity with non-target serotypes (n=20). Dilution of antisera resulted in a further 27 reagents passing QC. The remaining three reagents passed QC when prepared without centrifugation and wash steps. Protein estimates indicated that latex reagents that failed QC when prepared using the PCP method passed when made with antiserum containing ≤ 500 μg/ml of protein. Sixty-one nasopharyngeal isolates were serotyped with our in-house latex agglutination reagents, with the results showing complete concordance with the Quellung reaction. The method described here to produce latex agglutination reagents allows simple and efficient serotyping of pneumococci and may be applicable to latex agglutination reagents for typing or identification of other microorganisms. We recommend diluting antisera or removing centrifugation and wash steps for any latex reagents that fail QC. Our latex reagents are cost-effective, technically undemanding to prepare and remain stable for long periods of time, making them ideal for use in low-income countries.

  20. High pneumococcal density correlates with more mucosal inflammation and reduced respiratory syncytial virus disease severity in infants.

    Science.gov (United States)

    Vissers, Marloes; Ahout, Inge M; van den Kieboom, Corné H; van der Gaast-de Jongh, Christa E; Groh, Laszlo; Cremers, Amelieke J; de Groot, Ronald; de Jonge, Marien I; Ferwerda, Gerben

    2016-03-17

    Respiratory syncytial virus (RSV) is an important cause of lower respiratory tract infections in infants. A small percentage of the infected infants develops a severe infection, while most of these severely ill patients were previously healthy. It remains unclear why these children develop severe RSV infections. In this study, we investigate whether pneumococcal nasopharyngeal carriage patterns correlate with mucosal inflammation and severity of disease. In total, 105 infants hospitalized with RSV infection were included and recovery samples were taken from 42 patients. The presence and density of Streptococcus pneumoniae was determined by RT qPCR to study its relation to viral load, inflammation (MMP-9 and IL-6) and severity of RSV disease. We show that pneumococcal presence or absence in the nasopharynx does not correlate with viral load, inflammation or severity of disease. However, when pneumococcus is present in patients, a higher nasopharyngeal pneumococcal density was correlated with a higher RSV load, higher MMP-9 levels and a less severe course of disease. Our results show correlations between S. pneumoniae density and viral load, inflammation and disease severity, suggesting that pneumococcal density may be an indicator for severity in paediatric RSV disease.

  1. Molecular characterization of pneumococcal isolates from pets and laboratory animals.

    Directory of Open Access Journals (Sweden)

    Mark van der Linden

    Full Text Available BACKGROUND: Between 1986 and 2008 Streptococcus pneumoniae was isolated from 41 pets/zoo animals (guinea pigs (n = 17, cats (n = 12, horses (n = 4, dogs (n = 3, dolphins (n = 2, rat (n = 2, gorilla (n = 1 treated in medical veterinary laboratories and zoos, and 44 laboratory animals (mastomys (multimammate mice; n = 32, mice (n = 6, rats (n = 4, guinea pigs (n = 2 during routine health monitoring in an animal facility. S. pneumoniae was isolated from nose, lung and respiratory tract, eye, ear and other sites. METHODOLOGY/PRINCIPAL FINDINGS: Carriage of the same isolate of S. pneumoniae over a period of up to 22 weeks was shown for four mastomys. Forty-one animals showed disease symptoms. Pneumococcal isolates were characterized by optochin sensitivity, bile solubility, DNA hybridization, pneumolysin PCR, serotyping and multilocus sequence typing. Eighteen of the 32 mastomys isolates (56% were optochin resistant, all other isolates were optochin susceptible. All mastomys isolates were serotype 14, all guinea pig isolates serotype 19F, all horse isolates serotype 3. Rats had serotypes 14 or 19A, mice 33A or 33F. Dolphins had serotype 23F, the gorilla serotype 14. Cats and dogs had many different serotypes. Four isolates were resistant to macrolides, three isolates also to clindamycin and tetracycline. Mastomys isolates were sequence type (ST 15 (serotype 14, an ST/serotype combination commonly found in human isolates. Cats, dogs, pet rats, gorilla and dolphins showed various human ST/serotype combinations. Lab rats and lab mice showed single locus variants (SLV of human STs, in human ST/serotype combinations. All guinea pig isolates showed the same completely new combination of known alleles. The horse isolates showed an unknown allele combination and three new alleles. CONCLUSIONS/SIGNIFICANCE: The isolates found in mastomys, mice, rats, cats, dogs, gorilla and dolphins are most likely identical to human pneumococcal isolates. Isolates from

  2. Determination of phenotypes and pneumococcal surface protein A family types of Streptococcus pneumoniae from Malaysian healthy children.

    Science.gov (United States)

    Yatim, Masura Mohd; Masri, Siti Norbaya; Desa, Mohd Nasir Mohd; Taib, Niazlin Mohd; Nordin, Syafinaz Amin; Jamal, Farida

    2013-06-01

    There is limited information about pneumococcal carriage among healthy children in Malaysia. Therefore, this study was conducted to determine the prevalence rate, serotype distribution, susceptibility pattern, and pneumococcal surface protein A (PspA) family types of Streptococcus pneumoniae isolates in the nasal carriage of children 5 years old or younger in three day care centers in Kuala Lumpur, Malaysia. Nasal swabs were collected from 195 healthy children, age 5 years or younger, from June to December 2010. S pneumoniae was identified by phenotypic and genotypic methods. The serotyping was performed using Pneumotest kit (Statens Serum Institut, Copenhagen, Denmark) and the susceptibility pattern was determined by using the E-test method (AB Biodisk, Solna, Sweden). PspA family typing was done using polymerase chain reaction. S pneumoniae was found in the nasal carriage of 35.4% of children (69 of 195) and penicillin resistance was found in 23.2% (16 of 69). Among the 69 isolates, multidrug-resistant S pneumoniae (MDRSP) was present in 20.3%. All 16 penicillin-resistant S pneumoniae (PRSP) isolates were resistant to erythromycin and 14 PRSPs (87.5%) were resistant to co-trimoxazole. The six most common serotypes were 6A, 23F, 19A, 6B, 19F, and 15C, which were found in 87% of all isolates. Of the 69 isolates, 24.6% belonged to PspA family 1, 71.0% to PspA family 2, and 4.3% to PspA family 3. Twenty-eight of the isolates (40.6%) belonged to serotypes included in the pneumococcal polysaccharide vaccines (PCV) 7 and 10, whereas 48 (69.5%) were included in PCV13. The high rate of PRSP and MDRSP supports the need for continuing surveillance of pneumococcal carriage. The major PspA families were 1 and 2 (95.7%), thus making them suitable candidates for future vaccines. Copyright © 2012. Published by Elsevier B.V.

  3. Staphylococcus aureus Nasal Carriage among Surgical personnel ...

    African Journals Online (AJOL)

    Introduction: Staphylococcus aureus (S. aureus) is one of the most common causes of both community and hospital acquired bacterial infection. There is strong correlation between S aureus nasal carriage and disease progress. Nasal carriage is high among health care workers. Inappropriate usage of antibiotic may

  4. Nasal Carriage of Staphylococcus aureus and Antibiotic ...

    African Journals Online (AJOL)

    Nasal carriage of Staphylococcus aureus has been demonstrated to be a major risk factor for invasive S. aureus infections in various population including children. The extent of S. aureus carriage in Sierra Leonean children is largely unknown. To determine the prevalence and pattern of antibiotic susceptibility of nasal S.

  5. 46 CFR 154.702 - Refrigerated carriage.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 5 2010-10-01 2010-10-01 false Refrigerated carriage. 154.702 Section 154.702 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SAFETY STANDARDS... Pressure and Temperature Control § 154.702 Refrigerated carriage. (a) Each refrigeration system must: (1...

  6. Determinants of pneumococcal conjugate vaccine uptake among ...

    African Journals Online (AJOL)

    Determinants of pneumococcal conjugate vaccine uptake among children attending immunisation services at Kenyatta National Hospital, Nairobi, Kenya. ... Results: The study established that the determinants of uptake of Pneumococcal Conjugate Vaccine are age(OR 5.8, CI 1.4-23.4, p=0.014), level of education (OR 5.8, ...

  7. Rates of acquisition and clearance of pneumococcal serotypes in the nasopharynges of children in Kilifi District, Kenya.

    Science.gov (United States)

    Abdullahi, Osman; Karani, Angela; Tigoi, Caroline C; Mugo, Daisy; Kungu, Stella; Wanjiru, Eva; Jomo, Jane; Musyimi, Robert; Lipsitch, Marc; Scott, J Anthony G

    2012-10-01

    To understand and model the impact of pneumococcal conjugate vaccines at the population level, we need to know the transmission dynamics of individual pneumococcal serotypes. We estimated serotype-specific clearance and acquisition rates of nasopharyngeal colonization among Kenyan children. Children aged 3-59 months who were identified as carriers in a cross-sectional survey were followed-up approximately 1, 2, 4, 8, 16, and 32 days later and monthly thereafter until culture of 2 consecutive swabs yielded an alternative serotype or no pneumococcus. Serotype-specific clearance rates were estimated by exponential regression of interval-censored carriage durations. Duration was estimated as the reciprocal of the clearance rate, and acquisition rates were estimated on the basis of prevalence and duration, assuming an equilibrium state. Of 2840 children sampled between October 2006 and December 2008, 1868 were carriers. The clearance rate was 0.032 episodes/day (95% confidence interval [CI], .030-.034), for a carriage duration of 31.3 days, and the rate varied by serotype (P< .0005). Carriage durations for the 28 serotypes with ≥ 10 carriers ranged from 6.7 to 50 days. Clearance rates increased with year of age, adjusted for serotype (hazard ratio, 1.21; 95% CI, 1.15-1.27). The acquisition rate was 0.061 episodes/day (95% CI, .055-.067), which did not vary with age. Serotype-specific acquisition rates varied from 0.0002 to 0.0022 episodes/day. Serotype-specific acquisition rates correlated with prevalence (r=0.91; P< .00005) and with acquisition rates measured in a separate study involving 1404 newborns in Kilifi (r=0.87; P< .00005). The large sample size and short swabbing intervals provide a precise description of the prevalence, duration, and acquisition of carriage of 28 pneumococcal serotypes. In Kilifi, young children experience approximately 8 episodes of carriage per year. The declining prevalence with age is attributable to increasing clearance rates.

  8. Temporal trends in invasive pneumococcal disease and pneumococcal serotypes over 7 decades

    DEFF Research Database (Denmark)

    Harboe, Zitta B; Benfield, Thomas; Valentiner-Branth, Palle

    2010-01-01

    BACKGROUND: Pneumococcal infections have historically played a major role in terms of morbidity and mortality. We explored historical trends of invasive pneumococcal disease (IPD) and pneumococcal serotypes in a population exposed to limited antibiotic selective pressure and conjugate pneumococcal...... vaccination (PCV). METHODS: Retrospective cohort study based on nationwide laboratory surveillance data on IPD collected uninterruptedly in Denmark during 1938-2007. Changes in the reported incidence and trends of pneumococcal serotypes were explored using nonlinear regression analysis. RESULTS: There were 25...... by serotype 19A increased before introduction of PCV. Between 1993 and 2007, the level of resistance to macrolides and beta-lactams was 6%. CONCLUSIONS: The epidemiology of IPD and single serotypes has constantly changed over the past 7 decades. PCV serotypes appeared to dominate the pneumococcal population....

  9. Characteristics and prognosis of pneumococcal endocarditis: a case-control study.

    Science.gov (United States)

    Daudin, M; Tattevin, P; Lelong, B; Flecher, E; Lavoué, S; Piau, C; Ingels, A; Chapron, A; Daubert, J-C; Revest, M

    2016-06-01

    Case series have suggested that pneumococcal endocarditis is a rare disease, mostly reported in patients with co-morbidities but no underlying valve disease, with a rapid progression to heart failure, and high mortality. We performed a case-control study of 28 patients with pneumococcal endocarditis (cases), and 56 patients with non-pneumococcal endocarditis (controls), not matched for sex and age, during the years 1991-2013, in one referral centre. Alcoholism (39.3% versus 10.7%; p endocarditis. Cardiac surgery was required in 64.3% of patients with pneumococcal endocarditis, much earlier than in patients with non-pneumococcal endocarditis (mean time from symptom onset, 14.1 ± 18.2 versus 69.0 ± 61.1 days). In-hospital mortality rates were similar (7.1% versus 12.5%). Streptococcus pneumoniae causes rapidly progressive endocarditis requiring life-saving early cardiac surgery in most cases. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  10. A subset of AID-dependent B-1a cells initiates hypersensitivity and pneumococcal pneumonia resistance

    NARCIS (Netherlands)

    Askenase, Phillip W; Bryniarski, Krzysztof; Paliwal, Vipin; Redegeld, Frank; Groot Kormelink, Thomas; Kerfoot, Steven; Hutchinson, Andrew T; van Loveren, Henk; Campos, Regis; Itakura, Atsuko; Majewska-Szczepanik, Monika; Yamamoto, Natsuo; Nazimek, Katarzyn; Szczepanik, Marian; Ptak, Wold

    2015-01-01

    We propose that there is a special B-1a B cell subset ("sB-1a" cells) that mediates linked processes very early after immunization to initiate cutaneous contact sensitivity (CS), delayed-type hypersensitivity (DTH), and immune resistance to pneumococcal pneumonia. Our published data indicate that in

  11. Nasopharyngeal Pneumococcal Colonization among Children after Pneumococcal Conjugate Vaccine Introduction

    Directory of Open Access Journals (Sweden)

    Manoochehr Karami

    2017-08-01

    Full Text Available World Health Organization has recommended all countries to introduction of Pneumococcal Conjugate Vaccine (PCV in routine immunization schedule, especially those countries with higher rate of mortality in children. However, Islamic Republic of Iran and more than 50 other countries including Algeria, Antigua and Barbuda, Belarus, Belize, Bhutan, Bosnia and Herzegovina, Brunei Darussalam, Cabo Verde, Chad, China, Comoros, Cook Islands, Croatia, Cuba, Czech Republic, Democratic People's Republic of Korea, Dominica, Egypt, Equatorial Guinea, Estonia, Gabon, Grenada, Guinea, Haiti, India, Jamaica, Jordan, Malaysia, Maldives, Malta, Montenegro, Nauru, Poland, Romania, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Samoa, San Marino, Serbia, Seychelles, Slovenia, Somalia, South Sudan, Sri Lanka, Syrian Arab Republic, Tajikistan, Thailand, The former Yugoslav Republic of Macedonia, Timor-Leste, Tonga, Tunisia, Turkmenistan, Tuvalu, Ukraine, Vanuatu, and Viet Namhave not introduced PCV till April 2016.

  12. NNDSS - Table II. Invasive Pneumococcal to Legionellosis

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table II. Invasive Pneumococcal to Legionellosis - 2014.In this Table, all conditions with a 5-year average annual national total of more than or equals...

  13. NNDSS - Table II. Invasive Pneumococcal to Legionellosis

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table II. Invasive Pneumococcal to Legionellosis - 2015.In this Table, provisional cases of selected notifiable diseases (≥1,000 cases reported during the...

  14. NNDSS - Table II. Invasive Pneumococcal to Legionellosis

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table II. Invasive Pneumococcal to Legionellosis - 2016. In this Table, provisional* cases of selected†notifiable diseases (≥1,000 cases reported during...

  15. Genotypic characterization of Malaysian human isolates of Streptococcus pneumoniae from carriage and clinical sources.

    Science.gov (United States)

    Shakrin, Nik Noorul Shakira Mohamed; Masri, Siti Norbaya; Taib, Niazlin Mohd; Nordin, Syafinaz Amin; Jamal, Farida; Desa, Mohd Nasir Mohd

    2014-12-01

    This study characterized carriage and clinical pneumococcal isolates for serotypes, penicillin susceptibility, virulence genes and restriction fragment length polymorphism (RFLP) pattern of penicillin binding protein (PBP) genes. DNA fingerprint of isolates was generated by BOX-PCR. Majority of serotypes were 23F followed by 19F, 19A and 6A. Twenty-four percent of isolates were penicillin non-susceptible (PNSP). All of the targeted virulence genes were detected in all isolates with the exception of pili; 20.6% (n=22) for PI-1 and 14.0% (n=15) for PI-2. Of the 13 isolates which carried both PI-1 and PI-2, 10 were of clinical origin. Digested pbp-DNA produced three PBP-RFLP profiles for pbp1a (A1 to A3), six profiles for pbp2b (B1 to B6) and seven for pbp2x (X1 to X7) mostly in PNSPs. Based on BOX-PCR analysis, the majority of isolates were genetically diverse with a small number of potentially related isolates carrying pili genes. No obvious genotypic association was observed pertaining to carriage and clinical origin of isolates. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Effects of Infant Pneumococcal Conjugate Vaccination on Serotype Distribution in Invasive Pneumococcal Disease among Children and Adults in Germany.

    Science.gov (United States)

    van der Linden, Mark; Falkenhorst, Gerhard; Perniciaro, Stephanie; Imöhl, Matthias

    2015-01-01

    This study describes the effects of the introduction of universal infant pneumococcal conjugate vaccination in 2006 on invasive pneumococcal disease (IPD) among children and adults in Germany with a focus on the dynamics of serotype distribution in vaccinated and non-vaccinated age groups. Over a period of 22 years (1992-2014), microbiological diagnostic laboratories from all over Germany have been sending isolates of IPD cases to the German National Reference Center for Streptococci on a voluntary basis. Streptococcus pneumoniae isolates were serotyped using Neufeld's Quellung method. Among children vaccination (1997-2006) to 23.5% in the early vaccination period (2007-2010; p = 1.30E-72) and sank further to 5.2% in the late vaccination period (2010-2014; p = 4.59E-25). Similar reductions were seen for the separate age groups vaccination period (1992-2006) to 24.7% (p = 3.78E-88) in the early vaccination period and 8.2% (p = 5.97E-161) in the late vaccination period. Both among children and among adults, the non-PCV7 serotypes 1, 3, 7F and 19A significantly increased in the early vaccination period. After the switch from PCV7 to PVC10/PCV13 for infant vaccination in 2010, serotypes 1, 6A and 7F significantly decreased. A decrease in serotype 19A was only observed in 2013-2014, as compared to 2010-2011 (children p = 4.16E-04, adults p = 6.98E-06). Among adults, serotype 3, which strongly increased in the early vaccination period (p = 4.44E-15), remained at a constant proportion in the late vaccination period. The proportion of non-PCV13 vaccine serotypes increased over the whole vaccination period, with serotypes 10A, 12F, 23B, 24F and 38 most significantly increasing among children and serotypes 6C, 12F, 15A, 22F and 23B increasing among adults. Eight years of childhood pneumococcal conjugate vaccination have had a strong effect on the pneumococcal population in Germany, both among the target group for vaccination as well as among older children and adults.

  17. Streptococcus pneumoniae(Spn) Nasopharyngeal Carriage in Children Under 3 Years Old, Attending Day Care Centers in Argentina

    Science.gov (United States)

    Gentile, Angela; Rearte, Analía; Von Spetch, Martha; Laban, Celia; Papucci, Santiago Lopez; Badano, Andrea; Ferrario, Claudia; Pereda, Rosana; Flores, Devora; Berry, Diana; Aguilera, Alejandra; Sponton, Norma; Sorhouet, Cecilia; Napoli, Daniela; Devoto, Susana; Vizzotti, Carla

    2017-01-01

    Abstract Background In 2012 the 13-valent conjugated pneumococcal vaccine (PCV-13) was introduced in the National Immunization Program. We performed an epidemiological study to describe SPN nasopharyngeal carriage prevalence. Methods Between June to September 2015 it was performed a cross-sectional study among children <3 years old, attending day care centers. Nasopharyngeal samples were collected from children at public and private centers from 5 cities of Argentina (Salta (North West), Trelew (South), Rosario (Centre), Buenos Aires (Capital city) and Posadas (North East)). Samples were analyzed at references hospitals of each city and isolates were submitted to the INEI “Dr. Carlos G. Malbrán “, for confirming and serotyping. We considered completed schedule 3 doses of PCV13, administrated14 days prior to enrollment. Results We included 359 toddlers, 61,6% (IC95% 56,3–66,6) were SPN carriers. Median age was 24 months, without significative difference in carriage status. Multivariate analysis showed that independently of age, sex and socioeconomic level, variables associated with carriage were: · City: Taking Salta as reference (less carriage prevalence), Rosario and Posadas were statistically associated with higher prevalence rates: OR: 3,1 (IC95% 1,3–7,1) y OR: 2,8 (IC96% 1,2–6,3) respectively · Children attending to public day care centers had higher carriage rates than those attending private ones: OR: 1,9 (IC95% 1,06–3,4) · Children sharing bedroom with 3 or more persons, were associated to mayor risk or carriage: OR: 1,7 (IC95% 1,03–2,7) We found 46 serotypes in the 221 isolates. (2 couldn’t be serotyped), 90,9% (IC95% 86,3–94,3) were non PCV 13 serotypes (most frequent were 15B, 23B and 11A). Only 7 of 46 were PCV13 serotypes. (Graphic 1) Of the 20 toddlers with PCV13 serotypes, 16 were completely vaccinated Graphic 1: S pneumoniae serotype distribution. N = 221 Conclusion Nasopharyngeal carriage of SPN was high in children < 3 years

  18. Mechanical Predictors of Discomfort during Load Carriage.

    Directory of Open Access Journals (Sweden)

    Patrick D Wettenschwiler

    Full Text Available Discomfort during load carriage is a major issue for activities using backpacks (e.g. infantry maneuvers, children carrying school supplies, or outdoor sports. It is currently unclear which mechanical parameters are responsible for subjectively perceived discomfort. The aim of this study was to identify objectively measured mechanical predictors of discomfort during load carriage. We compared twelve different configurations of a typical load carriage system, a commercially available backpack with a hip belt. The pressure distribution under the hip belt and the shoulder strap, as well as the tensile force in the strap and the relative motion of the backpack were measured. Multiple linear regression analyses were conducted to investigate possible predictors of discomfort. The results demonstrate that static peak pressure, or alternatively, static strap force is a significant (p<0.001 predictor of discomfort during load carriage in the shoulder and hip region, accounting for 85% or more of the variation in discomfort. As an additional finding, we discovered that the regression coefficients of these predictors are significantly smaller for the hip than for the shoulder region. As static peak pressure is measured directly on the body, it is less dependent on the type of load carriage system than static strap force. Therefore, static peak pressure is well suited as a generally applicable, objective mechanical parameter for the optimization of load carriage system design. Alternatively, when limited to load carriage systems of the type backpack with hip belt, static strap force is the most valuable predictor of discomfort. The regionally differing regression coefficients of both predictors imply that the hip region is significantly more tolerant than the shoulder region. In order to minimize discomfort, users should be encouraged to shift load from the shoulders to the hip region wherever possible, at the same time likely decreasing the risk of low

  19. Neisseria meningitidis nasopharyngeal carriage during the Hajj: A cohort study evaluating the need for ciprofloxacin prophylaxis.

    Science.gov (United States)

    Memish, Ziad A; Al-Tawfiq, Jaffar A; Almasri, Malak; Azhar, Esam I; Yasir, Muhammad; Al-Saeed, Muneera S; Ben Helaby, Huda; Borrow, Ray; Turkistani, Abdulhafeez; Assiri, Abdallah

    2017-04-25

    The annual Muslim pilgrimage has the potential of increase risk for acquisition of Neisseria meningitidis. Here, we evaluate the Hajj impact on the prevalence of N. meningitidis carriage in a paired and non-paired cohort of pilgrims. Secondary objectives were to calculate the compliance with recommended vaccination. This is a prospective paired (arriving and departing), non-paired arriving and non-paired departing cohort study with the collection of nasopharyngeal samples at the start and the end of the Hajj. The study included unpaired arriving pilgrims at King Abdul Aziz International Airport (N=1055), unpaired departing cohort (N=373), and a paired cohort (N=628) who were tested on arrival and departure. Meningococcal vaccination was received by all pilgrims, 98.2% received quadrivalent polysaccharide vaccine (ACWY), and 1.8% received meningococcal quadrivalent conjugate vaccine (MCV4). Only 1.61% and 23.03% received pneumococcal and influenza vaccines, respectively. Of the 1055 arriving unpaired pilgrim, 36 (3.4%) tested positive for nasopharyngeal carriage of N. meningitidis, and 24 (66.7%) of these were serogroup B, the remainder were non-groupable. Haemophilus influenza was detected among 45 (4.3%), and 11 (1%) carriers were positive for both N. meningitidis and H. influenzae. Out of 373 in the unpaired departing cohort, 6 (1.61%) tested positive for N. meningitidis, and 34 (9.1%) were positive for H. influenzae. Of the 628 paired cohort pilgrims, 36 (5.7%) pilgrims were positive for N. meningitidis at arrival and 16 (2.5%) pilgrims were positive after the hajj. This the largest study of the epidemiology of N. meningitidis among pilgrims. The study showed a significant difference in the carriage between pilgrims from high endemicity and other pilgrims with a predominance of serogroup B. The continued use of ciprofloxacin as prophylactic antibiotics should be reconsidered as well as the consideration to add serogroup B as a required vaccination. Copyright

  20. Pneumococcal polysaccharide vaccine - what you need to know

    Science.gov (United States)

    ... taken in its entirety from the CDC Pneumococcal Polysaccharide Vaccine Information Statement (VIS): www.cdc.gov/vaccines/ ... statements/ppv.html CDC review information for Pneumococcal Polysaccharide VIS: Page last reviewed: April 24, 2015 Page ...

  1. Decline in Kids' Ear Infections Linked to Pneumococcal Vaccine

    Science.gov (United States)

    ... Decline in Kids' Ear Infections Linked to Pneumococcal Vaccine The shots are effective in killing the main ... compared to the 1980s, largely due to pneumococcal vaccines that protect against one type of bacteria that ...

  2. Characteristics of invasive pneumococcal disease in hospitalized children in Austria.

    Science.gov (United States)

    Paulke-Korinek, Maria; Kollaritsch, Herwig; Kundi, Michael; Schmidle-Loss, Birgit; Zwazl, Ines; Laaber, Brigitte; Lakovits, Karin; Vecsei, Andreas; Wiedermann, Ursula; Burgmann, Heinz

    2014-04-01

    In a prospective surveillance study covering all pediatric wards in Austria, 308 cases of invasive pneumococcal disease (IPD) were reported in hospitalized children Austria, no change in the incidence of invasive pneumococcal disease was observed yet.

  3. Clinical characteristics of invasive pneumococcal disease in children in Uzbekistan

    OpenAIRE

    DAMINOV TURGUNPULAT ABIDOVICH; TUYCHIEV LAZIZ NODIROVICH; TADJIEVA NIGORA UBAYDULLAEVNA; ABDUHALILOVA GULNARA KUDRATULLAEVNA; TURSUNOVA DILOROM ALIMOVNA

    2015-01-01

    Clinical course of pneumococcal meningitis I s characterized by brain edema, infectious and toxic shock and severe course. It remains one of the main pediatric pathologies with outcomes. Characteristic clinical and laboratory feature of pneumococcal pneumonia is lobar process with frequent right lung lesion and development of pleuritis (6/16,2%), increased number of leucocytes (62,2%) and C-reactive protein (43,7%). Isolated pneumococcal serotypes are included in modern pneumococcal vaccines,...

  4. Serotype distribution in non-bacteremic pneumococcal pneumonia

    DEFF Research Database (Denmark)

    Benfield, Thomas Lars Vibe; Skovgaard, Marlene; Schønheyder, Henrik Carl

    2013-01-01

    There is limited knowledge of serotypes that cause non-bacteremic pneumococcal pneumonia (NBP). Here we report serotypes, their associated disease potential and coverage of pneumococcal conjugate vaccines (PCV) in adults with NBP and compare these to bacteremic pneumonia (BP).......There is limited knowledge of serotypes that cause non-bacteremic pneumococcal pneumonia (NBP). Here we report serotypes, their associated disease potential and coverage of pneumococcal conjugate vaccines (PCV) in adults with NBP and compare these to bacteremic pneumonia (BP)....

  5. NEXT GENERATION PNEUMOCOCCAL CONJUGATE VACCINES EFFICACY AND EFFECTIVENESS IN DIFFERENT REGIONS OF THE WORLD

    Directory of Open Access Journals (Sweden)

    O. P. Kovtun

    2014-01-01

    Full Text Available In the article latest published and presented data on 10- and 13-valent pneumococcal conjugate vaccines (PCV10 and PCV13 efficacy and effectiveness in different regions of the world overview is provided for prognosis of expected effect of Russian infants mass immunization as anti-pneumococcal vaccination has been included into the National immunization program in Russia since January 1, 2014. Based on analyzed data conclusion about PCV10 and PCV13 high effectiveness against invasive pneumococcal diseases (IPD in 3+1 schedule has been made. PCV10 effectiveness against IPD in 2+1 schedule has been determined as 85,8% (Finland, for PCV13 — 100% (Norway. Serotype-specific effectiveness for IPD has been established for PCV10 only for serotypes 6B and 14, at the same time PCV13 serotype-specific effectiveness in 3+1 and 2+1 schedules has been established not only for PCV7-common serotypes, but for additional serotypes 1, 6А, 7F, 19А. In comparison with PCV7 efficacy and effectiveness against pneumonia and otitis media PCV10 has not shown additional benefits (in COMPAS and FinIP trials, at the same time PCV13 has demonstrated subsequent decreasing and additional effectiveness against these diseases (USA, Israel, France, Uruguay, Argentina, South Africa. Sustained and apparent statistically significant nasopharyngeal carriage reduction and herd effect (decreasing of IPD in non-vaccinated part of the population have been established only for PCV13 (USA, England and Wales, Israel, France. 

  6. PCR deduction of invasive and colonizing pneumococcal serotypes from Venezuela: a critical appraisal.

    Science.gov (United States)

    Bello Gonzalez, Teresita; Rivera-Olivero, Ismar Alejandra; Sisco, María Carolina; Spadola, Enza; Hermans, Peter W; de Waard, Jacobus H

    2014-04-15

    Serotype surveillance of Streptococcus pneumoniae is indispensable for evaluating the potential impact of pneumococcal conjugate vaccines. Serotyping by the standard Quellung reaction is technically demanding, time consuming, and expensive. A simple and economical strategy is multiplex PCR-based serotyping. We evaluated the cost effectiveness of a modified serial multiplex PCR (mPCR), resolving 24 serotypes in four PCR reactions and optimally targeting the most prevalent invasive and colonizing pneumococcal serotypes found in Venezuela. A total of 223 pneumococcal isolates, 140 invasive and 83 carriage isolates, previously serotyped by the Quellung reaction and representing the 18 most common serotypes/groups identified in Venezuela, were serotyped with the adapted mPCR. The mPCR serotyped 76% of all the strains in the first two PCR reactions and 91% after four reactions, correctly identifying 17 serotypes/groups. An isolate could be serotyped with mPCR in less than 2 minutes versus 15 minutes for the Quellung reaction, considerably lowering labor costs. A restrictive weakness of mPCR was found for the detection of 19F strains. Most Venezuelan 19F strains were not typeable using the mPCR, and two 19F cps serotype variants were identified. The mPCR assay is an accurate, rapid, and economical method for the identification of the vast majority of the serotypes from Venezuela and can be used in place of the standard Quellung reaction. An exception is the identification of serotype 19F. In this setting, most 19F strains were not detectable with mPCR, demonstrating a need of serology-based quality control for PCR-based serotyping.

  7. 220D-F2 from Rubus ulmifolius kills Streptococcus pneumoniae planktonic cells and pneumococcal biofilms.

    Directory of Open Access Journals (Sweden)

    Sharmila J Talekar

    Full Text Available Streptococcus pneumoniae (pneumococcus forms organized biofilms to persist in the human nasopharynx. This persistence allows the pneumococcus to produce severe diseases such as pneumonia, otitis media, bacteremia and meningitis that kill nearly a million children every year. While bacteremia and meningitis are mediated by planktonic pneumococci, biofilm structures are present during pneumonia and otitis media. The global emergence of S. pneumoniae strains resistant to most commonly prescribed antibiotics warrants further discovery of alternative therapeutics. The present study assessed the antimicrobial potential of a plant extract, 220D-F2, rich in ellagic acid, and ellagic acid derivatives, against S. pneumoniae planktonic cells and biofilm structures. Our studies first demonstrate that, when inoculated together with planktonic cultures, 220D-F2 inhibited the formation of pneumococcal biofilms in a dose-dependent manner. As measured by bacterial counts and a LIVE/DEAD bacterial viability assay, 100 and 200 µg/ml of 220D-F2 had significant bactericidal activity against pneumococcal planktonic cultures as early as 3 h post-inoculation. Quantitative MIC's, whether quantified by qPCR or dilution and plating, showed that 80 µg/ml of 220D-F2 completely eradicated overnight cultures of planktonic pneumococci, including antibiotic resistant strains. When preformed pneumococcal biofilms were challenged with 220D-F2, it significantly reduced the population of biofilms 3 h post-inoculation. Minimum biofilm inhibitory concentration (MBIC50 was obtained incubating biofilms with 100 µg/ml of 220D-F2 for 3 h and 6 h of incubation. 220D-F2 also significantly reduced the population of pneumococcal biofilms formed on human pharyngeal cells. Our results demonstrate potential therapeutic applications of 220D-F2 to both kill planktonic pneumococcal cells and disrupt pneumococcal biofilms.

  8. Clonal expansion within pneumococcal serotype 6C after use of seven-valent vaccine.

    Directory of Open Access Journals (Sweden)

    Nicholas J Loman

    Full Text Available Streptococcus pneumoniae causes invasive infections, primarily at the extremes of life. A seven-valent conjugate vaccine (PCV7 is used to protect against invasive pneumococcal disease in children. Within three years of PCV7 introduction, we observed a fourfold increase in serotype 6C carriage, predominantly due to a single clone. We determined the whole-genome sequences of nineteen S. pneumoniae serotype 6C isolates, from both carriage (n = 15 and disease (n = 4 states, to investigate the emergence of serotype 6C in our population, focusing on a single multi-locus sequence type (MLST clonal complex 395 (CC395. A phylogenetic network was constructed to identify different lineages, followed by analysis of variability in gene sets and sequences. Serotype 6C isolates from this single geographical site fell into four broad phylogenetically distinct lineages. Variation was seen in the 6C capsular locus and in sequences of genes encoding surface proteins. The largest clonal complex was characterised by the presence of lantibiotic synthesis locus. In our population, the 6C capsular locus has been introduced into multiple lineages by independent capsular switching events. However, rapid clonal expansion has occurred within a single MLST clonal complex. Worryingly, plasticity exists within current and potential vaccine-associated loci, a consideration for future vaccine use, target selection and design.

  9. Serotype-Specific Changes in Invasive Pneumococcal Disease after Pneumococcal Conjugate Vaccine Introduction: A Pooled Analysis of Multiple Surveillance Sites

    NARCIS (Netherlands)

    Feikin, Daniel R.; Kagucia, Eunice W.; Loo, Jennifer D.; Link-Gelles, Ruth; Puhan, Milo A.; Cherian, Thomas; Levine, Orin S.; Whitney, Cynthia G.; O'Brien, Katherine L.; Moore, Matthew R.; Adegbola, Claire A.; Agocs, Mary; Ampofo, Krow; Andrews, Nick; Barton, Theresa; Benito, Javier; Broome, Claire V.; Bruce, Michael G.; Bulkow, Lisa R.; Byington, Carrie L.; Camou, Teresa; Cook, Heather; Cotter, Suzanne; Dagan, Ron; de Wals, Philippe; Deceuninck, Geneviève; Denham, Barbara; Edwards, Giles; Eskola, Juhani; Fitzgerald, Margaret; Galanakis, Emmanouil; Garcia-Gabarrot, Gabriela; Garcia-Garcia, Juan J.; Gene, Amadeu; Gomez, Borja; Heffernan, Helen; Hennessy, Thomas W.; Heuberger, Sigrid; Hilty, Markus; Ingels, Helene; Jayasinghe, Sanjay; Kellner, James D.; Klein, Nicola P.; Kormann-Klement, Andrea; Kozakova, Jana; Krause, Vicki; Kriz, Paula; Lambertsen, Lotte; Lepoutre, Agnès; Lipsitch, Marc; Lopez-Vega, Mariana; Lovgren, Marguerite; Maraki, Sofia; Mason, Edward O.; McIntyre, Peter B.; Menzies, Robert; Messina, Allison; Miller, Elizabeth; Mintegi, Santiago; Motlova, Jitka; Moulton, Lawrence H.; Mühlemann, Kathrin; Muñoz-Almagro, Carmen; Murdoch, David R.; Park, Daniel E.; Reingold, Arthur L.; Sa-Leao, Raquel; Sanyal, Abanti; Smith, Peter G.; Spanjaard, Lodewijk; Techasaensiri, Chonnamet; Thompson, Richard E.; Thoon, Koh C.; Tyrrell, Gregory J.; Valentiner-Branth, Palle; van der Ende, Arie; Vanderkooi, Otto G.; van der Linden, Mark P. G.; Varon, Emmanuelle; Verhaegen, Jan; Vestrheim, Didrik F.; Vickers, Imelda; von Gottberg, Anne; von Kries, Rüdiger; Waight, Pauline; Weatherholtz, Robert; Weiss, Susanne; Yee, Arnold; Zaidi, Anita K. M.

    2013-01-01

    Background: Vaccine-serotype (VT) invasive pneumococcal disease (IPD) rates declined substantially following introduction of 7-valent pneumococcal conjugate vaccine (PCV7) into national immunization programs. Increases in non-vaccineserotype (NVT) IPD rates occurred in some sites, presumably

  10. 42 CFR 410.57 - Pneumococcal vaccine and flu vaccine.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Pneumococcal vaccine and flu vaccine. 410.57... § 410.57 Pneumococcal vaccine and flu vaccine. (a) Medicare Part B pays for pneumococcal vaccine and its administration when reasonable and necessary for the prevention of disease, if the vaccine is ordered by a doctor...

  11. 47 CFR 101.1403 - Broadcast carriage requirements.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 5 2010-10-01 2010-10-01 false Broadcast carriage requirements. 101.1403... GHz Band § 101.1403 Broadcast carriage requirements. MVDDS licensees are not required to provide all... must-carry rules, nor the local signal carriage requirements of the Rural Local Broadcast Signal Act...

  12. 47 CFR 76.56 - Signal carriage obligations.

    Science.gov (United States)

    2010-10-01

    ... requirements of this section require that, after the broadcast television transition from analog to digital... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Carriage of Television Broadcast Signals § 76.56 Signal carriage obligations. (a) Carriage of qualified noncommercial educational stations. A cable television...

  13. 46 CFR 126.170 - Carriage of offshore workers.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Carriage of offshore workers. 126.170 Section 126.170... CERTIFICATION General § 126.170 Carriage of offshore workers. (a) Offshore workers may be carried aboard an OSV in compliance with this subchapter. The maximum number of offshore workers authorized for carriage...

  14. Carriage of Haemophilus influenzae in Cape Town children ...

    African Journals Online (AJOL)

    Duration of hospitalisation or outpatient therapy in the patients with tuberculosis did not influence carriage rates. We conclude that carriage of H. influenzae in normal children is similar to that reported from other countries and that carriage, particularly of type b, in children hospitalised with tuberculosis was of significance ...

  15. Pathogenesis and Pathophysiology of Pneumococcal Meningitis

    Science.gov (United States)

    Mook-Kanamori, Barry B.; Geldhoff, Madelijn; van der Poll, Tom; van de Beek, Diederik

    2011-01-01

    Summary: Pneumococcal meningitis continues to be associated with high rates of mortality and long-term neurological sequelae. The most common route of infection starts by nasopharyngeal colonization by Streptococcus pneumoniae, which must avoid mucosal entrapment and evade the host immune system after local activation. During invasive disease, pneumococcal epithelial adhesion is followed by bloodstream invasion and activation of the complement and coagulation systems. The release of inflammatory mediators facilitates pneumococcal crossing of the blood-brain barrier into the brain, where the bacteria multiply freely and trigger activation of circulating antigen-presenting cells and resident microglial cells. The resulting massive inflammation leads to further neutrophil recruitment and inflammation, resulting in the well-known features of bacterial meningitis, including cerebrospinal fluid pleocytosis, cochlear damage, cerebral edema, hydrocephalus, and cerebrovascular complications. Experimental animal models continue to further our understanding of the pathophysiology of pneumococcal meningitis and provide the platform for the development of new adjuvant treatments and antimicrobial therapy. This review discusses the most recent views on the pathophysiology of pneumococcal meningitis, as well as potential targets for (adjunctive) therapy. PMID:21734248

  16. Nasal carriage of methicillin resistant staphylococci

    DEFF Research Database (Denmark)

    Faria, Nuno A; Conceição, Teresa; Miragaia, Maria

    2014-01-01

    . A total of 54 patients (80%) were colonized with staphylococci that included nine different species identified by internal transcribed spacer PCR (ITS-PCR) and 16S RNA sequencing. The highest rates of colonization were found for S. epidermidis (58%) and S. aureus (39%). Methicillin resistance was present......%). Carriage of multiple species was detected in 20 patients (30%), 16 of whom were colonized with both S. aureus and S. epidermidis. In two cases, simultaneous carriage of different methicillin resistant species was detected. However, the strains carried different SCCmec types. Additional studies in the same...

  17. Pneumococcal conjugate vaccines for preventing otitis media.

    Science.gov (United States)

    Fortanier, Alexandre C; Venekamp, Roderick P; Boonacker, Chantal W B; Hak, Eelko; Schilder, Anne G M; Sanders, Elisabeth A M; Damoiseaux, Roger A M J

    2014-04-02

    Acute otitis media (AOM) is a very common respiratory infection in early infancy and childhood. The marginal benefits of antibiotics for AOM in low-risk populations in general, the increasing problem of bacterial resistance to antibiotics and the huge estimated direct and indirect annual costs associated with otitis media (OM) have prompted a search for effective vaccines to prevent AOM. To assess the effect of pneumococcal conjugate vaccines (PCVs) in preventing AOM in children up to 12 years of age. We searched CENTRAL (2013, Issue 11), MEDLINE (1995 to November week 3, 2013), EMBASE (1995 to December 2013), CINAHL (2007 to December 2013), LILACS (2007 to December 2013) and Web of Science (2007 to December 2013). Randomised controlled trials (RCTs) of PCVs to prevent AOM in children aged 12 years or younger, with a follow-up of at least six months after vaccination. Two review authors independently assessed trial quality and extracted data. We included 11 publications of nine RCTs (n = 48,426 children, range 74 to 37,868 per study) of 7- to 11-valent PCV (with different carrier proteins). Five trials (n = 47,108) included infants, while four trials (n = 1318) included children aged one to seven years that were either healthy (one study, n = 264) or had a previous history of upper respiratory tract infection (URTI), including AOM. We judged the methodological quality of the included studies to be moderate to high. There was considerable clinical diversity between studies in terms of study population, type of conjugate vaccine and outcome measures. We therefore refrained from pooling the results.In three studies, the 7-valent PCV with CRM197 as carrier protein (CRM197-PCV7) administered during early infancy was associated with a relative risk reduction (RRR) of all-cause AOM ranging from -5% in high-risk children (95% confidence interval (CI) -25% to 12%) to 7% in low-risk children (95% CI 4% to 9%). Another 7-valent PCV with the outer membrane protein complex of

  18. Impact of intermittent preventive treatment in pregnancy with azithromycin-containing regimens on maternal nasopharyngeal carriage and antibiotic sensitivity of Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus: a cross-sectional survey at delivery.

    Science.gov (United States)

    Unger, Holger W; Aho, Celestine; Ome-Kaius, Maria; Wangnapi, Regina A; Umbers, Alexandra J; Jack, Wanda; Lafana, Alice; Michael, Audrey; Hanieh, Sarah; Siba, Peter; Mueller, Ivo; Greenhill, Andrew R; Rogerson, Stephen J

    2015-04-01

    Sulfadoxine-pyrimethamine (SP) plus azithromycin (AZ) (SPAZ) has the potential for intermittent preventive treatment of malaria in pregnancy (IPTp), but its use could increase circulation of antibiotic-resistant bacteria associated with severe pediatric infections. We evaluated the effect of monthly SPAZ-IPTp compared to a single course of SP plus chloroquine (SPCQ) on maternal nasopharyngeal carriage and antibiotic susceptibility of Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus at delivery among 854 women participating in a randomized controlled trial in Papua New Guinea. Serotyping was performed, and antibiotic susceptibility was evaluated by disk diffusion and Etest. Potential risk factors for carriage were examined. Nasopharyngeal carriage at delivery of S. pneumoniae (SPAZ, 7.2% [30/418], versus SPCQ, 19.3% [84/436]; P<0.001) and H. influenzae (2.9% [12/418] versus 6.0% [26/436], P=0.028), but not S. aureus, was significantly reduced among women who had received SPAZ-IPTp. The number of macrolide-resistant pneumococcal isolates was small but increased in the SPAZ group (13.3% [4/30], versus SPCQ, 2.2% [2/91]; P=0.033). The proportions of isolates with serotypes covered by the 13-valent pneumococcal conjugate vaccine were similar (SPAZ, 10.3% [3/29], versus SPCQ, 17.6% [16/91]; P=0.352). Although macrolide-resistant isolates were rare, they were more commonly detected in women who had received SPAZ-IPTp, despite the significant reduction of maternal carriage of S. pneumoniae and H. influenzae observed in this group. Future studies on SPAZ-IPTp should evaluate carriage and persistence of macrolide-resistant S. pneumoniae and other pathogenic bacteria in both mothers and infants and assess the clinical significance of their circulation. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  19. Carriage rates, circulating serotypes and antibiotic resistance ...

    African Journals Online (AJOL)

    The carriage of Streptococcus pneumoniae, serotypes, antimicrobial susceptibility patterns and disease development are poorly understood in Yei. Availability of affordable antibiotics over the counter, lack of laboratory infrastructure and high rates of penicillin resistance have the potential to aggravate rates of childhood ...

  20. Carriage of multidrug resistant Enterococcus faecium and ...

    African Journals Online (AJOL)

    Carriage of multidrug resistant Enterococcus faecium and Enterococcus faecalis among apparently healthy humans. ... If you would like more information about how to print, save, and work with PDFs, Highwire Press provides a helpful Frequently Asked Questions about PDFs. Alternatively, you can download the PDF file ...

  1. Nasal Carriage of Methicillin Resistant Staphylococcus aureus ...

    African Journals Online (AJOL)

    BACKGROUND: Staphylococcus aureus is one of the major causes of community and hospital acquired infections. The emergence of methicillin resistant strains of Staphylococcus aureus in the hospitals and the community is a serious health problem. The aim of this study was to determine the nasal carriage and ...

  2. Nasal carriage of Meticillin resistance Staphylococcus aureus ...

    African Journals Online (AJOL)

    Gemeda

    BACKGROUND: Staphylococcus aureus is one of the major causes of community and hospital acquired infections. The emergence of methicillin resistant strains of. Staphylococcus aureus in the hospitals and the community is a serious health problem. The aim of this study was to determine the nasal carriage and ...

  3. Pneumococcal DNA is not detectable in the blood of healthy carrier children by real-time PCR targeting the lytA gene.

    Science.gov (United States)

    Azzari, Chiara; Cortimiglia, Martina; Moriondo, Maria; Canessa, Clementina; Lippi, Francesca; Ghiori, Federica; Becciolini, Laura; de Martino, Maurizio; Resti, Massimo

    2011-06-01

    The diagnosis of invasive pneumococcal disease (IPD) is currently based on culture methods, which lack sensitivity, especially after antibiotic therapy. Molecular methods have improved sensitivity and do not require viable bacteria; however, their use is complicated by reports of low specificity with some assays. The present study investigated the specificity of a real-time PCR targeting lytA for the detection of IPD. A group of 147 healthy children, aged 6 months to 16 years (mean 6.4 years, median 4.9 years, interquartile range 6.4 years), who were in hospital for routine examinations, were tested for pneumococcal carrier status and for the presence of detectable pneumococcal DNA in their blood by real-time PCR targeting the pneumococcal lytA gene. In addition, 35 culture-positive biological samples were analysed. Urine was examined for the presence of pneumococcal DNA and C-polysaccharide antigen. Carriage was detected in 77 of the 147 subjects (52.4 %); however, regardless of carrier status, none of the subjects had a positive result from blood. Analysis of the culture-positive biological samples yielded positive results in 100 % (15/15) of cerebrospinal fluid samples and 95 % (19/20) of blood samples. All urine samples from healthy carriers were negative for DNA, whilst antigenuria was detected in 44/77 carriers (57.1 %). In conclusion, real-time PCR is both sensitive and specific and can be a useful tool in the routine diagnosis of IPD. Its sensitivity, which surpasses that of other methods for this purpose, does not come at the cost of reduced specificity.

  4. Pneumococcal capsular polysaccharide structure predicts serotype prevalence.

    Directory of Open Access Journals (Sweden)

    Daniel M Weinberger

    2009-06-01

    Full Text Available There are 91 known capsular serotypes of Streptococcus pneumoniae. The nasopharyngeal carriage prevalence of particular serotypes is relatively stable worldwide, but the host and bacterial factors that maintain these patterns are poorly understood. Given the possibility of serotype replacement following vaccination against seven clinically important serotypes, it is increasingly important to understand these factors. We hypothesized that the biochemical structure of the capsular polysaccharides could influence the degree of encapsulation of different serotypes, their susceptibility to killing by neutrophils, and ultimately their success during nasopharyngeal carriage. We sought to measure biological differences among capsular serotypes that may account for epidemiological patterns. Using an in vitro assay with both isogenic capsule-switch variants and clinical carriage isolates, we found an association between increased carriage prevalence and resistance to non-opsonic neutrophil-mediated killing, and serotypes that were resistant to neutrophil-mediated killing tended to be more heavily encapsulated, as determined by FITC-dextran exclusion. Next, we identified a link between polysaccharide structure and carriage prevalence. Significantly, non-vaccine serotypes that have become common in vaccinated populations tend to be those with fewer carbons per repeat unit and low energy expended per repeat unit, suggesting a novel biological principle to explain patterns of serotype replacement. More prevalent serotypes are more heavily encapsulated and more resistant to neutrophil-mediated killing, and these phenotypes are associated with the structure of the capsular polysaccharide, suggesting a direct relationship between polysaccharide biochemistry and the success of a serotype during nasopharyngeal carriage and potentially providing a method for predicting serotype replacement.

  5. treatment and prevention of pneumococcal disease

    African Journals Online (AJOL)

    to disease pathogenesis and pathology, as well as various immunological and pharmacological strategies that may target these deleterious effects of the toxin. ..... Construction and immunological characterization of a novel nontoxic protective pneumolysin mutant for use in future pneumococcal vaccines. Infect Immun 2006 ...

  6. Prevention of pneumococcal infections during mass gathering

    Science.gov (United States)

    Al-Tawfiq, Jaffar A; Memish, Ziad A

    2016-01-01

    The interest in mass gathering and its implications has been increasing due to globalization and international travel. The potential occurrence of infectious disease outbreaks during mass gathering is most feared. In this context, respiratory tract infections are of great concern due to crowding in a limited space which facilitates and magnifies the potential of disease spread among attendees. Pneumococcal disease is best described among pilgrims to Makkah and vaccination is one of the methods for the prevention of this disease. Pneumonia was described in a mass gathering with a prevalence of 4.8/100,000 pilgrims and contributes to 15–39% of hospitalizations. Various studies showed that 7–37% of pilgrims are 65 y of age or older. The uptake of pneumococcal vaccine among pilgrims is low at 5%. There is no available data to make strong recommendations for S. pneumoniae vaccination of all pilgrims, it is important that a high risk population receive the indicated vaccination. We reviewed the available literature on the burden of pneumococcal infections during mass gathering and evaluate the available literature on pneumococcal vaccinations for attendees of mass gathering. PMID:26176306

  7. Pneumococcal Vaccination Recommendations for Children and Adults by Age and/or Risk Factor

    Science.gov (United States)

    Pneumococcal Vaccination Recommendations for Children 1 and Adults by Age and/or Risk Factor Routine Recommendations for Pneumococcal Conjugate ... X X X X X 1 For PCV13 vaccination of healthy children, see “Recommen- dations for Pneumococcal ...

  8. [Pneumococcal vaccine recommendations in chronic respiratory diseases].

    Science.gov (United States)

    Casas Maldonado, F; Alfageme Michavila, I; Barchilón Cohen, V S; Peis Redondo, J I; Vargas Ortega, D A

    2014-09-01

    Community-acquired pneumonia is an acute respiratory infectious disease which has an incidence of 3-8 cases/1,000 inhabitants, and increases with age and comorbidities. The pneumococcus is the organism most frequently involved in community-acquired pneumonia in the adult (30-35%). Around 40% of patients with community-acquired pneumonia require hospital admission, and around 10% need to be admitted to an intensive care unit. The most serious forms of pneumococcal infection include invasive pneumococcal disease (IPD), which covers cases of bacteremia (associated or not to pneumonia), meningitis, pleuritis, arthritis, primary peritonitis and pericarditis. Currently, the biggest problem with the pneumococcus is the emergence of resistance to antimicrobial agents, and its high morbimortality, despite the use of appropriate antibiotics and proper medical treatment. Certain underlying medical conditions increase the risk of IPD and its complications, especially, from the respiratory diseases point of view, smoking and chronic respiratory diseases. Pneumococcal disease, according to the WHO, is the first preventable cause of death worldwide in children and adults. Among the strategies to prevent IPD is vaccination. WHO considers that its universal introduction and implementation against pneumococcus is essential and a priority in all countries. There are currently 2 pneumococcal vaccines for adults: the 23 serotypes polysaccharide and conjugate 13 serotypes. The scientific societies represented here have worked to develop some recommendations, based on the current scientific evidence, regarding the pneumococcal vaccination in the immunocompetent adult with chronic respiratory disease and smokers at risk of suffering from IPD. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  9. Nasopharyngeal carriage, antibiogram & serotype distribution of Streptococcus pneumoniae among healthy under five children

    Directory of Open Access Journals (Sweden)

    K.L. Ravi Kumar

    2014-01-01

    Full Text Available Background & objectives: Information related to nasopharyngeal carriage of Streptococcus pneumoniae among healthy children is scanty in India. This prospective study was undertaken to determine the presence of asymptomatic nasopharyngeal colonization, assess serogroups/types (SGT and drug resistance of S. pneumoniae in children below five years of age. Methods: A total of 109 male and 81 female children in the age group of three months to five years belonging to different socio-economic classes were enrolled. They were recruited across all age groups from those attending paediatric OPD of a tertiary care and research centre for immunization program. Fifty three isolates identified as pneumococci were tested for their antimicrobial susceptibility pattern by Kirby-Bauer′s disc diffusion and E-Test methods. Serotyping was performed by detection of the quelling reaction with specific antiserum. Result: The pneumococcal carriage rate in the study population was 27.9 per cent. The isolation rate was associated with age being higher (49.2% in smaller children (3-12 months and among male (62.2%. The most prevalent SGTs were 19 followed by 10, 14 and 7; 21 per cent of isolates belonging to serotype 10 (n=7 were 11 (n=4 were not covered in any of the conjugate vaccines currently available in Indian market. Resistance to co-trimoxazole, tetracycline, penicillin and erythromycin was observed in 91 per cent (n=48, 36 per cent (n=19, 17 per cent (n=9 and 9 per cent (n=5 isolates, respectively. All the penicillin resistant isolates were found to be intermediately resistant by E-Test. Multidrug resistance was observed in 19 per cent (n=10 isolates. Interpretation & conclusions: High level of antibiotic resistance was present in S. pneumoniae isolated from healthy children below age five. A pneumococcal conjugate vaccine with the prevailing SGTs would help to reduce the pool of antibiotic resistant pneumococci. Continued surveillance of serotypes and tracking

  10. Prevalence of nasopharyngeal antibiotic-Resistant pneumococcal ...

    African Journals Online (AJOL)

    Nasopharyngeal samples were taken and parent interviews were conducted. Results: Pneumococci were isolated from 121 children (40%). The most common serotypes were 6B, 19F, 6A,23F, 14, and 19A. Carriage was significantly associated with prior hospital admission (odds ratio 1.89) and day care attendance (odds ...

  11. Self-reported load carriage injuries of military soldiers.

    Science.gov (United States)

    Orr, Robin Marc; Coyle, Julia; Johnston, Venerina; Pope, Rodney

    2017-06-01

    The aim of this study was to investigate whether occupational load carriage constitutes a significant source of injury to military soldiers. An online survey was sent to soldiers serving in specific Australian Army Corps known to experience the greatest occupational exposure to load carriage. Of the 338 respondents, 34% sustained at least one load carriage injury. Fifty-two per cent of those injured during initial training reported sustaining an additional load carriage injury. The majority of injuries (61%) were to the lower limbs with bones and joints the most frequently injured body structures (39%). Endurance marching (continuous marching as part of a physical training session) was the activity accounting for most (38%) injuries. Occupational load carriage is associated with military soldier injuries and, once injured, soldiers are at a high risk of future load carriage injury. The bodily sites and nature of self-reported injuries in this study are akin to those of formally reported injuries and those of other militaries.

  12. Acute Primary Pneumococcal Purulent Pericarditis With Cardiac Tamponade

    Science.gov (United States)

    Patel, Hiren; Patel, Charmi; Soni, Mrugesh; Patel, Amit; Banda, Venkat

    2015-01-01

    Abstract Bacterial pericarditis is a rapidly progressive and highly fatal infection, and is often diagnosed postmortem in half of the cases. Even with drainage and antibiotics, the mortality rate is high. Gram-positive cocci, specifically Streptococcus penumoniae, have been the most common cause of bacterial pericarditis with a preceding primary site of infection. Following the introduction of antibiotics in the 1940s and more recently the pneumococcal conjugate vaccine, the incidence has drastically decreased. We describe an extremely rare case of primary streptococcus pneumoniae purulent pericarditis that presented with cardiac tamponade. The patient was successfully treated with broad-spectrum antibiotics and urgent pericardiocentesis. Due to the high mortality rate with purulent pericarditis, a high index of suspicion is needed when acute pericarditis is suspected for early diagnosis to instate appropriate therapy with antibiotics and drainage. PMID:26469910

  13. Potential serotype coverage of three pneumococcal conjugate vaccines against invasive pneumococcal infection in Italian children.

    Science.gov (United States)

    Azzari, Chiara; Moriondo, Maria; Cortimiglia, Martina; Valleriani, Claudia; Canessa, Clementina; Indolfi, Giuseppe; Ricci, Silvia; Nieddu, Francesco; de Martino, Maurizio; Resti, Massimo

    2012-03-30

    Since the introduction of the 7-valent vaccine, invasive pneumococcal disease have greatly decreased; however, changes in the distribution of pneumococcal serotypes have recently highlighted the need for vaccines with wider coverage. The aim of the work was to assess the potential serotype coverage of three pneumococcal conjugate vaccines (7-, 10- and 13-valent) against bacteremic pneumococcal pneumonia and meningitis/sepsis in Italian children. We determined pneumococcal serotypes in immunocompetent patients who had been admitted to hospital with suspicion of invasive bacterial disease and had confirmed bacteremic pneumococcal pneumonia or meningitis/sepsis determined by molecular detection of Streptococcus pneumoniae in a normally sterile site. Positive samples were serotyped using Realtime-PCR. Between April 2008 and March 2011, a total of 144 patients (age median 4.1 years; Interquartile range 1.8-5.6) with pneumococcal meningitis/sepsis (n=43) or pneumonia (n=101) from 83 participating centers located in 19 of 20 Italian regions were serotyped. The 10 most prevalent serotypes were 1 (29.9%), 3 (16.0%), 19A (13.2%), 7F (8.3%), 5 (4.2%), 14 (4.2%), 6A (3.5%), 6B (3.5%), 18C (3.5%), 19F (3.5%). Overall, serotype coverage for PCV-7, -10 and -13 were respectively 19.4%, 61.8% and 94.4% with no statistical difference between pneumonia and meningitis/sepsis. Potential coverage was similar for children 0-2 or 2-5 years of age. Cultures resulted positive in 35/99 (35.4%) samples simultaneously obtained for both culture and RT-PCR. These findings indicate that increasing the potential serotype coverage by introducing PCV13 in the vaccination schedule for infancy could provide substantial added benefit for protection from pneumococcal pneumonia or meningitis/sepsis in Italy in children below 2 years as well in older children. The importance of molecular methods for diagnosis and serotyping of invasive pneumococcal disease was confirmed. Copyright © 2012. Published by

  14. Hearing loss in adults surviving pneumococcal meningitis is associated with otitis and pneumococcal serotype.

    Science.gov (United States)

    Heckenberg, S G B; Brouwer, M C; van der Ende, A; Hensen, E F; van de Beek, D

    2012-09-01

    We assessed the incidence of hearing loss and its relationship with clinical characteristics and pneumococcal serotypes in adults surviving pneumococcal meningitis. We analysed hearing loss in 531 adults surviving pneumococcal meningitis included in two prospective nationwide cohort studies performed from April 1998 through to October 2002 and March 2006 through to January 2009. Hearing loss was evaluated on admission and discharge for all patients. Severe hearing loss was assessed by pure tone average on audiology and corrected for age, or by the combination of hearing loss on discharge and a score on the Glasgow Outcome Scale below 5, which could not be explained by other neurological sequelae. A total of 531 episodes of pneumococcal meningitis with non-lethal outcome were included. Predisposing conditions for pneumococcal meningitis were present in the majority of patients (64%), most commonly otitis (36%). Hearing loss was present at discharge in 116 patients (22%) and was classified as mild in 53% and severe in 47%. Hearing loss was related to otitis (odds ratio [OR], 2.58; 95% confidence interval [CI], 1.66-4.02; p otitis, but not disease severity. Otitis and resulting perilympathic inflammation contribute to meningitis-associated hearing loss. © 2011 The Authors. Clinical Microbiology and Infection © 2011 European Society of Clinical Microbiology and Infectious Diseases.

  15. Hospitalization rates for pneumococcal disease in Brazil, 2004 - 2006

    Directory of Open Access Journals (Sweden)

    Hillegonda Maria Dutilh Novaes

    2011-06-01

    Full Text Available OBJECTIVE: To estimate hospitalization rates for pneumococcal disease based on the Brazilian Hospital Information System (SIH. METHODS: Descriptive study based on the Hospital Information System of Brazilian National Health System data from January 2004 to December 2006: number of hospitalizations and deaths for pneumococcal meningitis, pneumococcal sepsis, pneumococcal pneumonia and Streptococcus pneumoniae as the cause of diseases reported in Brazil. Data from the 2003 Brazilian National Household Survey were used to estimate events in the private sector. Pneumococcal meningitis cases and deaths reported to the Notifiable Diseases Information System during the study period were also analyzed. RESULTS: Pneumococcal disease accounted for 34,217 hospitalizations in the Brazilian National Health System (0.1% of all hospitalizations in the public sector. Pneumococcal pneumonia accounted for 64.8% of these hospitalizations. The age distribution of the estimated hospitalization rates for pneumococcal disease showed a "U"-shape curve with the highest rates seen in children under one (110 to 136.9 per 100,000 children annually. The highest hospital case-fatality rates were seen among the elderly, and for sepsis and meningitis. CONCLUSIONS: PD is a major public health problem in Brazil. The analysis based on the SIH can provide an important input to pneumococcal disease surveillance and the impact assessment of immunization programs.

  16. Pneumococcal lipoproteins involved in bacterial fitness, virulence, and immune evasion

    National Research Council Canada - National Science Library

    Kohler, Sylvia; Voß, Franziska; Gómez Mejia, Alejandro; Brown, Jeremy S; Hammerschmidt, Sven

    2016-01-01

    .... Pneumococcal lipoproteins are peripherally anchored membrane proteins and have pivotal roles in bacterial fitness including envelope stability, cell division, nutrient acquisition, signal transduction, transport (as substrate...

  17. Initial and subsequent response to pneumococcal polysaccharide and protein-conjugate vaccines administered sequentially to adults who have recovered from pneumococcal pneumonia.

    Science.gov (United States)

    Musher, Daniel M; Rueda, Adriana M; Nahm, Moon H; Graviss, Edward A; Rodriguez-Barradas, Maria C

    2008-10-01

    Controversy persists over the benefits of pneumococcal polysaccharide vaccine (PPV) for adults at high risk for pneumococcal disease. We studied PPV, protein-conjugate pneumococcal vaccine (PCV), and immunologic "priming" with PCV followed by "boosting" with PPV in adults who had recovered from pneumococcal pneumonia. Subjects received PPV followed by PCV 6 months later, or vice versa. The levels of IgG to capsular polysaccharide and opsonophagocytic killing activity (OPK) were studied at baseline and at 4-8 weeks and 6 months after each vaccination. PPV and PCV stimulated similar IgG levels and OPK at 4-8 weeks after vaccination. Six months after receipt of PPV, the antibody levels declined to baseline but remained modestly elevated after receipt of PCV. PCV administered 6 months after PPV stimulated modest increases in IgG level that failed to reach the peaks observed after receipt of PPV. In contrast, PPV administered 6 months after PCV caused dramatic increases in the levels of IgG and OPK for all polysaccharides at 4-8 weeks, consistent with a booster effect. Six months after receipt of the second vaccination, however, levels of IgG and OPK fell precipitously in all patients, approaching baseline levels. In these high-risk subjects who have recovered after treatment for pneumonia, the effect of PPV is short-lived; PCV stimulates a more prolonged response. The use of PPV as a booster following PCV causes early increases in antibody levels, but the level of IgG declines rapidly thereafter, consistent with induction of suppressor cells or tolerance. Protein vaccines may be needed for high-risk adults.

  18. Pneumococcal Replicative State in Relation to its Adherence Capacity to A549-cell Line: A Preliminary in vitro Analysis

    Directory of Open Access Journals (Sweden)

    Mohd Desa, M. N.

    2011-01-01

    Full Text Available This study was to compare the replication capacity of pneumococcal isolates (serotypes 1, 7F, 19F and 23F with their adherence pattern to monolayer cells (A549. For standardization purposes, all isolates showed a normal growth curve in both bacteriological (THB + 0.5% yeast extract with and without 2% FBS and cell culture media (RPMI + 2% FBS. In the former media, a shorter lag phase was observed for isolate serotypes 1 and 7F in presence of serum while in the later; growth yield was lower for all isolates with stationary phase approaching OD600 of 0.01 as compared to 1.0 in bacteriological media. In the replicative analysis at different growth phases of the isolates in cell culture media, growth capacity at 3 h post-incubation was frequently twice as that at 1 h, and that at early-log phase was frequently higher than that at mid-log phase at both post-incubation times. Adherence was frequently the least at early-log phase although the isolates were in the most active state of replication to increase the number of pneumococcal cells to adhere. At mid- and late-log phases, pneumococcal adherence was frequently higher although the replication was reduced. This study marks the potential correlation between pneumococcal growth fitness and adherence capacity whereby the later may not be superior during the early growth phase.

  19. Targets for adjunctive therapy in pneumococcal meningitis.

    Science.gov (United States)

    Barichello, Tatiana; Collodel, Allan; Generoso, Jaqueline S; Simões, Lutiana R; Moreira, Ana Paula; Ceretta, Renan A; Petronilho, Fabrícia; Quevedo, João

    2015-01-15

    Pneumococcal meningitis is a severe infectious disease of the central nervous system (CNS) and a significant cause of morbidity and mortality worldwide. The inflammatory reaction to the disease contributes to neuronal injury and involves the meninges, the subarachnoid space and the brain parenchymal vessels. Bacterial pathogens may reach the blood-brain barrier and be recognized by antigen-presenting cells through the binding of Toll-like receptors, triggering an inflammatory cascade. This in turn produces cytokines and chemokines, increases adhesion molecule expression and attracts leukocytes from the blood. This cascade leads to lipid peroxidation, mitochondrial damage and blood-brain barrier permeability. In spite of effective antibacterial treatments, approximately one third of survivors suffer from long-term sequelae, such as hearing loss, cerebral palsy, seizures, hydrocephaly or cognitive impairment. This review summarizes the information on targets of adjuvant treatments of acute pneumococcal meningitis. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Outbreak of Pneumonia in the Setting of Fatal Pneumococcal Meningitis among US Army Trainees: Potential Role of Chlamydia pneumoniae Infection

    Directory of Open Access Journals (Sweden)

    Mitchell Stephanie L

    2011-06-01

    Full Text Available Abstract Background Compared to the civilian population, military trainees are often at increased risk for respiratory infections. We investigated an outbreak of radiologically-confirmed pneumonia that was recognized after 2 fatal cases of serotype 7F pneumococcal meningitis were reported in a 303-person military trainee company (Alpha Company. Methods We reviewed surveillance data on pneumonia and febrile respiratory illness at the training facility; conducted chart reviews for cases of radiologically-confirmed pneumonia; and administered surveys and collected nasopharyngeal swabs from trainees in the outbreak battalion (Alpha and Hotel Companies, associated training staff, and trainees newly joining the battalion. Results Among Alpha and Hotel Company trainees, the average weekly attack rates of radiologically-confirmed pneumonia were 1.4% and 1.2% (most other companies at FLW: 0-0.4%. The pneumococcal carriage rate among all Alpha Company trainees was 15% with a predominance of serotypes 7F and 3. Chlamydia pneumoniae was identified from 31% of specimens collected from Alpha Company trainees with respiratory symptoms. Conclusion Although the etiology of the outbreak remains unclear, the identification of both S. pneumoniae and C. pneumoniae among trainees suggests that both pathogens may have contributed either independently or as cofactors to the observed increased incidence of pneumonia in the outbreak battalion and should be considered as possible etiologies in outbreaks of pneumonia in the military population.

  1. Evaluation of anti-pneumococcal capsular antibodies as adjunctive therapy in experimental pneumococcal meningitis

    DEFF Research Database (Denmark)

    Brandt, Christian; Frimodt-Moller, N; Lundgren, Jens Dilling

    2006-01-01

    OBJECTIVE: Bacteraemia concomitant with meningitis has been shown to greatly affect outcome. Consequently, the efficacy of serotype-specific anti-pneumococcal antiserum (APAS) was investigated in a rat model of pneumococcal meningitis. METHODS: Rats were infected with Streptococcus pneumoniae...... serotype 3. All rats received ceftriaxone starting 26 h post-infection. APAS was administered either at the time of infection or 26 h post-infection and effects were compared with rats treated with antibiotics only. RESULTS AND CONCLUSION: A significant clinical benefit was found when APAS was given...... at the time of infection whereas no effect was found when administered 26 h after infection. This work indicates that the clinical value of using APAS in pneumococcal meningitis may be limited...

  2. Thrombotic Thrombocytopenic Purpura Associated with Pneumococcal Sepsis

    Directory of Open Access Journals (Sweden)

    Jeffrey R Schriber

    1993-01-01

    Full Text Available The first documented case of thrombotic thrombocytopenic purpura (TTP associated with pneumococcal septicemia is reported. This association has been previously demonstrated with hemolytic uremic syndrome. The patient presented with recurrent seizures, oliguric renal failure, fever, thrombocytopenia and microangiopathic hemolytic anemia; coagulation studies were normal. Blood and sputum cultures were positive for Streptococcus pneumoniae. The patient responded to therapy with plasmapheresis and antiplatelet agents as well as antibiotics. Coincident infection should be searched for in all cases of TTP.

  3. Association of secondhand smoke exposure with pediatric invasive bacterial disease and bacterial carriage: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Chien-Chang Lee

    2010-12-01

    Full Text Available A number of epidemiologic studies have observed an association between secondhand smoke (SHS exposure and pediatric invasive bacterial disease (IBD but the evidence has not been systematically reviewed. We carried out a systematic review and meta-analysis of SHS exposure and two outcomes, IBD and pharyngeal carriage of bacteria, for Neisseria meningitidis (N. meningitidis, Haemophilus influenzae type B (Hib, and Streptococcus pneumoniae (S. pneumoniae.Two independent reviewers searched Medline, EMBASE, and selected other databases, and screened articles for inclusion and exclusion criteria. We identified 30 case-control studies on SHS and IBD, and 12 cross-sectional studies on SHS and bacterial carriage. Weighted summary odd ratios (ORs were calculated for each outcome and for studies with specific design and quality characteristics. Tests for heterogeneity and publication bias were performed. Compared with those unexposed to SHS, summary OR for SHS exposure was 2.02 (95% confidence interval [CI] 1.52-2.69 for invasive meningococcal disease, 1.21 (95% CI 0.69-2.14 for invasive pneumococcal disease, and 1.22 (95% CI 0.93-1.62 for invasive Hib disease. For pharyngeal carriage, summary OR was 1.68 (95% CI, 1.19-2.36 for N. meningitidis, 1.66 (95% CI 1.33-2.07 for S. pneumoniae, and 0.96 (95% CI 0.48-1.95 for Hib. The association between SHS exposure and invasive meningococcal and Hib diseases was consistent regardless of outcome definitions, age groups, study designs, and publication year. The effect estimates were larger in studies among children younger than 6 years of age for all three IBDs, and in studies with the more rigorous laboratory-confirmed diagnosis for invasive meningococcal disease (summary OR 3.24; 95% CI 1.72-6.13.When considered together with evidence from direct smoking and biological mechanisms, our systematic review and meta-analysis indicates that SHS exposure may be associated with invasive meningococcal disease. The

  4. Decreased immune response to pneumococcal conjugate vaccine after 23-valent pneumococcal polysaccharide vaccine in children.

    Science.gov (United States)

    Sigurdardottir, Sigurveig Th; Center, Kimberly J; Davidsdottir, Katrin; Arason, Vilhjalmur A; Hjalmarsson, Bjorn; Elisdottir, Ragnheidur; Ingolfsdottir, Gunnhildur; Northington, Robert; Scott, Daniel A; Jonsdottir, Ingileif

    2014-01-09

    Pneumococcal polysaccharide vaccine (PPV) is used in children at high risk of IPD. PPV is generally not considered to induce immunologic memory, whereas pneumococcal conjugate vaccines (PCVs) elicit protective antibody responses in infants and induce immunologic memory. Little is known about the characteristics of immune responses to PCV in children who previously received PCV and PPV in series. To characterize immune responses to 13-valent pneumococcal CRM197 conjugate vaccine (PCV13; serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, and 23F) in children vaccinated in infancy with 9-valent pneumococcal-meningococcal C-CRM197 conjugate combination vaccine (PCV9-MnCC), followed by a toddler dose of PCV9-MnCC or 23-valent pneumococcal polysaccharide vaccine (PPV23). Children (n=89) who received PCV9-MnCC in infancy and PPV23 or PCV9-MnCC at age 12 months in a previous (2002-2003) study were vaccinated at age 7.5 years with PCV13; groups PPV23/PCV13 (n=50) and PCV9/PCV13 (n=39). Immunoglobulin (Ig)G antibodies, avidity, and opsonophagocytic activity (OPA) were measured before and at 1 and 4 weeks postvaccination. One week postvaccination, IgG levels increased significantly for all serotypes in both groups, and >97% of vaccinees achieved IgG ≥0.35μg/ml 4 weeks after PCV13 vaccination. The PCV9/PCV13 group had higher IgG responses compared with the PPV23/PCV13 group. The upper limits of the 95% confidence intervals of the PPV23/PCV13:PCV9/PCV13 IgG geometric mean concentration ratios were vaccination of toddlers may compromise subsequent responses to pneumococcal conjugate vaccines. The clinical relevance of this finding is unclear. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. [Pneumococcal vaccines. New conjugate vaccines for adults].

    Science.gov (United States)

    Campins Martí, Magda

    2015-11-01

    Pneumococcal infections are a significant cause of morbidity and mortality, and are one of the 10 leading causes of death worldwide. Children under 2 years have a higher incidence rate, followed by adults over 64 years. The main risk group are individuals with immunodeficiency, and those with anatomical or functional asplenia, but can also affect immunocompetent persons with certain chronic diseases. Significant progress has been made in the last 10 years in the prevention of these infections. Until a few years ago, only the 23-valent non-conjugate pneumococcal vaccine was available. Its results were controversial in terms of efficacy and effectiveness, and with serious limitations on the type of immune response induced. The current possibility of using the 13-valent conjugate vaccine in adults has led to greater expectations in improving the prevention of pneumococcal disease in these age groups. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  6. Understanding pneumococcal serotype 1 biology through population genomic analysis

    Directory of Open Access Journals (Sweden)

    Chrispin Chaguza

    2016-11-01

    Full Text Available Abstract Background Pneumococcus kills over one million children annually and over 90 % of these deaths occur in low-income countries especially in Sub-Saharan Africa (SSA where HIV exacerbates the disease burden. In SSA, serotype 1 pneumococci particularly the endemic ST217 clone, causes majority of the pneumococcal disease burden. To understand the evolution of the virulent ST217 clone, we analysed ST217 whole genomes from isolates sampled from African and Asian countries. Methods We analysed 226 whole genome sequences from the ST217 lineage sampled from 9 African and 4 Asian countries. We constructed a whole genome alignment and used it for phylogenetic and coalescent analyses. We also screened the genomes to determine presence of antibiotic resistance conferring genes. Results Population structure analysis grouped the ST217 isolates into five sequence clusters (SCs, which were highly associated with different geographical regions and showed limited intracontinental and intercontinental spread. The SCs showed lower than expected genomic sequence, which suggested strong purifying selection and small population sizes caused by bottlenecks. Recombination rates varied between the SCs but were lower than in other successful clones such as PMEN1. African isolates showed higher prevalence of antibiotic resistance genes than Asian isolates. Interestingly, certain West African isolates harbored a defective chloramphenicol and tetracycline resistance-conferring element (Tn5253 with a deletion in the loci encoding the chloramphenicol resistance gene (catpC194, which caused lower chloramphenicol than tetracycline resistance. Furthermore, certain genes that promote colonisation were absent in the isolates, which may contribute to serotype 1’s rarity in carriage and consequently its lower recombination rates. Conclusions The high phylogeographic diversity of the ST217 clone shows that this clone has been in circulation globally for a long time, which

  7. Increase in hippocampal water diffusion and volume during experimental pneumococcal meningitis is aggravated by bacteremia

    DEFF Research Database (Denmark)

    Holler, Jon G; Brandt, Christian T; Leib, Stephen L

    2014-01-01

    pneumococci. The study comprised of four experimental groups. I. Uninfected controls (n = 8); II. Meningitis (n = 11); III. Meningitis with early onset bacteremia by additional i.v. injection of live pneumococci (n = 10); IV. Meningitis with attenuated bacteremia by treatment with serotype-specific anti......BACKGROUND: The hippocampus undergoes apoptosis in experimental pneumococcal meningitis leading to neurofunctional deficits in learning and memory function. The aim of the present study was 1) to investigate hippocampal apparent diffusion coefficient (ADC) and volume with MRI during the course...... of experimental pneumococcal meningitis, 2) to explore the influence of accompanying bacteremia on hippocampal water distribution and volume, 3) and to correlate these findings to the extent of apoptosis in the hippocampus. METHODS: Experimental meningitis in rats was induced by intracisternal injection of live...

  8. Pneumococcal conjugate vaccine – a health priority | Zar | South ...

    African Journals Online (AJOL)

    Streptococcus pneumoniae is the most important bacterial pathogen causing pneumonia in children. The HIV epidemic has increased the burden and severity of childhood pneumococcal pneumonia and invasive disease fortyfold. Pneumococcal conjugate vaccine (PCV) is a highly effective intervention to reduce invasive ...

  9. Patient outcome in adults with pneumococcal meningitis or ...

    African Journals Online (AJOL)

    217 patients with pneumococcal disease were studied over an 18-month period. Among these, 158 of 167 consenting to testing (95%) were HIV positive. Inpatient mortality was 65% for pneumococcal meningitis (n=64), 20% for pneumococcaemic pneumonia (n=92) and 26% for patients with pneumococcaemia without ...

  10. Patient outcome in adults with pneumococcal meningitis or ...

    African Journals Online (AJOL)

    Patient outcome in adults with pneumococcal meningitis or bacteraemia admitted to QECH. Stephen B Gordon. Malawi—Liverpool—Wellcome Trust Clinical Research Programme, Blantyre. Email: sgordon@mlw.medcol.mw. ABSTRACT. Pneumococcal infections are common in Malawian adults. We set out to determine ...

  11. Carriage ofHaernophilus influenzae in Cape Town children

    African Journals Online (AJOL)

    The overall and type b specific carriage rates in normal children (N =107) were 45,8% and 4,7% respectively. The yield following nasopharyngeal culture was twice that following throat culture. (P < 0,001). Children hospitalised with tuberculo- sis (N =62) had significantly greater carriage rates, 66,1% and 37,1% respectively ...

  12. 47 CFR 76.62 - Manner of carriage.

    Science.gov (United States)

    2010-10-01

    ... provided in § 76.64. (b) Each digital television broadcast signal carried shall be carried without material... material. (h) If a digital television broadcast signal is carried in accordance with § 76.62(b) and either... CABLE TELEVISION SERVICE Carriage of Television Broadcast Signals § 76.62 Manner of carriage. (a) Cable...

  13. 47 CFR 76.66 - Satellite broadcast signal carriage.

    Science.gov (United States)

    2010-10-01

    ... digital signals of each television broadcast station that is located in a local market in Alaska or Hawaii... reasonable digital compression techniques in the carriage of local television stations. (2) Satellite... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Carriage of Television Broadcast Signals § 76.66 Satellite...

  14. Streptococcal throat carriage in a population of nursery and primary ...

    African Journals Online (AJOL)

    Background: Group A streptococcus (GAS) is a major cause of mortality in man. Regular disease surveillance can be achieved through evaluation of throat carriage. Objectives: To evaluate GAS throat carriage amongst nursery and primary schools pupils in Benin City, Nigeria. Method: This cross sectional study was carried ...

  15. Immunological role of nasal staphylococcus aureus carriage in ...

    African Journals Online (AJOL)

    raoul

    2008-10-30

    Oct 30, 2008 ... Nasal carriage of staphylococcus aureus (S. aureus) exerts immunomodulatory effects in patients with atopic dermatitis and it may contribute to airway inflammation and allergic response in patients with allergic rhinitis. We investigated the frequency of nasal S. aureus carriage in patients with perennial ...

  16. Nasal carriage of Staphylococcus aureus by members of the ...

    African Journals Online (AJOL)

    hospitalized persons at the University of Port-Harcourt, Port Harcourt, Nigeria, showed that carriage was influenced primarily by age (p=0.0344). Carriage was found to be 50% among primary school pupils, ages 5 to 11 years and 29.4% among ...

  17. Pneumococcal serotype distribution in adults with invasive disease and in carrier children in Italy: Should we expect herd protection of adults through infants' vaccination?

    Science.gov (United States)

    Azzari, Chiara; Cortimiglia, Martina; Nieddu, Francesco; Moriondo, Maria; Indolfi, Giuseppe; Mattei, Romano; Zuliani, Massimo; Adriani, Beatrice; Degl'Innocenti, Roberto; Consales, Guglielmo; Aquilini, Donatella; Bini, Giancarlo; Di Natale, Massimo Edoardo; Canessa, Clementina; Ricci, Silvia; de Vitis, Elisa; Mangone, Giusi; Bechini, Angela; Bonanni, Paolo; Pasinato, Angela; Resti, Massimo

    2016-01-01

    The 7-valent pneumococcal conjugate vaccine (PCV7) produced a significant herd protection in unvaccinated adult population mostly because of pneumococcus carriage decrease in vaccinated children. It is not known if the 13-valent pneumococcal vaccine can give similar effect on adults. Aims of the work were to evaluate whether the 6 additional serotypes are present in nasopharynx of children and serotype distribution in invasive pneumococcal infections (IPD) in adults. Realtime-PCR was used to evaluate pneumococcal serotypes in adults with confirmed IPD and in nasopharyngeal swabs (NP) from 629 children not vaccinated or vaccinated with PCV7 and resident in the same geographical areas. Two hundred twenty-one patients (116 males, median 67.9 years) with IPD were studied (pneumonia n = 103, meningitis n = 61 sepsis n = 50, other n = 7). Two hundred twelve were serotyped. The most frequent serotypes were 3, (31/212; 14.6%), 19A, (19/212; 9.0%), 12 (17/212; 8.0%), 7F, (14/212; 6.6%). In NP of children, the frequency of those serotypes causing over 50% of IPD in adults was very low, ranging from 0.48% for serotype 7F to 7.9% for serotype 19A. On the other side serotype 5, very frequent in NP (18.7%) caused <1% IPD. In conclusion serotypes causing IPD in adults are very rarely found in children NP. We suggest that herd protection obtainable with the additional 6 serotypes included in PCV13 may be more limited than that demonstrated with PCV7 in the past. In order to reduce the burden of disease in adults, adults should be offered a specific vaccination program with highly immunogenic PCV.

  18. A case-control study of mastitis: nasal carriage of Staphylococcus aureus

    Directory of Open Access Journals (Sweden)

    Garland Suzanne M

    2006-10-01

    Full Text Available Abstract Background Mastitis is a common problem for breastfeeding women. Researchers have called for an investigation into the possible role of maternal nasal carriage of S. aureus in the causation of mastitis in breastfeeding women. Methods The aim of the study was to investigate the role of maternal S. aureus nasal carriage in mastitis. Other factors such as infant nasal S. aureus carriage, nipple damage, maternal fatigue and oversupply of milk were also investigated. A case-control design was used. Women with mastitis (cases, n = 100 were recruited from two maternity hospitals in Melbourne, Australia (emergency departments, breastfeeding clinics and postnatal wards. Breastfeeding women without mastitis (controls, n = 99 were recruited from maternal and child health (community centres and the rooms of a private obstetrician. Women completed a questionnaire and nasal specimens were collected from mother and baby and placed in charcoal transport medium. Women also collected a small sample of milk in a sterile jar. Results There was no difference between nasal carriage of S. aureus in breastfeeding women with mastitis (42/98, 43% and control women (45/98, 46%. However, significantly more infants of mothers with mastitis were nasal carriers of S. aureus (72/88, 82% than controls (52/93, 56%. The association was strong (adjusted OR 3.23, 95%CI 1.30, 8.27 after adjustment for the following confounding factors: income, private health insurance, difficulty with breastfeeding, nipple damage and tight bra. There was also a strong association between nipple damage and mastitis (adjusted OR 9.34, 95%CI 2.99, 29.20. Conclusion We found no association between maternal nasal carriage of S. aureus and mastitis, but nasal carriage in the infant was associated with breast infections. As in other studies of mastitis, we found a strong association between nipple damage and mastitis. Prevention of nipple damage is likely to reduce the incidence of infectious

  19. Live attenuated influenza virus increases pneumococcal translocation and persistence within the middle ear.

    Science.gov (United States)

    Mina, Michael J; Klugman, Keith P; Rosch, Jason W; McCullers, Jonathan A

    2015-07-15

    Infection with influenza A virus (IAV) increases susceptibility to respiratory bacterial infections, resulting in increased bacterial carriage and complications such acute otitis media, pneumonia, bacteremia, and meningitis. Recently, vaccination with live attenuated influenza virus (LAIV) was reported to enhance subclinical bacterial colonization within the nasopharynx, similar to IAV. Although LAIV does not predispose to bacterial pneumonia, whether it may alter bacterial transmigration toward the middle ear, where it could have clinically relevant implications, has not been investigated. BALB/c mice received LAIV or phosphate-buffered saline 1 or 7 days before or during pneumococcal colonization with either of 2 clinical isolates, 19F or 7F. Middle ear bacterial titers were monitored daily via in vivo imaging. LAIV increased bacterial transmigration to and persistence within the middle ear. When colonization followed LAIV inoculation, a minimum LAIV incubation period of 4 days was required before bacterial transmigration commenced. While LAIV vaccination is safe and effective at reducing IAV and coinfection with influenza virus and bacteria, LAIV may increase bacterial transmigration to the middle ear and could thus increase the risk of clinically relevant acute otitis media. These data warrant further investigations into interactions between live attenuated viruses and naturally colonizing bacterial pathogens. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  20. Meningococcal carriage in the African meningitis belt

    Science.gov (United States)

    2013-01-01

    A meningococcal serogroup A polysaccharide/tetanus toxoid conjugate vaccine (PsA-TT) (MenAfriVac#x2122;) is being deployed in countries of the African meningitis belt. Experience with other polysaccharide/protein conjugate vaccines has shown that an important part of their success has been their ability to prevent the acquisition of pharyngeal carriage and hence to stop transmission and induce herd immunity. If PsA-TT is to achieve the goal of preventing epidemics, it must be able to prevent the acquisition of pharyngeal carriage as well as invasive meningococcal disease and whether PsA-TT can prevent pharyngeal carriage needs to be determined. To address this issue, a consortium (the African Meningococcal Carriage (MenAfriCar) consortium) was established in 2009 to investigate the pattern of meningococcal carriage in countries of the African meningitis belt prior to and after the introduction of PsA-TT. This article describes how the consortium was established, its objectives and the standardised field and laboratory methods that were used to achieve these objectives. The experience of the MenAfriCar consortium will help in planning future studies on the epidemiology of meningococcal carriage in countries of the African meningitis belt and elsewhere. Un vaccin conjugué contenant un polysaccharide du sérogroupe A méningococcique et une anatoxine du tétanos (PsA-TT) (MenAfriVac™) est en cours de déploiement dans les pays de la ceinture africaine de la méningite. L’ expérience avec d’ autres vaccins conjugués polysaccharide/protéine a montré qu’ une partie importante de leur succès a été leur capacité à empêcher l’ acquisition du portage pharyngé et donc à arrêter la transmission et à induire une immunité de group. Si PsA-TT doit d’ atteindre l’ objectif de prévenir les épidémies, il devrait être en mesure d’ empêcher l’ acquisition du portage pharyngé ainsi que la méningococcie invasive et le fait que PsA-TT puisse emp

  1. [Pneumococcal septic arthritis in HIV infection].

    Science.gov (United States)

    Trivalle, C; Cremieux, A C; Carbon, C

    1995-11-04

    Infections due to pneumococci are frequent in patients infected with the human immunodeficiency virus (HIV), but joint infections are rare. We observed two cases of septic arthritis due to pneumococci in two non-haemophilic HIV seropositive patients. In the first case, a 31-year old drug addict who had undergone splenectomy, developed hip joint infection during an episode of meningitis due to pneumococci. The germ was moderately sensitive to ampicillin. The second case involved the knee joint in a 29-year-old woman who developed pneumococcal pneumonia after a trip to Zaire. In both cases, joint infection developed after antibiotics had been initiated, and in the first case, after the infection appear to be under control. This would be similar to "post-infectious" arthritis described in gonococcal and meningococcal infections. In HIV positive patients, joint infections are rare compared with other types of immunodepression, but can be observed in all stages of the disease. A total of 75 cases have been reported in the literature, including 8 cases due to pneumococci. These joint infections could be another argument in favour of anti-pneumococcal vaccination in HIV positive patients.

  2. Prevalence of MERS-CoV nasal carriage and compliance with the Saudi health recommendations among pilgrims attending the 2013 Hajj.

    Science.gov (United States)

    Memish, Ziad A; Assiri, Abdullah; Almasri, Malak; Alhakeem, Rafat F; Turkestani, Abdulhafeez; Al Rabeeah, Abdullah A; Al-Tawfiq, Jaffar A; Alzahrani, Abdullah; Azhar, Essam; Makhdoom, Hatem Q; Hajomar, Waleed H; Al-Shangiti, Ali M; Yezli, Saber

    2014-10-01

    Annually, Saudi Arabia is the host of the Hajj mass gathering. We aimed to determine the Middle East respiratory syndrome coronavirus (MERS-CoV) nasal carriage rate among pilgrims performing the 2013 Hajj and to describe the compliance with the Saudi Ministry of Health vaccine recommendations. Nasopharyngeal samples were collected from 5235 adult pilgrims from 22 countries and screened for MERS-CoV using reverse transcriptase-polymerase chain reaction. Information regarding the participants' age, gender, country of origin, medical conditions, and vaccination history were obtained. The mean age of the screened population was 51.8 years (range, 18-93 years) with a male/female ratio of 1.17:1. MERS-CoV was not detected in any of the samples tested (3210 pre-Hajj and 2025 post-Hajj screening). According to the vaccination documents, all participants had received meningococcal vaccination and the majority of those from at-risk countries were vaccinated against yellow fever and polio. Only 22% of the pilgrims (17.5% of those ≥65 years and 36.3% of diabetics) had flu vaccination, and 4.4% had pneumococcal vaccination. There was no evidence of MERS-CoV nasal carriage among Hajj pilgrims. While rates of compulsory vaccinations uptake were high, uptake of pneumococcal and flu seasonal vaccinations were low, including among the high-risk population. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  3. Impact of 13-Valent Pneumococcal Conjugate Vaccination in Invasive Pneumococcal Disease Incidence and Mortality

    DEFF Research Database (Denmark)

    Harboe, Zitta Barrella; Dalby, Tine; Weinberger, Daniel M

    2014-01-01

    incidence in the total population after PCV13's introduction, and a 71% reduction (95% CI, 62%-79%) in children aged vaccine effectiveness. We estimated a 28% reduction (95% CI, 18%-37%) in IPD-related 30-day mortality, from 3.4 deaths (95% CI, 3.2-3.6) per 100 000 population......BACKGROUND: The impact of the 13-valent pneumococcal conjugate vaccine (PCV13) at the population level is unclear. We explored PCV13's effect in reducing invasive pneumococcal disease (IPD)-related morbidity and mortality, and whether serotype-specific changes were attributable to vaccination...... conjugate vaccine (PCV7) (2008-2010), and PCV13 (2011-2013) periods were estimated. Predicted incidences of serotypes were estimated controlling for cyclical trends from historical patterns observed during the past 20 years. RESULTS: We observed a 21% reduction (95% confidence interval [CI], 17%-25%) in IPD...

  4. Estimated effect of pneumococcal conjugate vaccination on invasive pneumococcal disease and associated mortality, Denmark 2000-2005

    DEFF Research Database (Denmark)

    Harboe, Zitta B; Valentiner-Branth, Palle; Benfield, Thomas

    2008-01-01

    In order to provide an estimation of the direct and indirect benefits of pneumococcal vaccination with three protein-conjugate pneumococcal vaccines (PCV) we described the epidemiology and mortality from invasive pneumococcal disease (IPD) in Denmark between 2000 and 2005. Approximately 1080 cases......% to 91% depending on the PCV used. The mean mortality proportion after IPD was 18%, with approximately 190 deaths annually. One to two deaths among children younger than 5 years and approximately 50 deaths related to IPD caused by vaccine serotypes among older age groups could be prevented annually...

  5. Comparison of the clinical presentations of Naegleria fowleri primary amoebic meningoencephalitis with pneumococcal meningitis: a case-control study.

    Science.gov (United States)

    Zahid, Mohammad Faizan; Saad Shaukat, Muhammad Hamza; Ahmed, Bilal; Beg, Mohammad Asim; Kadir, Muhammad Masood; Mahmood, Syed Faisal

    2016-08-01

    Primary amoebic meningoencephalitis (PAM) is a rare but fatal infection caused by Naegleria fowleri. The infection is acquired by deep nasal irrigation with infected water. Patients present with signs and symptoms similar to pneumococcal meningitis, leading to delayed diagnosis and treatment and hence high mortality. We conducted a case-control study comparing culture proven cases of PAM with pneumococcal meningitis presenting to our center between April 2008 and September 2014. Only patients with blood and/or cerebrospinal fluid cultures positive for Streptococcus pneumoniae during the same time period were included for comparison. There were 19 cases of PAM and pneumococcal meningitis, each. When comparing PAM with pneumococcal meningitis, patients with PAM were more likely to be male (89.5 vs. 36.8 %), younger (mean age: 30 vs. 59 years), present with seizures (42.1 vs. 5.3 %). Both groups of patients presented with similar vital signs and there were no remarkable differences on physical examinations, Glasgow Coma Scale scores, laboratory and radiological investigations and cerebrospinal fluid parameters. PAM was also more likely to present if the city's average maximum temperature was higher in the previous week (mean: 34.6 vs. 30 °C). There was history of fresh water contact in only one patient. On multivariate analysis, PAM was more likely if patients presented when the city's average maximum temperature was high, being young males. PAM and pneumococcal meningitis remain virtually indistinguishable; however, these predictive features should be validated in a prospective study and may lead to a viable algorithm for early management of these patients.

  6. NNDSS - Table II. Invasive pneumococcal disease, all ages

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table II. Invasive pneumococcal disease, all ages - 2018. In this Table, provisional cases of selected notifiable diseases (≥1,000 cases reported during...

  7. NNDSS - Table II. Invasive Pneumococcal Diseases, All Ages

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table II. Invasive Pneumococcal Diseases, All Ages - 2017. In this Table, provisional cases of selected notifiable diseases (≥1,000 cases reported during...

  8. NNDSS - Table II. Invasive pneumococcal disease, age <5

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table II. Invasive pneumococcal disease, age <5 - 2018. In this Table, provisional cases of selected notifiable diseases (≥1,000 cases reported during...

  9. NNDSS - Table II. Invasive Pneumococcal Diseases, Age <5

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table II. Invasive Pneumococcal Diseases, Age <5 - 2017. In this Table, provisional cases of selected notifiable diseases (≥1,000 cases reported during...

  10. Pneumococcal conjugate vaccine (PCV13) - What you need to know

    Science.gov (United States)

    ... the United States. Treatment of pneumococcal infections with penicillin and other drugs is not as effective as ... Anyone who has ever had a life-threatening allergic reaction to a dose of this vaccine, to an ...

  11. Pneumococcal Conjugate Vaccine (PCV13): What You Need to Know

    Science.gov (United States)

    ... the United States. Treatment of pneumococcal infections with penicillin and other drugs is not as effective as ... Anyone who has ever had a life-threatening allergic reaction to a dose of this vaccine, to an ...

  12. Pneumococcal Polysaccharide Vaccine: What You Need to Know

    Science.gov (United States)

    ... Unite d States. Treatment of pneumococcal infections with penicillin and other drugs used to be more effective. ... get • Anyone who has had a life-threatening allergic reaction to PPSV should not get another dose. • Anyone ...

  13. Staphylococcus aureus nasal carriage in hemodialysis centers of Fez, Morocco

    OpenAIRE

    Idrissa Diawara; Khadija Bekhti; Driss Elhabchi; Rachid Saile; Naima Elmdaghri; Mohammed Timinouni; Mohamed Elazhari

    2014-01-01

    Background and objectives Staphylococcus aureus (S. aureus) nasal carriage may be responsible for some serious infections in hemodialyzed patients. The main target of this study was to estimate the prevalence of S. aureus nasal carriage in hemodialysis outpatients and medical staff in hemodialysis centers specifically in Fez region. The second target is to identify the risks of colonization, resistance pattern of isolates and their virulence toxin genes. Patients and Methods Nasal swab specim...

  14. Traditional Posterior Load Carriage: Ergonomic Assessment and Intervention Efficacy

    OpenAIRE

    Muslim, Khoirul

    2013-01-01

    There is a high prevalence of musculoskeletal symptoms (MSS) among manual material handling (MMH) workers. However, limited investigations have been undertaken among one large group of workers using a particular MMH method called traditional posterior load carriage (PLC). Such load carriage is typically done without the use of an assistive device (e.g., backpack) in developing countries, and involves exposure to known risk factors for MSS such as heavy loads, non-neutral postures, and high ...

  15. Molecular dynamics of Staphylococcus aureus nasal carriage in Hajj pilgrims.

    Science.gov (United States)

    Verhoeven, P O; Gautret, P; Haddar, C H; Benkouiten, S; Gagnaire, J; Belhouchat, K; Grattard, F; Charrel, R; Pozzetto, B; Drali, T; Lucht, F; Brouqui, P; Memish, Z A; Berthelot, P; Botelho-Nevers, E

    2015-07-01

    During the 2012 Hajj season, the risk of acquisition of Staphylococcus aureus nasal carriage in a cohort of French pilgrims was 22.8%, and was statistically associated with the acquisition of viral respiratory pathogens (p 0.03). The carriage of S. aureus belonging to the emerging clonal complex 398 significantly increased following the pilgrimage (p < 0.05). Copyright © 2015 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  16. Detection of Significant Pneumococcal Meningitis Biomarkers by Ego Network.

    Science.gov (United States)

    Wang, Qian; Lou, Zhifeng; Zhai, Liansuo; Zhao, Haibin

    2017-06-01

    To identify significant biomarkers for detection of pneumococcal meningitis based on ego network. Based on the gene expression data of pneumococcal meningitis and global protein-protein interactions (PPIs) data recruited from open access databases, the authors constructed a differential co-expression network (DCN) to identify pneumococcal meningitis biomarkers in a network view. Here EgoNet algorithm was employed to screen the significant ego networks that could accurately distinguish pneumococcal meningitis from healthy controls, by sequentially seeking ego genes, searching candidate ego networks, refinement of candidate ego networks and significance analysis to identify ego networks. Finally, the functional inference of the ego networks was performed to identify significant pathways for pneumococcal meningitis. By differential co-expression analysis, the authors constructed the DCN that covered 1809 genes and 3689 interactions. From the DCN, a total of 90 ego genes were identified. Starting from these ego genes, three significant ego networks (Module 19, Module 70 and Module 71) that could predict clinical outcomes for pneumococcal meningitis were identified by EgoNet algorithm, and the corresponding ego genes were GMNN, MAD2L1 and TPX2, respectively. Pathway analysis showed that these three ego networks were related to CDT1 association with the CDC6:ORC:origin complex, inactivation of APC/C via direct inhibition of the APC/C complex pathway, and DNA strand elongation, respectively. The authors successfully screened three significant ego modules which could accurately predict the clinical outcomes for pneumococcal meningitis and might play important roles in host response to pathogen infection in pneumococcal meningitis.

  17. Invasive pneumococcal infection despite 7-valent conjugated vaccine

    Directory of Open Access Journals (Sweden)

    Sebastien Joye

    2013-03-01

    Full Text Available Despite good cover with 7-valent vaccination, invasive pneumococcal infections may still be misdiagnosed and may lead to lifethreatening situations or death in young children. New serotypes are emerging and, therefore, clinicians must keep a high level of suspicion in young children regardless of their vaccination status. We report three cases of invasive pneumococcal infection due to new serotypes not covered by the 7-valent conjugated vaccine, two of which led children to death.

  18. Macrophage serum markers in pneumococcal bacteremia

    DEFF Research Database (Denmark)

    Møller, Holger Jon; Moestrup, Søren K; Weis, Nina

    2006-01-01

    with pneumococcal bacteremia. DESIGN: Observational cohort study. SETTING: Five university hospitals in Denmark. PATIENTS: A total of 133 patients with Streptococcus pneumoniae bacteremia (positive blood culture) and 133 age- and gender-matched controls. INTERVENTIONS: Samples were collected for biochemical...... analyses at the time of first positive blood culture. MEASUREMENTS AND MAIN RESULTS: sCD163 was highly correlated with other macrophage markers and was significantly elevated (median [25-75 percentiles], 4.6 mg/L [2.8-8.9]) compared with healthy controls (2.7 mg/L [2.1-3.3], p ... were observed in patients who needed intensive care (hemodialysis, p = .0011; hypotension, p = .0014; mechanical ventilation, p = .0019). Significantly lower levels of sCD163, ferritin, transcobalamin, and suPAR (but not C-reactive protein) were measured in patients > or =75 yrs. In patients

  19. Anaphylaxis to the 23-valent pneumococcal vaccine: a second explored case by means of immediate-reading skin tests with pneumococcal vaccines.

    Science.gov (United States)

    Ponvert, C; Scheinmann, P; de Blic, J

    2010-12-06

    Anaphylaxis to pneumococcal vaccines is rare. In the only one child with anaphylaxis to a first injection of the 23-valent pneumococcal vaccine that has been explored, skin tests and specific IgE determination diagnosed immediate-type hypersensitivity to pneumococcal antigens. We report the case of a child who tolerated three injections of the 7-valent pneumococcal vaccine, but experienced anaphylaxis to a fourth injection of the 23-valent vaccine. Immediate responses in skin tests diagnosed immediate-type hypersensitivity to the two vaccines. Immunizations with the 7-valent pneumococcal vaccine may induce IgE-dependent sensitization to pneumococcal antigens, responsible for anaphylaxis to subsequent injections of pneumococcal vaccines. Copyright © 2010 Elsevier Ltd. All rights reserved.

  20. Characterization of a pneumococcal meningitis mouse model

    Directory of Open Access Journals (Sweden)

    Mook-Kanamori Barry

    2012-03-01

    Full Text Available Abstract Background S. pneumoniae is the most common causative agent of meningitis, and is associated with high morbidity and mortality. We aimed to develop an integrated and representative pneumococcal meningitis mouse model resembling the human situation. Methods Adult mice (C57BL/6 were inoculated in the cisterna magna with increasing doses of S. pneumoniae serotype 3 colony forming units (CFU; n = 24, 104, 105, 106 and 107 CFU and survival studies were performed. Cerebrospinal fluid (CSF, brain, blood, spleen, and lungs were collected. Subsequently, mice were inoculated with 104 CFU S. pneumoniae serotype 3 and sacrificed at 6 (n = 6 and 30 hours (n = 6. Outcome parameters were bacterial outgrowth, clinical score, and cytokine and chemokine levels (using Luminex® in CSF, blood and brain. Meningeal inflammation, neutrophil infiltration, parenchymal and subarachnoidal hemorrhages, microglial activation and hippocampal apoptosis were assessed in histopathological studies. Results Lower doses of bacteria delayed onset of illness and time of death (median survival CFU 104, 56 hrs; 105, 38 hrs, 106, 28 hrs. 107, 24 hrs. Bacterial titers in brain and CSF were similar in all mice at the end-stage of disease independent of inoculation dose, though bacterial outgrowth in the systemic compartment was less at lower inoculation doses. At 30 hours after inoculation with 104 CFU of S. pneumoniae, blood levels of KC, IL6, MIP-2 and IFN- γ were elevated, as were brain homogenate levels of KC, MIP-2, IL-6, IL-1β and RANTES. Brain histology uniformly showed meningeal inflammation at 6 hours, and, neutrophil infiltration, microglial activation, and hippocampal apoptosis at 30 hours. Parenchymal and subarachnoidal and cortical hemorrhages were seen in 5 of 6 and 3 of 6 mice at 6 and 30 hours, respectively. Conclusion We have developed and validated a murine model of pneumococcal meningitis.

  1. Fecal carriage of extended-spectrum β-lactamase-producing Enterobacteriaceae in Korean community and hospital settings.

    Science.gov (United States)

    Ko, Y J; Moon, H-W; Hur, M; Park, C-M; Cho, S E; Yun, Y-M

    2013-02-01

    The assessment and early recognition of risk factors for infections due to extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) are important for infection control and proper treatment. The aim of the present study was to investigate the prevalence of fecal carriage of ESBL-E in healthy individuals and hospitalized high-risk patients in Korea and to compare the characteristics of ESBL-E in these two groups. A total of 384 samples from 290 healthy individuals and 94 high-risk patients were collected. The screening of ESBL-E was performed using a commercial chromogenic medium. Bacterial identification and antibiotic susceptibility testing were performed using the Vitek 2 system. The prevalence of ESBL-E carriage was 20.3 % in healthy individuals and 42.5 % in high-risk patients. Escherichia coli comprised a large majority (96.6 %) of the isolates from healthy individuals, but Klebsiella pneumoniae was more commonly detected (45.0 %) in high-risk patients than in healthy individuals. K. pneumoniae isolates exhibited significantly higher resistance to ceftazidime, ampicillin, and carbapenem, and E. coli exhibited higher resistance to cefotaxime. E. coli from high-risk patients exhibited significantly higher resistance to levofloxacin and cefepime than that from healthy individuals. We demonstrated the high prevalence of ESBL-E carriage in Korea and clarified the characteristics of ESBL-E carriage in healthy individuals and high-risk patients. The distribution and antibiotic susceptibility of colonizing ESBL-E were different between the group of healthy individuals and the high-risk patients. Active surveillance of ESBL-E carriage is suggested for infection control, and the use of chromogenic agar appears to be an efficient method.

  2. Pitfalls in the Diagnosis and Management of Invasive Pneumococcal Meningoencephalitis – What We Can Learn From a Case

    Directory of Open Access Journals (Sweden)

    Pascale S Grzonka

    2017-08-01

    Full Text Available Invasive pneumococcal meningitis is a life-threatening infectious disease affecting the central nervous system. It continues to be the most common type of community-acquired acute bacterial meningitides. Despite advances in neuro-critical care, the case fatality rate remains high. Rapid diagnosis and initiation of antibiotic therapy precludes mortality and long-term neurological sequelae in survivors. However, not all cases are easily recognised, and unanticipated complications may impede optimal course and outcome. Here, we describe a case of invasive pneumococcal meningoencephalitis in a 65-year-old man with an unusual initial presentation and pitfalls in the course of the disease. We highlight the importance of early diagnosis and treatment as well as recognition and management of complications.

  3. Pitfalls in the Diagnosis and Management of Invasive Pneumococcal Meningoencephalitis - What We Can Learn From a Case.

    Science.gov (United States)

    Grzonka, Pascale S; Sutter, Raoul

    2017-01-01

    Invasive pneumococcal meningitis is a life-threatening infectious disease affecting the central nervous system. It continues to be the most common type of community-acquired acute bacterial meningitides. Despite advances in neuro-critical care, the case fatality rate remains high. Rapid diagnosis and initiation of antibiotic therapy precludes mortality and long-term neurological sequelae in survivors. However, not all cases are easily recognised, and unanticipated complications may impede optimal course and outcome. Here, we describe a case of invasive pneumococcal meningoencephalitis in a 65-year-old man with an unusual initial presentation and pitfalls in the course of the disease. We highlight the importance of early diagnosis and treatment as well as recognition and management of complications.

  4. [Pneumococcal vaccination coverage in at-risk children in Catalonia].

    Science.gov (United States)

    González, Roser; Armadans, Lluís; Martínez, Xavier; Moraga, Fernando; Campins, Magda

    2015-11-01

    The public health system in Catalonia only funds pneumococcal vaccination in paediatrics for children at-risk. The aim of this study was to determine pneumococcal vaccination coverage and its association with age, sociodemographic factors and other variables. Descriptive cross-sectional study of children aged between 2 months and 15 years old assigned to primary care centres in Catalonia and with diseases that are included for pneumococcal vaccine in the official vaccination program. The information on vaccination status and study variables were obtained from data registered in the electronic medical records in the primary care centres. An analysis was made of the association between pneumococcal vaccination and demographic and medical variables using bivariate analysis and a multiple logistic regression model. The adjusted odds ratio (aOR), with a confidence interval of 95%, was used to measure the relationships. Pneumococcal vaccination coverage was 47.7%. Variables which predicted pneumococcal vaccination were: age (aOR: 9.2 [7.9-10.7] in children 2 months-2 years old; aOR 8.1 [7.0-9.3] in children 3-5 years; aOR: 4.6 [4.0-5.2] in children 6-10 years), Spanish nationality (aOR: 3.9 [3.5-4.3]), correct immunisation according to systematic immunisation schedule (aOR: 2.5 [2.1-3.0]), and number of risk conditions (aOR: 3.2 [2.5-4.1] in children with 2 or more conditions). Pneumococcal vaccination coverage in children with risk conditions is low in Catalonia. Strategies need to be implemented to increase coverage. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  5. Pediatric Acute Otitis Media in the Era of Pneumococcal Vaccination.

    Science.gov (United States)

    Tawfik, Kareem O; Ishman, Stacey L; Altaye, Mekibib; Meinzen-Derr, Jareen; Choo, Daniel I

    2017-05-01

    Objectives (1) Describe longitudinal trends in annual prevalence of hospital admission for pediatric acute otitis media (AOM) and complications of AOM (CAOM) since introduction of pneumococcal vaccination in 2000 and (2) describe the longitudinal trend of prevalence of hospital admission for pneumococcal meningitis in children with AOM-related diagnoses in the postvaccination era. Study Design Retrospective analysis of Kids' Inpatient Database from 2000 to 2012. Setting Community, nonrehabilitation hospitals. Subjects and Methods To determine annual prevalence of admission for AOM/CAOM, nationally weighted frequencies of children aged media, acute mastoiditis, suppurative labyrinthitis, and/or acute petrositis were collected. The frequency of coexisting pneumococcal meningitis diagnoses among these patients was also collected. Trend analysis of prevalences of admission for AOM/CAOM and for pneumococcal meningitis occurring in the setting of AOM/CAOM from 2000 to 2012 was performed. Results Between 2000 and 2012, annual prevalence of admission for AOM/CAOM decreased from 3.956 to 2.618 per 100,000 persons ( P < .0001) (relative risk reduction 34%). Declines in admission prevalence were most pronounced in children <1 year of age (from 22.647 to 8.715 per 100,000 persons between 2000 and 2012, P < .0001) and 1 to 2 years of age (from 13.652 to 5.554 per 100,000 persons between 2000 and 2012, P < .0001). For all ages, the admission prevalence for pneumococcal meningitis and concomitant AOM/CAOM decreased (from 1.760 to 0.717 per 1,000,000 persons, P < .0001) over the study period. Conclusions The prevalence of hospital admission for pediatric AOM/CAOM has declined since the advent of pneumococcal vaccination. Admission rates for pneumococcal meningitis with AOM/CAOM have similarly declined.

  6. Adult survivors of invasive pneumococcal disease exhibit defective B cell function.

    Science.gov (United States)

    Darton, Tom C; Wing, James B; Lees, Andrew; Heath, Andrew W; Read, Robert C

    2011-05-01

    Adults who have recovered from an episode of invasive pneumococcal disease demonstrate defective B cell activation in response to αδ-dex, a polyclonal polysaccharide mimic, compared with matched control subjects. The defect is not overcome by CD4(+) T cell assistance and may explain the relatively poor response to pneumococcal vaccination in survivors of invasive pneumococcal disease.

  7. Long-term mortality after IPD and bacteremic versus non-bacteremic pneumococcal pneumonia

    NARCIS (Netherlands)

    Wagenvoort, Gertjan H J; Sanders, Elisabeth A M; de Melker, Hester E.; van der Ende, Arie; Vlaminckx, Bart J.; Knol, Mirjam J.

    2017-01-01

    Background Short-term mortality after invasive pneumococcal disease (IPD) and pneumococcal pneumonia is high but data on long-term mortality (including the comparison between bacteremic and non-invasive/non-bacteremic pneumococcal pneumonia) within the first years after diagnosis are scarce. Methods

  8. Long-term mortality after IPD and bacteremic versus non-bacteremic pneumococcal pneumonia

    NARCIS (Netherlands)

    Wagenvoort, Gertjan H. J.; Sanders, Elisabeth A. M.; de Melker, Hester E.; van der Ende, Arie; Vlaminckx, Bart J.; Knol, Mirjam J.

    2017-01-01

    Short-term mortality after invasive pneumococcal disease (IPD) and pneumococcal pneumonia is high but data on long-term mortality (including the comparison between bacteremic and non-invasive/non-bacteremic pneumococcal pneumonia) within the first years after diagnosis are scarce. Adult patients

  9. MRSA carriage in healthcare personnel in contact with farm animals.

    Science.gov (United States)

    Wulf, M W H; Tiemersma, E; Kluytmans, J; Bogaers, D; Leenders, A C A P; Jansen, M W H; Berkhout, J; Ruijters, E; Haverkate, D; Isken, M; Voss, A

    2008-10-01

    In The Netherlands it has been shown that people in contact with pigs have a higher risk of meticillin-resistant Staphylococcus aureus (MRSA) carriage than the general population. Isolates of closely related spa types, corresponding to multilocus sequence type (MLST) ST398, were found in pig farmers, pig veterinarians and pigs. The objective of this study was to investigate whether contact with pigs and veal calves or other livestock is a risk factor for MRSA carriage in Dutch healthcare workers (HCWs). HCWs at four general hospitals and one university hospital were asked to fill in questionnaires covering contact with animals and to take MRSA cultures of their throat and nares. Cultures of HCWs in contact with livestock were processed with samples from HCWs with no contact with livestock as controls. Seventy-seven of 1721 HCWs (4.4%) reported direct or indirect contact with pigs and/or veal calves and 145 reported contact with other livestock animals. The MRSA carriage rate in the group in contact with pigs and veal calves was 1.7% and in the control group was 0.15%. No carriers were found among HCWs in contact with other livestock. An estimated 3% of hospital staff working in Dutch hospitals serving rural populations belong to a high risk group for MRSA carriage according to the Dutch guidelines. Although MRSA carriage in HCWs in contact with livestock is 10-fold higher than in other HCWs, the difference is not statistically significant.

  10. Healthcare Workers’ Hand Microbiome May Mediate Carriage of Hospital Pathogens

    Directory of Open Access Journals (Sweden)

    Mariana Rosenthal

    2013-12-01

    Full Text Available One function of skin microbiota is to resist colonization and infection by external microorganisms. We sought to detect whether the structure of the hand microbiota of 34 healthcare workers (HCW in a surgical intensive care unit mediates or modifies the relationship between demographic and behavioral factors and potential pathogen carriage on hands after accounting for pathogen exposure. We used a taxonomic screen (16S rRNA to characterize the bacterial community, and qPCR to detect presence of Staphylococcus aureus, Enterococcus spp., methicillin-resistant Staphylococcus aureus (MRSA, and Candida albicans on their dominant hands. Hands were sampled weekly over a 3-week period. Age, hand hygiene, and work shift were significantly associated with potential pathogen carriage and the associations were pathogen dependent. Additionally, the overall hand microbiota structure was associated with the carriage of potential pathogens. Hand microbiota community structure may act as a biomarker of pathogen carriage, and modifying that structure may potentially limit pathogen carriage among HCW.

  11. Screening Adolescents in the Emergency Department for Weapon Carriage

    Science.gov (United States)

    Cunningham, Rebecca M.; Resko, Stella M.; Harrison, Stephanie Roahen; Zimmerman, Marc; Stanley, Rachel; Chermack, Stephen T.; Walton, Maureen A.

    2010-01-01

    Objective To describe prevalence and correlates of past year weapon involvement among adolescents seeking care in an inner-city ED. Methods This cross-sectional study administered a computerized survey to all eligible adolescents (age 14–18), seven days a week seeking care in the ED over an 18 month period in an inner-city Level 1 ED. Validated measures were administered including measures of demographics, sexual activity, substance use, injury, violent behavior and weapon carriage/use. Results Adolescents (N=2069, 86% response rate) completed the computerized survey. 55% were female; 56.5% were African American. In the past year, 20% of adolescents reported knife/razor carriage, 7% reported gun carriage, and 6% pulled a knife/gun on someone; zero-inflated Poisson (ZIP) regression models were used to identify correlates of the occurrence and past year frequency of these weapon variables. Although gun carriage was more frequent among males, females were as likely to carry a knife or pull a weapon in the past year. Conclusions One fifth of all adolescent’s seeking care in this inner city ED have carried a weapon. Understanding weapon carriage among teens seeking ED care is a critical first step to future ED based injury prevention initiatives. PMID:20370746

  12. Natural antibodies against several pneumococcal virulence proteins in children during the pre-pneumococcal-vaccine era: the generation R study.

    Science.gov (United States)

    Lebon, Ankie; Verkaik, Nelianne J; Labout, Joost A M; de Vogel, Corné P; Hooijkaas, Herbert; Verbrugh, Henri A; van Wamel, Willem J B; Jaddoe, Vincent W V; Hofman, Albert; Hermans, Peter W M; Ma, Jiangtao; Mitchell, Tim J; Moll, Henriette A; van Belkum, Alex

    2011-04-01

    The currently available pneumococcal vaccines do not protect against all serotypes of Streptococcus pneumoniae. A shift toward nonvaccine serotypes causing colonization and invasive disease has occurred, and studies on protein-based vaccines have been undertaken. We assessed the association between specific antibodies against pneumococcal virulence proteins and colonization and respiratory tract infections (RTIs). Additionally, we assessed the extent to which colonization induces a humoral immune response. Nasopharyngeal swabs collected from children at 1.5, 6, 14, and 24 months of age were cultured for pneumococcus. Serum samples were obtained at birth and at 6, 14, and 24 months (n = 57 children providing 177 serum samples). Data were collected prior to the pneumococcal vaccine era. IgG, IgA, and IgM levels against 17 pneumococcal protein vaccine candidates were measured using a bead-based flow cytometry technique (xMAP; Luminex Corporation). Information regarding RTIs was questionnaire derived. Levels of IgG against all proteins were high in cord blood, decreased in the first 6 months and increased again thereafter, in contrast to the course of IgA and IgM levels. Specific antibodies were induced upon colonization. Increased levels of IgG against BVH-3, NanA, and SP1003 at 6 months, NanA, PpmA, PsaA, SlrA, SP0189, and SP1003 at 14 months, and SlrA at 24 months were associated with a decreased number of RTIs in the third year of life but not with colonization. Maternal antipneumococcal antibodies did not protect against pneumococcal colonization and infection. Certain antibodies against pneumococcal virulence proteins, some of which are induced by colonization, are associated with a decreased number of RTIs in children. This should be taken into account in future pneumococcal vaccine studies.

  13. Natural Antibodies against Several Pneumococcal Virulence Proteins in Children during the Pre-Pneumococcal-Vaccine Era: the Generation R Study▿

    Science.gov (United States)

    Lebon, Ankie; Verkaik, Nelianne J.; Labout, Joost A. M.; de Vogel, Corné P.; Hooijkaas, Herbert; Verbrugh, Henri A.; van Wamel, Willem J. B.; Jaddoe, Vincent W. V.; Hofman, Albert; Hermans, Peter W. M.; Ma, Jiangtao; Mitchell, Tim J.; Moll, Henriette A.; van Belkum, Alex

    2011-01-01

    The currently available pneumococcal vaccines do not protect against all serotypes of Streptococcus pneumoniae. A shift toward nonvaccine serotypes causing colonization and invasive disease has occurred, and studies on protein-based vaccines have been undertaken. We assessed the association between specific antibodies against pneumococcal virulence proteins and colonization and respiratory tract infections (RTIs). Additionally, we assessed the extent to which colonization induces a humoral immune response. Nasopharyngeal swabs collected from children at 1.5, 6, 14, and 24 months of age were cultured for pneumococcus. Serum samples were obtained at birth and at 6, 14, and 24 months (n = 57 children providing 177 serum samples). Data were collected prior to the pneumococcal vaccine era. IgG, IgA, and IgM levels against 17 pneumococcal protein vaccine candidates were measured using a bead-based flow cytometry technique (xMAP; Luminex Corporation). Information regarding RTIs was questionnaire derived. Levels of IgG against all proteins were high in cord blood, decreased in the first 6 months and increased again thereafter, in contrast to the course of IgA and IgM levels. Specific antibodies were induced upon colonization. Increased levels of IgG against BVH-3, NanA, and SP1003 at 6 months, NanA, PpmA, PsaA, SlrA, SP0189, and SP1003 at 14 months, and SlrA at 24 months were associated with a decreased number of RTIs in the third year of life but not with colonization. Maternal antipneumococcal antibodies did not protect against pneumococcal colonization and infection. Certain antibodies against pneumococcal virulence proteins, some of which are induced by colonization, are associated with a decreased number of RTIs in children. This should be taken into account in future pneumococcal vaccine studies. PMID:21282409

  14. Optical carriage for laser-induced fluorescence in a magnetized plasma

    Science.gov (United States)

    Anderegg, F.; Paris, P. J.; Skiff, F.; Good, T. N.; Tran, M. Q.

    1988-10-01

    An ``optical carriage'' has been developed to improve plasma access for LIF diagnostics. Laser light inducing the fluorescence is transported through an optical fiber to the carriage. A telescope fixed on the carriage collects the plasma fluorescence light and sends it through a fiber bundle to an external PMT. The whole carriage is mounted on rails and can be scanned along and across the magnetic field.

  15. The potential for pneumococcal vaccination in Hajj pilgrims: expert opinion.

    Science.gov (United States)

    Rashid, Harunor; Abdul Muttalif, Abdul Razak; Mohamed Dahlan, Zuraimi Bin; Djauzi, Samsuridjal; Iqbal, Zafar; Karim, Hj Matnoh; Naeem, Syed Muhammad; Tantawichien, Terapong; Zotomayor, Ricardo; Patil, Shilpa; Schmitt, Heinz-Josef

    2013-01-01

    Hajj is the annual pilgrimage to Mecca in the Kingdom of Saudi Arabia, and is one of the largest mass gathering events in the world. Acute respiratory tract infections are very common during Hajj, primarily as a result of close contact among pilgrims, intense congestion, shared accommodation and air pollution. A number of vaccines are (or have been) recommended for Hajj pilgrims in recent years. Several additional vaccines could significantly reduce the morbidity and mortality at Hajj and should be considered in health recommendations for pilgrims. Pneumococcal vaccines (particularly for those aged >65 years) are widely available, and have been shown to reduce the burden of disease associated with Streptococcus pneumoniae infection. Importantly, a considerable percentage of Hajj pilgrims have pre-existing illnesses or are elderly, both important risk factors for pneumococcal infection. While there are substantial gaps that need to be addressed regarding our knowledge of the exact burden of disease in Hajj pilgrims and the effectiveness of pneumococcal vaccination in this population, S. pneumoniae may be an important cause of illness among this group of travelers. It can be assumed that the majority of pneumococcal serotypes circulating during Hajj are included in the existing pneumococcal vaccines. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Pneumococcal Conjugate Vaccines and Otitis Media: An Appraisal of the Clinical Trials

    Science.gov (United States)

    Fletcher, Mark A.; Fritzell, Bernard

    2012-01-01

    Streptococcus pneumoniae is the predominant otitis media pathogen and its prevention through effective vaccination could diminish childhood illness and antibiotic use. This paper reviews 5 pneumococcal conjugate vaccine (PCV) trials that used otitis media as an endpoint: Northern California Kaiser Permanente (NCKP; vaccine, 7-valent PCV [PCV7]-CRM); Finnish Otitis Media (FinOM; vaccines, PCV7-CRM or PCV7-OMPC); Native American Trial (vaccine, PCV7-CRM); Pneumococcal Otitis Efficacy Trial (POET; vaccine, 11-valent PCV [PCV11]-PD). For the microbiological endpoint, vaccine efficacy against vaccine-serotype pneumococcal otitis media was about 60% across trials. Against the clinical endpoint of all episodes, vaccine efficacy was 7% (PCV7-CRM/NCKP), 6% (PCV7-CRM/FinOM), −1% (PCV7-OMPC/FinOM), and −0.4% (PCV7-CRM/Native American Trial); 34% against first episodes of ear, nose, and throat specialist-referral cases (PCV11-PD/POET). Both follow-up through 2 years of age, for the 5 trials, and long-term follow-up, for PCV7-CRM/NCKP and PCV7-CRM/FinOM, demonstrated greater vaccine efficacy against recurrent AOM and tympanostomy-tube placement, suggesting that vaccination against early episodes of AOM may prevent subsequent episodes of complicated otitis media. Although study designs varied by primary endpoint measured, age at follow-up, source of middle-ear fluid for culture, case ascertainment, and type of randomization, each clinical trial demonstrated vaccine efficacy against microbiological and/or clinical otitis media. PMID:22701486

  17. Soldier occupational load carriage: a narrative review of associated injuries.

    Science.gov (United States)

    Orr, Robin Marc; Pope, Rodney; Johnston, Venerina; Coyle, Julia

    2014-01-01

    This narrative review examines injuries sustained by soldiers undertaking occupational load carriage tasks. Military soldiers are required to carry increasingly heavier occupational loads. These loads have been found to increase the physiological cost to the soldier and alter their gait mechanics. Aggregated research findings suggest that the lower limbs are the most frequent anatomical site of injury associated with load carriage. While foot blisters are common, other prevalent lower limb injuries include stress fractures, knee and foot pain, and neuropathies, like digitalgia and meralgia. Shoulder neuropathies (brachial plexus palsy) and lower back injuries are not uncommon. Soldier occupational load carriage has the potential to cause injuries that impact on force generation and force sustainment. Through understanding the nature of these injuries targeted interventions, like improved physical conditioning and support to specialised organisations, can be employed.

  18. Immunological role of nasal staphylococcus aureus carriage in patients with persistent allergic rhinitis

    Directory of Open Access Journals (Sweden)

    Mohamed Yousif Atia

    2008-10-01

    Full Text Available Nasal carriage of staphylococcus aureus (S.aureus exerts immunomodulatory effect in patients with atopic dermatitis and it may contribute to airway inflammation and allergic response in patients with allergic rhinitis. We Aim to investigate the frequency of nasal S.aureus carriage in patients with persistent allergic rhinitis and its possible influence on their symptoms and immune markers. We chosed 20 non smoker patients with house dust mite (HDM allergy causing allergic rhinitis and 20 non smoker healthy subjects matched for age and sex. For all subjects rhinoscopy was done, skin prick test, nasal culture for S.aureus, nasal interleukin 4,nasal total IgE, serum total IgE and serum specific IgE(SSIgE for HDM. Nasal S.aureus was detected in 16/20 patients (80% and 5/20 (25% in healthy subjects with highly significant statistical difference plt0.01. Correlation of nasal staph.aureus count and different systemic and local immune markers revealed highly significant positive correlation between nasal S.aureus count and serum total IgE (r = 0.78, plt0.01 and significant positive correlation with SSIgE (HDM (r = 0.53, plt0.05, nasal total IgE (r = 0.39, plt0.05 and nasal IL-4 (r = 0.55, plt0.05. Nasal staph.aureus actively modulated the immune reaction in persistent allergic rhinitis patients by promoting local IgE production, so we recommend early detection and treatment of S.aureus carriage in patients

  19. Bacteremia causes hippocampal apoptosis in experimental pneumococcal meningitis

    DEFF Research Database (Denmark)

    Andersen, Christian Østergaard; Leib, S.L.; Rowland, Ian J

    2010-01-01

    by antibody treatment resulted in significantly reduced apoptosis (0.08 (0.02-0.20), P=0.01) as compared to meningitis. CONCLUSIONS: Our results demonstrate that bacteremia accompanying meningitis plays an important role in the development of hippocampal injury in pneumococcal meningitis.......ABSTRACT: BACKGROUND: Bacteremia and systemic complications both play important roles in brain pathophysiological alterations and the outcome of pneumococcal meningitis. Their individual contributions to the development of brain damage, however, still remain to be defined. METHODS: Using an adult...... rat pneumococcal meningitis model, the impact of bacteremia accompanying meningitis on the development of hippocampal injury was studied. The study comprised of the three groups: I. Meningitis (n=11), II. meningitis with attenuated bacteremia resulting from iv injection of serotype...

  20. Recurrent pneumococcal meningitis in a splenectomised HIV-infected patient

    Directory of Open Access Journals (Sweden)

    Quesne Gilles

    2003-11-01

    Full Text Available Abstract Background Streptococcus pneumoniae is a major cause of human disease, especially in pre-school children and elderly people, as well as in special risk groups such as asplenic, antibody deficient patients, or presenting disruption of natural barriers. The occurrence of pneumococcal disease has increased with the onset of the HIV epidemic and the emergence of drug-resistance. Case presentation We report the case of an HIV-1-infected patient who experienced three episodes of recurrent pneumococcal meningitis over a 4-year period, despite chemoprophylaxis and capsular vaccination. Conclusions Efficacy of anti-pneumococcal chemoprophylaxis and vaccination in HIV-infected patients are discussed in the light of this particular case.

  1. Evolution of pneumococcal infections in adult patients during a four-year period after vaccination of a pediatric population with 13-valent pneumococcal conjugate vaccine

    OpenAIRE

    Payeras, Antoni; Villoslada, Aroa; Garau, Margarita; Salvador, Mª. Neus; Gallegos, Mª. Carmen

    2015-01-01

    Objectives: To describe the distribution of vaccine and non-vaccine pneumococcal serotypes from adult patients for different clinical scenarios, after the introduction of the 13-valent pneumococcal conjugate vaccine (PCV-13) for children. Methods: This was a prospective study of pneumococcal infections in adult patients (January 2010 to April 2014) in Hospital Son Llàtzer, Mallorca (Spain). Two different periods of time were compared, the first before (first period) and the second after (s...

  2. TNF-related apoptosis-inducing ligand (TRAIL) exerts therapeutic efficacy for the treatment of pneumococcal pneumonia in mice.

    Science.gov (United States)

    Steinwede, Kathrin; Henken, Stefanie; Bohling, Jennifer; Maus, Regina; Ueberberg, Bianca; Brumshagen, Christina; Brincks, Erik L; Griffith, Thomas S; Welte, Tobias; Maus, Ulrich A

    2012-10-22

    Apoptotic death of alveolar macrophages observed during lung infection with Streptococcus pneumoniae is thought to limit overwhelming lung inflammation in response to bacterial challenge. However, the underlying apoptotic death mechanism has not been defined. Here, we examined the role of the TNF superfamily member TNF-related apoptosis-inducing ligand (TRAIL) in S. pneumoniae-induced macrophage apoptosis, and investigated the potential benefit of TRAIL-based therapy during pneumococcal pneumonia in mice. Compared with WT mice, Trail(-/-) mice demonstrated significantly decreased lung bacterial clearance and survival in response to S. pneumoniae, which was accompanied by significantly reduced apoptosis and caspase 3 cleavage but rather increased necrosis in alveolar macrophages. In WT mice, neutrophils were identified as a major source of intraalveolar released TRAIL, and their depletion led to a shift from apoptosis toward necrosis as the dominant mechanism of alveolar macrophage cell death in pneumococcal pneumonia. Therapeutic application of TRAIL or agonistic anti-DR5 mAb (MD5-1) dramatically improved survival of S. pneumoniae-infected WT mice. Most importantly, neutropenic mice lacking neutrophil-derived TRAIL were protected from lethal pneumonia by MD5-1 therapy. We have identified a previously unrecognized mechanism by which neutrophil-derived TRAIL induces apoptosis of DR5-expressing macrophages, thus promoting early bacterial killing in pneumococcal pneumonia. TRAIL-based therapy in neutropenic hosts may represent a novel antibacterial treatment option.

  3. TNF-related apoptosis-inducing ligand (TRAIL) exerts therapeutic efficacy for the treatment of pneumococcal pneumonia in mice

    Science.gov (United States)

    Steinwede, Kathrin; Henken, Stefanie; Bohling, Jennifer; Maus, Regina; Ueberberg, Bianca; Brumshagen, Christina; Brincks, Erik L.; Griffith, Thomas S.; Welte, Tobias

    2012-01-01

    Apoptotic death of alveolar macrophages observed during lung infection with Streptococcus pneumoniae is thought to limit overwhelming lung inflammation in response to bacterial challenge. However, the underlying apoptotic death mechanism has not been defined. Here, we examined the role of the TNF superfamily member TNF-related apoptosis-inducing ligand (TRAIL) in S. pneumoniae–induced macrophage apoptosis, and investigated the potential benefit of TRAIL-based therapy during pneumococcal pneumonia in mice. Compared with WT mice, Trail−/− mice demonstrated significantly decreased lung bacterial clearance and survival in response to S. pneumoniae, which was accompanied by significantly reduced apoptosis and caspase 3 cleavage but rather increased necrosis in alveolar macrophages. In WT mice, neutrophils were identified as a major source of intraalveolar released TRAIL, and their depletion led to a shift from apoptosis toward necrosis as the dominant mechanism of alveolar macrophage cell death in pneumococcal pneumonia. Therapeutic application of TRAIL or agonistic anti-DR5 mAb (MD5-1) dramatically improved survival of S. pneumoniae–infected WT mice. Most importantly, neutropenic mice lacking neutrophil-derived TRAIL were protected from lethal pneumonia by MD5-1 therapy. We have identified a previously unrecognized mechanism by which neutrophil-derived TRAIL induces apoptosis of DR5-expressing macrophages, thus promoting early bacterial killing in pneumococcal pneumonia. TRAIL-based therapy in neutropenic hosts may represent a novel antibacterial treatment option. PMID:23071253

  4. A functional variant in TIRAP, also known as MAL, and protection against invasive pneumococcal disease, bacteraemia, malaria and tuberculosis

    Science.gov (United States)

    Khor, Chiea C.; Chapman, Stephen J.; Vannberg, Fredrik O; Dunne, Aisling; Murphy, Caroline; Ling, Edmund Y; Frodsham, Angela J.; Walley, Andrew J; Kyrieleis, Otto; Khan, Amir; Aucan, Christophe; Segal, Shelley; Moore, Catrin E.; Knox, Kyle; Campbell, Sarah J.; Lienhardt, Christian; Scott, Anthony; Aaby, Peter; Sow, Oumou Y.; Grignani, Robert T.; Sillah, Jackson; Sirugo, Girogio; Peshu, Nobert; Williams, Thomas N.; Maitland, Kathryn; Davies, Robert J. O.; Kwiatkowski, Dominic P.; Day, Nicholas P.; Yala, Djamel; Crook, Derrick W.; Marsh, Kevin; Berkley, James A; O’Neill, Luke A.J.; Hill, Adrian V. S.

    2009-01-01

    Toll-like receptors (TLRs) and members of their signalling pathway play an important role in the initiation of the innate immune response to a wide variety of pathogens1,2,3. The adaptor protein TIRAP mediates downstream signalling of TLR-2 and -44,5,6. We report a case-control genetic association study of 6106 individuals from Gambia, Kenya, United Kingdom, and Vietnam, with invasive pneumococcal disease, bacteraemia, malaria and tuberculosis. Thirty-three SNPs were genotyped, including TIRAP S180L. Heterozygous carriage of this variant was found to associate independently with all four infectious diseases in the different study populations (P=0.003, OR=0.59, 95%CI 0.42-0.83 for IPD; P=0.003, OR=0.40, 95%CI 0.21-0.77 for bacteraemia; P=0.002, OR=0.47, 95%CI 0.28-0.76 for malaria; P=0.008, OR=0.23 95%CI 0.07-0.73 for tuberculosis). Substantial support for a protective effect of S180L heterozygosity against infectious diseases was observed when the study groups were combined (N=6106, Overall P≤9.6×10-8). Tirap S180L was also shown to be functionally impaired in TLR2 signal transduction. PMID:17322885

  5. Estimated effect of pneumococcal conjugate vaccination on invasive pneumococcal disease and associated mortality, Denmark 2000-2005

    DEFF Research Database (Denmark)

    Harboe, Z.B.; Valentiner-Branth, P.; Benfield, T.L.

    2008-01-01

    % to 91% depending on the PCV used. The mean mortality proportion after IPD was 18%, with approximately 190 deaths annually. One to two deaths among children younger than 5 years and approximately 50 deaths related to IPD caused by vaccine serotypes among older age groups could be prevented annually......In order to provide an estimation of the direct and indirect benefits of pneumococcal vaccination with three protein-conjugate pneumococcal vaccines (PCV) we described the epidemiology and mortality from invasive pneumococcal disease (IPD) in Denmark between 2000 and 2005. Approximately 1080 cases...... were registered annually during the period. The overall incidence of IPD increased significantly, from 15.4 cases per 100,000 population in 2000 to 20.7 cases per 100,000 in 2005 (pchildren under 5 years varied from 64...

  6. Antibody Response is More Likely to Pneumococcal Proteins Than to Polysaccharide After HIV-associated Invasive Pneumococcal Disease

    DEFF Research Database (Denmark)

    Kantsø, Bjørn; Green, Nicola; Goldblatt, David

    2015-01-01

    BACKGROUND: Human immunodeficiency virus (HIV)-infected individuals are at increased risk of invasive pneumococcal disease (IPD). In order to assess the immunogenicity of pneumococcal proteins and polysaccharide, we investigated protein and serotype-specific antibody responses after HIV......-associated IPD. METHODS: Specific antipneumococcal immunoglobulin G to 27 pneumococcal protein antigens and 30 serotype polysaccharides was measured in plasma before and after IPD in HIV-infected individuals and compared to HIV-infected individuals without IPD. RESULTS: Over time, 81% of IPD cases responded...... to at least 1 protein compared to 51% of non-IPD controls. HIV IPD cases responded to more proteins than non-IPD controls (8.6 ± 8.4 vs 4.2 ± 7.6 proteins; P = .01), and had a significantly higher probability of yielding an antibody response to the proteins PiaA, PsaA, and PcpA. Twenty-two percent of HIV...

  7. V-akt murine thymoma viral oncogene homolog 3 (AKT3) contributes to poor disease outcome in humans and mice with pneumococcal meningitis.

    Science.gov (United States)

    Valls Serón, Mercedes; Ferwerda, Bart; Engelen-Lee, JooYeon; Geldhoff, Madelijn; Jaspers, Valery; Zwinderman, Aeilko H; Tanck, Michael W; Baas, Frank; van der Ende, Arie; Brouwer, Matthijs C; van de Beek, Diederik

    2016-05-18

    Pneumococcal meningitis is the most common and severe form of bacterial meningitis. Fatality rates are substantial, and long-term sequelae develop in about half of survivors. Here, we have performed a prospective nationwide genetic association study using the Human Exome BeadChip and identified gene variants in encoding dynactin 4 (DCTN4), retinoic acid early transcript 1E (RAET1E), and V-akt murine thymoma viral oncogene homolog 3 (AKT3) to be associated with unfavourable outcome in patients with pneumococcal meningitis. No clinical replication cohort is available, so we validated the role of one of these targets, AKT3, in a pneumococcal meningitis mouse model. Akt3 deficient mice had worse survival and increased histopathology scores for parenchymal damage (infiltration) and vascular infiltration (large meningeal artery inflammation) but similar bacterial loads, cytokine responses, compared to wild-type mice. We found no differences in cerebrospinal fluid cytokine levels between patients with risk or non-risk alleles. Patients with the risk genotype (rs10157763, AA) presented with low scores on the Glasgow Coma Scale and high rate of epileptic seizures. Thus, our results show that AKT3 influences outcome of pneumococcal meningitis.

  8. [Changes in the immunocompetent cell system of the peripheral blood in HIV carriage].

    Science.gov (United States)

    Karabanov, V R; Markov, I S; Marchenko, N E

    1995-01-01

    HIV-carriage is characterized by hematological signs such as normocytosis of the general leucocyte count and deviations within normal range of values for myeloid series cells (neutrophiles, eosinophiles, basophiles). A peculiar hematological sign seen in HIV-infection is a finding of a raised content of cellular elements of mononuclear type on a hemogramme of peripheral blood and consistent decrease in the level of small T-lymphocytes against the background of substantial growth of suppressor-killer populations (large lymphocytes and lymphocyte-like mononuclears) as evidenced by a mononucleorogramme of peripheral blood, which fact provide a mechanism of antiviral protection at early stages of HIV-infection. Such changes in hemogrammes of peripheral blood, consistently found in all virus carriers, may be used in clinical settings as an early diagnostic sign of HIV-infection.

  9. Nasal carriage of Staphylococcus aureus among healthy adults.

    Science.gov (United States)

    Choi, Chong Seng; Yin, Chow Suet; Bakar, Afra Abu; Sakewi, Zamberi; Naing, Nyi Nyi; Jamal, Farida; Othman, Norlijah

    2006-12-01

    Data on the carriage rate and antibiotic sensitivity pattern of Staphylococcus aureus strains prevalent in the community are not available for many developing countries including Malaysia. To estimate the extent of community S. aureus transmission, in particular methicillin-resistant S. aureus (MRSA), the prevalence of S. aureus nasal colonization in a population of healthy adults was determined. Factors associated with S. aureus nasal carriage and antibiotic sensitivity patterns of the isolates were also analyzed. A cross-sectional study involving 346 adults was conducted. Nasal swabs were examined for the presence of S. aureus. Epidemiological information concerning risk factors for nasal carriage was also obtained. Antibiotic susceptibility testing was performed using the disk diffusion method according to the National Committee for Clinical Laboratory Standards guidelines. MRSA strains isolated were further subjected to pulse-field gel electrophoresis analysis. The prevalence of S. aureus nasal carriage was 23.4%. The findings also revealed that ex-smokers (95% confidence interval [CI] 1.08-6.32, p=0.033) and oral contraceptive users (95% CI 1.12-21.67, p=0.035) were more likely to harbor S. aureus. One person was colonized with MRSA, which was different from the hospital strain. MRSA nasal colonization was found to be low outside of the health care environment. Smokers and oral contraceptive users have high nasal carrier rates.

  10. Nasal carriage of Staphylococcus aureus among food handlers and ...

    African Journals Online (AJOL)

    Food handlers have been recognized to play a major role in the transmission of food borne diseases; contributing significantly to the global incidence and burden of the diseases. This study therefore, assesses the nasal carriage of staphylococcus aureus among food handlers and restaurant workers in Ekpoma, Edo State, ...

  11. 47 CFR 76.1506 - Carriage of television broadcast signals.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Carriage of television broadcast signals. 76.1506 Section 76.1506 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO... television broadcast signals. (a) The provisions of Subpart D shall apply to open video systems in accordance...

  12. Ethiopian Law of International Carriage by Air: An Overview ...

    African Journals Online (AJOL)

    Ethiopia's aviation history goes back to the late 1920s. And, carriage of goods and passengers by air dates at least as far back as the 1940s – the decade which witnessed the establishment of Ethiopian Air Lines Corporation (now Ethiopian Airlines). Despite Ethiopia's relative success in commercial aviation, domestic ...

  13. Carriage of sub-microscopic sexual and asexual Plasmodium ...

    African Journals Online (AJOL)

    SUMMARY. Background: We investigated the prevalence of sub-microscopic Plasmodium falciparum infections and gameto- cyte carriage in asymptomatic individuals in Navrongo in northern Ghana, an area of seasonal malaria transmission. Design: A cross sectional study of 209 randomly selected participants of all ...

  14. The health impact of schoolbag carriage: A systematic review (2007 ...

    African Journals Online (AJOL)

    ... (v) examine the biomechanics of pelvic alignment when carrying heavy schoolbags, (vi) understand the effectiveness of back care and strengthening intervention programmes in order to reduce pain and deviant posture, and (vii) take global research regarding schoolbag carriage on health and well-being into account.

  15. A study of the intestinal carriage of antibiotic resistant ...

    African Journals Online (AJOL)

    Background: The gastrointestinal tract has been recognized as a major ecological site for Staphylococcus aureus where it can reach neighboring sites and cause mild or serious infections. Objectives: To determine the prevalence of intestinal carriage of S. aureus in children aged 3 years and below in Ile-Ife, Nigeria and the ...

  16. Carriage of multidrug-resistant bacteria among pediatric patients ...

    African Journals Online (AJOL)

    Miniar Tfifha

    2017-12-25

    Dec 25, 2017 ... To cite this article: Miniar Tfifha, Asma Ferjani, Manel Mallouli, Nesrine Mlika, Saoussen Abroug &. Jalel Boukadida (2018) Carriage of multidrug-resistant bacteria among pediatric patients before and during their hospitalization in a tertiary pediatric unit in Tunisia, Libyan Journal of Medicine, 13:1,. 1419047 ...

  17. 76 FR 60675 - Revision of the Commission's Program Carriage Rules

    Science.gov (United States)

    2011-09-29

    ... rules pertaining to carriage of video programming vendors by multichannel video programming distributors... promoting competition and diversity in the video programming and video distribution markets. In this.... Federal Communications Commission's Web site: http://www.fcc.gov/cgb/ecfs/ . Follow the instructions for...

  18. Helicobacter pylori carriage among adult Nigerian subjects without ...

    African Journals Online (AJOL)

    Background:H.Pylori bacteria has a world wide distribution. It is implicated in the aetiology of peptic ulcer disease and gastric cancer. Population screening may have significant clinical import. Objective: To determine the frequency of H.pylori carriage and associated social demographic factors in asymptomatic patients and ...

  19. Carriage of sub-microscopic sexual and asexual Plasmodium ...

    African Journals Online (AJOL)

    Carriage of sub-microscopic sexual and asexual Plasmodium falciparum stages in the dry season at Navrongo, Ghana. ... infections and therefore the need for active case detection surveillance to eliminate "asymptomatic reservoir" parasites and consequently break the transmission of the disease in Ghana. Funding: Bill ...

  20. Carriage of Staphylococcus aureus on armpits of secondary school ...

    African Journals Online (AJOL)

    A study of carriage of Staphylococcus aureus on armpits and factors affecting it was carried out on 50 students from Community Secondary School, Oroworokwu, Port Harcourt and 50 University of Port Harcourt students. Samples were inoculated onto mannitol salt agar plates and coagulate positive S. aureus isolates were ...

  1. Method for inducing experimental pneumococcal meningitis in outbred mice

    Directory of Open Access Journals (Sweden)

    Cintorino Marcella

    2004-09-01

    Full Text Available Abstract Background Streptococcus pneumoniae is the leading cause of bacterial meningitis. Pneumococcal meningitis is associated with the highest mortality among bacterial meningitis and it may also lead to neurological sequelae despite the use of antibiotic therapy. Experimental animal models of pneumococcal meningitis are important to study the pathogenesis of meningitis, the host immune response induced after infection, and the efficacy of novel drugs and vaccines. Results In the present work, we describe in detail a simple, reproducible and efficient method to induce pneumococcal meningitis in outbred mice by using the intracranial subarachnoidal route of infection. Bacteria were injected into the subarachnoid space through a soft point located 3.5 mm rostral from the bregma. The model was tested with several doses of pneumococci of three capsular serotypes (2, 3 and 4, and mice survival was recorded. Lethal doses killing 50 % of animals infected with type 2, 3 and 4 S. pneumoniae were 3.2 × 10, 2.9 × 10 and 1.9 × 102 colony forming units, respectively. Characterisation of the disease caused by the type 4 strain showed that in moribund mice systemic dissemination of pneumococci to blood and spleen occurred. Histological analysis of the brain of animals infected with type 4 S. pneumoniae proved the induction of meningitis closely resembling the disease in humans. Conclusions The proposed method for inducing pneumococcal meningitis in outbred mice is easy-to-perform, fast, cost-effective, and reproducible, irrespective of the serotype of pneumococci used.

  2. Pneumococcal Pneumonia and Pandemic H1N1

    Centers for Disease Control (CDC) Podcasts

    2012-06-06

    Dr. George Nelson, a CDC medical officer, discusses the relationship between pneumococcal pneumonia and Pandemic H1N1.  Created: 6/6/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 6/6/2012.

  3. CLINICAL PROFILE OF INVASIVE PNEUMOCOCCAL DISEASES AT CHILDREN IN UZBEKISTAN

    Directory of Open Access Journals (Sweden)

    T. A. Daminov

    2015-01-01

    Full Text Available From January 2008 to December 2013, a study was conducted of children patients (between the ages of 3 months to 14 years with purulent meningitis (n = 210 and pneumonia (n = 265 admitted to specialized hospitals of Tashkent city. The material for the study were the blood, cerebrospinal fluid, pleural fluid. Of the 210 patients with purulent meningitis 98 (46.6% cultures of S. pneumoniae were isolated, of 265 patients with pneumonia 37 (13.9% cultures of S. pneumoniae were isolated (33 strains from the blood, 4 strains from pleural fluids. It has been found that there is a high sensitivity of the isolates of S. pneumoniae (94.8% to penicillin. It is recommended to rationally use macrolides in the treatment of invasive pneumococcal diseases in children, given the spread of strains of S.pneumoniae, resistant to the drugs of these group. Identified pneumococcal serotypes are included in the pneumococcal vaccines, which quite justifies the need to introduce preventive vaccination in the schedule of vaccination of children against pneumococcal diseases in the Republic of Uzbekistan.

  4. Pneumococcal meningitis in adults: new approaches to management and prevention

    NARCIS (Netherlands)

    Weisfelt, Martijn; de Gans, Jan; van der Poll, Tom; van de Beek, Diederik

    2006-01-01

    Since the virtual eradication of meningitis due to Haemophilus influenzae type B by vaccination in the developed world, pneumococcal meningitis has become the leading cause of bacterial meningitis beyond the neonatal period. Clinical and experimental research has increased our knowledge about the

  5. Development of lactococcal GEM-based pneumococcal vaccines

    NARCIS (Netherlands)

    Audouy, Sandrine A. L.; van Selm, Saskia; van Roosmalen, Maarten L.; Post, Eduard; Kanninga, Rolf; Neef, Jolanda; Estevao, Silvia; Nieuwenhuis, Edward E. S.; Adrian, Peter V.; Leenhouts, Kees; Hermans, Peter W. M.

    2007-01-01

    We report the development of a novel protein-based nasal vaccine against Streptococcus pneumoniae, in which three pneumococcal proteins were displayed on the surface of a non-recombinant, killed Lactococcus lactis-derived delivery system, called Gram-positive Enhancer Matrix (GEM). The GEM particles

  6. New pneumococcal conjugate vaccine introductions in four sub ...

    African Journals Online (AJOL)

    Background: Pneumonia is a main cause of under-five mortality in low-income settings. The pneumococcal conjugate vaccine (PCV) has been introduced in many countries as a tool in the disease's prevention. Although PCV's effectiveness has been established, less is known about the effects of introducing additional ...

  7. Pneumococcal responses are similar in Papua New Guinean children aged 3-5 years vaccinated in infancy with pneumococcal polysaccharide vaccine with or without prior pneumococcal conjugate vaccine, or without pneumococcal vaccination.

    Science.gov (United States)

    van den Biggelaar, Anita H J; Richmond, Peter C; Fuery, Angela; Anderson, Denise; Opa, Christine; Saleu, Gerard; Lai, Mildred; Francis, Jacinta P; Alpers, Michael P; Pomat, William S; Lehmann, Deborah

    2017-01-01

    In an earlier trial, Papua New Guinean (PNG) children at high risk of pneumococcal disease were randomized to receive 0 or 3 doses of 7-valent pneumococcal conjugate vaccine (PCV7), followed by a single dose of 23-valent pneumococcal polysaccharide vaccine (PPV23) at 9 months of age. We here studied in a non-randomized follow-up trial the persistence of pneumococcal immunity in these children at 3-5 years of age (n = 132), and in 121 community controls of a similar age with no prior pneumococcal vaccination. Circulating IgG antibody titers to all PCV7 and PPV23-only serotypes 2, 5 and 7F were measured before and after challenge with 1/5th of a normal PPV23 dose. Serotype-specific memory B-cells were enumerated at 10 months and 3-5 years of age for a subgroup of study children. Serotype-specific IgG antibody titers before and after challenge were similar for children who received PCV7/PPV23, PPV23 only, or no pneumococcal vaccines. Before challenge, at least 89% and 59% of children in all groups had serotype-specific titers ≥ 0.35μg/ml and ≥ 1.0 μg/ml, respectively. Post-challenge antibody titers were higher or similar to pre-challenge titers for most children independent of pneumococcal vaccination history. The rise in antibody titers was significantly lower when pre-challenge titers were higher. Overall the relative number of serotype-specific memory B-cells remained the same or increased between 10 months and 3-5 years of age, and there were no differences in serotype-specific memory B-cell numbers at 3-5 years of age between the three groups. Immunity induced by PCV7 and/or PPV23 immunization in infancy does not exceed that of naturally acquired immunity in 3-5-year-old children living in a highly endemic area. Also, there was no evidence that PPV23 immunization in the first year of life following PCV7 priming induces longer-term hypo-responsiveness. Clinicaltrials.gov NCT01414504 and NCT00219401.

  8. Invasive pneumococcal disease in Danish children, 1996-2007, prior to the introduction of heptavalent pneumococcal conjugate vaccine

    DEFF Research Database (Denmark)

    Winther, Thilde N; Kristensen, Tim D; Kaltoft, Margit S

    2008-01-01

    Aim: The aim of this study was to document the epidemiology, microbiology and outcome of invasive pneumococcal disease (IPD) among children vaccine (PCV7) into the Danish routine...... children vaccination....... immunization programme October 2007. Methods: Clinical and microbiological records on cases of IPD in children children

  9. Genetic diversity of pneumococcal surface protein A in invasive pneumococcal isolates from Korean children, 1991-2016.

    Directory of Open Access Journals (Sweden)

    Ki Wook Yun

    Full Text Available Pneumococcal surface protein A (PspA is an important virulence factor of pneumococci and has been investigated as a primary component of a capsular serotype-independent pneumococcal vaccine. Thus, we sought to determine the genetic diversity of PspA to explore its potential as a vaccine candidate. Among the 190 invasive pneumococcal isolates collected from Korean children between 1991 and 2016, two (1.1% isolates were found to have no pspA by multiple polymerase chain reactions. The full length pspA genes from 185 pneumococcal isolates were sequenced. The length of pspA varied, ranging from 1,719 to 2,301 base pairs with 55.7-100% nucleotide identity. Based on the sequences of the clade-defining regions, 68.7% and 49.7% were in PspA family 2 and clade 3/family 2, respectively. PspA clade types were correlated with genotypes using multilocus sequence typing and divided into several subclades based on diversity analysis of the N-terminal α-helical regions, which showed nucleotide sequence identities of 45.7-100% and amino acid sequence identities of 23.1-100%. Putative antigenicity plots were also diverse among individual clades and subclades. The differences in antigenicity patterns were concentrated within the N-terminal 120 amino acids. In conclusion, the N-terminal α-helical domain, which is known to be the major immunogenic portion of PspA, is genetically variable and should be further evaluated for antigenic differences and cross-reactivity between various PspA types from pneumococcal isolates.

  10. Acute Primary Pneumococcal Purulent Pericarditis With Cardiac Tamponade: A Case Report and Literature Review.

    Science.gov (United States)

    Patel, Hiren; Patel, Charmi; Soni, Mrugesh; Patel, Amit; Banda, Venkat

    2015-10-01

    Bacterial pericarditis is a rapidly progressive and highly fatal infection, and is often diagnosed postmortem in half of the cases. Even with drainage and antibiotics, the mortality rate is high. Gram-positive cocci, specifically Streptococcus penumoniae, have been the most common cause of bacterial pericarditis with a preceding primary site of infection. Following the introduction of antibiotics in the 1940s and more recently the pneumococcal conjugate vaccine, the incidence has drastically decreased.We describe an extremely rare case of primary streptococcus pneumoniae purulent pericarditis that presented with cardiac tamponade. The patient was successfully treated with broad-spectrum antibiotics and urgent pericardiocentesis.Due to the high mortality rate with purulent pericarditis, a high index of suspicion is needed when acute pericarditis is suspected for early diagnosis to instate appropriate therapy with antibiotics and drainage.

  11. Impact of Preceding Flu-Like Illness on the Serotype Distribution of Pneumococcal Pneumonia

    OpenAIRE

    Joon Young Song; Nahm, Moon H.; Hee Jin Cheong; Woo Joo Kim

    2014-01-01

    Background Even though the pathogenicity and invasiveness of pneumococcus largely depend on capsular types, the impact of serotypes on post-viral pneumococcal pneumonia is unknown. Methods and Findings This study was performed to evaluate the impact of capsular serotypes on the development of pneumococcal pneumonia after preceding respiratory viral infections. Patients with a diagnosis of pneumococcal pneumonia were identified. Pneumonia patients were divided into two groups (post-viral pneum...

  12. Initial Serological Response after Prime-boost Pneumococcal Vaccination in Rheumatoid Arthritis Patients

    DEFF Research Database (Denmark)

    Nguyen, Mai T T; Lindegaard, Hanne; Hendricks, Oliver

    2017-01-01

    OBJECTIVE: To evaluate the initial serological responses to pneumococcal vaccination with the 13-valent protein-conjugated pneumococcal vaccine (PCV13) followed by the 23-valent polysaccharide pneumococcal vaccine (PPV23) among patients with rheumatoid arthritis (RA) treated with biological disease...... serological response to prime-boost vaccination with PCV13 followed by PPV23 was very similar among participants receiving bDMARD and csDMARD. However, notable differences in response were observed according to individual bDMARD. It is important to consider the RA treatment when planning pneumococcal...

  13. Incidence of Hospitalized Pneumococcal Pneumonia among Adults in Guatemala, 2008-2012.

    Science.gov (United States)

    Contreras, Carmen Lucía; Verani, Jennifer R; Lopez, María Renee; Paredes, Antonio; Bernart, Chris; Moscoso, Fabiola; Roldan, Aleida; Arvelo, Wences; Lindblade, Kim A; McCracken, John P

    2015-01-01

    Streptococcus pneumoniae is a leading cause of pneumonia worldwide. However, the burden of pneumococcal pneumonia among adults in low- and middle-income countries is not well described. Data from 2008-2012 was analyzed from two surveillance sites in Guatemala to describe the incidence of pneumococcal pneumonia in adults. A case of hospitalized pneumococcal pneumonia was defined as a positive pneumococcal urinary antigen test or blood culture in persons aged ≥ 18 years hospitalized with an acute respiratory infection (ARI). Among 1595 adults admitted with ARI, 1363 (82%) had either urine testing (n = 1286) or blood culture (n = 338) performed. Of these, 188 (14%) had pneumococcal pneumonia, including 173 detected by urine only, 8 by blood culture only, and 7 by both methods. Incidence rates increased with age, with the lowest rate among 18-24 year-olds (2.75/100,000) and the highest among ≥65 year-olds (31.3/100,000). The adjusted incidence of hospitalized pneumococcal pneumonia was 18.6/100,000 overall, with in-hospital mortality of 5%. An important burden of hospitalized pneumococcal pneumonia in adults was described, particularly for the elderly. However, even adjusted rates likely underestimate the true burden of pneumococcal pneumonia in the community. These data provide a baseline against which to measure the indirect effects of the 2013 introduction of the pneumococcal conjugate vaccine in children in Guatemala.

  14. PROPHYLAXIS OF PNEUMOCOCCAL INFECTION IN CHILDREN HAS POSITIVE EFFECT ON ALL POPULATION

    Directory of Open Access Journals (Sweden)

    M.V. Fedoseenko

    2008-01-01

    Full Text Available Modern data of effectiveness prophylaxis of pneumococcal infection in children younger 1 year old with vaccine is presented in this article. Including of 7 - valency pneumococcal conjugated vaccine (PCV-7 in immunization program of some countries resulted in decrease of morbidity as in vaccinated group, as in all population. It was marked that vaccination with PCV-7 plays important pathogenetic role in termination of hidden forms of disease and prevention of spreading of pneumococcal infection, including the most severe types, hardly treated with antibiotics.Key words: children, pneumococcal infection, vaccination.

  15. Moving in extreme environments:extreme loading; carriage versus distance

    OpenAIRE

    Lucas, Samuel J. E.; Helge, Jørn W.; Schütz, Uwe H W; Goldman, Ralph F.; Cotter, James D

    2016-01-01

    This review addresses human capacity for movement in the context of extreme loading and with it the combined effects of metabolic, biomechanical and gravitational stress on the human body. This topic encompasses extreme duration, as occurs in ultra-endurance competitions (e.g. adventure racing and transcontinental races) and expeditions (e.g. polar crossings), to the more gravitationally limited load carriage (e.g. in the military context). Juxtaposed to these circumstances is the extreme met...

  16. Staphylococcus aureus nasal carriage in hemodialysis centers of Fez, Morocco.

    Science.gov (United States)

    Diawara, Idrissa; Bekhti, Khadija; Elhabchi, Driss; Saile, Rachid; Elmdaghri, Naima; Timinouni, Mohammed; Elazhari, Mohamed

    2014-06-01

    Staphylococcus aureus (S. aureus) nasal carriage may be responsible for some serious infections in hemodialyzed patients. The main target of this study was to estimate the prevalence of S. aureus nasal carriage in hemodialysis outpatients and medical staff in hemodialysis centers specifically in Fez region. The second target is to identify the risks of colonization, resistance pattern of isolates and their virulence toxin genes. Nasal swab specimens were obtained from 143 hemodialyzed outpatients and 32 medical staff from January to June 2012. Each participant completed a short questionnaire. Nasal carriage of S. aureus was demographically related (age, gender, hemodialysis duration), comorbidity (diabetes, malignancy) and exposure to health care (dialysis staff, hospitalization). PCR (Polymerase Chain Reaction) were used on all the isolates in the research of twelve staphylococcal enterotoxins genes. Also the PCR was used to investigate on the three factors epidermal cell differentiation inhibitors; three exfoliatin toxins; two leukotoxins; the toxic shock syndrome toxin-1 and the hemolysin beta genes. Nasal screening revealed 38.16%, 50% and 18.75% S. aureus carries in chronic, acute hemodialysis patients and medical staff, respectively. Only young participants were likely to be S. aureus carries (p = 0.002). But there were no gender differences between the isolate carriers and non-carriers or some comorbidity factors such as viral hepatitis B and C, HIV (Human Immunodeficiency Virus) infections, diabetes, chronic smoking, recent hospitalization or antibiotic therapy. Out of all isolates, only one (1.61%) was methicillin-resistant and Twenty-one (33.87%) had at least two virulence toxin genes. Knowledge and monitoring of antibiotic resistance profile and virulence of S. aureus carriage are essential in the treatment of infections generated by this pathogen, as well as in the control of clonal dissemination and prevent the spread of S. aureus resistance.

  17. Staphylococcus aureus carriage in selected kindergartens in Klang Valley.

    Science.gov (United States)

    Mohamed, N A; Ramli, S; Amin, N N Z; Sulaiman, W S W; Isahak, I; Jamaluddin, T Z M T; Salleh, N M

    2016-04-01

    Nasal colonisation of S. aureus in healthy children was 18% to 30%. One to three percent of them were colonised by Methicillin-resistant Staphlycoccus aureus (MRSA). Although MRSA infection has become increasingly reported, population-based S. aureus and MRSA colonisation estimates are lacking. The main objective of this study was to determine the prevalence of S. aureus carriage among children. Nasal samples for S. aureus culture were obtained from 250 children from three kindergartens in the Klang Valley, after consent was obtained from the children and their parents. Swabs were transported in Stuart medium, and inoculated on mannitol-salt agar within four hours of collection. Identification and disk diffusion test were done according to guidelines. Polymerase chain reaction was done on MRSA isolates for the presence of mecA and lukS/FPV genes. Overall prevalence of S. aureus and MRSA carriage were 19.2% (48/250) and 1.6% (4/250) respectively. mecA gene was present in all isolates, 50% isolates carried Panton-Valentine leucocidin (PVL) gene. Sccmec type I was found in 2 isolates and the remaining isolates has Sccmec type V. The prevalence of S. aureus and MRSA carriage were similar to other studies. However, risk of contracting severe infection might be higher due to presence of PVL gene in half of the MRSA isolates.

  18. Polymicrobial pneumococcal bacteraemia: a case-control study.

    Science.gov (United States)

    Grau, I; Ardanuy, C; Schulze, M H; Liñares, J; Pallares, R

    2017-05-01

    Polymicrobial bacteraemia involving Streptococcus pneumoniae and other bacteria (e.g. Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Haemophilus influenza, viridans streptococci, Salmonella spp.) occurred in 3.4% of our pneumococcal bacteraemia cases. Compared with 308 controls (monomicrobial bacteraemia), the 77 polymicrobial cases included more males (83 vs 62%, p = 0.001), had serious underlying diseases (100 vs 80%, p < 0.001), abdominal infection (18 vs 5%, p < 0.001), nosocomial infection (33 vs 8%, p < 0.001), shock (40 vs 13%, p < 0.001), and higher mortality (52 vs 18%, p < 0.001). Clinicians must be aware that some patients with pneumococcal bacteraemia may have other bacteria in their blood, which would confer higher mortality and may lead to inappropriate or incomplete antibiotic therapy.

  19. Attempt to modify klebsiella carriage in ankylosing spondylitic patients by diet: correlation of klebsiella carriage with disease activity.

    OpenAIRE

    Shinebaum, R; Neumann, V; Hopkins, R; Cooke, E M; Wright, V

    1984-01-01

    Patients with ankylosing spondylitis were asked to follow a 'klebsiella exclusion diet' for 5 months of a 10-month study. The same percentage of faecal samples were positive for klebsiella whether the patients were on or off the experimental diet. The diet also failed to influence variability of klebsiella serotypes. We found no correlation between acquisition of klebsiella and deterioration of disease symptoms, as recorded by the patients. Furthermore, carriage of klebsiella did not correlat...

  20. Exome Array Analysis of Susceptibility to Pneumococcal Meningitis

    Science.gov (United States)

    Kloek, Anne T.; van Setten, Jessica; van der Ende, Arie; Bots, Michiel L.; Asselbergs, Folkert W.; Serón, Mercedes Valls; Brouwer, Matthijs C.; van de Beek, Diederik; Ferwerda, Bart

    2016-01-01

    Host genetic variability may contribute to susceptibility of bacterial meningitis, but which genes contribute to the susceptibility to this complex disease remains undefined. We performed a genetic association study in 469 community-acquired pneumococcal meningitis cases and 2072 population-based controls from the Utrecht Health Project in order to find genetic variants associated with pneumococcal meningitis susceptibility. A HumanExome BeadChip was used to genotype 102,097 SNPs in the collected DNA samples. Associations were tested with the Fisher exact test. None of the genetic variants tested reached Bonferroni corrected significance (p-value meningitis were rs139064549 on chromosome 1 in the COL11A1 gene (p = 1.51 × 10−6; G allele OR 3.21 [95% CI 2.05–5.02]) and rs9309464 in the EXOC6B gene on chromosome 2 (p = 6.01 × 10−5; G allele OR 0.66 [95% CI 0.54–0.81]). The sequence kernel association test (SKAT) tests for associations between multiple variants in a gene region and pneumococcal meningitis susceptibility yielded one significant associated gene namely COL11A1 (p = 1.03 × 10−7). Replication studies are needed to validate these results. If replicated, the functionality of these genetic variations should be further studied to identify by which means they influence the pathophysiology of pneumococcal meningitis. PMID:27389768

  1. A Non-Human Primate Model of Severe Pneumococcal Pneumonia

    Science.gov (United States)

    Reyes, Luis F.; Restrepo, Marcos I.; Hinojosa, Cecilia A.; Soni, Nilam J.; Shenoy, Anukul T.; Gilley, Ryan P.; Gonzalez-Juarbe, Norberto; Noda, Julio R.; Winter, Vicki T.; de la Garza, Melissa A.; Shade, Robert E.; Coalson, Jacqueline J.; Giavedoni, Luis D.; Anzueto, Antonio; Orihuela, Carlos J.

    2016-01-01

    Rationale Streptococcus pneumoniae is the leading cause of community-acquired pneumonia and infectious death in adults worldwide. A non-human primate model is needed to study the molecular mechanisms that underlie the development of severe pneumonia, identify diagnostic tools, explore potential therapeutic targets, and test clinical interventions during pneumococcal pneumonia. Objective To develop a non-human primate model of pneumococcal pneumonia. Methods Seven adult baboons (Papio cynocephalus) were surgically tethered to a continuous monitoring system that recorded heart rate, temperature, and electrocardiography. Animals were inoculated with 109 colony-forming units of S. pneumoniae using bronchoscopy. Three baboons were rescued with intravenous ampicillin therapy. Pneumonia was diagnosed using lung ultrasonography and ex vivo confirmation by histopathology and immunodetection of pneumococcal capsule. Organ failure, using serum biomarkers and quantification of bacteremia, was assessed daily. Results Challenged animals developed signs and symptoms of pneumonia 4 days after infection. Infection was characterized by the presence of cough, tachypnea, dyspnea, tachycardia and fever. All animals developed leukocytosis and bacteremia 24 hours after infection. A severe inflammatory reaction was detected by elevation of serum cytokines, including Interleukin (IL)1Ra, IL-6, and IL-8, after infection. Lung ultrasonography precisely detected the lobes with pneumonia that were later confirmed by pathological analysis. Lung pathology positively correlated with disease severity. Antimicrobial therapy rapidly reversed symptomology and reduced serum cytokines. Conclusions We have developed a novel animal model for severe pneumococcal pneumonia that mimics the clinical presentation, inflammatory response, and infection kinetics seen in humans. This is a novel model to test vaccines and treatments, measure biomarkers to diagnose pneumonia, and predict outcomes. PMID:27855182

  2. Diagnosis of Pneumococcal Pneumonia: Current Pitfalls and the Way Forward

    OpenAIRE

    Song, Joon Young; Eun, Byung Wook; Nahm, Moon H.

    2013-01-01

    Streptococcus pneumoniae is the most common cause of community-acquired pneumonia. However, it can also asymptomatically colonize the upper respiratory tract. Because of the need to distinguish between S. pneumoniae that is simply colonizing the upper respiratory tract and S. pneumoniae that is causing pneumonia, accurate diagnosis of pneumococcal pneumonia is a challenging issue that still needs to be solved. Sputum Gram stains and culture are the first diagnostic step for identifying pneumo...

  3. Pneumococcal conjugate vaccine: a newer vaccine available in India.

    Science.gov (United States)

    Verma, Ramesh; Khanna, Pardeep

    2012-09-01

    Streptococcus pneumoniae, or "pneumococcus," causes pneumonia and infections of the brain and blood that are responsible for significant mortality in children under five years as well as in the elderly. Pneumococcal diseases are a major public health problem worldwide. S. pneumoniae is responsible for 15-50% of all episodes of community-acquired pneumonia, 30-50% of all cases of acute otitis media, and a significant proportion of bacterial meningitis and bacteremia. S. pneumoniae kills at least one million children under the age of five every year, which is more than malaria, AIDS and measles combined. More than 70% of the deaths are in developing countries. In 2007, pneumococcal pneumonia was the leading infectious killer of children worldwide. Perhaps more importantly, pneumonia remains the leading killer of children in India. A recent UNICEF publication estimated that 410,000 children under age 5 y die of pneumonia each year in India, and recent data shows that an estimated 25% of all child deaths in India are due to pneumonia. The fact that this high burden of pneumonia has remained undiminished in India in spite of economic growth and decline in child mortality due to other diseases is a reminder of the importance of tackling pneumonia head-on with dedicated resources. The burden of pneumococcal meningitis, which constitutes about half of all childhood meningitis cases in most settings and a greater proportion of meningitis deaths, makes it difficult to avoid the conclusion that the pneumococcus is responsible for 1 million child deaths each year. Global Alliance for Vaccine and Immunization (GAVI) has offered to supply PCV at a cost of 0.15-0.30 USD/dose to India for inclusion in the national immunization schedule and commits to extending this support until the year 2015. Pneumococcal vaccination in not recommended in children aged 5 and above.

  4. Hemolytic Uremic Syndrome Associated with Pneumococcal Pneumonia. A Case Report

    OpenAIRE

    Ariel Efrén Uriarte Méndez; Andrés Prieto Apesteguía; Jesús Vila Díaz; Jorge Luis Capote Padrón; Kendrie Villavicencio Cardoso; Alnilam Fernández González

    2013-01-01

    Hemolytic uremic syndrome is a condition characterized by hemolytic microangiopathic anemia, thrombocytopenia and acute renal failure. In its classic form it is associated with diarrhea and it has a good prognosis. When there is an invasive pneumococcal disease as underlying condition, it has a mortality rate of 25%, and half of the surviving cases develop end-stage renal disease (ESRD). We present the case of a 17-month-old child with hemolytic uremic syndrome secondary to pneumonia with emp...

  5. Pneumococcal lipoproteins involved in bacterial fitness, virulence, and immune evasion.

    Science.gov (United States)

    Kohler, Sylvia; Voß, Franziska; Gómez Mejia, Alejandro; Brown, Jeremy S; Hammerschmidt, Sven

    2016-11-01

    Streptococcus pneumoniae (pneumococcus) has evolved sophisticated strategies to survive in several niches within the human body either as a harmless commensal or as a serious pathogen causing a variety of diseases. The dynamic interaction between pneumococci and resident host cells during colonization of the upper respiratory tract and at the site of infection is critical for bacterial survival and the development of disease. Pneumococcal lipoproteins are peripherally anchored membrane proteins and have pivotal roles in bacterial fitness including envelope stability, cell division, nutrient acquisition, signal transduction, transport (as substrate-binding proteins of ABC transporter systems), resistance to oxidative stress and antibiotics, and protein folding. In addition, lipoproteins are directly involved in virulence-associated processes such as adhesion, colonization, and persistence through immune evasion. Conversely, lipoproteins are also targets for the host response both as ligands for toll-like receptors and as targets for acquired antibodies. This review summarizes the multifaceted roles of selected pneumococcal lipoproteins and how this knowledge can be exploited to combat pneumococcal infections. © 2016 Federation of European Biochemical Societies.

  6. An audit of influenza and pneumococcal vaccination in rheumatology outpatients

    Directory of Open Access Journals (Sweden)

    Mitchell William S

    2007-07-01

    Full Text Available Abstract Background Influenza and pneumococcal vaccination are recommended for a number of clinical risk groups including patients treated with major immunosuppressant disease modifying anti-rheumatic drugs. Such immunisation is not only safe but immunogenic in patients with rheumatic diseases. We sought to establish dual vaccination rates and significant influencing factors amongst our hospital rheumatology outpatients. Method We audited a sample of 101 patients attending hospital rheumatology outpatient clinics on any form of disease modifying treatment by clinical questionnaire and medical record perusal. Further data were collected from the local immunisation coordinating agency and analysed by logistic regression modelling. Results Although there was a high rate of awareness with regard to immunisation, fewer patients on major immunosuppressants were vaccinated than patients with additional clinical risk factors against influenza (53% vs 93%, p Conclusion Influenza and pneumococcal immunisation is suboptimal amongst patients on current immunosuppressant treatments attending rheumatology outpatient clinics. Raising awareness amongst patients may not be sufficient to improve vaccination rates and alternative strategies such as obligatory pneumococcal vaccination prior to treatment initiation and primary care provider education need to be explored.

  7. Impact of preceding flu-like illness on the serotype distribution of pneumococcal pneumonia.

    Directory of Open Access Journals (Sweden)

    Joon Young Song

    Full Text Available Even though the pathogenicity and invasiveness of pneumococcus largely depend on capsular types, the impact of serotypes on post-viral pneumococcal pneumonia is unknown.This study was performed to evaluate the impact of capsular serotypes on the development of pneumococcal pneumonia after preceding respiratory viral infections. Patients with a diagnosis of pneumococcal pneumonia were identified. Pneumonia patients were divided into two groups (post-viral pneumococcal pneumonia versus primary pneumococcal pneumonia, and then their pneumococcal serotypes were compared. Nine hundred and nineteen patients with pneumococcal pneumonia were identified during the study period, including 327 (35.6% cases with post-viral pneumococcal pneumonia and 592 (64.4% cases with primary pneumococcal pneumonia. Overall, serotypes 3 and 19A were the most prevalent, followed by serotypes 19F, 6A, and 11A/11E. Although relatively uncommon (33 cases, 3.6%, infrequently colonizing invasive serotypes (4, 5, 7F/7A, 8, 9V/9A, 12F, and 18C were significantly associated with preceding respiratory viral infections (69.7%, P<0.01. Multivariate analysis revealed several statistically significant risk factors for post-viral pneumococcal pneumonia: immunodeficiency (OR 1.66; 95% CI, 1.10-2.53, chronic lung diseases (OR 1.43; 95% CI, 1.09-1.93 and ICI serotypes (OR 4.66; 95% CI, 2.07-10.47.Infrequently colonizing invasive serotypes would be more likely to cause pneumococcal pneumonia after preceding respiratory viral illness, particularly in patients with immunodeficiency or chronic lung diseases.

  8. From individual to herd protection with pneumococcal vaccines: the contribution of the Cuban pneumococcal conjugate vaccine implementation strategy

    Directory of Open Access Journals (Sweden)

    Nivaldo Linares-Pérez

    2017-07-01

    Full Text Available A new pneumococcal conjugate vaccine is currently undergoing advanced clinical evaluation prior to its planned introduction in Cuba. The implementation of the pneumococcal vaccination strategy has been designed with consideration of the need to maximize both its direct and indirect effects. A novel approach is suggested, which addresses preschool children as the first-line target group to generate herd immunity in infants and to have an impact on transmission at the community level. The clinical evaluation pipeline is described herein, including evaluations of effectiveness, cost-effectiveness, and impact. The scientific contribution of the Cuban strategy could support a paradigm shift from individual protection to a population effect based on a rigorous body of scientific evidence.

  9. Pneumococcal meningitis: development of a new animal model.

    Science.gov (United States)

    Wei, Benjamin P C; Shepherd, Robert K; Robins-Browne, Roy M; Clark, Graeme M; O'Leary, Stephen J

    2006-09-01

    The rat is a suitable animal to establish a model for the study of pneumococcal meningitis postcochlear implantation. There has been an increase in the number of cases of cochlear implant-related meningitis. The most common organism identified was Streptococcus pneumoniae. Whether cochlear implantation increases the risk of pneumococcal meningitis in healthy subjects without other risk factors remains to be determined. Previous animal studies do not focus on the pathogenesis and risk of pneumococcal meningitis postimplantation and are based on relatively small animal numbers, making it difficult to assess the cause-and-effect relationship. There is, therefore, a need to develop a new animal model allowing direct examination of the pathogenesis of meningitis in the presence of a cochlear implant. Eighteen nonimplanted rats were infected with 1 x 10 and 1 x 10 colony-forming units (CFU) of a clinical isolate of S. pneumoniae via three different inoculation routes (middle ear, inner ear, and i.p.) to examine for evidence of meningitis during 24 hours. Six implanted rats were infected with the highest amount of bacteria possible for each route of inoculation (4 x 10 CFU i.p., 3 x 10 CFU middle ear, and 1 x 10 CFU inner ear) to examine for evidence of meningitis with the presence of an implant. The histological pattern of cochlear infections for each of the three different inoculating routes were examined. Pneumococcal meningitis was evident in all 6 implanted animals for each of the three different routes of inoculation. Once in the inner ear, bacteria were found to enter the central nervous system via either the cochlear aqueduct or canaliculi perforantes of the osseous spiral lamina, reaching the perineural and perivascular space then the internal acoustic meatus. The rate, extent, and pattern of infection within the cochleae depended on the route of inoculation. Finally, there was no evidence of pneumococcal meningitis observed in 18 nonimplanted rats inoculated at

  10. Impact of 10-valent pneumococcal conjugate vaccine on pneumococcal meningitis in children up to two years of age in Brazil

    Directory of Open Access Journals (Sweden)

    Indianara Maria Grando

    2015-02-01

    Full Text Available The objective of this study was to analyze the impact of vaccination against Streptococcus pneumoniae on the morbidity and mortality from pneumococcal meningitis in children ≤ 2 years in Brazil, from 2007 to 2012. This is a descriptive study and ecological analysis using data from the Information System on Notifiable Diseases. Pre-vaccination (2007-2009 and post-vaccination (2011-2012 periods were defined to compare incidence rates and mortality. A total of 1,311 cases and 430 deaths were reported during the study period. Incidence decreased from 3.70/100,000 in 2007 to 1.84/100,000 in 2012, and mortality decreased from 1.30/100,000 to 0.40/100,000, or 50% and 69% respectively, with the greatest impact in the 6-11 month age group. This decrease in Pneumococcal meningitis morbidity and mortality rates two years after introduction of the 10-valent pneumococcal conjugate vaccine suggests its effectiveness.

  11. Antibody Responses to Pneumococcal Polysaccharide Vaccine in Taiwanese Patients with Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Chih-Cheng Lai

    2007-01-01

    Conclusion: Taiwanese elderly adults with COPD, even in advanced age, can mount a significant antibody response to pneumococcal polysaccharide vaccine. This study may support the existing recommendation that pneumococcal vaccine be offered to persons ≥ 65 years old with COPD. [J Formos Med Assoc 2007;106(3: 196-203

  12. ANTIGEN-DETECTION IN OROPHARYNGEAL SECRETIONS FOR RAPID DIAGNOSIS OF PNEUMOCOCCAL PNEUMONIA

    NARCIS (Netherlands)

    BOERSMA, WG; HOLLOWAY, Y; KUTTSCHRUTTER, H; LOWENBERG, A; SNIJDER, JAM; KOETER, GH

    To determine the value of detection of antigen in the oropharynx in the diagnosis of pneumococcal pneumonia, oropharyngeal secretions were cultured for the presence of Streptococcus pneumoniae and tested for the presence of pneumococcal antigen. Sputum (if available) collected on the same day was

  13. Pneumococcal Endometritis with Peritonitis: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    KI Ostrowska

    1991-01-01

    Full Text Available The first case of pneumococcal endometritis with peritonitis in a woman using tampons is described. The patient responded to removal of the tampon and administration of broad spectrum antibiotics. The pathogenesis of pneumococcal endometritis and peritonitis and the potential significance of a tampon in situ are discussed.

  14. Outer membrane protein complex of Meningococcus enhances the antipolysaccharide antibody response to pneumococcal polysaccharide-CRM₁₉₇ conjugate vaccine.

    Science.gov (United States)

    Lai, Zengzu; Schreiber, John R

    2011-05-01

    Bacterial polysaccharides (PS) are T cell-independent antigens that do not induce immunologic memory and are poor immunogens in infants. Conjugate vaccines in which the PS is covalently linked to a carrier protein have enhanced immunogenicity that resembles that of T cell-dependent antigens. The Haemophilus influenzae type b (Hib) conjugate vaccine, which uses the outer membrane protein complex (OMPC) from meningococcus as a carrier protein, elicits protective levels of anti-capsular PS antibody (Ab) after a single dose, in contrast to other conjugate vaccines, which require multiple doses. We have previously shown that OMPC robustly engages Toll-like receptor 2 (TLR2) and enhances the early anti-Hib PS Ab titer associated with an increase in TLR2-mediated induction of cytokines. We now show that the addition of OMPC to the 7-valent pneumococcal PS-CRM₁₉₇ conjugate vaccine during immunization significantly increases the anti-PS IgG and IgM responses to most serotypes of pneumococcus contained in the vaccine. The addition of OMPC also increased the likelihood of anti-PS IgG3 production against serotypes 4, 6B, 9V, 18C, 19F, and 23F. Splenocytes from mice who had received OMPC with the pneumococcal conjugate vaccine produced significantly more interleukin-2 (IL-2), IL-4, IL-6, IL-10, tumor necrosis factor alpha (TNF-α), and gamma interferon (IFN-γ) than splenocytes from mice who received phosphate-buffered saline (PBS) plus the conjugate vaccine. We conclude that OMPC enhances the anti-PS Ab response to pneumococcal PS-CRM₁₉₇ conjugate vaccine, an effect associated with a distinct change in cytokine profile. It may be possible to reduce the number of conjugate vaccine doses required to achieve protective Ab levels by priming with adjuvants that are TLR2 ligands.

  15. Antimicrobial resistance, penicillin-binding protein sequences, and pilus islet carriage in relation to clonal evolution of Streptococcus pneumoniae serotype 19A in Russia, 2002-2013.

    Science.gov (United States)

    Mayanskiy, N; Savinova, T; Alyabieva, N; Ponomarenko, O; Brzhozovskaya, E; Lazareva, A; Katosova, L; Kozlov, R

    2017-06-01

    Clonal changes of serotype 19A pneumococci have been appreciated in conjunction with growing prevalence of this serotype after implementation of the seven-valent pneumococcal conjugate vaccine (PCV7). In the present study, we characterized serotype 19A pneumococci collected in Russia within a decade preceding the implementation of PCV vaccination and described their clonal evolution. We retrospectively analyzed non-invasive serotype 19A isolates collected in 2002-2013. All isolates were subjected to multilocus sequence typing, antimicrobial susceptibility testing, determination of macrolide resistance genotype, molecular detection of pilus islet (PI) carriage, sequencing of penicillin-binding protein (PBP) genes. A total of 49 serotype 19A isolates represented 25 sequence types, of which 14 were newly described. The majority of isolates were distributed among clonal complex (CC) 663 (28%), CC230 (25%), CC156, and CC320 (14% each). CC663 and CC156 dominated in 2003, but were replaced by CC230 and CC320 later on; CC320 was only evident starting 2010. All isolates of CC663 and CC156 carried PI1; CC320 possessed both PI1 and PI2. The overall rate of altered amino acids in penicillin-nonsusceptible isolates was 13·9%, 7·2%, and 8·7% for PBP1a, PBP2b, and PBP2x, respectively. Our findings demonstrate that the clonal structure of serotype 19A pneumococci may evolve without PCV pressure.

  16. Long-term effects of penicillin resistance and fitness cost on pneumococcal transmission dynamics in a developed setting

    Directory of Open Access Journals (Sweden)

    Diana Tilevik

    2016-05-01

    Full Text Available Background: The increasing prevalence of penicillin non-susceptible pneumococci (PNSP throughout the world threatens successful treatment of infections caused by this important bacterial pathogen. The rate at which PNSP clones spread in the community is thought to mainly be determined by two key determinants; the volume of penicillin use and the magnitude of the fitness cost in the absence of treatment. The aim of the study was to determine the impacts of penicillin consumption and fitness cost on pneumococcal transmission dynamics in a developed country setting. Methods: An individual-based network model based on real-life demographic data was constructed and applied in a developed country setting (Sweden. A population structure with transmission of carriage taking place within relevant mixing groups, i.e. families, day care groups, school classes, and other close contacts, was considered to properly assess the transmission dynamics for susceptible and PNSP clones. Several scenarios were simulated and model outcomes were statistically analysed. Results: Model simulations predicted that with an outpatient penicillin use corresponding to the sales in Sweden 2010 (118 recipes per 1,000 inhabitants per year, the magnitude of a fitness cost for resistance must be at least 5% to offset the advantage of penicillin resistance. Moreover, even if there is a fitness cost associated with penicillin resistance, a considerable reduction of penicillin usage appears to be required to significantly decrease the incidence of PNSP in a community. Conclusion: The frequency of PNSP clones is hard to reverse by simply reducing the penicillin consumption even if there is a biological cost associated with resistance. However, because penicillin usage does promote further spread of PNSP clones, it is important to keep down penicillin consumption considering future resistance problems.

  17. Recurrent severe invasive pneumococcal disease in an adult with previously unknown hyposplenia

    DEFF Research Database (Denmark)

    Ballegaard, Vibe C; Schejbel, Lone; Hoffmann, Steen

    2015-01-01

    of meningitis and developed sufficient levels of pneumococcal antibodies. The pneumococcal strains isolated were serotype 7 F and 17 F. To our knowledge, there has been no previously reported case of recurrent invasive pneumococcal disease in a pneumococcal vaccinated adult with hyposplenia and apparently...... was found. Despite immunization against S. pneumoniae and measurement of what was interpreted as protective levels of serotype-specific IgG antibodies after vaccination, the patient suffered from a third episode of IPD. CONCLUSIONS: Individuals with predisposing medical conditions or a history of severe......BACKGROUND: The risk of life-threatening and invasive infections with encapsulated bacteria is increased in patients with hyposplenia or asplenia. We report a case of recurrent invasive pneumococcal meningitis in a woman with previous unknown hyposplenia. She was vaccinated after the first episode...

  18. Factors associated with the occurrence of hearing loss after pneumococcal meningitis

    DEFF Research Database (Denmark)

    Worsøe, Lise Lotte; Caye-Thomasen, P.; Brandt, C.T.

    2010-01-01

    Background. On the basis of a nationwide registration during a 5-year period (1999-2003), the frequency and severity of hearing loss was investigated retrospectively in 343 consecutive Danish patients who survived pneumococcal meningitis, to identify important risk factors (including the pneumoco......Background. On the basis of a nationwide registration during a 5-year period (1999-2003), the frequency and severity of hearing loss was investigated retrospectively in 343 consecutive Danish patients who survived pneumococcal meningitis, to identify important risk factors (including...... hearing loss, and another 16 (7%) had bilateral profound hearing loss. Significant risk factors for hearing loss were advanced age, the presence of comorbidity, severity of meningitis, a low CSF glucose level, a high CSF protein level, and a certain pneumococcal serotype (P ... is common after pneumococcal meningitis, and audiometry should be performed on all those who survive pneumococcal meningitis. Important risk factors for hearing loss are advanced age, female sex, severity of meningitis, and bacterial serotype...

  19. Extended Spectrum Beta-Lactamase Carriage State among Elderly Nursing Home Residents in Beirut

    Directory of Open Access Journals (Sweden)

    M. A. Jallad

    2015-01-01

    Full Text Available Introduction. ESBL-producing Enterobacteriaceae can cause severe infections, but they are also isolated from the stool of asymptomatic subjects. Faecal carriage of such organism is poorly understood. Methods. First phase of the study was cross-sectional with prevalence and epidemiology of ESBL faecal carriage in two nursing homes in Beirut: 57 residents in the first (NH1 and 151 residents in the second (NH2. In second phase, faecal swabs from cohort of NH1 residents were examined for carriage at six-week intervals over three-month period. Residents’ charts were reviewed to assess carriage risk factors. Results. Over 3 consecutive samplings at NH1, 81% of residents were at least one-time carriers with 50% at the first round, 60.4% at the second, and 74.5% at the last one. At NH2, 68.2% of residents were carriers. Constipation (in NH1 and antibiotic intake (in NH2 were significantly associated with higher ESBL faecal carriage while the length of stay at the nursing home (in NH2 was associated with less carriage. Conclusion. Faecal carriage of ESBL-producing Enterobacteriaceae is high among nursing home patients in Beirut. The rate of carriage changes rapidly and significantly over time either with multiple factors playing a possible role like outbreak spreading, antibiotic, and health care system exposure.

  20. The impact of habitual school bag carriage on the health of ...

    African Journals Online (AJOL)

    The impact of habitual school bag carriage on the health of pubescent scholars. ... African Journal for Physical Activity and Health Sciences ... The carriage of heavy school bags is a suspected aetiological factor of the daily physical stress of school pupils which negatively impacts on the health of their vertebral column.

  1. The Effects of Load Carriage and Muscle Fatigue on Lower-Extremity Joint Mechanics

    Science.gov (United States)

    Wang, He; Frame, Jeff; Ozimek, Elicia; Leib, Daniel; Dugan, Eric L.

    2013-01-01

    Military personnel are commonly afflicted by lower-extremity overuse injuries. Load carriage and muscular fatigue are major stressors during military basic training. Purpose: To examine effects of load carriage and muscular fatigue on lower-extremity joint mechanics during walking. Method: Eighteen men performed the following tasks: unloaded…

  2. Carriage of Neisseria meningitidis in the Hajj and Umrah mass gatherings

    Directory of Open Access Journals (Sweden)

    Saber Yezli

    2016-06-01

    Full Text Available Meningococcal disease is a serious public health threat, especially during mass gatherings such as Hajj and Umrah which provide optimal conditions for disease transmission. The disease is caused by Neisseria meningitidis and transmitted mainly via asymptomatic carriers. A review of the literature on asymptomatic N. meningitidis carriage among Hajj and Umrah pilgrims and their household contacts was performed. Carriage studies reported carriage rates to be higher in Hajj pilgrims compared to Umrah pilgrims and that these events promote acquisition of carriage among pilgrims. With some outliers, most studies found carriage rates among pilgrims to be comparable to those in populations under non-epidemic settings. However, these results should be interpreted with caution, taking into account the limitations within the studies identified. A wide variety of N. meningitidis serogroups appear to be circulating among Hajj and Umrah pilgrims, with serogroups W135 and B being most prominent. Current Hajj and Umrah meningococcal disease preventative measures do not necessarily prevent carriage and transmission, which may result in local and international outbreaks among susceptible populations. Monitoring carriage states of visitors and local inhabitants in the Kingdom of Saudi Arabia, as well as the implementation of preventive measures that impact carriage, are warranted to reduce the risk of Hajj and Umrah-related meningococcal disease outbreaks.

  3. Acquisition of Streptococcus pneumoniae carriage in pilgrims during the 2012 Hajj.

    Science.gov (United States)

    Benkouiten, Samir; Gautret, Philippe; Belhouchat, Khadidja; Drali, Tassadit; Salez, Nicolas; Memish, Ziad A; Al Masri, Malak; Fournier, Pierre-Edouard; Brouqui, Philippe

    2014-02-01

    To investigate the nasal carriage of some respiratory bacterial pathogens that are responsible for infections associated with person-to-person transmission, we conducted a cohort survey of pilgrims departing to Mecca for the 2012 Hajj season. In this report, we demonstrate the acquisition of Streptococcus pneumoniae nasal carriage in returning Hajj pilgrims.

  4. Carriage of Neisseria meningitidis in the Hajj and Umrah mass gatherings.

    Science.gov (United States)

    Yezli, Saber; Wilder-Smith, Annelies; Bin Saeed, Abdulaziz A

    2016-06-01

    Meningococcal disease is a serious public health threat, especially during mass gatherings such as Hajj and Umrah which provide optimal conditions for disease transmission. The disease is caused by Neisseria meningitidis and transmitted mainly via asymptomatic carriers. A review of the literature on asymptomatic N. meningitidis carriage among Hajj and Umrah pilgrims and their household contacts was performed. Carriage studies reported carriage rates to be higher in Hajj pilgrims compared to Umrah pilgrims and that these events promote acquisition of carriage among pilgrims. With some outliers, most studies found carriage rates among pilgrims to be comparable to those in populations under non-epidemic settings. However, these results should be interpreted with caution, taking into account the limitations within the studies identified. A wide variety of N. meningitidis serogroups appear to be circulating among Hajj and Umrah pilgrims, with serogroups W135 and B being most prominent. Current Hajj and Umrah meningococcal disease preventative measures do not necessarily prevent carriage and transmission, which may result in local and international outbreaks among susceptible populations. Monitoring carriage states of visitors and local inhabitants in the Kingdom of Saudi Arabia, as well as the implementation of preventive measures that impact carriage, are warranted to reduce the risk of Hajj and Umrah-related meningococcal disease outbreaks. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Epidemiology of nasopharyngeal carriage of Neisseria meningitidis in healthy Dutch children.

    NARCIS (Netherlands)

    Bogaert, D.; Hermans, P.W.M.; Boelens, H.; Sluijter, M.; Luijendijk, A.; Rumke, H.C.; Koppen, S.; Belkum, A. van; Groot, R. de; Verbrugh, H.A.

    2005-01-01

    We investigated the prevalence and determinants of nasopharyngeal carriage of Neisseria meningitidis in 3200 healthy children aged 1-19 years. The incidence of meningococcal carriage was, on average, 1.5%. Peak incidences were seen at age 1 year and after age 15 years. The independent determinants

  6. Pneumococcal conjugate vaccines for preventing otitis media

    NARCIS (Netherlands)

    Fortanier, Alexandre C.; Venekamp, Roderick P.; Boonacker, Chantal W. B.; Hak, Eelko; Schilder, Anne G. M.; Sanders, Elisabeth A. M.; Damoiseaux, Roger A. M. J.

    2014-01-01

    BACKGROUND: Acute otitis media (AOM) is a very common respiratory infection in early infancy and childhood. The marginal benefits of antibiotics for AOM in low-risk populations in general, the increasing problem of bacterial resistance to antibiotics and the huge estimated direct and indirect annual

  7. Pneumococcal conjugate vaccines for preventing otitis media

    NARCIS (Netherlands)

    Jansen, Angelique G S C; Hak, Eelko; Veenhoven, Reinier H; Damoiseaux, Roger A M J; Schilder, Anne G M; Sanders, Elisabeth A M

    2009-01-01

    BACKGROUND: Acute otitis media (AOM) is a very common early infancy and childhood disease. The marginal benefits of antibiotics on AOM, the increasing problem of bacterial resistance to antibiotics, and the huge estimated direct and indirect annual costs associated with otitis media (OM) have

  8. Uncommon mixed outbreak of pneumococcal and meningococcal ...

    African Journals Online (AJOL)

    Objective: The Jirapa District in Ghana falls within the African meningitis belt where over 500 million people are at risk of epidemic meningitis. The district suffered an outbreak of Neisseria meningitides, W (NMW) in 2012 and a mixed outbreak of Streptococcus pneumonia and NMW in early 2016. We investigated the ...

  9. APOL1 Risk Variants Independently Associated With Early Cardiovascular Disease Death

    Directory of Open Access Journals (Sweden)

    Michael D. Hughson

    2018-01-01

    Conclusion: Carriage of 1 or 2 APOL1 risk alleles in African Americans was associated with earlier age deaths due to coronary artery disease and cardiomyopathy. For 2 risk alleles, the early age was independent of nephrosclerosis.

  10. [Carriage of Staphylococcus aureus. A severity factor of erysipelas?].

    Science.gov (United States)

    Bernard, P; Risse, L; Mounier, M; Bonnetblanc, J M

    1996-01-01

    Occasional superinfection or co-infection with Staphylococcus aureus led us to search for S. aureus carriage prospectively in patients with non-necrotizing bacterial dermophypodermitis, in particular erysipelas. This prospective study included immunocompetent patients with bacterial dermophypodermitis without signs of toxicity or local manifestations suggesting necrotizing fasciitis. Bacteriology tests included: 1) direct immunofluorescence for streptococcus (groups A, C, G) on skin biopsies taken on day 0, 2) samples from the nasal orifices, the intergluteal fold, and potential skin portals for bacteriology culture, and 3) assay of antistreptolysine O and antistreptodornase B on day 0 and 15. The study group included 42 patients (23 females, 19 males, mean age 64 +/- 3.5 yr). In 39 cases (93%) bacterial dermohypodermitis was located on the lower limb with a potential skin portal in 36 cases (86%). Sample culture, direct immunofluorescence or serology findings demonstrated presence of streptococci in 33 cases (79%). Nasal, intergluteal or potential portal were identified in 19 patients (45%) including 16 with demonstrated presence of streptococci. The rate of cure after oral pristinamycin did not vary significantly between carriers (79%) an non-carriers (91%) of Staphylococcus aureus. Drainage of a localized abscess was successful in 5 of 6 patients after initial failure of antibiotic treatment; 4 of them were carriers of S. aureus. This prospective study demonstrated that cutaneous-mucosal carriage of Staphylococcus aureus is frequent in patients with non-necrotizing dermohypodermitis. This carriage is not a factor of over-morbidity as shown in this group of infections largely dominated by erysipelas.

  11. Effect of Load Carriage on Upper Limb Performance.

    Science.gov (United States)

    Hadid, Amir; Katz, Inbar; Haker, Tal; Zeilig, Gabi; Defrin, Ruth; Epstein, Yoram; Gefen, Amit

    2017-05-01

    Carrying heavy backpacks are often associated with shoulder discomfort or pain, loss of sensorimotor functions, and brachial plexus injuries that might hamper performance. On the basis of previous research, the cause of these symptoms could be tissue deformations of the brachial plexus and the subclavian artery caused by the shoulder straps. This study aimed to evaluate the changes in the upper extremity hemodynamic and neural function and to assess how they are associated with brachial plexus tissue deformation during heavy load carriage. Ten young healthy adults carried for 45 min a backpack load (40% of their body weight) while standing freely, followed by 15 min of recovery (unloaded). Index-finger microvascular flow and sensorimotor function were measured before and after carrying the load, and after recovery. The following sensorimotor functions were measured: light touch thresholds by the index finger and little finger, forearm thermal sensation thresholds, and gross motor function. In addition, marksmanship accuracy, as an indication for fine motor function, was tested. Load carriage resulted in an average decrease of ~40% in microvascular flow and a significant decrement in light touch sensation (P < 0.05), but not in thermal sensation and gross motor functions. An increase in the light touch threshold was highly correlated with a reduced index-finger microvascular blood flow (r = 0.79, P = 0.007). These physiological effects were associated with a functional 34% decrement in the accuracy of target acquisition. Heavy load carriage resulted in impaired light touch sensitivity and fine motor function, which were associated with reduced finger microvascular blood flow.

  12. Oral carriage of yeasts and coliforms in stroke sufferers: a prospective longitudinal study.

    Science.gov (United States)

    Zhu, H W; McMillan, A S; McGrath, C; Li, L S W; Samaranayake, L P

    2008-01-01

    To investigate prospectively the qualitative and quantitative changes in oral carriage of yeasts and coliforms in southern Chinese people suffering from stroke. In 56 elderly people suffering from stroke in a rehabilitation unit of a general medical hospital in Hong Kong, oral microbiological sampling using a combined imprint culture, oral rinse approach and clinical assessment was made during the acute stroke phase, on hospital discharge and 6 months later. The oral carriage of yeasts increased significantly during acute stroke (Pcoliform carriage did not. A reduction in oral carriage of yeasts was found on hospital discharge and 6 months later and in coliforms at the 6-month assessment (Pcoliform respectively. Stroke-related difficulty in tooth brushing and denture wearing were associated with higher oral yeast carriage (Pcoliforms in people suffering from stroke is noteworthy by care providers as K. pneumoniae may cause aspiration pneumonia.

  13. Evaluation of Pneumococcal Load in Blood by Polymerase Chain Reaction for the Diagnosis of Pneumococcal Pneumonia in Young Children in the PERCH Study.

    Science.gov (United States)

    Deloria Knoll, Maria; Morpeth, Susan C; Scott, J Anthony G; Watson, Nora L; Park, Daniel E; Baggett, Henry C; Brooks, W Abdullah; Feikin, Daniel R; Hammitt, Laura L; Howie, Stephen R C; Kotloff, Karen L; Levine, Orin S; O'Brien, Katherine L; Thea, Donald M; Ahmed, Dilruba; Antonio, Martin; Awori, Juliet O; Baillie, Vicky L; Chipeta, James; Deluca, Andrea N; Dione, Michel; Driscoll, Amanda J; Higdon, Melissa M; Jatapai, Anchalee; Karron, Ruth A; Mazumder, Razib; Moore, David P; Mwansa, James; Nyongesa, Sammy; Prosperi, Christine; Seidenberg, Phil; Siludjai, Duangkamon; Sow, Samba O; Tamboura, Boubou; Zeger, Scott L; Murdoch, David R; Madhi, Shabir A

    2017-06-15

    Detection of pneumococcus by lytA polymerase chain reaction (PCR) in blood had poor diagnostic accuracy for diagnosing pneumococcal pneumonia in children in 9 African and Asian sites. We assessed the value of blood lytA quantification in diagnosing pneumococcal pneumonia. The Pneumonia Etiology Research for Child Health (PERCH) case-control study tested whole blood by PCR for pneumococcus in children aged 1-59 months hospitalized with signs of pneumonia and in age-frequency matched community controls. The distribution of load among PCR-positive participants was compared between microbiologically confirmed pneumococcal pneumonia (MCPP) cases, cases confirmed for nonpneumococcal pathogens, nonconfirmed cases, and controls. Receiver operating characteristic analyses determined the "optimal threshold" that distinguished MCPP cases from controls. Load was available for 290 of 291 cases with pneumococcal PCR detected in blood and 273 of 273 controls. Load was higher in MCPP cases than controls (median, 4.0 × 103 vs 0.19 × 103 copies/mL), but overlapped substantially (range, 0.16-989.9 × 103 copies/mL and 0.01-551.9 × 103 copies/mL, respectively). The proportion with high load (≥2.2 log10 copies/mL) was 62.5% among MCPP cases, 4.3% among nonconfirmed cases, 9.3% among cases confirmed for a nonpneumococcal pathogen, and 3.1% among controls. Pneumococcal load in blood was not associated with respiratory tract illness in controls (P = .32). High blood pneumococcal load was associated with alveolar consolidation on chest radiograph in nonconfirmed cases, and with high (>6.9 log10 copies/mL) nasopharyngeal/oropharyngeal load and C-reactive protein ≥40 mg/L (both P < .01) in nonconfirmed cases but not controls. Quantitative pneumococcal PCR in blood has limited diagnostic utility for identifying pneumococcal pneumonia in individual children, but may be informative in epidemiological studies.

  14. Effects of military load carriage on kinematics of gait.

    Science.gov (United States)

    Majumdar, Deepti; Pal, Madhu Sudan; Majumdar, Dhurjati

    2010-06-01

    Manual load carriage is a universal activity and an inevitable part of the daily schedule of a soldier. Indian Infantry soldiers carry loads on the waist, back, shoulders and in the hands for a marching order. There is no reported study on the effects of load on gait in this population. It is important to evaluate their kinematic responses to existing load carriage operations and to provide guidelines towards the future design of heavy military backpacks (BPs) for optimising soldiers' performance. Kinematic changes of gait parameters in healthy male infantry soldiers whilst carrying no load (NL) and military loads of 4.2-17.5 kg (6.5-27.2% body weight) were investigated. All comparisons were conducted at a self-selected speed. Soldier characteristics were: mean (SD) age 23.3 (2.6) years; height 172.0 (3.8) cm; weight 64.3 (7.4) kg. Walk trials were collected using a 3-D Motion Analysis System. Results were subjected to one-way ANOVA followed by Dunnett post hoc test. There were increases in step length, stride length, cadence and midstance with the addition of a load compared to NL. These findings were resultant of an adaptive phenomenon within the individual to counterbalance load effect along with changes in speed. Ankle and hip ranges of motion (ROM) were significant. The ankle was more dorsiflexed, the knee and hip were more flexed during foot strike and helped in absorption of the load. The trunk showed more forward leaning with the addition of a load to adjust the centre of mass of the body and BP system back to the NL condition. Significant increases in ankle and hip ROM and trunk forward inclination (> or =10 degrees ) with lighter loads, such as a BP (10.7 kg), BP with rifle (14.9 kg) and BP with a light machine gun (17.5 kg), may cause joint injuries. It is concluded that the existing BP needs design improvisation specifically for use in low intensity conflict environments. STATEMENT OF RELEVANCE: The present study evaluates spatial, temporal and angular

  15. The empty carriage: lessons in leadership from Florence Nightingale.

    Science.gov (United States)

    Hegge, Marge

    2011-01-01

    Florence Nightingale made a profound statement about leadership when she returned from the Crimean War without the fanfare offered to her. Promoters paraded her empty carriage around the city of Southampton England to applaud her accomplishments in the war. Her absence signaled a new leadership, one of quiet determination, humility, and political strategy to improve quality of life. The lessons to be learned for today's nurse leaders revolve around mindfulness, clarity of purpose, reverence for human life, collaborative partnerships, co-evolution, engagement, keeping up with a world in motion, and making meaning.

  16. Mitigated-force carriage for high magnetic field environments

    Science.gov (United States)

    Ludtka, Gerard M.; Ludtka, Gail M.; Wilgen, John B.; Murphy, Bart L.

    2015-05-19

    A carriage for high magnetic field environments includes a plurality of work-piece separators disposed in an operable relationship with a work-piece processing magnet having a magnetic field strength of at least 1 Tesla for supporting and separating a plurality of work-pieces by a preselected, essentially equal spacing, so that, as a first work-piece is inserted into the magnetic field, a second work-piece is simultaneously withdrawn from the magnetic field, so that an attractive magnetic force imparted on the first work-piece offsets a resistive magnetic force imparted on the second work-piece.

  17. African meningitis belt pneumococcal disease epidemiology indicates a need for an effective serotype 1 containing vaccine, including for older children and adults

    Directory of Open Access Journals (Sweden)

    Mueller Judith E

    2010-02-01

    Full Text Available Abstract Background Pneumococcal conjugate vaccine strategies in GAVI-eligible countries are focusing on infant immunization but this strategy may not be optimal in all settings. We aimed to collect all available population based data on pneumococcal meningitis throughout life in the African meningitis belt and then to model overall meningitis risk to help inform vaccine policy. Methods After a systematic review of literature published from 1970 through the present, we found robust population-based Streptococcus pneumoniae (Sp meningitis data across age strata for four African meningitis belt countries that included 35 surveillance years spanning from 1970 to 2005. Using these data we modeled disease risk for a hypothetical cohort of 100,000 persons followed throughout life. Results Similar to meningococcal meningitis, laboratory-confirmed pneumococcal meningitis was seasonal, occurring primarily in the dry season. The mean annual Sp meningitis incidence rates were 98, 7.8 to 14, and 5.8 to 12 per 100,000 among persons Conclusions In the African meningitis belt, Sp is as important a cause of meningitis as Neisseria meningitidis, particularly among older children and working age adults. The meningitis belt population needs an effective serotype 1 containing vaccine and policy discussions should consider vaccine use outside of early childhood.

  18. The pneumococcal polysaccharide capsule and pneumolysin differentially affect CXCL8 and IL-6 release from cells of the upper and lower respiratory tract.

    Science.gov (United States)

    Küng, Eliane; Coward, William R; Neill, Daniel R; Malak, Hesham A; Mühlemann, Kathrin; Kadioglu, Aras; Hilty, Markus; Hathaway, Lucy J

    2014-01-01

    The polysaccharide capsule and pneumolysin toxin are major virulence factors of the human bacterial pathogen Streptococcus pneumoniae. Colonization of the nasopharynx is asymptomatic but invasion of the lungs can result in invasive pneumonia. Here we show that the capsule suppresses the release of the pro-inflammatory cytokines CXCL8 (IL-8) and IL-6 from the human pharyngeal epithelial cell line Detroit 562. Release of both cytokines was much less from human bronchial epithelial cells (iHBEC) but levels were also affected by capsule. Pneumolysin stimulates CXCL8 release from both cell lines. Suppression of CXCL8 homologue (CXCL2/MIP-2) release by the capsule was also observed in vivo during intranasal colonization of mice but was only discernable in the absence of pneumolysin. When pneumococci were administered intranasally to mice in a model of long term, stable nasopharyngeal carriage, encapsulated S. pneumoniae remained in the nasopharynx whereas the nonencapsulated pneumococci disseminated into the lungs. Pneumococcal capsule plays a role not only in protection from phagocytosis but also in modulation of the pro-inflammatory immune response in the respiratory tract.

  19. Gene expression in cortex and hippocampus during acute pneumococcal meningitis

    Directory of Open Access Journals (Sweden)

    Wittwer Matthias

    2006-06-01

    Full Text Available Abstract Background Pneumococcal meningitis is associated with high mortality (~30% and morbidity. Up to 50% of survivors are affected by neurological sequelae due to a wide spectrum of brain injury mainly affecting the cortex and hippocampus. Despite this significant disease burden, the genetic program that regulates the host response leading to brain damage as a consequence of bacterial meningitis is largely unknown. We used an infant rat model of pneumococcal meningitis to assess gene expression profiles in cortex and hippocampus at 22 and 44 hours after infection and in controls at 22 h after mock-infection with saline. To analyze the biological significance of the data generated by Affymetrix DNA microarrays, a bioinformatics pipeline was used combining (i a literature-profiling algorithm to cluster genes based on the vocabulary of abstracts indexed in MEDLINE (NCBI and (ii the self-organizing map (SOM, a clustering technique based on covariance in gene expression kinetics. Results Among 598 genes differentially regulated (change factor ≥ 1.5; p ≤ 0.05, 77% were automatically assigned to one of 11 functional groups with 94% accuracy. SOM disclosed six patterns of expression kinetics. Genes associated with growth control/neuroplasticity, signal transduction, cell death/survival, cytoskeleton, and immunity were generally upregulated. In contrast, genes related to neurotransmission and lipid metabolism were transiently downregulated on the whole. The majority of the genes associated with ionic homeostasis, neurotransmission, signal transduction and lipid metabolism were differentially regulated specifically in the hippocampus. Of the cell death/survival genes found to be continuously upregulated only in hippocampus, the majority are pro-apoptotic, while those continuously upregulated only in cortex are anti-apoptotic. Conclusion Temporal and spatial analysis of gene expression in experimental pneumococcal meningitis identified potential

  20. Role of nasal carriage of Staphylococcus aureus in chronic urticaria

    Directory of Open Access Journals (Sweden)

    Ashimav Deb Sharma

    2012-01-01

    Full Text Available Aim: To evaluate the role of nasal carriage of Staphylococcus aureus in patients suffering from chronic urticaria. Method: All total 82 patients were included for this study. Study group comprised 57 patients with chronic urticaria and the control group comprised 25 healthy volunteers. Nasal swab specimens were taken from all the 82 patients for bacterial culture and antimicrobial sensitivity. Patients with chronic urticaria who had positive growth for S. aureus were treated with sensitive antimicrobial agent. Nasal swab specimens were taken again from all the patients who received antimicrobial therapy to ensure complete eradication of S. aureus. All patients were followed up for a period of 6 weeks after the treatment. Urticarial activity was measured with the help of urticarial activity score. Results: S. aureus was detected in swab specimens from the nasal cavity in 32 patients in the study group and 7 patients in the control group. In the study group, after the antimicrobial treatment, 9 patients (28.12% had complete recovery from urticaria during the follow-up period; 4 patients (12.5% showed partial recovery from urticaria while the remaining patients (59.37% continued to suffer from urticaria. Conclusion: This study showed that nasal carriage of S. aureus can act as an etiological factor in chronic urticaria.

  1. Intractable pneumococcal meningoencephalitis associated with a TNF-α antagonist.

    Science.gov (United States)

    Kang, Seok-Jae; Kim, Hyun Young; Kim, Young Seo; Lee, Ha Neul; Kim, Hee Tae; Kim, Seung H

    2014-09-15

    A 34-year-old man was treated with a TNF-α antagonist for ankylosing spondylitis, and this subsequently developed a CNS infection. Magnetic resonance imaging showed diffuse subcortical white matter lesions. Streptococcus pneumoniae was cultured from the cerebrospinal fluid and blood. The patient died of multifocal widespread brain damage and subarachnoid hemorrhage, despite intensive antibacterial medication. Pneumococcal meningoencephalitis can occur in association with TNF-α antagonists. Clinicians should be aware of both the risk of fatal bacterial meningoencephalitis associated with TNF-α antagonists and the possibility of an unusual presentation of bacterial meningitis. Copyright © 2014. Published by Elsevier B.V.

  2. Paroxysmal Autonomic Instability with Dystonia after Pneumococcal Meningoencephalitis

    Directory of Open Access Journals (Sweden)

    Layal Safadieh

    2012-01-01

    Full Text Available Streptococcus pneumoniae is a common cause of bacterial meningitis, frequently resulting in severe neurological impairment. A seven-month-old child presenting with Streptococcus pneumoniae meningoencephalitis developed right basal ganglia and hypothalamic infarctions. Daily episodes of agitation, hypertension, tachycardia, diaphoresis, hyperthermia, and decerebrate posturing were observed. The diagnosis of paroxysmal autonomic instability with dystonia was established. The patient responded to clonidine, baclofen, and benzodiazepines. Although this entity has been reported in association with traumatic brain injury, and as a sequel to some nervous system infections, this is the first case, to our knowledge, associated with pneumococcal meningoencephalitis.

  3. Invasive pneumococcal disease in Australia, 2009 and 2010.

    Science.gov (United States)

    Bareja, Chritina; Toms, Cindy; Lodo, Kerryn; de Kluyver, Rachel

    2015-06-30

    Enhanced surveillance for invasive pneumococcal disease (IPD) was conducted in all Australian states and territories in 2009 and 2010 with comprehensive comparative data available since 2002. There were 1,556 cases of IPD notified to the National Notifiable Diseases Surveillance System in Australia in 2009, a notification rate of 7.2 cases per 100,000 population. In 2010 there were 1,640 cases, a notification rate of 7.4 cases per 100,000. The overall rate of IPD in Indigenous Australians was almost 6 times the rate in non-Indigenous Australians in both 2009 and 2010. In 2009 and 2010, notification rates of IPD caused by serotypes included in the 7-valent pneumococcal conjugate vaccine (7vPCV) continued to decrease across all age groups. Rates of IPD caused by non-7vPCV serotypes continued to show an increasing trend in both Indigenous and non-Indigenous children aged less than 5 years. In Indigenous adults (≥50 years), rates of IPD caused by both 23-valent pneumococcal polysaccharide vaccine (23vPPV) serotypes and non-23vPPV serotypes continued to show an overall increase, particularly in 2010. There were 110 deaths attributed to IPD in 2009 and 137 in 2010, although it should be noted that deaths may be under-reported. The number of invasive pneumococcal isolates with reduced penicillin susceptibility remained low and reduced susceptibility to third generation cephalosporins was rare. This work is copyright. You may download, display, print and reproduce the whole or part of this work in unaltered form for your own personal use or, if you are part of an organisation, for internal use within your organisation, but only if you or your organisation do not use the reproduction for any commercial purpose and retain this copyright notice and all disclaimer notices as part of that reproduction. Apart from rights to use as permitted by the Copyright Act 1968 or allowed by this copyright notice, all other rights are reserved and you are not allowed to reproduce the

  4. Recombinant BCG expressing a PspA-PdT fusion protein protects mice against pneumococcal lethal challenge in a prime-boost strategy.

    Science.gov (United States)

    Goulart, Cibelly; Rodriguez, Dunia; Kanno, Alex I; Lu, Ying-Jie; Malley, Richard; Leite, Luciana C C

    2017-03-23

    Pneumococcal proteins have been evaluated as genetically-conserved potential vaccine candidates. We have previously demonstrated that a fragment of PspA in fusion with PdT (rPspA-PdT) induced protective immune responses in mice. However, purified proteins have shown poor immunogenicity and often require the combination with strong adjuvants and booster doses. Here, we investigated the use of a Bacillus Calmette-Guérin (BCG) strain, a well-established prophylactic vaccine for tuberculosis with known adjuvant properties, for delivery of the PspA-PdT fusion protein. Immunization of mice in a prime-boost strategy, using rPspA-PdT as a boost, demonstrated that rBCG PspA-PdT/rPspA-PdT was able to induce an antibody response against both proteins, promoting an IgG1 to IgG2 antibody isotype shift. Sera from rBCG PspA-PdT/rPspA-PdT immunized mice showed antibodies able to bind to the pneumococcal surface and promoted higher complement deposition when compared with WT-BCG/rPspA-PdT or a single dose of rPspA-PdT. In addition, these antisera inhibited the cytolytic activity of Ply. Production of interleukin-6 (IL-6), gamma interferon (IFN-γ), and tumor necrosis factor alpha (TNF-α) was increased in splenocytes culture. Furthermore, a higher expression of CD69 early activation molecule was observed on splenic CD4 + T cells from mice immunized with rBCG PspA-PdT before and after the protein booster dose. Finally, immunization with rBCG PspA-PdT/rPspA-PdT protected mice against pneumococcal lethal challenge. These results support the further investigation of recombinant BCG strains to express pneumococcal proteins, which could be administered in early stages of life and lead to protective pneumococcal immunity in infants and children. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Celiac Disease and Increased Risk of Pneumococcal Infection: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Simons, Malorie; Scott-Sheldon, Lori A J; Risech-Neyman, Yesenia; Moss, Steven F; Ludvigsson, Jonas F; Green, Peter H R

    2018-01-01

    Celiac disease has been associated with hyposplenism, and multiple case reports link celiac disease and pneumococcal infections; however, increased risk of pneumococcal infection in celiac disease has not been confirmed. The purpose of this study was to conduct a systematic review to determine the risk of pneumococcal infections in celiac disease. Relevant studies were identified using electronic bibliographic searches of PubMed, OVID, Medline, and EMBASE (1980 to February 2017) and reviewing abstracts from major conferences in gastroenterology. Using number of events in celiac patients and referent patients, we calculated a summary relative risk of pneumococcal infections. All analyses were conducted in Comprehensive Meta-Analysis software using random-effects assumptions. Of a total of 156 articles, 3, representing 3 large databases (the Swedish National Inpatient Register; the Oxford Record Linkage Study; and the English National Hospital Episode Statistics) were included. Each compared patients with celiac disease and confirmed pneumococcal infection to a specific reference group: inpatients and/or the general population. Overall, the odds of pneumococcal infection were higher among hospitalized celiac patients compared with controls (odds ratio 1.66; 95% confidence interval 1.43-1.92). There was no evidence of heterogeneity (Q[1] = 1.17, P = .56, I 2  = 0%). Celiac disease is associated with an increased risk of pneumococcal infection. Preventive pneumococcal vaccination should be considered for those with celiac disease, with special attention to those aged 15-64 years who have not received the scheduled pneumococcal vaccination series as a child. Copyright © 2018 Elsevier Inc. All rights reserved.

  6. Viability and virulence of pneumolysin, pneumococcal surface protein A, and pneumolysin/pneumococcal surface protein A mutants in the ear.

    Science.gov (United States)

    Schachern, Patricia A; Tsuprun, Vladimir; Goetz, Sarah; Cureoglu, Sebahattin; Juhn, Steven K; Briles, David E; Paparella, Michael M; Ferrieri, Patricia

    2013-09-01

    Understanding how pneumococcal proteins affect the pathology of the middle ear and inner ear is important for the development of new approaches to prevent otitis media and its complications. To determine the viability and virulence of Streptococcus pneumoniae mutants deficient in pneumolysin (Ply-) and pneumococcal surface protein A (PspA-) in the chinchilla middle ear. Bullae of chinchillas were inoculated bilaterally with wild-type (Wt), Ply-, PspA-, and Ply-/PspA- strains. Bacterial colony-forming units (CFUs) in middle ear effusions were counted at 48 hours. The CFUs of the PspA- group were also counted at 6 to 36 hours after inoculation. Temporal bone histopathological results were compared. Twenty-seven chinchillas in an academic research laboratory. Chinchilla middle ears were inoculated with S pneumoniae to produce sufficient volumes of effusions and noticeable histopathological changes in the ears. The CFU counts in the middle ear effusions and histopathological changes were compared to determine the effect of pneumococcal protein mutations on chinchilla ears. At 48 hours, CFUs in middle ears were increased for the Wt and Ply-/PspA- strains, but Ply- remained near inoculum level. No bacteria were detected in the PspA- group. The CFUs of PspA- decreased over time to a low level at 30 to 36 hours. In vitro, PspA- in Todd-Hewitt broth showed an increase in bacterial growth of 2 logs at 43 hours, indicating PspA- susceptibility to host defenses in vivo. The PspA- and Ply- groups had fewer pathologic findings than the Wt or Ply-/PspA- groups. Histopathological analysis showed significant differences in the number of bacteria in the scala tympani in the Wt group compared with the Ply-, PspA-, and Ply-/PspA- groups. The PspA- strain was the least virulent. The PspA- mutant was much less viable and less virulent in the ear than the Wt, Ply-, and Ply-/PspA- strains. There was no significant attenuation in the viability and virulence of the Ply-/PspA- mutant

  7. Detection of Pneumococcal DNA in Blood by Polymerase Chain Reaction for Diagnosing Pneumococcal Pneumonia in Young Children From Low- and Middle-Income Countries.

    Science.gov (United States)

    Morpeth, Susan C; Deloria Knoll, Maria; Scott, J Anthony G; Park, Daniel E; Watson, Nora L; Baggett, Henry C; Brooks, W Abdullah; Feikin, Daniel R; Hammitt, Laura L; Howie, Stephen R C; Kotloff, Karen L; Levine, Orin S; Madhi, Shabir A; O'Brien, Katherine L; Thea, Donald M; Adrian, Peter V; Ahmed, Dilruba; Antonio, Martin; Bunthi, Charatdao; DeLuca, Andrea N; Driscoll, Amanda J; Githua, Louis Peter; Higdon, Melissa M; Kahn, Geoff; Karani, Angela; Karron, Ruth A; Kwenda, Geoffrey; Makprasert, Sirirat; Mazumder, Razib; Moore, David P; Mwansa, James; Nyongesa, Sammy; Prosperi, Christine; Sow, Samba O; Tamboura, Boubou; Whistler, Toni; Zeger, Scott L; Murdoch, David R

    2017-06-15

    We investigated the performance of polymerase chain reaction (PCR) on blood in the diagnosis of pneumococcal pneumonia among children from 7 low- and middle-income countries. We tested blood by PCR for the pneumococcal autolysin gene in children aged 1-59 months in the Pneumonia Etiology Research for Child Health (PERCH) study. Children had World Health Organization-defined severe or very severe pneumonia or were age-frequency-matched community controls. Additionally, we tested blood from general pediatric admissions in Kilifi, Kenya, a PERCH site. The proportion PCR-positive was compared among cases with microbiologically confirmed pneumococcal pneumonia (MCPP), cases without a confirmed bacterial infection (nonconfirmed), cases confirmed for nonpneumococcal bacteria, and controls. In PERCH, 7.3% (n = 291/3995) of cases and 5.5% (n = 273/4987) of controls were blood pneumococcal PCR-positive (P < .001), compared with 64.3% (n = 36/56) of MCPP cases and 6.3% (n = 243/3832) of nonconfirmed cases (P < .001). Blood pneumococcal PCR positivity was higher in children from the 5 African countries (5.5%-11.5% among cases and 5.3%-10.2% among controls) than from the 2 Asian countries (1.3% and 1.0% among cases and 0.8% and 0.8% among controls). Among Kilifi general pediatric admissions, 3.9% (n = 274/6968) were PCR-positive, including 61.7% (n = 37/60) of those with positive blood cultures for pneumococcus. The utility of pneumococcal PCR on blood for diagnosing childhood pneumococcal pneumonia in the 7 low- and middle-income countries studied is limited by poor specificity and by poor sensitivity among MCPP cases.

  8. Sinusitis and pneumonia hospitalization after introduction of pneumococcal conjugate vaccine.

    Science.gov (United States)

    Lindstrand, Ann; Bennet, Rutger; Galanis, Ilias; Blennow, Margareta; Ask, Lina Schollin; Dennison, Sofia Hultman; Rinder, Malin Ryd; Eriksson, Margareta; Henriques-Normark, Birgitta; Ortqvist, Ake; Alfvén, Tobias

    2014-12-01

    Streptococcus pneumoniae is a major cause of pneumonia and sinusitis. Pneumonia kills >1 million children annually, and sinusitis is a potentially serious pediatric disease that increases the risk of orbital and intracranial complications. Although pneumococcal conjugate vaccine (PCV) is effective against invasive pneumococcal disease, its effectiveness against pneumonia is less consistent, and its effect on sinusitis is not known. We compared hospitalization rates due to sinusitis, pneumonia, and empyema before and after sequential introduction of PCV7 and PCV13. All children 0 to sinusitis, pneumonia, or empyema in Stockholm County, Sweden, from 2003 to 2012 were included in a population-based study of hospital registry data on hospitalizations due to sinusitis, pneumonia, or empyema. Trend analysis, incidence rates, and rate ratios (RRs) were calculated comparing July 2003 to June 2007 with July 2008 to June 2012, excluding the year of PCV7 introduction. Hospitalizations for sinusitis decreased significantly in children aged 0 to sinusitis and pneumonia in children aged 0 to sinusitis and 19% lower risk of hospitalization for pneumonia in children aged 0 to <2 years, in a comparison of 4 years before and 4 years after vaccine introduction. Copyright © 2014 by the American Academy of Pediatrics.

  9. (1)H MRI of pneumococcal pneumonia in a murine model.

    Science.gov (United States)

    Marzola, Pasquina; Lanzoni, Anna; Nicolato, Elena; Di Modugno, Vincenza; Cristofori, Patrizia; Osculati, Francesco; Sbarbati, Andrea

    2005-07-01

    To detect and quantify pulmonary lesions due to pneumococcal pneumonia in a murine model by (1)H MRI. Pneumonia was induced in mice (N = 5) by intranasal administration of about 1 x 10(6) colony-forming units (CFU) of Streptococcus pneumonie. A group of noninfected animals (N = 5) was used as a control group. MRI was performed, 48 hours after infection induction, at 4.7 T. ECG-gated gradient-echo (GRE) sequences with TE = 5 msec were used. After MRI examination, the animals were sacrificed for histological examination. Lungs appeared at MRI as regions with signal intensity (SI) at the level of the noise. Lesions appeared as hyperintense regions over the background and were localized mainly in the apical part of the lungs, in the medial and peribronchial regions. The anatomical localization of the lesions was confirmed by histology. The total lesion volume quantified by MRI data correlated with the total lesion volume quantified by histology. This work shows that standard (1)H MRI allows detection and quantification of lesions due to pneumococcal pneumonia in mice.

  10. A Contribution to Recognising Carrier's Liability in International Carriage by Air and Sea

    Directory of Open Access Journals (Sweden)

    Slobodan Kaštela

    2003-07-01

    Full Text Available The paper presents the provisions of the part of MontrealConvention which refers to the air carriers' liability regardingdamage to passengers and luggage, with the intention of indicatingthe possible influence of this Convention on the equal liabilityin maritime carriage, settled by the recent changes of theAthens Convention on the carriage of passengers and their luggageby sea. The provisions of these documents are comparedregarding the basic principles of the carrier's liability and theamount of liability for the damage, showing both some similaritiesand some differences in the carriage of passengers by air, i.e.by sea.

  11. External store carriage loads prediction at transonic speeds

    Science.gov (United States)

    Rosen, Bruce S.

    1988-01-01

    A computational method for prediction of external store carriage loads at transonic speeds is described. The geometric flexibility required for treatment of isolated and underwing, pylon-mounted stores is achieved by computing solutions on a five-level embedded grid arrangement. A completely automated grid generation procedure facilitates applications. Store modeling capability consists of bodies of revolution with multiple fore and aft fins. A body-conforming grid improves the accuracy of the computed store body flow field. A nonlinear finite difference relaxation scheme, developed specifically for modified transonic small disturbance flow equations, enhances numerical stability and accuracy. As a result, more accurate treatment of low aspect ratio, highly swept and tapered wing planforms is possible. A limited supersonic freestream capability is also provided. Pressure, load distribution, force and moment correlations show good agreement for several test cases.

  12. Method to predict external store carriage loads at transonic speeds

    Science.gov (United States)

    Rosen, Bruce S.

    1989-01-01

    A computational method for prediction of external store carriage loads at transonic speeds is described. The geometric flexibility required for treatment of isolated and underwing, pylon mounted stores is achieved by computing solutions on a five level embedded grid arrangement. A completely automated grid generation procedure facilitates applications. Store modeling capability consists of bodies of revolution with multiple fore and aft fins. A body conforming grid improves the accuracy of the computed store body flow field. A nonlinear finite difference relaxation scheme, developed specifically for modified transonic small disturbance flow equations, enhances numerical stability and accuracy. As a result, more accurate treatment of low aspect ratio, highly swept and tapered wing planforms is possible. A limited supersonic freestream capability is also provided. Pressure, load distribution, force and moment correlation show good agreement for several test cases.

  13. Aspects of Legal Translation in Contracts of Carriage

    Directory of Open Access Journals (Sweden)

    Lavinia Nădrag

    2016-01-01

    Full Text Available This article analyzes several aspects of the maritime law vocabulary, in order to overcome theproblem of maritime inaccuracies in translation and to contribute to the better understanding andtranslation of texts and legislations within this field. The first section of this article deals withseveral key terms and issues in the field of legal translation and maritime language and highlightsthe fact that maritime language represents a functional variety of register. The second sectionpresents the corpus analyzed within this paper in order to reveal the language variation in the twolanguages (i.e. Romanian and English and to assess their lexical density. The third section isfocused on corpus analysis, highlighting the language variation in the English and Romaniantranslation of the chosen texts from the field of contracts of carriage in maritime law.

  14. Invasive pneumococcal and meningococcal disease : association with influenza virus and respiratory syncytial virus activity?

    NARCIS (Netherlands)

    Jansen, A G S C; Sanders, E A M; VAN DER Ende, A; VAN Loon, A M; Hoes, A W; Hak, E

    2008-01-01

    Few studies have examined the relationship between viral activity and bacterial invasive disease, considering both influenza virus and respiratory syncytial virus (RSV). This study aimed to assess the potential relationship between invasive pneumococcal disease (IPD), meningococcal disease (MD), and

  15. Invasive pneumococcal and meningococcal disease: association with influenza virus and respiratory syncytial virus activity?

    NARCIS (Netherlands)

    Jansen, A. G. S. C.; Sanders, E. A. M.; van der Ende, A.; van Loon, A. M.; Hoes, A. W.; Hak, E.

    2008-01-01

    Few studies have examined the relationship between viral activity and bacterial invasive disease, considering both influenza virus and respiratory syncytial virus (RSV). This study aimed to assess the potential relationship between invasive pneumococcal disease (IPD), meningococcal disease (MD), and

  16. Immune response capacity after human splenic autotransplantation - Restoration of response to individual pneumococcal vaccine subtypes

    NARCIS (Netherlands)

    Leemans, R; Manson, W; Snijder, JAM; Smit, JW; Klasen, HJ; The, TH; Timens, W

    Objective To evaluate features of general immune function, in particular the restoration of the humoral immune response to pneumococcal capsular polysaccharides, in humans undergoing a spleen autotransplantation after splenectomy because of trauma. Summary Background Data After splenectomy, patients

  17. Clinical and Epidemiological Evidence of the Red Queen Hypothesis in Pneumococcal Serotype Dynamics.

    Science.gov (United States)

    Stockmann, Chris; Ampofo, Krow; Pavia, Andrew T; Blaschke, Anne J; Mason, Edward O; Presson, Angela P; Forney, Larry J; Byington, Carrie L

    2016-09-01

    The Red Queen hypothesis is an evolutionary theory that describes the reciprocal coevolution of competing species. We sought to study whether introduction of the 7- and 13-valent pneumococcal conjugate vaccines (PCV7 and PCV13, respectively) altered pneumococcal serotype dynamics among children with invasive pneumococcal disease (IPD) as predicted by the Red Queen hypothesis. This study examined pneumococcal isolates (n = 641) obtained from children Red Queen hypothesis, which reveals a limitation of serotype-specific vaccines and offers insights that may facilitate alternative strategies for the elimination of IPD. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  18. Mucosal delivery of a pneumococcal vaccine using lactococcus lactis affords protection against respiratory infection

    NARCIS (Netherlands)

    Hanniffy, S.B.; Carter, A.T.; Hitchin, E.; Wells, J.

    2007-01-01

    Background - Economical and effective vaccines against Streptococcus pneumoniae (pneumococcus) are needed for implementation in poorer countries where the disease burden is highest. Here, we evaluated Lactococcus lactis intracellularly producing the pneumococcal surface protein A (PspA) as a mucosal

  19. PNEUMOCOCCAL INFECTION AND ASSOCIATED DISEASES — A SERIOUS PROBLEM OF MODERN HEALTH CARE

    Directory of Open Access Journals (Sweden)

    A.A. Baranov

    2008-01-01

    Full Text Available Pneumococcal infection is one of the most widespread reasons for the development of infections of the respiratory passages (otitis, sinusitis in children. At the same time, it may act as an etiological factor of severe urgent conditions, such as pneumococcal meningitis and pneumococcal pneumonia, especially in children under 2 years old. A reliable method for preventing this infection is specific immunological prophylaxis. The article covers in detail the issue of vaccination in Russia and in other countries. The necessity of vaccination of all infants is demonstrated, as well as the necessity of participation in resolving this issue not only of pediatricians but governmental institutions as well in order to enhance safety and efficiency of vaccination and include this vaccine into the national calendar.Key words: pneumococcal infection, forms, complications, vaccination, national vaccination calendar, risk groups, children.

  20. Study of invasive pneumococcal infection in adults with reference to penicillin resistance

    Directory of Open Access Journals (Sweden)

    Vrishali Avinash Muley

    2017-01-01

    Conclusions: Invasive pneumococcal infection has poor prognosis and penicillin-resistant strains have become increasingly common. This study emphasizes the importance of judicious use of antibiotics, especially to refrain their use in mild self-limiting upper respiratory infections.

  1. Recurrent Invasive Pneumococcal Disease Serotype 12F in a Vaccinated Splenectomized Patient

    DEFF Research Database (Denmark)

    Blaabjerg, Anne Katrine; Schumacher, Anna Holst; Kantsø, Bjørn

    2016-01-01

    This is the first case report of recurrent invasive pneumococcal disease (IPD), specifically, due to serotype 12F. The patient described here was vaccinated with the 23-valent pneumococcal polysaccharide vaccine (PPV23) due to previous splenectomy, and an anti-pneumococcal IgG test concluded...... that she had responded sufficiently to vaccination. Still, she had a fulminate recurrent infection with PPV23 serotype 12F. We investigated the anti-pneumococcal IgG test, and it turned out that it is based on the geometric mean value of only 12 of the serotypes included in PPV23; 12F is none of them...... vaccines, in order to get a more accurate estimation of the vaccination coverage for the individual patient. Therefore, more research on this area is warranted, along with a discussion of whether the laboratory answers to the clinicians should be more detailed....

  2. Dynamic pattern and genotypic diversity of Staphylococcus aureus nasopharyngeal carriage in healthy pre-school children

    National Research Council Canada - National Science Library

    Blumental, S; Deplano, A; Jourdain, S; De Mendonça, R; Hallin, M; Nonhoff, C; Rottiers, S; Vergison, A; Denis, O

    2013-01-01

    .... The objectives of this study were to assess the S. aureus temporal carriage pattern among a healthy community of pre-school children, with concomitant description of genotype diversity, toxin-encoding genes and antibiotic resistance...

  3. Gametocyte carriage in uncomplicated Plasmodium falciparum malaria following treatment with artemisinin combination therapy

    DEFF Research Database (Denmark)

    Abdulla, Salim; Achan, Jane; Adam, Ishag

    2016-01-01

    Background: Gametocytes are responsible for transmission of malaria from human to mosquito. Artemisinin combination therapy (ACT) reduces post-treatment gametocyte carriage, dependent upon host, parasite and pharmacodynamic factors. The gametocytocidal properties of antimalarial drugs are importa...

  4. Economic evaluation of pneumococcal conjugate vaccination in The Gambia

    Directory of Open Access Journals (Sweden)

    Kim Sun-Young

    2010-09-01

    Full Text Available Abstract Background Gambia is the second GAVI support-eligible country to introduce the 7-valent pneumococcal conjugate vaccine (PCV7, but a country-specific cost-effectiveness analysis of the vaccine is not available. Our objective was to assess the potential impact of PCVs of different valences in The Gambia. Methods We synthesized the best available epidemiological and cost data using a state-transition model to simulate the natural histories of various pneumococcal diseases. For the base-case, we estimated incremental cost (in 2005 US dollars per disability-adjusted life year (DALY averted under routine vaccination using PCV9 compared to no vaccination. We extended the base-case results for PCV9 to estimate the cost-effectiveness of PCV7, PCV10, and PCV13, each compared to no vaccination. To explore parameter uncertainty, we performed both deterministic and probabilistic sensitivity analyses. We also explored the impact of vaccine efficacy waning, herd immunity, and serotype replacement, as a part of the uncertainty analyses, by assuming alternative scenarios and extrapolating empirical results from different settings. Results Assuming 90% coverage, a program using a 9-valent PCV (PCV9 would prevent approximately 630 hospitalizations, 40 deaths, and 1000 DALYs, over the first 5 years of life of a birth cohort. Under base-case assumptions ($3.5 per vaccine, compared to no intervention, a PCV9 vaccination program would cost $670 per DALY averted in The Gambia. The corresponding values for PCV7, PCV10, and PCV13 were $910, $670, and $570 per DALY averted, respectively. Sensitivity analyses that explored the implications of the uncertain key parameters showed that model outcomes were most sensitive to vaccine price per dose, discount rate, case-fatality rate of primary endpoint pneumonia, and vaccine efficacy against primary endpoint pneumonia. Conclusions Based on the information available now, infant PCV vaccination would be expected to reduce

  5. Cost-effectiveness analysis of infant universal routine pneumococcal vaccination in Malaysia and Hong Kong

    OpenAIRE

    Wu, David Bin-Chia; Roberts, Craig; Lee, Vivian Wing Yan; Hong, Li-Wen; Tan, Kah Kee; Mak, Vivienne; Lee, Kenneth Kwing Chin

    2015-01-01

    Pneumococcal disease causes large morbidity, mortality and health care utilization and medical and non-medical costs, which can all be reduced by effective infant universal routine immunization programs with pneumococcal conjugate vaccines (PCV). We evaluated the clinical and economic benefits of such programs with either 10- or 13-valent PCVs in Malaysia and Hong Kong by using an age-stratified Markov cohort model with many country-specific inputs. The incremental cost per quality-adjusted l...

  6. The uptake of influenza and pneumococcal vaccination among immunocompromised patients attending rheumatology outpatient clinics.

    LENUS (Irish Health Repository)

    Haroon, Muhammad

    2011-07-01

    PURPOSE AND OBJECTIVES: The patients using immunosuppressive agents are considered at high risk for acquiring different infections. Accordingly, international guidelines recommend vaccinating such patients against influenza and pneumococcal organisms. The aims of this study were two-fold: (1) to assess the influenza and pneumococcal vaccination uptake among our rheumatology outpatients who are immunosuppressed; (2) to identify the factors influencing immunisation uptake among our sample of patients.

  7. Systemic steroid reduces long-term hearing loss in experimental pneumococcal meningitis

    DEFF Research Database (Denmark)

    Worsøe, Lise Lotte; Brandt, C.T.; Lund, S.P.

    2010-01-01

    Sensorineural hearing loss is a common complication of pneumococcal meningitis. Treatment with corticosteroids reduces inflammatory response and may thereby reduce hearing loss. However, both experimental studies and clinical trials investigating the effect of corticosteroids on hearing loss have...... generated conflicting results. The objective of the present study was to determine whether systemic steroid treatment had an effect on hearing loss and cochlear damage in a rat model of pneumococcal meningitis....

  8. Teichoic acid-containing muropeptides from Streptococcus pneumoniae as substrates for the pneumococcal autolysin.

    OpenAIRE

    Garcia-Bustos, J F; Tomasz, A

    1987-01-01

    Pneumococcal cell walls in which the normal phosphorylcholine component of the wall teichoic acids is replaced with phosphorylethanolamine cannot absorb the homologous autolytic enzyme and are completely resistant to autolytic degradation (S. Giudicelli and A. Tomasz, J. Bacteriol. 158:1188-1190, 1984). We have now isolated and characterized soluble teichoic acid-containing muropeptides from such cell walls and tested them as substrates for the pneumococcal autolytic enzyme. Both choline- and...

  9. Cost-effectiveness analysis of a universal vaccination programme with the 7-valent pneumococcal conjugate vaccine (PCV-7) in Sweden

    DEFF Research Database (Denmark)

    Bergman, Annika; Hjelmgren, Jonas; Ortqvist, Ake

    2008-01-01

    The 7-valent pneumococcal conjugate vaccine (PCV-7) has proved to be highly effective against invasive pneumococcal disease and has also provided some protection against all-cause pneumonia and acute otitis media. The objective of this study was to evaluate the projected health benefits, costs...... and cost-effectiveness of vaccination with the 7-valent conjugated pneumococcal vaccine compared with no vaccination, in all infants in Sweden, taking herd immunity into account. A Markov model was used and a hypothetical birth cohort was simulated for a lifelong perspective. The results show...... that vaccination of 1 cohort could potentially prevent 9 cases of pneumococcal meningitis, 22 cases of pneumococcal septicaemia, 509 cases of hospitalized pneumonia, 7812 cases of acute otitis media, and 2.7 fatalities, among children 0-4 y of age and 6 episodes of pneumococcal meningitis and 167 cases...

  10. GM risk assessment: Pollen carriage from Brassica napus to B. rapa varies widely between pollinators

    OpenAIRE

    Ronca, S; Allainguillaume, J.; Ford, C.; Warren, J; Wilkinson, M.

    2017-01-01

    Characterizing insect pollen carriage between closely related plant species is especially challenging where source species possess morphologically identical pollen and share many pollinators in common. Here, we use an SNP-based assay using the plant DNA barcoding locus matK to characterize pollen carriage between cultivated Brassica napus and wild Brassica rapa in three sites across southern England. The assay differentiated B. napus and B. rapa pollen carried by honey bees (Apis melifera), b...

  11. Variable performance of models for predicting methicillin-resistant Staphylococcus aureus carriage in European surgical wards

    OpenAIRE

    Lee, Andie S; Pan, Angelo; Harbarth, Stephan; Patroni, Andrea; Chalfine, Annie; Daikos, George L; Garilli, Silvia; Mart?nez, Jos? Antonio; Cooper, Ben S

    2015-01-01

    BACKGROUND: Predictive models to identify unknown methicillin-resistant Staphylococcus aureus (MRSA) carriage on admission may optimise targeted MRSA screening and efficient use of resources. However, common approaches to model selection can result in overconfident estimates and poor predictive performance. We aimed to compare the performance of various models to predict previously unknown MRSA carriage on admission to surgical wards. METHODS: The study analysed data collected during a prospe...

  12. Factors associated with influenza and pneumococcal vaccine uptake among rheumatoid arthritis patients in Denmark invited to participate in a pneumococcal vaccine trial (Immunovax_RA)

    DEFF Research Database (Denmark)

    Nguyen, MTT; Lindegaard, H.; Hendricks, O.

    2017-01-01

    Objective: This study investigates predictors of influenza and pneumococcal vaccine coverage among rheumatoid arthritis (RA) patients, and explores possible differences according to type of RA therapy. Method: RA patients from two clinics in the region of Southern Denmark were informed about...... the survey during scheduled follow-up visits. The questionnaire included questions concerning previous influenza and pneumococcal vaccine uptake, attitudes about vaccination, and socio-demographic factors. Factors associated with recalled vaccine uptake were assessed by multivariate logistic regression......-rheumatic drugs (bDMARDs). Self-reported uptake of vaccination against seasonal influenza ever was 59% overall; 57% among patients receiving cDMARDs and 61% in patients receiving bDMARDs. Self-reported vaccine uptake against pneumococcal diseases was only 6% overall. Older age, educational level, and information...

  13. Pneumococcal pneumonia prevention among adults: is the herd effect of pneumococcal conjugate vaccination in children as good a way as the active immunization of the elderly?

    Science.gov (United States)

    Prato, Rosa; Fortunato, Francesca; Martinelli, Domenico

    2016-01-01

    The indirect protection of adults as a result of pneumococcal conjugate vaccination of infants has been discussed from different epidemiological points of view. In some countries, including Italy, even after pediatric vaccination, vaccine serotypes are still responsible for most pneumonia and invasive diseases in the elderly. Although the Community-Acquired Pneumonia Immunization Trial in Adults (CAPITA) produced encouraging results, it has not showed the efficacy of the 13-valent conjugate vaccine in preventing pneumococcal community-acquired pneumonia regardless of the number of episodes and serotype. Addressing these points by monitoring the direct impact of adult vaccination in real life distinguished from the effects of herd immunity will assist public health decision-making on the most effective adult pneumococcal vaccination strategies.

  14. Inflammasome activation mediates inflammation and outcome in humans and mice with pneumococcal meningitis

    Science.gov (United States)

    2013-01-01

    Background Inflammasomes are multi-protein intracellular signaling complexes that have recently been hypothesized to play a role in the regulation of the inflammation response. We studied associations between inflammasome-associated cytokines IL-1β and IL-18 in cerebrospinal fluid (CSF) of patients with bacterial meningitis and clinical outcome, and pneumococcal serotype. In a murine model of pneumococcal meningitis we examined the pathophysiological roles of two inflammasome proteins, NLRP3 (Nod-like receptor protein-3) and adaptor protein ASC (apoptosis-associated speck-like protein). Methods In a nationwide prospective cohort study, CSF cytokine levels were measured and related to clinical outcome and pneumococcal serotype. In a murine model of pneumococcal meningitis using Streptococcus pneumoniae serotype 3, we examined bacterial titers, cytokine profiles and brain histology at 6 and 30 hours after inoculation in wild-type (WT), Asc and Nlrp3 deficient mice. Results In patients with bacterial meningitis, CSF levels of inflammasome associated cytokines IL-1β and IL-18 were related to complications, and unfavorable disease outcome. CSF levels of IL-1β were associated with pneumococcal serotype (pmeningitis, which may dependent on the pneumococcal serotype. PMID:23902681

  15. Complement component 5 contributes to poor disease outcome in humans and mice with pneumococcal meningitis

    Science.gov (United States)

    Woehrl, Bianca; Brouwer, Matthijs C.; Murr, Carmen; Heckenberg, Sebastiaan G.B.; Baas, Frank; Pfister, Hans W.; Zwinderman, Aeilko H.; Morgan, B. Paul; Barnum, Scott R.; van der Ende, Arie; Koedel, Uwe; van de Beek, Diederik

    2011-01-01

    Pneumococcal meningitis is the most common and severe form of bacterial meningitis. Fatality rates are substantial, and long-term sequelae develop in about half of survivors. Disease outcome has been related to the severity of the proinflammatory response in the subarachnoid space. The complement system, which mediates key inflammatory processes, has been implicated as a modulator of pneumococcal meningitis disease severity in animal studies. Additionally, SNPs in genes encoding complement pathway proteins have been linked to susceptibility to pneumococcal infection, although no associations with disease severity or outcome have been established. Here, we have performed a robust prospective nationwide genetic association study in patients with bacterial meningitis and found that a common nonsynonymous complement component 5 (C5) SNP (rs17611) is associated with unfavorable disease outcome. C5 fragment levels in cerebrospinal fluid (CSF) of patients with bacterial meningitis correlated with several clinical indicators of poor prognosis. Consistent with these human data, C5a receptor–deficient mice with pneumococcal meningitis had lower CSF wbc counts and decreased brain damage compared with WT mice. Adjuvant treatment with C5-specific monoclonal antibodies prevented death in all mice with pneumococcal meningitis. Thus, our results suggest C5-specific monoclonal antibodies could be a promising new antiinflammatory adjuvant therapy for pneumococcal meningitis. PMID:21926466

  16. [Conjugate pneumococcal vaccines and influence on the ear, nose and throat area].

    Science.gov (United States)

    Almaç, Ahmet; Kuru, F Demir

    2011-01-01

    The importance of anti-pneumococcal vaccines has increased due to the gradually increasing incidence rate of pneumococcal infections and their antibiotic resistance. Conjugate pneumococcal vaccine began to be used routinely in the USA in 2000. An important property of this conjugate vaccine is the ability to create immunity in infants after two months. Thus, conjugate vaccines allow us to protect children below the age of two years against to invasive and mortal pneumococcal infections. The first pneumococcal conjugate vaccine (PCV7) contains the seven most common pneumococcal serotypes in the USA. Pneumococci are also the most important bacterial agents in acute otitis media (AOM) and recurrent acute otitis media. Acute otitis media is the most common infectious disease in childhood and resistance to treatment has rapidly increased over the last decade. The incidence of AOM and applications of tympanostomy tubes saw statistically significant decreases in the USA after implementation of PCV7 in national immunization programs. PCV7 was implemented in the national immunization program in Turkey in 2008. For this reason, reductions in the incidence of upper respiratory tract infectious diseases and especially AOM should be expected in our country.

  17. Clinical burden of pneumonia, meningitis and septicemia in Norway 2 years after 7-valent pneumococcal conjugate vaccine introduction.

    Science.gov (United States)

    Munson, Samantha; Raluy-Callado, Mireia; Lambrelli, Dimitra; Wasiak, Radek; Eriksson, Daniel; Gray, Sharon

    2015-08-01

    This population-based, retrospective study quantified the rates of all-cause and pneumococcal pneumonia, meningitis and septicemia in Norway from 2008 to 2009 and determined the proportions of cases caused by pneumococcal vaccine serotypes. Data on patients with all-cause and pneumococcal pneumonia, meningitis and septicemia were obtained from the Norwegian Patient Registry, which collects hospitalization data from all Norwegian public hospitals based on International Classification of Diseases codes. Norwegian Patient Registry case records linked to the Norwegian Surveillance System for Communicable Diseases provided serotype data for invasive pneumococcal disease in patients with microbiological cultures. In 2008 and 2009, hospitalization rates were relatively stable for all-cause pneumonia (5.28 and 5.35, respectively, per 1000), meningitis (10.70 and 9.67, respectively, per 100,000), and septicemia (from 171.81 to 161.46 per 100,000). In contrast, rates decreased for International Classification of Diseases-10 diagnosed pneumococcal pneumonia (from 13.66 to 10.52 per 100,000), although these cases may be under-reported because of inclusion in all-cause pneumonia. Rates also decreased in diagnosed pneumococcal meningitis (from 1.60 to 1.19 per 100,000) and diagnosed pneumococcal septicemia (from 9.08 to 7.94 per 100,000). Diagnosed pneumococcal disease rates were highest in younger children and older adults, peaking at ⩾ 60 years old. Pneumococcal pneumonia, meningitis and septicemia caused by serotypes included in the 7-valent pneumococcal conjugate vaccine decreased substantially during the study period, with corresponding serotype replacement by non-7-valent pneumococcal conjugate vaccine serotypes. From 2008 to 2009, International Classification of Diseases-10 diagnosed pneumococcal pneumonia, meningitis and septicemia decreased in most age groups but remained greatest among subjects aged 0-1 and ⩾ 60 years. © 2015 the Nordic Societies of Public Health.

  18. Candida species in patients with oral dysesthesia: a comparison of carriage among oral disease states.

    Science.gov (United States)

    Farah, Camile S; Amos, Kate; Leeson, Rachel; Porter, Stephen

    2018-01-02

    Oral dysesthesia (burning mouth syndrome) is characterised by a burning-like sensation of the oral mucosa. The aetiology of this disorder is still unknown, however associations with oral fungal carriage have been proposed and applied clinically. The aim of the this study was to compare oral Candida carriage in patients with oral dysesthesia with Candida carriage in patients with other commonly diagnosed oral diseases to clarify the relationship between Candida and oral dysesthesia. 441 patients in total including 79 patients diagnosed with oral dysesthesia were included in this study. A retrospective analysis of mycological investigations undertaken in patients with clinically diagnosed oral dysesthesia compared with other oral conditions was undertaken. Oral carriage of Candida was found in 63.3% (50 of 79) of patients with oral dysesthesia. The frequency of carriage, and oral load of Candida were not significantly increased in patients with oral dysesthesia relative to the other conditions assessed. Patients with clinical signs of fungal infection or xerostomia presented with increased carriage of Candida. There is no association between oral dysesthesia and the presence or load of oral Candida. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  19. Relationship and susceptibility profile of Staphylococcus aureus infection diabetic foot ulcers with Staphylococcus aureus nasal carriage.

    Science.gov (United States)

    Taha, Aza Bahadeen

    2013-03-01

    Staphylococcus aureus is the main cause of diabetic foot infection with the patient's endogenous flora as the principal source. Nasal carriage of S. aureus has been identified as an important risk factor for the acquisition of diabetic foot infections. The study assessment the associations of S. aureus with methicillin resistant S. aureus were isolation from diabetic foot infection and nasal carriage of the same patients and their antibiotic susceptibility profile. Diagnosis of S. aureus and methicillin resistant S. aureus were carried out by using standard procedures. Antibiotic sensitivity profiles were determent by breakpoint dilution method. Out of 222 S. aureus isolation, 139 (62.61%) were isolated from the diabetic foot and 83 (37.39%) from the nasal carriage. Seventy one (30.87%) of the patients were S. aureus infection diabetic foot with nasal carriage. Among diabetic foot infection and nasal carriage patients, 40.85% of S. aureus were considered as methicillin resistant S. aureus. Rifampicin (96.40%) and Levofloxacin (91.44%) were active against S. aureus. Patients at strong risk for methicillin resistant S. aureus nasal carriage and subsequent diabetic foot infection with high resistance to antibiotics. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. Immunodeficiency among children with recurrent invasive pneumococcal disease

    DEFF Research Database (Denmark)

    Ingels, Helene; Schejbel, Lone; Lundstedt, A C

    2015-01-01

    examined. RESULTS: In total, rIPD were observed in 54 children (68 cases of rIPD of 2192 IPD cases). Children with classical risk factors for IPD were excluded, and among the remaining 22 children, 15 were eligible for analysis. Of these 6 (40%) were complement C2-deficient. Impaired vaccination response......BACKGROUND: Recurrent invasive pneumococcal disease (rIPD) occurs mostly in children with an underlying disease, but some cases remain unexplained. Immunodeficiency has been described in children with rIPD, but the prevalence is unknown. We used a nationwide registry of all laboratory......-confirmed cases of rIPD to identify cases of unexplained rIPD and examine them for immunodeficiency. METHODS: Cases of rIPD in children 0-15 years of age from 1980 to 2008 were identified. Children without an obvious underlying disease were screened for complement function, T-cell, B-cell, natural killer...

  1. Risk of red queen dynamics in pneumococcal vaccine strategy.

    Science.gov (United States)

    Jefferies, Johanna M C; Clarke, Stuart C; Webb, Jeremy S; Kraaijeveld, Alex R

    2011-08-01

    Pathogens increasingly evade current vaccines, and new strategies to control them are needed. There is mounting evidence that replacement of vaccine serotypes of Streptococcus pneumoniae with non-vaccine serotypes has taken place following widespread use of limited-serotype conjugate vaccines. New strategies to control vaccine evasion are needed and understanding evolutionary theory is important for the development of such approaches. Hosts are under selection pressure to evolve resistance against pathogens whereas pathogens are under selection pressure to evolve counter-resistance against the resistance mechanism of their host. Evolutionary changes in both host and pathogen lead to a continuous turnover of host and pathogen genotypes; this is known as Red Queen dynamics. We argue that integrating evolutionary thinking into pneumococcal vaccine design will lead to the avoidance of Red Queen dynamics and improved interventions against pneumococci. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. Cost-effectiveness of pneumococcal conjugate vaccination in Croatia.

    Science.gov (United States)

    Vučina, V Višekruna; Filipović, S Kurečić; Kožnjak, N; Stamenić, V; Clark, A D; Mounaud, B; Blau, J; Hoestlandt, C; Kaić, B

    2015-05-07

    Pneumococcus is a known cause of meningitis, pneumonia, sepsis, and acute otitis media in children and adults globally. Two new vaccines for children have the potential to prevent illness, disability, and death, but these vaccines are expensive. The Croatian Ministry of Health has considered introducing the vaccine in the past, but requires economic evidence to ensure that the limited funds available for health care will be used in the most effective way. Croatia appointed a multidisciplinary team of experts to evaluate the cost-effectiveness of introducing pneumococcal conjugate vaccination (PCV) into the national routine child immunization program. Both 10-valent and 13-valent PCV (PCV10 and PCV13) were compared to a scenario assuming no vaccination. The TRIVAC decision-support model was used to estimate cost-effectiveness over the period 2014-2033. We used national evidence on demographics, pneumococcal disease incidence and mortality, the age distribution of disease in children, health service utilization, vaccine coverage, vaccine timeliness, and serotype coverage. Vaccine effectiveness was based on evidence from the scientific literature. Detailed health care costs were not available from the Croatian Institute for Health Insurance at the time of the analysis so assumptions and World Health Organization (WHO) estimates for Croatia were used. We assumed a three-dose primary vaccination schedule, and an initial price of US$ 30 per dose for PCV10 and US$ 35 per dose for PCV13. We ran univariate sensitivity analyses and multivariate scenario analyses. Either vaccine is estimated to prevent approximately 100 hospital admissions and one death each year in children younger than five in Croatia. Compared to no vaccine, the discounted cost-effectiveness of either vaccine is estimated to be around US$ 69,000-77,000 per disability-adjusted life-years (DALYs) averted over the period 2014-2033 (from the government or societal perspective). Only two alternative scenarios

  3. Decrease in mortality in severe community-acquired pneumococcal pneumonia: impact of improving antibiotic strategies (2000-2013).

    Science.gov (United States)

    Gattarello, Simone; Borgatta, Bárbara; Solé-Violán, Jordi; Vallés, Jordi; Vidaur, Loreto; Zaragoza, Rafael; Torres, Antoni; Rello, Jordi

    2014-07-01

    The objective of the present study was to compare antibiotic prescribing practices and survival in the ICU for patients with pneumococcal severe community-acquired pneumonia (SCAP) between 2000 and 2013. This was a matched case-control study of two prospectively recorded cohorts in Europe. Eighty patients from the Community-Acquired Pneumonia en la Unidad de Cuidados Intensivos (CAPUCI) II study (case group) were matched with 80 patients from CAPUCI I (control group) based on the following: shock at admission, need of mechanical ventilation, COPD, immunosuppression, and age. Demographic data were comparable in the two groups. Combined antibiotic therapy increased from 66.2% to 87.5% (P < .01), and the percentage of patients receiving the first dose of antibiotic within 3 h increased from 27.5% to 70.0% (P < .01). ICU mortality was significantly lower (OR, 0.82; 95% CI, 0.68-0.98) in cases, both in the whole population and in the subgroups of patients with shock (OR, 0.67; 95% CI, 0.50-0.89) or receiving mechanical ventilation (OR, 0.73; 95% CI, 0.55-0.96). In the multivariate analysis, ICU mortality increased in patients requiring mechanical ventilation (OR, 5.23; 95% CI, 1.60-17.17) and decreased in patients receiving early antibiotic treatment (OR, 0.36; 95% CI, 0.15-0.87) and combined therapy (OR, 0.19; 95% CI, 0.07-0.51). In pneumococcal SCAP, early antibiotic prescription and use of combination therapy increased. Both were associated with improved survival.

  4. Declining mortality from adult pneumococcal infections linked to children's vaccination.

    Science.gov (United States)

    Grau, Imma; Ardanuy, Carmen; Cubero, Meritxell; Benitez, Miguel A; Liñares, Josefina; Pallares, Roman

    2016-04-01

    To determine changes in mortality among adults with invasive pneumococcal disease (IPD) after introducing pneumococcal conjugate vaccines (PCVs) in children. An active surveillance of adults with culture-proven IPD in Barcelona. Serotype-specific mortality and rates of disease and death were analysed in three periods: baseline (1994-2001), PCV7 (2002-2009) and PCV13 (2010-2013). Overall, IPD caused by PCV7 serotypes was associated with increased case fatality rate (24 percent). In patients 18-64 years (baseline vs. PCV7 vs. PCV13 periods), case fatality rate from IPD decreased (22 vs.14 vs. 12 percent), and it was associated with a decline in PCV7 serotypes (3.56 vs. 2.80 vs. 1.49 cases/10(5) person-years) and in PCV7 serotypes-specific death (0.74 vs. 0.53 vs. 0.09 deaths/10(5) person-years). In patients ≥65 years, case fatality rate did not change (24 vs. 22 vs. 24 percent); however, there was a decline in PCV7 serotypes-specific death (4.94 vs. 3.58 vs. 2.45 deaths/10(5) person-years), and an increase in non-PCV serotypes-specific death (2.55 vs. 3.70 vs. 4.09 deaths/10(5) person-years). The use of PCVs for children was associated with a reduction of mortality from IPD in adults 18-64 years, through the indirect effect of herd protection. In older adults, age-related factors could play a role in IPD mortality. Copyright © 2016 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  5. Clinical outcome of pneumococcal meningitis during the emergence of pencillin-resistant Streptococcus pneumoniae: an observational study

    Directory of Open Access Journals (Sweden)

    Gouveia Edilane L

    2011-11-01

    Full Text Available Abstract Background Prior to the availability of generic third-generation cephalosporins, penicillins were widely used for treatment of pneumococcal meningitis in developing countries despite concerns about rising levels of penicillin resistance among pneumococcal isolates. We examined the impact of penicillin resistance on outcomes of pneumococcal meningitis over a ten year period in an infectious diseases hospital in Brazil. Methods Clinical presentation, antimicrobial therapy and outcomes were reviewed for 548 patients with culture-confirmed pneumococcal meningitis from December, 1995, to November, 2005. Pneumococcal isolates from meningitis patients were defined as penicillin-resistant if Minimum Inhibitory Concentrations for penicillin were greater than 0.06 μg/ml. Proportional hazards regression was used to identify risk factors for fatal outcomes. Results During the ten-year period, ceftriaxone replaced ampicillin as first-line therapy for suspected bacterial meningitis. In hospital case-fatality for pneumococcal meningitis was 37%. Of 548 pneumococcal isolates from meningitis cases, 92 (17% were resistant to penicillin. After controlling for age and severity of disease at admission, penicillin resistance was associated with higher case-fatality (Hazard Ratio [HR], 1.62; 95% Confidence Interval [CI], 1.08-2.43. Penicillin-resistance remained associated with higher case-fatality when initial therapy included ceftriaxone (HR, 1.68; 95% CI 1.02-2.76. Conclusions Findings support the use of third generation cephalosporin antibiotics for treatment of suspected pneumococcal meningitis even at low prevalence of pneumococcal resistance to penicillins.

  6. Neonatal exposure to pneumococcal phosphorylcholine modulates the development of house dust mite allergy during adult life.

    Science.gov (United States)

    Patel, Preeyam S; Kearney, John F

    2015-06-15

    Currently, ∼20% of the global population suffers from an allergic disorder. Allergies and asthma occur at higher rates in developed and industrialized countries. It is clear that many human atopic diseases are initiated neonatally and herald more severe IgE-mediated disorders, including allergic asthma, which is driven by the priming of Th2 effector T cells. The hygiene hypothesis attempts to link the increased excessively sanitary conditions early in life to a default Th2 response and increasing allergic phenomena. Despite the substantial involvement of IgE Abs in such conditions, little attention has been paid to the effects of early microbial exposure on the B cell repertoire prior to the initiation of these diseases. In this study, we use Ab-binding assays to demonstrate that Streptococcus pneumoniae and house dust mite (HDM) bear similar phosphorylcholine (PC) epitopes. Neonatal C57BL/6 mice immunized with a PC-bearing pneumococcal vaccine expressed increased frequencies of PC-specific B cells in the lungs following sensitizing exposure to HDM as adults. Anti-PC IgM Abs in the lung decreased the interaction of HDM with pulmonary APCs and were affiliated with lowered allergy-associated cell infiltration into the lung, IgE production, development of airway hyperresponsiveness, and Th2 T cell priming. Thus, exposure of neonatal mice to PC-bearing pneumococci significantly reduced the development of HDM-induced allergic disease during adult life. Our findings demonstrate that B cells generated against conserved epitopes expressed by bacteria, encountered early in life, are also protective against the development of allergic disease during adult life. Copyright © 2015 by The American Association of Immunologists, Inc.

  7. NASAL AND HAND CARRIAGE OF BACTERIA IN DIFFERENT GROUPS OF PERSONS IN A TEACHING HOSPITAL IN INDIA

    Directory of Open Access Journals (Sweden)

    Parthasarathi Gangulv

    1995-09-01

    Full Text Available 275 persons of different categories were studiedfor nasal and hand carnage of different pathogenic bacteria. Overall carriage rate was 54.5%. Doc­tors and paramedical staff had higher bacterial carriage rate in comparison to other groups. Though Staphylococcus aureus iwu the commonest or­ganism isolated from both nose and skin, earners of Escherichia coli. Pseudomonas and Klebsiella group ofgramnegative bacilli was also observed. Nasal carrier were commonest than dermal carriage

  8. Effect of influenza and pneumococcal vaccines in elderly persons in years of low influenza activity

    Directory of Open Access Journals (Sweden)

    Sylvan Staffan PE

    2008-04-01

    Full Text Available Abstract Background The present prospective study was conducted from 2003–2005, among all individuals 65 years and older in Uppsala County, a region with 300 000 inhabitants situated close to the Stockholm urban area. The objective of this study was to assess the preventive effect of influenza and pneumococcal vaccination in reducing hospitalisation and length of hospital stay (LOHS even during periods of low influenza activity. The specificity of the apparent vaccine associations were evaluated in relation to the influenza seasons. Results In 2003, the total study population was 41,059, of which 12,907 (31% received influenza vaccine of these, 4,447 (11% were administered the pneumococcal vaccine. In 2004, 14,799 (34% individuals received the influenza vaccine and 8,843 (21% the pneumococcal vaccine and in 2005 16,926 (39% individuals were given the influenza vaccine and 12,340 (28% the pneumococcal vaccine. Our findings indicated that 35% of the vaccinated cohort belonged to a medical risk category (mainly those persons that received the pneumococcal vaccine. Data on hospitalisation and mortality during the 3-year period were obtained from the administrative database of the Uppsala county council. During the influenza seasons, reduction of hospital admissions and significantly shorter in-hospital stay for influenza was observed in the vaccinated cohort (below 80 years of age. For individuals who also had received the pneumococcal vaccine, a significant reduction of hospital admissions and of in-hospital stay was observed for invasive pneumococcal disease and for pneumococcal pneumonia. Effectiveness was observed for cardiac failure even in persons that also had received the pneumococcal vaccine, despite that the pneumococcal vaccinated mainly belonged to a medical risk category. Reduction of death from all causes was observed during the influenza season of 2004, in the 75–84-year old age group and in all age-groups during the influenza

  9. Carriage of methicillin-resistant Staphylococcus pseudintermedius in dogs--a longitudinal study

    Directory of Open Access Journals (Sweden)

    Windahl Ulrika

    2012-03-01

    Full Text Available Abstract Background Methicillin-resistant S. pseudintermedius strains (MRSP are reported with increasing frequency in bacterial cultures from dogs. The objectives of this study were to determine whether MRSP could be found in dogs several months after a clinically apparent infection and whether the length of carriage varied depending on systemic antimicrobial treatment, diagnosis at time of the first positive MRSP culture and the presence of skin disease or wounds. Thirty-one dogs previously diagnosed with a clinical infection were sampled repeatedly for a minimum of eight months or, with the exception of two dogs, until two consecutive negative results were obtained. Five specified locations were sampled, and the results were evaluated to determine future recommendations concerning sample strategies when screening for MRSP carriage. Information was collected from medical records and questionnaires to evaluate factors that may influence length of carriage. Results The overall median length of MRSP carriage was 11 months (48 weeks. The presence of wounds and signs of dermatitis did not influence length of carriage. Systemic treatment for three weeks or longer with antimicrobial agents to which the bacterium was resistant was associated with prolonged carriage compared to dogs treated for a shorter period of time. Three of five dogs treated with an antimicrobial to which their MRSP-isolates were susceptible (tetracycline were found to still be MRSP-positive when sampled after the end of treatment. Wound samples had the highest positive MRSP yield (81% for the positive sample sites, compared to less than 70% for each of the other four sample sites. Cultures from the nostrils were less likely to detect MRSP carriage relative to the pharynx, perineum, wounds and the corner of the mouth. Conclusions Dogs can carry MRSP for more than a year after a clinically apparent infection. Systemic antimicrobial treatment of infections with antimicrobial agents

  10. Long-term immune responses to pneumococcal conjugate vaccines in children previously vaccinated with 7-valent pneumococcal conjugate vaccine.

    Science.gov (United States)

    Klein, Nicola P; Ensor, Kathy; Jouve, Sylvie; Northington, Robert; Moscariello, Michele; McGovern, Paul C

    2013-09-01

    Seven-valent pneumococcal conjugate vaccine (PCV7) has reduced incidence of vaccine-serotype pneumococcal diseases. Using a single dose of 13-valent pneumoccal conjugate vaccine (PCV13), we evaluated late immune responses 10 years after vaccination with PCV7 in infancy, compared with a PCV7-naïve cohort. In this open-label study, we administered 1 dose of PCV13 to children aged 11-14 years who had previously received PCV7 (PCV7/PCV13) or meningococcal group C conjugate vaccine (MnCC/PCV13) during infancy. We evaluated serotype-specific immunoglobulin G concentrations and opsonophagocytic activity prevaccination and 1 week and 1 month postvaccination. We recorded local reactions and systemic events for 4 days postvaccination and adverse events for 6 months. Seventy-four subjects received PCV13 (PCV7/PCV13, n = 38; MnCC/PCV13, n = 36). Prevaccination with PCV13, >62.9% of subjects had immunoglobulin G concentrations ≥0.35 µg/mL for all serotypes except serotype 4 (28-29%); proportions increased at 1 month postvaccination to 100% for all serotypes except serotypes 3 (PCV7/PCV13, 94.7%; MnCC/PCV13, 97.0%) and 14 (MnCC/PCV13, 97.1%). Immunoglobulin G and opsonophagocytic activity concentrations for the 7 common and 6 additional serotypes were similar in both groups prevaccination and increased in both groups from prevaccination to 1 week and 1 month postvaccination. Local reactions and fever were mild or moderate; no serious adverse events were reported. Late immune responses after a single dose of PCV13 were similar in children aged 11-14 years regardless of previous vaccination with PCV7 or MnCC. PCV13 was immunogenic, safe and well tolerated.

  11. Acquisition of meningococcal serogroup W-135 carriage in Turkish Hajj pilgrims who had received the quadrivalent meningococcal polysaccharide vaccine.

    Science.gov (United States)

    Ceyhan, M; Celik, M; Demir, E T; Gurbuz, V; Aycan, A E; Unal, S

    2013-01-01

    Invasive meningococcal disease is a recognized public health problem worldwide, with a dynamic and changeable epidemiology. In Turkey, the second most common pathogenic meningococcal serogroup (after serogroup B) is W-135, including an epidemic in 2005, which has been strongly associated with Hajj pilgrims and their close contacts. In two studies conducted in 2010, we assessed meningococcal carriage in intending Turkish pilgrims to the Hajj when they attended to receive a plain polysaccharide vaccine against serogroups A, C, W-135, and Y and, upon their return, to determine the acquisition of meningococcal carriage by the pilgrims themselves and subsequently their household contacts. Nasopharyngeal swabs were obtained from pilgrims before the Hajj and upon their return. Swabs were then obtained from 39 household contacts of pilgrims who were shown to have acquired carriage during the Hajj. Of the 472 pilgrims before the Hajj, 63 (13%) were positive for meningococcal carriage, of which 52 cases (83%) were serogroup W-135. In the 296 pilgrims tested after the Hajj, 81 (27%) were positive for meningococcal carriage, including 74 (91%) with W-135. In 11 family members of pilgrims who acquired W-135 carriage at the Hajj, 10 (91%) had acquired carriage of serogroup W-135. This study illustrates the acquisition of meningococcal carriage, predominantly of serogroup W-135 by pilgrims attending the Hajj, and the transmission of this carriage to their family members on their return, explaining the source of W-135 meningococcal disease in Turkey.

  12. Pneumococcal colonisation density: a new marker for disease severity in HIV-infected adults with pneumonia.

    Science.gov (United States)

    Albrich, Werner C; Madhi, Shabir A; Adrian, Peter V; van Niekerk, Nadia; Telles, Jean-Noel; Ebrahim, N; Messaoudi, Melina; Paranhos-Baccalà, Glaucia; Giersdorf, Sven; Vernet, Guy; Mueller, Beat; Klugman, Keith P

    2014-08-11

    A high genomic load of Pneumococcus from blood or cerebrospinal fluid has been associated with increased mortality. We aimed to analyse whether nasopharyngeal colonisation density in HIV-infected patients with community-acquired pneumonia (CAP) is associated with markers of disease severity or poor outcome. Quantitative lytA real-time PCR was performed on nasopharyngeal swabs in HIV-infected South African adults hospitalised for acute CAP at Chris Hani Baragwanath Hospital, Soweto, South Africa. Pneumonia aetiology was considered pneumococcal if any sputum culture or Gram stain, urinary pneumococcal C-polysaccharide-based antigen, blood culture or whole blood lytA real-time PCR revealed pneumococci. There was a moderate correlation between the mean nasopharyngeal colonisation densities and increasing CURB65 scores among all-cause patients with pneumonia (Spearman correlation coefficient r=0.15, p=0.06) or with the Pitt bacteraemia score among patients with pneumococcal bacteraemia (p=0.63). In patients with pneumococcal pneumonia, nasopharyngeal pneumococcal colonisation density was higher among non-survivors than survivors (7.7 vs 6.1 log10 copies/mL, respectively, p=0.02) and among those who had pneumococci identified from blood cultures and/or by whole blood lytA real-time PCR than those with non-bacteraemic pneumococcal pneumonia (6.6 vs 5.6 log10 copies/mL, p=0.03). Nasopharyngeal colonisation density correlated positively with the biomarkers procalcitonin (Spearman correlation coefficient r=0.37, pmarker for pneumococcal pneumonia in HIV-infected adults. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. [Estimates of Target Population for Pneumococcal Vaccination in People over 50 years in Catalonia and Spain].

    Science.gov (United States)

    Vila-Córcoles, Angel; Ochoa-Gondar, Olga; Satué, Eva; de Diego, Cinta; Vila-Rovira, Marc; Jariod, Manel

    2017-03-15

    Published data about prevalence of distinct risk condictions for pneumococcal disease is scarce. This study investigated the prevalence of distinct risk conditions for pneumococal disease in Catalonian adults and stimated the potential size of target population for pneumococcal vaccination in Catalonia and Spain. Cross-sectional population-based study that included 2,033,465 individuals older than 49 years-old assigned to the Catalonian Health Institute (Catalonia, Spain) at 01/01/2015. The Catalonian Health Institute Information System for the Development of Research in Primary Care (SIDIAP) was used to identify comorbidities and/or underlying conditions in each subject and establish potential target population for pneumococcal vaccination on the basis of their risk for suffering pneumococcal infections: 1) immunocompromised subjects; 2) immunocompetents subjects with any risk condition; 3) immunocompetents subjects without risk conditions. Of the 2,033,465 study subjects, 1,053,155 (51.8%) had no risk conditions, 649,014 (31.9%) had one risk condition and 331,296 (16.3%) had multiple risk conditions (11.4% in 50-64 years vs 21.2% in people older than 65 years, p smaller than 0.001; 21.8% in men vs 11.6% in women, p smaller than 0.001). Overall, 176,600 (8.7%) and 803,710 (39.5%) were classified in risk stratum 1 and 2, respectively. According to distinct risk strata considered, the target population for pneumococcal vaccination varied between 0.2-1.9 million in Catalonia and 1.5-2.3 million in Spain. In our setting, almost fifty percent of people ≥50 years have at least one risk condition to suffert pneumococcal disease. Adult population susceptible for pneumococal vaccination largely varies depending on the risk stratum considered as targeted people for pneumococcal vaccination.

  14. Pneumococcal infection of respiratory cells exposed to welding fumes; Role of oxidative stress and HIF-1 alpha.

    Science.gov (United States)

    Grigg, Jonathan; Miyashita, Lisa; Suri, Reetika

    2017-01-01

    Welders are more susceptible to pneumococcal pneumonia. The mechanisms are yet unclear. Pneumococci co-opt the platelet activating factor receptor (PAFR) to infect respiratory epithelial cells. We previously reported that exposure of respiratory cells to welding fumes (WF), upregulates PAFR-dependent pneumococcal infection. The signaling pathway for this response is unknown, however, in intestinal cells, hypoxia-inducible factor-1 α (HIF 1α) is reported to mediate PAFR-dependent infection. We sought to assess whether oxidative stress plays a role in susceptibility to pneumococcal infection via the platelet activating factor receptor. We also sought to evaluate the suitability of nasal epithelial PAFR expression in welders as a biomarker of susceptibility to infection. Finally, we investigated the generalisability of the effect of welding fumes on pneumococcal infection and growth using a variety of different welding fume samples. Nasal epithelial PAFR expression in welders and controls was analysed by flow cytometry. WF were collected using standard methodology. The effect of WF on respiratory cell reactive oxygen species production, HIF-1α expression, and pneumococcal infection was determined using flow cytometry, HIF-1α knockdown and overexpression, and pneumococcal infection assays. We found that nasal PAFR expression is significantly increased in welders compared with controls and that WF significantly increased reactive oxygen species production, HIF-1α and PAFR expression, and pneumococcal infection of respiratory cells. In unstimulated cells, HIF-1α knockdown decreased PAFR expression and HIF-1α overexpression increased PAFR expression. However, in knockdown cells pneumococcal infection was paradoxically increased and in overexpressing cells infection was unaffected. Nasal epithelial PAFR expression may be used as a biomarker of susceptibility to pneumococcal infection in order to target individuals, particularly those at high risk such as welders

  15. Carbohydrate vs protein supplementation for recovery of neuromuscular function following prolonged load carriage

    Directory of Open Access Journals (Sweden)

    Fallowfield Joanne L

    2010-01-01

    Full Text Available Abstract Background This study examined the effect of carbohydrate and whey protein supplements on recovery of neuromuscular function after prolonged load carriage. Methods Ten male participants (body mass: 81.5 ± 10.5 kg, age: 28 ± 9 years, O2max: 55.0 ± 5.5 ml·kg-1·min-1 completed three treadmill walking tests (2 hr, 6.5 km·h-1, carrying a 25 kg backpack consuming 500 ml of either: (1 Placebo (flavoured water [PLA], (2 6.4% Carbohydrate Solution [CHO] or (3 7.0% Whey Protein Solution [PRO]. For three days after load carriage, participants consumed two 500 ml supplement boluses. Muscle performance was measured before and at 0, 24, 48 and 72 h after load carriage, during voluntary and electrically stimulated contractions. Results Isometric knee extension force decreased immediately after load carriage with no difference between conditions. During recovery, isometric force returned to pre-exercise values at 48 h for CHO and PRO but at 72 h for PLA. Voluntary activation decreased immediately after load carriage and returned to pre-exercise values at 24 h in all conditions (P = 0.086. During recovery, there were no differences between conditions for the change in isokinetic peak torque. Following reductions immediately after load carriage, knee extensor and flexor peak torque (60°·s-1 recovered to pre-exercise values at 72 h. Trunk extensor and flexor peak torque (15°·s-1 recovered to pre-exercise values at 24 h (P = 0.091 and 48 h (P = 0.177, respectively. Conclusion Recovery of neuromuscular function after prolonged load carriage is improved with either carbohydrate or whey protein supplementation for isometric contractions but not for isokinetic contractions.

  16. Point surveillance of Staphylococcus aureus carriage among medical staff in Infectious Diseases Hospital, Kuwait.

    Science.gov (United States)

    Dimitrov, Tz; Udo, E E; Grover, S

    2003-01-01

    To investigate the carriage of Staphylococcus aureus among doctors and nurses in Infectious Diseases Hospital, Kuwait, following the detection of 3 cases of methicillin-resistant S. aureus (MRSA). A total of 260 nasal and throat swabs were obtained from 19 doctors and 111 nurses and cultured for the carriage of S. aureus. Forty-three S. aureus were identified based on their growth characteristics on mannitol-salt agar, catalase and tube coagulase and DNA hydrolysis. The isolates were tested for susceptibility to antibacterial agents and typed by phage typing; plasmid analysis and pulsed-field electrophoresis were carried out to determine their relatedness. Of the 19 doctors, 4 (21%) had nasal carriage while only 1 of them had a throat carriage. Sixteen (14.4%) nurses carried S. aureus in their noses and 20 (18%) in their throats. The combined nasal carriage rate for both doctors and nurses was 15.8%, and combined throat carriage was 16.6%. None of them carried MRSA. The isolates were resistant to penicillin G (90%), tetracycline (23.3%), erythromycin (9.3%) and cadmium (100%). Typing of the isolates showed a variety of phage types, plasmid and pulsed-field gel electrophoresis patterns. None of the doctors or nurses carried MRSA. Typing of the methicillin-susceptible strains that they carried demonstrated that the S. aureus were different, indicating an absence of a dominant clone capable of spreading. It is important to maintain a low carriage of S. aureus among health-care workers. Copyright 2003 S. Karger AG, Basel

  17. Dynamic pattern and genotypic diversity of Staphylococcus aureus nasopharyngeal carriage in healthy pre-school children.

    Science.gov (United States)

    Blumental, S; Deplano, A; Jourdain, S; De Mendonça, R; Hallin, M; Nonhoff, C; Rottiers, S; Vergison, A; Denis, O

    2013-07-01

    It is common wisdom that persistent carriage of Staphylococcus aureus is more frequent in young children than in adults. The objectives of this study were to assess the S. aureus temporal carriage pattern among a healthy community of pre-school children, with concomitant description of genotype diversity, toxin-encoding genes and antibiotic resistance. Among 333 children 3-6 years of age, S. aureus nasopharyngeal carriage was assessed over one school year by culture of three sequential nasopharyngeal aspirates. Identification, methicillin resistance and toxin production profile were determined by PCR. Genotyping was performed by spa sequencing and multilocus sequence typing (MLST). Out of 830 samples collected, 286 (34%) yielded S. aureus from 185 carriers (55%). Based on consecutive genotype analysis, only 40/268 (15%) children could be classified as persistent carriers, and the remaining 118 (44%) showed intermittent carriage. spa typing revealed 82 types clustered into 13 spa clonal complexes (CCs). Fourteen strains isolated from 11 (3%) children were methicillin-resistant S. aureus (MRSA), half of these strains belonged to the commonly hospital-associated spa t008-ST8-SCCmec IV. Methicillin-susceptible S. aureus (MSSA) were genotypically more diverse. Toxic shock syndrome toxin and egc1/2 complexes were highly prevalent (24%). Contrastingly, Panton-Valentine leucocidin (PVL) was carried only by three MSSA strains (0.6% of children). Exfoliative toxins were detected in 10 (3.5%) MSSA strains, of which 5 were related to the impetigo clone CC121. Although S. aureus nasopharyngeal carriage was high among healthy pre-school children, persistent carriage seems to be less frequent than previously reported. The prevalence of MRSA carriage was 3%, but was not associated with PVL.

  18. Epidemiology and population structure of serotypes 1, 5 and 7f carried by children in Portugal from 1996-2010 before introduction of the 10-valent and 13-valent pneumococcal conjugate vaccines.

    Directory of Open Access Journals (Sweden)

    Sónia T Almeida

    Full Text Available Among the over 90 serotypes of Streptococcus pneumoniae described, serotypes 1, 5, and 7F account for a significant proportion of invasive disease worldwide and are now covered by the most recent 10- and 13-valent pneumococcal conjugate vaccines (PCVs. The epidemiology of these serotypes in carriage remains poorly studied because they are rarely detected. We aimed to gain insights into the epidemiology and population structure of serotypes 1, 5 and 7F carried by children in Portugal before PCV10 and PCV13 became widely used. Isolates obtained in cross-sectional studies carried out over a 15-year period (1996-2010 were retrospectively pooled and characterized. Of 5,123 pneumococci obtained, 70 were associated with serotypes 1 (n = 21, 5 (n = 7, and 7F (n = 42. The highest prevalence detected was 3.3% for serotype 1 in 2006, 1% for serotype 5 in 2009, and 3.3% for serotype 7F in 2006; Serotype 1 was associated with PMEN international clones Sweden(1-28(ST306 and Sweden(1-40(ST304; serotype 5 was associated with Colombia(5-19(ST289; and serotype 7F was associated with Netherlands(7F-39(ST191. All these isolates were fully susceptible. Most carriers of serotypes 1 (86%, 5 (86%, and 7F (91% were older than two years but a significant association with older age was only observed for serotype 7F (p = 0.006. Evidence for cross-transmission was obtained. In conclusion, we were able to detect and characterize the rarely carried serotypes 1, 5, and 7F among healthy children in Portugal. These data will constitute an important baseline for upcoming surveillance studies aimed to establish the impact of novel PCVs targeting these serotypes in carriage.

  19. Serotipos de neumococo en niños portadores antes de la vacunación antineumocócica en el Perú Pneumococcal serotypes in carrier children prior to the introduction of anti-pneumococcal vaccines in Peru

    Directory of Open Access Journals (Sweden)

    Erik H. Mercado

    2012-03-01

    Full Text Available Objetivos. Determinar la frecuencia y distribución de serotipos de S. pneumoniae en portadores nasofaríngeos sanos menores de dos años previa al uso universal de la vacuna conjugada antineumocócica en el Perú. Materiales y métodos. Entre los años 2007 y 2009 se tomaron muestras de hisopado nasofaríngeo a 2123 niños sanos entre 2 y 24 meses de edad en los consultorios de crecimiento y desarrollo o vacunación de hospitales y centros de salud de siete ciudades del Perú: costa (Lima, Piura; sierra (Cusco, Abancay, Arequipa y Huancayo y selva (Iquitos. Las cepas de neumococo fueron aisladas e identificadas en el laboratorio central del proyecto en Lima y serotipificadas por reacción de Quellung en el Laboratorio de Referencia de Neumococo del Centro de Control y Prevención de Enfermedades. Resultados. Se encontró 27,0% (573/2123 de portadores nasofaríngeos sanos de neumococo. En las 526 cepas analizadas se encontraron 42 serotipos; los más frecuentes fueron: 19F (18,1%, 6B (14,3%; 23F (8,9% y 14 (6,5%. Conclusiones. La distribución de serotipos vacunales en las cepas analizadas fue de 50,0% para los serotipos presentes en la vacuna conjugada heptavalente; 50,2% para los serotipos presentes en la vacuna decavalente y 57,2% para la vacuna 13-valente.Objectives. To determine the carriage rate and serotype distribution of Streptococcus pneumoniae in the nasopharynx of healthy children younger than 2 years prior to the universal use of the pneumococcal conjugate vaccines in Peru. Materials and methods. Between 2007 and 2009 we collected nasopharyngeal swab samples from 2,123 healthy children aged 2 to 24 months in the vaccination and healthy children consultation offices of pediatric hospitals and health centers in 7 cities in Peru: on the coast (Lima, Piura, highlands (Cusco, Abancay, Arequipa and Huancayo and amazon basin (Iquitos. The pneumococcal strains were isolated and identified at the central laboratory of the project in Lima

  20. Inspiratory muscle training improves exercise capacity with thoracic load carriage.

    Science.gov (United States)

    Shei, Ren-Jay; Chapman, Robert F; Gruber, Allison H; Mickleborough, Timothy D

    2018-02-01

    Thoracic load carriage (LC) exercise impairs exercise performance compared to unloaded exercise, partially due to impaired respiratory mechanics. We investigated the effects of LC on exercise and diaphragmatic fatigue in a constant-load exercise task; and whether inspiratory muscle training (IMT) improved exercise capacity and diaphragmatic fatigue with LC. Twelve recreationally active males completed three separate running trials to exhaustion (T lim ) at a fixed speed eliciting 70% of their V˙O 2max . The first two trials were completed either unloaded (UL) or while carrying a 10 kg backpack (LC). Subjects then completed 6 weeks of either true IMT or placebo-IMT. Posttraining, subjects completed an additional LC trial identical to the pretraining LC trial. Exercise metabolic and ventilatory measures were recorded. Diaphragm fatigue was assessed as the difference between preexercise and postexercise twitch diaphragmatic pressure (P di, tw ), assessed by bilateral stimulation of the phrenic nerve with esophageal balloon-tipped catheters measuring intrathoracic pressures. T lim was significantly shorter (P  0.05). Minute ventilation and breathing mechanics were unchanged post-IMT (P > 0.05). Six weeks of flow-resistive IMT improved exercise capacity, but did not mitigate diaphragmatic fatigue following submaximal, constant-load running to volitional exhaustion with LC. © 2018 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

  1. School bag carriage and pain in school children.

    Science.gov (United States)

    Puckree, T; Silal, S P; Lin, J

    2004-01-07

    In South Africa (SA), anecdotal evidence for the incidence of shoulder, back and neck pain in school children is alarming but no scientific studies have confirmed this impression. The purpose of the present study was to determine the relationship between pain and school bag carriage in scholars in Durban, SA. A study was carried out at four different schools in the Verulam and Chatsworth Regions in Kwa-Zulu Natal, SA. Schools were selected by convenience. One hundred and seventy six scholars between the ages of 11 and 14 years correctly filled out a questionnaire with open-ended and closed-ended questions. Each child also had his/her body and bag weight measured. In this study, most of the scholars experienced shoulder and a combination of shoulder and other bodily pain. The majority of the children carried backpacks over two shoulders. The type of bag carried was significantly related to pain experienced (0.00). A significantly larger number of female scholars experienced pain. The shoulder and other bodily pain experienced by the sample of scholars are strongly related to the type of bag and the gender of the children. More in-depth studies into identifying risk factors for bodily pains in school children are indicated.

  2. Shoulder skin and muscle hemodynamics during backpack carriage.

    Science.gov (United States)

    Mao, Clifford P; Macias, Brandon R; Hargens, Alan R

    2015-11-01

    The purpose of this study was to quantify the effects of loaded backpacks on shoulder muscle oxygenation, skin blood flow, and pain. We hypothesized that backpack load carriage is associated with lower shoulder muscle oxygenation and skin microvascular flow. Near-infrared spectroscopy quantified shoulder tissue oxygenation and laser Doppler flow measured skin microvascular flow. Eight adult volunteers donned a standard backpack without added load, 5 kg load, and 10 kg load for 5 min while standing. An 8 min rest period before each backpack donning condition ensured that all measured parameters returned to baseline. Data were analyzed using a repeated measures ANOVA and significance set at p shoulder muscle oxygenation by 22 ± 23% as compared to the empty backpack control condition (p = 0.023). In addition, a 10 kg backpack load reduced skin microvascular flow by 82 ± 22%, as compared to the empty backpack control condition (p = 0.024). Perceived pain was significantly higher when wearing the 10 kg backpack (level 4 on a 10-maximal pain scale) as compared to the empty backpack (0, 0-no pain) (p shoulder muscle oxygenation and skin microvascular flow. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  3. Effectiveness of the 23-Valent Pneumococcal Polysaccharide Vaccine (PPV23 against Pneumococcal Disease in the Elderly: Systematic Review and Meta-Analysis.

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    Gerhard Falkenhorst

    Full Text Available Routine vaccination of elderly people against pneumococcal diseases is recommended in many countries. National guidelines differ, recommending either the 23-valent polysaccharide vaccine (PPV23, the 13-valent conjugate vaccine (PCV13 or both. Considering the ongoing debate on the effectiveness of PPV23, we performed a systematic literature review and meta-analysis of the vaccine efficacy/effectiveness (VE of PPV23 against invasive pneumococcal disease (IPD and pneumococcal pneumonia in adults aged ≥60 years living in industrialized countries.We searched for pertinent clinical trials and observational studies in databases MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews. We assessed the risk of bias of individual studies using the Cochrane Risk of Bias tool for randomized controlled trials and the Newcastle-Ottawa Scale for observational studies. We rated the overall quality of the evidence by GRADE criteria. We performed meta-analyses of studies grouped by outcome and study design using random-effects models. We applied a sensitivity analysis excluding studies with high risk of bias.We identified 17 eligible studies. Pooled VE against IPD (by any serotype was 73% (95%CI: 10-92% in four clinical trials, 45% (95%CI: 15-65% in three cohort studies, and 59% (95%CI: 35-74% in three case-control studies. After excluding studies with high risk of bias, pooled VE against pneumococcal pneumonia (by any serotype was 64% (95%CI: 35-80% in two clinical trials and 48% (95%CI: 25-63% in two cohort studies. Higher VE estimates in trials (follow-up ~2.5 years than in observational studies (follow-up ~5 years may indicate waning protection. Unlike previous meta-analyses, we excluded two trials with high risk of bias regarding the outcome pneumococcal pneumonia, because diagnosis was based on serologic methods with insufficient specificity.Our meta-analysis revealed significant VE of PPV23 against both

  4. Combination of pneumococcal surface protein A (PspA with whole cell pertussis vaccine increases protection against pneumococcal challenge in mice.

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    Maria Leonor S Oliveira

    Full Text Available Streptococcus pneumoniae is the leading cause of respiratory acute infections around the world. In Latin America, approximately 20,000 children under 5 years of age die of pneumococcal diseases annually. Pneumococcal surface protein A (PspA is among the best-characterized pneumococcal antigens that confer protection in animal models of pneumococcal infections and, as such, is a good alternative for the currently available conjugated vaccines. Efficient immune responses directed to PspA in animal models have already been described. Nevertheless, few low cost adjuvants for a subunit pneumococcal vaccine have been proposed to date. Here, we have tested the adjuvant properties of the whole cell Bordetella pertussis vaccine (wP that is currently part of the DTP (diphtheria-tetanus-pertussis vaccine administrated to children in several countries, as an adjuvant to PspA. Nasal immunization of BALB/c mice with a combination of PspA5 and wP or wP(low--a new generation vaccine that contains low levels of B. pertussis LPS--conferred protection against a respiratory lethal challenge with S. pneumoniae. Both PspA5-wP and PspA5-wP(low vaccines induced high levels of systemic and mucosal antibodies against PspA5, with similar profile, indicating no essential requirement for B. pertussis LPS in the adjuvant properties of wP. Accordingly, nasal immunization of C3H/HeJ mice with PspA5-wP conferred protection against the pneumococcal challenge, thus ruling out a role for TLR4 responses in the adjuvant activity and the protection mechanisms triggered by the vaccines. The high levels of anti-PspA5 antibodies correlated with increased cross-reactivity against PspAs from different clades and also reflected in cross-protection. In addition, passive immunization experiments indicated that antibodies played an important role in protection in this model. Finally, subcutaneous immunization with a combination of PspA5 with DTP(low protected mice against challenge with two

  5. Effect of the 13-valent pneumococcal conjugate vaccine on invasive pneumococcal disease in England and Wales 4 years after its introduction: an observational cohort study.

    Science.gov (United States)

    Waight, Pauline A; Andrews, Nicholas J; Ladhani, Shamez N; Sheppard, Carmen L; Slack, Mary P E; Miller, Elizabeth

    2015-05-01

    The 13-valent pneumococcal conjugate vaccine (PCV13) protects against key serotypes that increased after routine immunisation with the seven-valent vaccine (PCV7), but its potential for herd protection and serotype replacement is uncertain. The aim of this study was to analyse the effect of the 13-valent pneumococcal conjugate vaccine on invasive pneumococcal disease in England and Wales 4 years after its introduction. We used a national dataset of electronically reported and serotyped invasive pneumococcal disease cases in England and Wales to estimate incidence rate ratios (IRRs) for vaccine and non-vaccine type invasive pneumococcal disease between July, 2013, and June, 2014, versus the pre-PCV13 and pre-PCV7 baseline. Incidence rates were corrected for missing serotype data and changes in surveillance sensitivity over time. An over-dispersed Poisson model was used to estimate IRRs and confidence intervals. Incidence of invasive pneumococcal disease in the epidemiological year 2013/14 decreased by 32% compared with the pre-PCV13 baseline (incidence 10·14 per 100,000 in 2008-10 vs 6·85 per 100,000 in 2013/14; IRR 0·68, 95% CI 0·64-0·72). This was due to an 86% reduction of the serotypes covered by PCV7 (1·46 vs 0·20 per 100,000; IRR 0·14, 0·10-0·18) and a 69% reduction of the additional six serotypes covered by PCV13 (4·48 vs 1·40 per 100,000; IRR 0·31, 0·28-0·35). When compared with the pre-PCV7 baseline, there was a 56% overall reduction in invasive pneumococcal disease (15·63 vs 6·85 per 100,000; IRR 0·44, 95% CI 0·43-0·47). Compared with the pre-PCV13 baseline, the incidence of non-PCV13 serotypes increased (incidence all ages 4·19 vs 5·25 per 100,000; IRR 1·25, 95% CI 1·17-1·35) due to increases across a broad range of serotypes in children younger than 5 years and in people aged 45 years or more. In children younger than 5 years, incidence of non-PCV13 serotypes in 2013/14 was higher than in 2012/13 (age Wales has reduced the

  6. Heterologous expression of the pneumococcal serotype 14 polysaccharide in Lactococcus lactis requires lactococcal epsABC regulatory genes

    NARCIS (Netherlands)

    Nierop Groot, M.N.; Godefrooij, J.; Kleerebezem, M.

    2008-01-01

    The pneumococcal serotype 14 polysaccharide was produced in Lactococcus lactis by coexpressing pneumococcal polysaccharide type 14-specific genes (cpsFGHIJKL(14)) with the lactococcal regulatory and priming glucosyltransferase-encoding genes specific for B40 polysaccharide (epsABCD(B40)). The

  7. Immunosuppressive drugs impairs antibody response of the polysaccharide and conjugated pneumococcal vaccines in patients with Crohn's disease

    DEFF Research Database (Denmark)

    Kantsø, Bjørn; Halkjær, Sofie Ingdam; Thomsen, Ole Østergaard

    2015-01-01

    with and without immunosuppressive treatment four weeks post vaccination. METHODS: In a randomized trial of the 23-valent pneumococcal polysaccharide vaccine (PPV23) and the 13-valent pneumococcal conjugated vaccine (PCV13), a group of CD patients treated with immunosuppressive drugs (IS) alone or in combination...

  8. Dynamics and Determinants of Pneumococcal Antibodies Specific against 13 Vaccine Serotypes in the Pre-Vaccination Era

    NARCIS (Netherlands)

    Prins-van Ginkel, Annemarijn C|info:eu-repo/dai/nl/413970434; Berbers, Guy A M; Grundeken, Lucienne H; Tcherniaeva, Irina; Wittenberns, Jelle I; Elberse, Karin; Mollema, Liesbeth; de Melker, Hester E; Knol, Mirjam J

    2016-01-01

    INTRODUCTION: Introduction of pneumococcal conjugate vaccines (PCVs) for infants decreased overall invasive pneumococcal disease (IPD), while non-vaccine serotype IPD increased. To fully understand this serotype replacement, knowledge about serotype dynamics in the pre-vaccine era is needed. In

  9. Prevotella intermedia induces severe bacteremic pneumococcal pneumonia in mice with upregulated platelet-activating factor receptor expression.

    Science.gov (United States)

    Nagaoka, Kentaro; Yanagihara, Katsunori; Morinaga, Yoshitomo; Nakamura, Shigeki; Harada, Tatsuhiko; Hasegawa, Hiroo; Izumikawa, Koichi; Ishimatsu, Yuji; Kakeya, Hiroshi; Nishimura, Masaharu; Kohno, Shigeru

    2014-02-01

    Streptococcus pneumoniae is the leading cause of respiratory infection worldwide. Although oral hygiene has been considered a risk factor for developing pneumonia, the relationship between oral bacteria and pneumococcal infection is unknown. In this study, we examined the synergic effects of Prevotella intermedia, a major periodontopathic bacterium, on pneumococcal pneumonia. The synergic effects of the supernatant of P. intermedia (PiSup) on pneumococcal pneumonia were investigated in mice, and the stimulation of pneumococcal adhesion to human alveolar (A549) cells by PiSup was assessed. The effects of PiSup on platelet-activating factor receptor (PAFR) transcript levels in vitro and in vivo were analyzed by quantitative real-time PCR, and the differences between the effects of pneumococcal infection induced by various periodontopathic bacterial species were verified in mice. Mice inoculated with S. pneumoniae plus PiSup exhibited a significantly lower survival rate, higher bacterial loads in the lungs, spleen, and blood, and higher inflammatory cytokine levels in the bronchoalveolar lavage fluid (macrophage inflammatory protein 2 and tumor necrosis factor alpha) than those infected without PiSup. In A549 cells, PiSup increased pneumococcal adhesion and PAFR transcript levels. PiSup also increased lung PAFR transcript levels in mice. Similar effects were not observed in the supernatants of Porphyromonas gingivalis or Fusobacterium nucleatum. Thus, P. intermedia has the potential to induce severe bacteremic pneumococcal pneumonia with enhanced pneumococcal adhesion to lower airway cells.

  10. Passive cigarette smoke exposure and other risk factors for invasive pneumococcal disease in children: a case-control study.

    Science.gov (United States)

    Chun, Colleen S; Weinmann, Sheila; Riedlinger, Karen; Mullooly, John P

    2015-01-01

    To investigate whether passive cigarette smoke exposure increases the risk of invasive pneumococcal disease in children. In a population-based case-control study, 171 children aged 0 to 12 years with culture-confirmed invasive pneumococcal disease during the years 1994 to 2004 were identified. Two controls were matched to each case on age and patterns of Health Plan membership. We reviewed medical records of subjects and family members for information on household cigarette smoke exposure within 2 years of the diagnosis of invasive pneumococcal disease. We collected information on sex, race, pneumococcal vaccination, selected medical conditions, and medications in the 3 months before the diagnosis. Similar proportions of cases (25%) and controls (30%) had definite or probable passive smoke exposure (odds ratio [OR] = 0.76, 95% confidence interval [CI] = 0.47-1.2). Cases of invasive pneumococcal disease were more likely to be nonwhite than controls (OR = 4.4, 95% CI = 2.3-8.2). Elevated risk of invasive pneumococcal disease was found in subjects with recent pulmonary diagnoses (OR = 2.2, 95% CI = 1.2-4.0) and recent antibiotic use (OR = 1.6, 95% CI = 1.1-2.3). Passive cigarette smoke exposure was not associated with invasive pneumococcal disease in this pediatric population. Invasive pneumococcal disease was associated with recent pulmonary diagnoses and recent antibiotic use.

  11. PHARMACOECONOMIC ASSESSMENT OF 13-VALENT PNEUMOCOCCAL CONJUGATE VACCINE IN IMMUNIZATION OF CHILDREN IN RUSSIAN FEDERATION

    Directory of Open Access Journals (Sweden)

    ​A. V. Rudakova

    2014-01-01

    Full Text Available Aim: cost-effectiveness assessment and budget impact analysis for 13-valent pneumococcal conjugate vaccine (PCV13 in infant immunization program in Russian Federation. Materials and methods: 10 year modeling with social perspective (direct medical and indirect costs and life expectancy with discounting by 3,5% per year and population effect based on results of clinical studies, global PCV13 use and Russian epidemiological data has been established. Budget impact has been analyzed without discounting. Direct effect was assessed by influence on pneumococcal meningitis, bacteremia, pneumonia and acute otitis media (AOM incidence, population effect — by pneumococcal meningitis and hospitalized all-cause pneumonia incidence. Results: Possible PCV13 effectiveness was estimated as 76,6% for invasive pneumococcal diseases (IPD and 23,7% for hospitalized cases of AOM. Vaccination (per 100 000 vaccinated infants can prevent 13,8 lethal cases in vaccinated population and 171,1 — in unvaccinated population. Cost-effectiveness ratio for PCV13 is estimated as 32,400 rubles / LYG and 32,400 rubles / QALY. Cost of 1 lethal case prevention is 140 100 rubles, additional cost for 10 years is 111,5 rubles per child. Conclusions: PCV13 mass vaccination of infants in Russian Federation is highly cost-effective and will significantly cut expenses due to pneumococcal diseases treatment. 

  12. Influenza and pneumococcal vaccine uptake among nursing home residents in Nottingham, England: a postal questionnaire survey

    Directory of Open Access Journals (Sweden)

    Vivancos Roberto

    2008-05-01

    Full Text Available Abstract Background Previous studies have shown influenza vaccine uptake in UK nursing home residents to be low. Very little information exists regarding the uptake of pneumococcal vaccine in this population. The formulation of policies relating to the vaccination of residents has been proposed as a simple step that may help improve vaccine uptake in care homes. Methods A postal questionnaire was sent to matrons of all care homes with nursing within the Greater Nottingham area in January 2006. Non respondents were followed up with up to 3 phone calls. Results 30% (16/53 of respondents reported having a policy addressing influenza vaccination and 15% (8/53 had a policy addressing pneumococcal vaccination. Seasonal influenza vaccine coverage in care homes with a vaccination policy was 87% compared with 84% in care homes without a policy (p = 0.47. The uptake of pneumococcal vaccination was found to be low, particularly in care homes with no vaccination policy. Coverage was 60% and 32% in care homes with and without a vaccination policy respectively (p = 0.06. This result was found to be statistically significant on multivariate analysis (p = 0.03, R = 0.46 Conclusion The uptake of influenza vaccine among care home residents in the Nottingham region is relatively high, although pneumococcal vaccine uptake is low. This study shows that there is an association between pneumococcal vaccine uptake and the existence of a vaccination policy in care homes, and highlights that few care homes have vaccination policies in place.

  13. T regulatory cells control susceptibility to invasive pneumococcal pneumonia in mice.

    Directory of Open Access Journals (Sweden)

    Daniel R Neill

    Full Text Available Streptococcus pneumoniae is an important human pathogen responsible for a spectrum of diseases including pneumonia. Immunological and pro-inflammatory processes induced in the lung during pneumococcal infection are well documented, but little is known about the role played by immunoregulatory cells and cytokines in the control of such responses. We demonstrate considerable differences in the immunomodulatory cytokine transforming growth factor (TGF-β between the pneumococcal pneumonia resistant BALB/c and susceptible CBA/Ca mouse strains. Immunohistochemistry and flow cytometry reveal higher levels of TGF-β protein in BALB/c lungs during pneumococcal pneumonia that correlates with a rapid rise in lung Foxp3(+Helios(+ T regulatory cells. These cells have protective functions during pneumococcal pneumonia, because blocking their induction with an inhibitor of TGF-β impairs BALB/c resistance to infection and aids bacterial dissemination from lungs. Conversely, adoptive transfer of T regulatory cells to CBA/Ca mice, prior to infection, prolongs survival and decreases bacterial dissemination from lungs to blood. Importantly, strong T regulatory cell responses also correlate with disease-resistance in outbred MF1 mice, confirming the importance of immunoregulatory cells in controlling protective responses to the pneumococcus. This study provides exciting new evidence for the importance of immunomodulation during pulmonary pneumococcal infection and suggests that TGF-β signalling is a potential target for immunotherapy or drug design.

  14. Pneumococcal Vaccine Uptake Among Australian Hajj Pilgrims in 2011-13.

    Science.gov (United States)

    Tashani, Mohamed; Barasheed, Osamah; Azeem, Mohammad; Alfelali, Mohammad; Badahdah, Al-Mamoon; Bokhary, Hamid; Almasri, Nedal; Alshehri, Jassir; Matbouly, Ghassan; Kalantan, Nadeen; Heron, Leon; Ridda, Iman; Haworth, Elizabeth; Asghar, Atif; Rashid, Harunor; Booy, Robert

    2014-01-01

    The uptake of the pneumococcal vaccine is suboptimal in Australia and remains unknown among Australian Hajj pilgrims, many of whom are eligible because of age or underlying disease and at particular risk because of travel and activities at Hajj. Pneumococcal vaccination uptake was examined over three consecutive years (2011 to 2013) through anonymous self-administered cross sectional surveys among Australian pilgrims who assembled in Mina valley, Mecca, Saudi Arabia. Respectively, 158, 513 and 219 pilgrims were recruited in 2011, 2012 and 2013; their mean ages were 43.8 (SD±13), 43 (SD±13.5) and 42.6 (SD±12.3) years; males accounted for 67 (42.4%), 325 (63.4%) and 172 (78.5%). Pneumococcal vaccine uptake rates were 28.5% (45/158), 28.7% (147/513) and 14.2% (31/219); among the pilgrims with 'at risk' conditions the pneumococcal vaccine uptake rates were 15 (30.6%), 43 (45.3%) and 9 (29%) respectively. According to our surveys, the pneumococcal vaccine uptake among Australian pilgrims is low. Further research is needed to explore the reasons through a validated study.

  15. Bacterial load of pneumococcal serotypes correlates with their prevalence and multiple serotypes is associated with acute respiratory infections among children less than 5 years of age.

    Science.gov (United States)

    Dhoubhadel, Bhim Gopal; Yasunami, Michio; Nguyen, Hien Anh Thi; Suzuki, Motoi; Vu, Thu Huong; Thi Thuy Nguyen, Ai; Dang, Duc Anh; Yoshida, Lay-Myint; Ariyoshi, Koya

    2014-01-01

    Among pneumococcal serotypes, some serotypes are more prevalent in the nasopharynx than others; determining factors for higher prevalence remain to be fully explored. As non-vaccine serotypes have emerged after the introduction of 7-valent conjugate vaccines, study of serotype specific epidemiology is in need. When two or more serotypes co-colonize, they evolve rapidly to defend host's immune responses; however, a clear association of co-colonization with a clinical outcome is lacking. Children less than 5 years old who were admitted to hospital due to acute respiratory infections (ARI) (n = 595) and healthy children (n = 350) were recruited. Carriage of pneumococcus was determined by culture and lytA PCR in the nasopharyngeal samples. Serotype/serogroup detection and its quantification were done by the nanofluidic real time PCR system. Spearman's correlation and logistic regression were used to examine a correlation of serotype/serogroup specific bacterial load with its prevalence and an association of co-colonization with ARI respectively. Serotype/serogroup specific bacterial load was correlated with its prevalence, both in ARI cases (Spearman's rho = 0.44, n = 186; Pprevalence of multiple serotypes was more common in ARI cases than in healthy children (18.5% vs 7.1%; aOR 2.92, 95% CI: 1.27-6.71; P = 0.01). The dominant serotype in the co-colonization had a 2 log10 higher bacterial load than the subdominant serotype, both in ARI cases (P<0.001) and healthy children (P<0.05). High bacterial load in the nasopharynx may help transmit pneumococci among hosts, and increase the chance of successful acquisition and colonization. Co-colonization of multiple serotypes of pneumococci is linked with ARI, which infers the interactions of multiple serotypes may increase their pathogenicity; however, they may compete for growth in number.

  16. 14 CFR 141.18 - Carriage of narcotic drugs, marijuana, and depressant or stimulant drugs or substances.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Carriage of narcotic drugs, marijuana, and depressant or stimulant drugs or substances. 141.18 Section 141.18 Aeronautics and Space FEDERAL AVIATION... General § 141.18 Carriage of narcotic drugs, marijuana, and depressant or stimulant drugs or substances...

  17. Nasal And Hand Carriage Of Bacteria In Different Groups Of Persons In A Teaching Hospital In India

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    P Ganguly

    1997-12-01

    Full Text Available Research Problem: What is the level of bacterial car­riage in different groups of hospital staff?Objective: To study nasal and hand carriage of bacteria in different groups of persons in a teaching hospital.Study Design: Prospective study.Setting: Surgical wards of J.N. Medical College Hospi­tal, A.M.U., Aligarh.Participants: Randomly selected persons from differ­ent groups of hospital staff (doctors, nurses, ward and OT assistants, visitors of patients, patients and medi­cal students.Sample Size: 275 persons.Study Variables: Nasal and hand carriage of S. aureus and gram negative bacilli.Outcome Variables: Percentage of hospital staff show­ing bacterial carriage in their nose or on their hands.Statistical Analysis: By tests of significance.Result: Overall bacterial carriage rate in different cat­egories of hospital staff was found to be 54.5%. Doc­tors and paramedical staff had higher bacterial carriage rate as compared to other groups. Though Staphylo­coccus aureus was the commonest organism isolated from both nose and skin, carriage of Escherichia coli, Pseudomonas and Klebsiella group of gram-negative bacilli was also observed. Nasal carriage was com­moner than dermal carriage.Conclusion: Doctors and paramedical staff in hospital should adopt appropriate preventive measures to avoid transmitting pathogenic bacteria from their nose and skin to their patients.

  18. 14 CFR 125.39 - Carriage of narcotic drugs, marihuana, and depressant or stimulant drugs or substances.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Carriage of narcotic drugs, marihuana, and depressant or stimulant drugs or substances. 125.39 Section 125.39 Aeronautics and Space FEDERAL AVIATION... AIRCRAFT Certification Rules and Miscellaneous Requirements § 125.39 Carriage of narcotic drugs, marihuana...

  19. 14 CFR 91.19 - Carriage of narcotic drugs, marihuana, and depressant or stimulant drugs or substances.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Carriage of narcotic drugs, marihuana, and... OPERATING AND FLIGHT RULES General § 91.19 Carriage of narcotic drugs, marihuana, and depressant or... operate a civil aircraft within the United States with knowledge that narcotic drugs, marihuana, and...

  20. 14 CFR 121.15 - Carriage of narcotic drugs, marihuana, and depressant or stimulant drugs or substances.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Carriage of narcotic drugs, marihuana, and depressant or stimulant drugs or substances. 121.15 Section 121.15 Aeronautics and Space FEDERAL AVIATION....15 Carriage of narcotic drugs, marihuana, and depressant or stimulant drugs or substances. If a...

  1. 14 CFR 135.41 - Carriage of narcotic drugs, marihuana, and depressant or stimulant drugs or substances.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Carriage of narcotic drugs, marihuana, and depressant or stimulant drugs or substances. 135.41 Section 135.41 Aeronautics and Space FEDERAL AVIATION... PERSONS ON BOARD SUCH AIRCRAFT General § 135.41 Carriage of narcotic drugs, marihuana, and depressant or...

  2. Parental knowledge, attitudes and perception of pneumococcal disease and pneumococcal conjugate vaccines in Singapore: a questionnaire-based assessment

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    Choon How How

    2016-09-01

    Full Text Available Abstract Background Under the National Childhood Immunisation Schedule (NCIS in Singapore most vaccines are provided free while some, including pneumococcal conjugate vaccines (PCV, added to the NCIS in October 2009, are not free. In contrast to ≥95 % coverage achieved for recommended childhood vaccines that are free, 2013 coverage of the PCV booster dose was 58.9 % (for unclear reasons. To date, no population impact on pneumococcal disease (PD has been observed. We conducted a questionnaire-based study of parents of young children to assess the value of PCV to parents, and to quantify the extent to which vaccine cost is a barrier to PCV uptake in Singapore. Methods A single, trained interviewer administered a questionnaire to 200 parents ≥21 years of age with young children attending the Singapore Sengkang Polyclinic. The questionnaire asked closed-ended questions on parents’ knowledge about PD and PCV. A 5-point Likert scale measured perceived benefits and barriers to PCV vaccination. Results There were 162 parents whose children were either PCV-vaccinated or who intended to vaccinate their child with PCV (Vaccinated group, and 38 whose children were non-PCV vaccinated or who did not intend to vaccinate (Unvaccinated group. The odds ratio for PCV vaccination among parents who perceived cost as a barrier was 0.16 (95%CI 0.02–1.23. Compared to the Vaccinated group, parents in the Unvaccinated group were less willing to pay for PCV (50.0 %/94.4 %. Compared to the Vaccinated group, fewer parents in the Unvaccinated group had heard about PD (34.2 %/82.1 % or PCV (36.8 %/69.1 %, or perceived that PD was a threat to their child. Fewer parents in the Unvaccinated group knew that vaccination could prevent PD (28.9 %/77.8 %, or reported that PCV vaccination was recommended to them by any source (63.2 % had no PCV recommendation, versus 20.4 %. When informed that PCV is included in the NCIS only 65.8 % of parents in the Unvaccinated

  3. Serotype-Specific Changes in Invasive Pneumococcal Disease after Pneumococcal Conjugate Vaccine Introduction: A Pooled Analysis of Multiple Surveillance Sites

    Science.gov (United States)

    Feikin, Daniel R.; Kagucia, Eunice W.; Loo, Jennifer D.; Link-Gelles, Ruth; Puhan, Milo A.; Cherian, Thomas; Levine, Orin S.; Whitney, Cynthia G.; O’Brien, Katherine L.; Moore, Matthew R.

    2013-01-01

    Background Vaccine-serotype (VT) invasive pneumococcal disease (IPD) rates declined substantially following introduction of 7-valent pneumococcal conjugate vaccine (PCV7) into national immunization programs. Increases in non-vaccine-serotype (NVT) IPD rates occurred in some sites, presumably representing serotype replacement. We used a standardized approach to describe serotype-specific IPD changes among multiple sites after PCV7 introduction. Methods and Findings Of 32 IPD surveillance datasets received, we identified 21 eligible databases with rate data ≥2 years before and ≥1 year after PCV7 introduction. Expected annual rates of IPD absent PCV7 introduction were estimated by extrapolation using either Poisson regression modeling of pre-PCV7 rates or averaging pre-PCV7 rates. To estimate whether changes in rates had occurred following PCV7 introduction, we calculated site specific rate ratios by dividing observed by expected IPD rates for each post-PCV7 year. We calculated summary rate ratios (RRs) using random effects meta-analysis. For children <5 years old, overall IPD decreased by year 1 post-PCV7 (RR 0·55, 95% CI 0·46–0·65) and remained relatively stable through year 7 (RR 0·49, 95% CI 0·35–0·68). Point estimates for VT IPD decreased annually through year 7 (RR 0·03, 95% CI 0·01–0·10), while NVT IPD increased (year 7 RR 2·81, 95% CI 2·12–3·71). Among adults, decreases in overall IPD also occurred but were smaller and more variable by site than among children. At year 7 after introduction, significant reductions were observed (18–49 year-olds [RR 0·52, 95% CI 0·29–0·91], 50–64 year-olds [RR 0·84, 95% CI 0·77–0·93], and ≥65 year-olds [RR 0·74, 95% CI 0·58–0·95]). Conclusions Consistent and significant decreases in both overall and VT IPD in children occurred quickly and were sustained for 7 years after PCV7 introduction, supporting use of PCVs. Increases in NVT IPD occurred in most sites, with variable magnitude

  4. Serotype-specific changes in invasive pneumococcal disease after pneumococcal conjugate vaccine introduction: a pooled analysis of multiple surveillance sites.

    Directory of Open Access Journals (Sweden)

    Daniel R Feikin

    Full Text Available BACKGROUND: Vaccine-serotype (VT invasive pneumococcal disease (IPD rates declined substantially following introduction of 7-valent pneumococcal conjugate vaccine (PCV7 into national immunization programs. Increases in non-vaccine-serotype (NVT IPD rates occurred in some sites, presumably representing serotype replacement. We used a standardized approach to describe serotype-specific IPD changes among multiple sites after PCV7 introduction. METHODS AND FINDINGS: Of 32 IPD surveillance datasets received, we identified 21 eligible databases with rate data ≥ 2 years before and ≥ 1 year after PCV7 introduction. Expected annual rates of IPD absent PCV7 introduction were estimated by extrapolation using either Poisson regression modeling of pre-PCV7 rates or averaging pre-PCV7 rates. To estimate whether changes in rates had occurred following PCV7 introduction, we calculated site specific rate ratios by dividing observed by expected IPD rates for each post-PCV7 year. We calculated summary rate ratios (RRs using random effects meta-analysis. For children <5 years old, overall IPD decreased by year 1 post-PCV7 (RR 0.55, 95% CI 0.46-0.65 and remained relatively stable through year 7 (RR 0.49, 95% CI 0.35-0.68. Point estimates for VT IPD decreased annually through year 7 (RR 0.03, 95% CI 0.01-0.10, while NVT IPD increased (year 7 RR 2.81, 95% CI 2.12-3.71. Among adults, decreases in overall IPD also occurred but were smaller and more variable by site than among children. At year 7 after introduction, significant reductions were observed (18-49 year-olds [RR 0.52, 95% CI 0.29-0.91], 50-64 year-olds [RR 0.84, 95% CI 0.77-0.93], and ≥ 65 year-olds [RR 0.74, 95% CI 0.58-0.95]. CONCLUSIONS: Consistent and significant decreases in both overall and VT IPD in children occurred quickly and were sustained for 7 years after PCV7 introduction, supporting use of PCVs. Increases in NVT IPD occurred in most sites, with variable magnitude. These findings may not

  5. Systemic inflammatory reaction after pneumococcal vaccine: a case series.

    Science.gov (United States)

    von Elten, Kelley A; Duran, Laurie L; Banks, Taylor A; Banks, Taylor A; Collins, Limone C; Collins, Limone C

    2014-01-01

    Fever, leukocytosis, and large local reactions following the pneumococcal polysaccharide vaccine (PS23) have been described only in isolated case reports in the adult literature. Such atypical reactions can pose difficulty to providers when determining management. Patients experiencing this noninfectious reaction may receive unnecessary treatment if the diagnosis of robust inflammatory response to the PS23 vaccine is not considered. This is a clinical case series of 5 adult patients who received the influenza and PS23 vaccines and experienced a cellulitis-like reaction, fever, and leukocytosis in the days following vaccination. Four of the five patients received the influenza and PS23 vaccines in the same arm. The patient who received the vaccines in opposite arms had the local findings in the arm that received the PS23 vaccine. All 5 patients sought care and 4 were admitted to the hospital for observation or treatment with intravenous antibiotics. This case series highlights potential side effects of the PS23 vaccine that are not well described in the adult literature. Antibiotics were not helpful in treating these patients' local and systemic symptoms. Patients with histories consistent with that highlighted in this case series may avoid antibiotics and hospitalization if their providers recognize these symptoms as a noninfectious reaction to the PS23 vaccine.

  6. Impact of conjugate pneumococcal vaccines on antibiotic resistance.

    Science.gov (United States)

    Dagan, Ron; Klugman, Keith P

    2008-12-01

    Reduction of drug-resistant Streptococcus pneumoniae (DRSP) by pneumococcal conjugate vaccines (PCVs) has recently become a reality. We now know that (1) most clinically significant DRSP strains belong to seven serotypes (6A, 6B, 9V, 14, 19A, 19F, 23F), (2) five (6B, 9V, 14, 19F, 23F) of the seven are constituents of heptavalent PCV (PCV7), and (3) the remaining two serotypes (6A, 19A) are immunologically related to serotypes in PCV7, but only 6A has been reduced by PCV7. Furthermore, PCVs can also reduce DRSP in unvaccinated individuals (herd immunity). PCVs lead to a reduction in antibiotic use, which is also potentially helpful to contain DRSP. Although a reduction in disease caused by most penicillin-resistant strains has been reported, reductions in intermediately penicillin-resistant strains has not been shown to the same degree, because of increased intermediate resistance among non-PCV7 serotypes. Serotype 19A, which is both antibiotic resistant and a common cause of disease, is not affected by PCV7, and is now increasing worldwide, including in countries without PCV7. Continued exposure of non-PCV7 serotypes to antibiotic pressure may reduce the overall impact of PCVs on DRSP. Further strategies include expansion of PCV serotype coverage, development of protein-based vaccines, and further limitation of antibiotic use.

  7. Unveiling Unexpected Immune Activities Induced by Your Pneumococcal Vaccine

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    Julia L. Hurwitz

    2016-03-01

    Full Text Available In modern-day vaccine design, a good pneumococcal capsular polysaccharide vaccine is measured by its ability to induce opsonic antibodies. These antibodies label bacteria for phagocytosis by neutrophils and thereby overcome the capsule’s barrier function. Doyle and Pirofski have raised a serious challenge to the current paradigm by describing anti-capsular antibodies that are highly protective but nonopsonic [C.R. Doyle and L. Pirofski, mBio 7(1:e02260-15, 2016, doi:10.1128/mBio.02260-15]. In fact, some functions are not related to neutrophils or phagocytosis at all. An increased awareness of these activities is critical not only for accurate comparisons of vaccine candidates but also for improvements in vaccination outcomes in settings of neutropenia. When vaccine developers select a single gatekeeper assay (e.g., an opsonophagocytic assay for bacteria or a neutralization assay for viruses, promising vaccine candidates may be missed. Doyle and Pirofski stress that multiple functions, not just one, should be investigated to enhance discovery of antibody mechanisms and to best assess vaccine-induced correlates of immune protection.

  8. Pulmonary dry powder vaccine of pneumococcal antigen loaded nanoparticles.

    Science.gov (United States)

    Kunda, Nitesh K; Alfagih, Iman M; Miyaji, Eliane N; Figueiredo, Douglas B; Gonçalves, Viviane M; Ferreira, Daniela M; Dennison, Sarah R; Somavarapu, Satyanarayana; Hutcheon, Gillian A; Saleem, Imran Y

    2015-11-30

    Pneumonia, caused by Streptococcus pneumoniae, mainly affects the immunocompromised, the very young and the old, and remains one of the leading causes of death. A steady rise in disease numbers from non-vaccine serotypes necessitates a new vaccine formulation that ideally has better antigen stability and integrity, does not require cold-chain and can be delivered non-invasively. In this study, a dry powder vaccine containing an important antigen of S. pneumoniae, pneumococcal surface protein A (PspA) that has shown cross-reactivity amongst serotypes to be delivered via the pulmonary route has been formulated. The formulation contains the antigen PspA adsorbed onto the surface of polymeric nanoparticles encapsulated in L-leucine microparticles that can be loaded into capsules and delivered via an inhaler. We have successfully synthesized particles of ∼150 nm and achieved ∼20 μg of PspA adsorption per mg of NPs. In addition, the spray-dried powders displayed a FPF of 74.31±1.32% and MMAD of 1.70±0.03 μm suggesting a broncho-alveolar lung deposition facilitating the uptake of the nanoparticles by dendritic cells. Also, the PspA released from the dry powders maintained antigen stability (SDS-PAGE), integrity (Circular dichroism) and activity (lactoferrin binding assay). Moreover, the released antigen also maintained its antigenicity as determined by ELISA. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Kinetic changes in gait during low magnitude military load carriage.

    Science.gov (United States)

    Majumdar, Deepti; Pal, Madhu Sudan; Pramanik, Anilendu; Majumdar, Dhurjati

    2013-01-01

    Indian infantry soldiers carry smaller magnitudes of loads for operational requirements. The ground reaction forces (GRFs) and impulse responses of 10 healthy male Indian infantry soldiers were collected while they walked carrying operational loads between 4.2 and 17.5 kg (6.5-27.2% of mean body weight (BW)) and a control condition of no external load (NL). The GRF and impulse components were normalised for BW, and data for each load condition were compared with NL in each side applying one-way analysis of variance followed by Dunnett's post hoc test. Right foot data were compared with corresponding left foot GRF data for all load conditions and NL. There were significant increases in vertical and anteroposterior GRFs with increase in load. Left and right feet GRF data in corresponding load conditions were significantly different in anteroposterior plane. No significant change was observed in the temporal components of support phase of gait. Changes in impulse parameter were observed in the anteroposterior and vertical planes while carrying load greater than 23 and 16.6% of BW for the right foot and left foot, respectively. Result indicates that smaller magnitudes of loads produced kinetic changes proportional to system weight, similar to heavier loads with the possibility of increased injury risk. Observed smaller asymmetric changes in gait may be considered as postural adjustment due to load. Unique physical characteristics of Indian soldiers and the probable design shortcomings of the existing backpack might have caused significant changes in GRF and peak impulse during smaller load carriage.

  10. Carrier’s liability under the international conventions for the carriage of goods by sea

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    Anežka GROBARČÍKOVÁ

    2014-09-01

    Full Text Available As is well known, there is no international convention for the carriage of goods in general. Each mode of transport counts on one or several international conventions that specifically regulate the provision of international transport by sea, rail, road or air. Thus, multimodal freight transport are characterised by a patchwork of different legal regimes that represents a huge challenge for the growth of multimodal transport industry. The paper aims to analyse the latest, but still not in force Convention on Contracts for the International Carriage of Goods Wholly or Partly by Sea (the Rotterdam rules that should provide global solution for multimodal carrier liability. Comparison of the carrier’s liability in the former conventions relating to the international carriage of goods by sea and other rules are also discussed.

  11. Detection and clinical relevance of Staphylococcus aureus nasal carriage: an update.

    Science.gov (United States)

    Verhoeven, Paul O; Gagnaire, Julie; Botelho-Nevers, Elisabeth; Grattard, Florence; Carricajo, Anne; Lucht, Frédéric; Pozzetto, Bruno; Berthelot, Philippe

    2014-01-01

    Staphylococcus aureus nasal carriage is a well-defined risk factor of infection with this bacterium. The increased risk of S. aureus infection in nasal carriers is supported by the fact that the strains isolated from both colonization and infection sites are indistinguishable in most of the cases. Persistent nasal carriage seems to be associated with an increased risk of infection and this status could be defined now in clinical routine by using one or two quantitative nasal samples. There is evidence for supporting the detection of nasal carriage of S. aureus in patients undergoing cardiac surgery and in those undergoing hemodialysis in order to implement decolonization measures. More studies are needed to determine which carriers have the highest risk of infection and why decolonization strategies failed to reduce S. aureus infection in some other groups of patients.

  12. Changes in empyema among U.S. children in the pneumococcal conjugate vaccine era.

    Science.gov (United States)

    Wiese, Andrew D; Griffin, Marie R; Zhu, Yuwei; Mitchel, Edward F; Grijalva, Carlos G

    2016-12-07

    Parapneumonic empyema, a serious complication of pneumonia, started increasing among U.S. children before the introduction of the 7-valent pneumococcal conjugate vaccine (PCV7) in 2000, and continued afterwards. This increase was due in part to pneumococcal serotypes not included in PCV7 that were included in the new 13-valent (PCV13) vaccine introduced in 2010. We assessed changes in the incidence of empyema hospitalizations among U.S. children after PCV13 introduction. We calculated annualized empyema hospitalization rates among U.S. children children children children 2-4 and 5-17years were similar. Most empyema were of unspecified etiology. Pneumococcal and unspecified empyema declined after PCV13 introduction. Although empyema hospitalization rates among U.S. children peaked after PCV7 introduction, rates decreased substantially following the introduction of PCV13. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Pneumococcal Sepsis Complicated by Splenic Abscesses and Purpura Fulminans in a 15-Month-Old Child

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    Scott Pangonis MD

    2016-02-01

    Full Text Available Streptococcus pneumoniae is an invasive organism that causes a wide range of common diseases, including sinusitis, acute otitis media, and pneumonia. Splenic abscesses and purpura fulminans (PF are rare complications of pneumococcal disease. Splenic abscesses caused by S pneumoniae have only been reported in the adult literature. PF has been described in the pediatric population as a rare complication in patients with invasive pneumococcal disease (IPD with and without underlying immunological disorders such as asplenia. Here, we report a patient with IPD complicated by splenic abscesses and PF. Our patient initially presented with bacteremia, septic shock, and disseminated intravascular coagulation. She subsequently developed PF and splenic abscesses. She survived her illness after receiving a total of 8 weeks of antibiotic therapy. This case highlights 2 rare complications of IPD and demonstrates the need to keep pneumococcal disease in the differential diagnosis even in children whose vaccination status is up to date.

  14. Impact of pneumococcal microbial surface components recognizing adhesive matrix molecules on colonization.

    Science.gov (United States)

    Voss, S; Gámez, G; Hammerschmidt, S

    2012-08-01

    Microorganisms have evolved elaborate strategies to adhere to host cells and to evade the host complement and immune attack, ensuring survival in various host niches and dissemination into sterile parts of the human body. Streptococcus pneumoniae (the pneumococcus) is not only a commensal of the human respiratory tract but also the etiological agent of severe and life-threatening diseases. Pneumococcal attachment to mucosal surfaces is a highly dynamic process requiring the contact of pneumococcal surface-exposed proteins with soluble or immobilized host factors. These avid interactions may trigger proteolytic cascades or result in engagement of cell surface receptors and intracellularly associated signaling machineries for subsequent uptake of pneumococci into host cells. In the present review, the intimate communication of S. pneumoniae molecules recognizing adhesive matrix molecules (microbial surface components recognizing adhesive matrix molecules) with their host counterparts and their individual role in pneumococcal colonization is discussed. © 2012 John Wiley & Sons A/S.

  15. Characterization of Clostridium perfringens TpeL Toxin Gene Carriage, Production, Cytotoxic Contributions, and Trypsin Sensitivity

    Science.gov (United States)

    Chen, Jianming

    2015-01-01

    Large clostridial toxins (LCTs) are produced by at least four pathogenic clostridial species, and several LCTs are proven pivotal virulence factors for both human and veterinary diseases. TpeL is a recently identified LCT produced by Clostridium perfringens that has received relatively limited study. In response, the current study surveyed carriage of the tpeL gene among different C. perfringens strains, detecting this toxin gene in some type A, B, and C strains but not in any type D or E strains. This study also determined that all tested strains maximally produce, and extracellularly release, TpeL at the late-log or early-stationary growth stage during in vitro culture, which is different from the maximal late-stationary-phase production reported previously for other LCTs and for TpeL production by C. perfringens strain JIR12688. In addition, the present study found that TpeL levels in culture supernatants can be repressed by either glucose or sucrose. It was also shown that, at natural production levels, TpeL is a significant contributor to the cytotoxic activity of supernatants from cultures of tpeL-positive strain CN3685. Lastly, this study identified TpeL, which presumably is produced in the intestines during diseases caused by TpeL-positive type B and C strains, as a toxin whose cytotoxicity decreases after treatment with trypsin; this finding may have pathophysiologic relevance by suggesting that, like beta toxin, TpeL contributes to type B and C infections in hosts with decreased trypsin levels due to disease, diet, or age. PMID:25824828

  16. [Nasopharyngeal Hib Carriage Among Healthy Children Attending Daycare Centers in Yokohama After One Year of a Publicly Funded Vaccine Program].

    Science.gov (United States)

    Saito, Ayako; Sumita, Hiroko; Minohara, Yutaka; Fujita, Shinji; Yazaki, Shigeyoshi; Kitamura, Miyoshi; Kawai, Shigehiko; Kamata, Kazumi; Oota, Yoshimi; Yamada, Mikiko; Matsumoto, Yuko; Takeyasu, Nobuaki

    2015-01-01

    Yokohama city started a regular, free vaccine program for Haemophilus influenzae type b (Hib) from February of 2011. This study was completed to verify the effectiveness of the vaccine on the nasopharyngeal Hib carriage among healthy children attending daycare centers in the Isogo area. The research was conducted during the late spring (Jun--Jul) and fall (Oct-Nov) of 2012. There was a significant decrease in the Hib carriage rate (spring 8.8%, fall 1.6%). During this period there was no increase in the Hib vaccine coverage. The Hib carriage rate of each daycare center was 0-18.4% in spring and 0-4.9% in fall. There was no significant relationship between the rate of non immunized children and that of Hib carriage. This improvement in nasopharyngeal Hib carriage shows the impact of community immunity.

  17. Low prevalence of Kingella kingae carriage in children aged 6-48 months in Sydney, Australia.

    Science.gov (United States)

    Khatami, Ameneh; Rivers, Braden Rl; Outhred, Alexander C; Kesson, Alison M

    2017-02-01

    A prospective observational study was conducted to estimate the prevalence of oropharyngeal carriage of Kingella kingae in healthy Australian pre-school children. Screening for carriage of K. kingae as well as Streptococcus pyogenes, Streptococcus pneumoniae, Streptococcus agalactiae, Staphylococcus aureus, Haemophilus influenzae, and K. kingae was undertaken using a single bacterial throat swab taken from well children aged 6 months to 4 years. Standard laboratory procedures were used for culture and identification of organisms. One hundred children were enrolled between October and December 2014 at the Children's Hospital at Westmead. Median age was 24.0 months (range 6.1-48.8 months); 52 children were male and 36 attended day-care facilities. Forty-one children had siblings aged less than 5 years and 67 children had siblings of any age. K. kingae oropharyngeal carriage was not detected in any of the children. Rates of carriage of other organisms were: 30% S. aureus, 21% H. influenzae, 2% S. pneumoniae and 2% S. pyogenes. Thirty-eight children were colonised with Kingella denitrificans. Our results suggest that prevalence of K. kingae carriage in pre-school children in Sydney is very low and support local and national guidelines that recommend flucloxacillin as empiric first-line therapy for children with osteoarticular infections. Studies conducted over the winter months and in other Australian centres could help answer outstanding questions regarding differences in carriage rates of K. kingae in children. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  18. Community-associated methicillin-resistant Staphylococcus aureus nasal carriage in a college student athlete population.

    Science.gov (United States)

    Rackham, Daniel M; Ray, Shaunta' M; Franks, Andrea S; Bielak, Kenneth M; Pinn, Tanika M

    2010-05-01

    This study evaluated the prevalence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) nasal carriage, risk factors for nasal carriage, and antibiotic susceptibility patterns in college student athletes. Cross-sectional study. Methicillin-resistant Staphylococcus aureus nasal samples and data collection forms were obtained at athletic team training rooms at 2 colleges. : The study population included 277 college student athletes older than 18 years. A nasal swab was obtained from each athlete after completion of a data collection form. Variables collected on the data collection form included age, sex, race/ethnicity, athletic team, recent health care exposure(s), history of CA-MRSA exposure, recent antibiotic treatment(s), sharing towels, razors or soap, nose picking, and on-campus or off-campus living. Prevalence of CA-MRSA nasal carriage and antibiotic susceptibility patterns was analyzed. Risk factors for nasal carriage were also evaluated. Five positive CA-MRSA nasal carriers (4 men and 1 woman) were identified of 277 sampled; a prevalence of 1.8%. Two institutions were involved in the study. Institution 1 had 4 positive CA-MRSA nasal carriers of 124 sampled (3.2%). Institution 2 had 1 positive CA-MRSA nasal carrier of 153 sampled (0.65%). No risk factors were found to be significantly associated with positive CA-MRSA nasal carriage. The prevalence of CA-MRSA nasal carriage in college student athletes in East Tennessee (1.8%) seems similar to what has been reported in the general population (1.5%).

  19. Community faecal carriage of extended-spectrum beta-lactamase-producing Enterobacteriaceae in French children.

    Science.gov (United States)

    Birgy, André; Cohen, Robert; Levy, Corinne; Bidet, Philippe; Courroux, Céline; Benani, Mohamed; Thollot, Franck; Bingen, Edouard

    2012-11-21

    The increasing incidence of community acquired infection due to Extended-Spectrum Beta-Lactamase (ESBL) -Producing Enterobacteriaceae represent a great concern because there are few therapeutic alternatives. The fecal flora of children in the community can represent a reservoir for ESBLs genes which are located on highly transmissible plasmids and the spread of these genes among bacterial pathogens is concerning. Because intestinal carriage is a key factor in the epidemiology of ESBL-producing Enterobacteriaceae, the study of the prevalence of these resistant bacteria and risk factors in young children is of particular interest. We assessed the prevalence and risk factors of community-acquired faecal carriage of extended-spectrum-β-lactamase (ESBL)-producing Enterobacteriaceae in children aged from 6 to 24 months, by means of rectal swabbing in community pediatric practices. Child's lifestyle and risk factors for carriage of resistant bacteria were noted. Among the 411 children enrolled, 4.6% carried ESBL-producing Enterobacteriaceae. CTX-M-1, CTX-M-15 and CTX-M-14 were the predominant ESBLs. The 18 E. coli isolates were genetically heterogeneous. Recent third-generation oral-cephalosporin exposure was associated with a higher risk of ESBL carriage (AOR=3.52, 95% CI[1.06-11.66], p=0.04). The carriage rate of ESBL-producing Enterobacteriacae in young children in the French community setting is noteworthy, underlining the importance of this population as a reservoir. Exposure to third-generation oral cephalosporins was associated with a significant risk of ESBL carriage in our study. Because of the significant public health implications including the treatment of community-acquired urinary tract infections, the spread of organisms producing ESBLs in the community merits close monitoring with enhanced efforts for surveillance.

  20. Community faecal carriage of extended-spectrum beta-lactamase-producing Enterobacteriaceae in french children

    Directory of Open Access Journals (Sweden)

    Birgy André

    2012-11-01

    Full Text Available Abstract Background The increasing incidence of community acquired infection due to Extended-Spectrum Beta-Lactamase (ESBL -Producing Enterobacteriaceae represent a great concern because there are few therapeutic alternatives. The fecal flora of children in the community can represent a reservoir for ESBLs genes which are located on highly transmissible plasmids and the spread of these genes among bacterial pathogens is concerning. Because intestinal carriage is a key factor in the epidemiology of ESBL-producing Enterobacteriaceae, the study of the prevalence of these resistant bacteria and risk factors in young children is of particular interest. Methods We assessed the prevalence and risk factors of community-acquired faecal carriage of extended-spectrum-β-lactamase (ESBL-producing Enterobacteriaceae in children aged from 6 to 24 months, by means of rectal swabbing in community pediatric practices. Child’s lifestyle and risk factors for carriage of resistant bacteria were noted. Results Among the 411 children enrolled, 4.6% carried ESBL-producing Enterobacteriaceae. CTX-M-1, CTX-M-15 and CTX-M-14 were the predominant ESBLs. The 18 E. coli isolates were genetically heterogeneous. Recent third-generation oral-cephalosporin exposure was associated with a higher risk of ESBL carriage (AOR=3.52, 95% CI[1.06-11.66], p=0.04. Conclusions The carriage rate of ESBL-producing Enterobacteriacae in young children in the French community setting is noteworthy, underlining the importance of this population as a reservoir. Exposure to third-generation oral cephalosporins was associated with a significant risk of ESBL carriage in our study. Because of the significant public health implications including the treatment of community-acquired urinary tract infections, the spread of organisms producing ESBLs in the community merits close monitoring with enhanced efforts for surveillance.

  1. Haemophilus influenzae type b carriage and novel bacterial population structure among children in urban Kathmandu, Nepal.

    Science.gov (United States)

    Williams, E J; Lewis, J; John, T; Hoe, J C; Yu, L; Dongol, S; Kelly, D F; Griffiths, D T; Shah, A; Limbu, B; Pradhan, R; Mawas, F; Shrestha, S; Thorson, S; Werno, A M; Murdoch, D R; Adhikari, N; Pollard, A J

    2011-04-01

    Haemophilus influenzae type b (Hib) is a major cause of invasive bacterial infection in children that can be prevented by a vaccine, but there is still uncertainty about its relative importance in Asia. This study investigated the age-specific prevalence of Hib carriage and its molecular epidemiology in carriage and disease in Nepal. Oropharyngeal swabs were collected from children in Kathmandu, Nepal, from 3 different settings: a hospital outpatient department (OPD), schools, and children's homes. Hib was isolated using Hib antiserum agar plates, and serotyping was performed with latex agglutination. Hib isolates from children with invasive disease were obtained during active microbiological surveillance at Patan Hospital, Kathmandu, Nepal. Genotyping of disease and carriage isolates was undertaken using multilocus sequence typing (MLST). Swabs were taken from 2,195 children, including 1,311 children at an OPD, 647 children attending schools, and 237 children in homes. Overall, Hib was identified in 5.0% (110/2,195; 95% confidence interval [95% CI], 3.9% to 6.4%). MLST was performed on 108 Hib isolates from children carrying Hib isolates and 15 isolates from children with invasive disease. Thirty-one sequence types (STs) were identified, and 20 of these were novel STs. The most common ST isolates were sequence type 6 (ST6) and the novel ST722. There was marked heterogeneity among the STs from children with disease and children carrying Hib. STs identified from invasive infections were those commonly identified in carriage. This study provides evidence of Hib carriage among children in urban Nepal with genetically diverse strains prior to introduction of universal vaccination. The Hib carriage rate in Nepal was similar to the rates observed in other populations with documented high disease rates prior to vaccination, supporting implementation of Hib vaccine in Nepal in 2009.

  2. Otitis-Prone Children Produce Functional Antibodies to Pneumolysin and Pneumococcal Polysaccharides.

    Science.gov (United States)

    Kirkham, Lea-Ann S; Wiertsema, Selma P; Corscadden, Karli J; Mateus, Tulia; Mullaney, Gemma L; Zhang, Guicheng; Richmond, Peter C; Thornton, Ruth B

    2017-03-01

    The pneumococcus is a major otitis media (OM) pathogen, but data are conflicting regarding whether otitis-prone children have impaired humoral immunity to pneumococcal antigens. We and others have shown that otitis-prone and healthy children have similar antibody titers to pneumococcal proteins and polysaccharides (vaccine and nonvaccine types); however, the quality of antibodies from otitis-prone children has not been investigated. Antibody function, rather than titer, is considered to be a better correlate of protection from pneumococcal disease. Therefore, we compared the capacities of antibodies from otitis-prone (cases) and healthy (controls) children to neutralize pneumolysin, the pneumococcal toxin currently in development as a vaccine antigen, and to opsonize pneumococcal vaccine and nonvaccine serotypes. A pneumolysin neutralization assay was conducted on cholesterol-depleted complement-inactivated sera from 165 cases and 61 controls. A multiplex opsonophagocytosis assay (MOPA) was conducted on sera from 20 cases and 20 controls. Neutralizing and opsonizing titers were calculated with antigen-specific IgG titers to determine antibody potency for pneumolysin, pneumococcal conjugate vaccine (PCV) polysaccharides, and non-PCV polysaccharides. There was no significant difference in antibody potencies between cases and controls for the antigens tested. Antipneumolysin neutralizing titers increased with the number of episodes of acute OM, but antibody potency did not. Pneumolysin antibody potency was lower in children colonized with pneumococci than in noncarriers, and this was significant for the otitis-prone group (P otitis-prone children demonstrates that they respond to the current PCV and are likely to respond to pneumolysin-based vaccines as effectively as healthy children. Copyright © 2017 Kirkham et al.

  3. Pneumococcal infections in elderly patients attending hospital since PCV-13 authorization in Spain.

    Science.gov (United States)

    Payeras, Antoni; Peñaranda, Maria; Iñigo, Antonio; Garau, Margarita; Luis Pérez, José; Gallegos, Carmen; Riera, Melchor

    2017-01-01

    To study the characteristics and outcomes of pneumococcal infections in patients aged ≥65 years since the authorization of the 13-valent pneumococcal conjugate vaccine (PCV-13) in Spain. All pneumococcal pneumonias, empyemas or primary bacteraemias treated at two hospitals in Majorca from 2010 to 2015 were included. Clinical variables, serotypes, and antibiotic susceptibility were collected. Two hundred and forty-nine pneumonias, 11 primary bacteraemias, and 2 empyemas in 243 patients were studied; 181 (69.1%) men, median age 76 years (range: 66-99). Seven (2.6%) were pneumococcal-vaccinated. Bacteraemia was present in 127 (61.9%) cases and related to a higher severity, p= 0.02, and not having chronic lung disease, p = 0.002. Ninety-seven (37%) episodes involved complications and 30 (11.5%) patients died. Mortality was related with the presence of complications at admission, p < 0.001. Only septic shock was more frequent in patients ≥65 years during the period 2010-2015 compared to the period 2006-2010: 38 of 262 (14.5%) vs. 17 of 212 (8%), p = 0.02. Most infections (57.6%) were due to PCV-13 serotypes but were not related to a worse prognosis. The proportion of PCV-13 serotypes tended to decrease from 61% (non-invasive) and 80% (invasive) in 2010-2011 to 33% and 47% in 2014-2015. The antibiotic susceptibility remained stable. Rates of pneumococcal vaccination in elderly patients with pneumococcal infections were very low. Except for septic shock, the main outcome variables (including mortality) were similar to the ones observed in the period preceding PCV-13 authorization. PCV-13 serotypes were responsible for most infections although they showed a decreasing trend.

  4. Interchangeability between Pneumococcal Conjugate Vaccines: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Ciapponi, Agustín; Lee, Alison; Bardach, Ariel; Glujovsky, Demián; Rey-Ares, Lucila; Luisa Cafferata, María; Valanzasca, Pilar; García Martí, Sebastián

    2016-12-01

    To assess the efficacy, cost-effectiveness, immunogenicity, and safety related to the interchangeability between pneumococcal conjugate vaccines (PCVs) and vaccination schedules in pediatric population. Systematic searches were conducted in December 2010 and April 2015 for economic evaluations in MEDLINE, EMBASE, LILACS, and Cochrane Central Register of Controlled Trials. Web sites and databases from medical societies, experts, and associations related to the topic, proceedings or congressional annals, and doctoral theses were also searched. No language or temporal restriction was applied. We included randomized controlled trials, economic evaluations, and systematic reviews evaluating antibody response, cost-effectiveness, and effectiveness of PCVs' interchangeability. A Strengthening the Reporting of Observational Studies in Epidemiology-based checklist was used to assess the risk of bias in observational studies and a Cochrane approach for experimental/quasi-experimental studies. Pairs of reviewers independently selected (through the Web-based Early Reviewer Organizer Software), assessed the quality, and extracted the data of the studies. Discrepancies were resolved by consensus. We planned to perform meta-analysis whenever appropriate. Forty-six of 202 studies were included. There was no direct information available on the interchangeability between PCVs. The immunogenicity and safety between the 10-valent PCV (PCV10) and the 7-valent PCV were similar when both vaccines were coadministered with other routine pediatric vaccines. PCV10 and 13-valent PCV (PCV13) were consistently more cost-effective than 7-valent PCV. There was no direct comparative information available on the interchangeability among PCVs, but they have pretty similar immunogenicity and safety. PCV10 versus PCV13 cost-effectiveness varied according to price, indirect effects, and indirect costs. PCV10 gains more quality-adjusted life-years because of the prevention of more frequent yet less

  5. Is faecal microbiota transplantation an option to eradicate highly drug-resistant enteric bacteria carriage?

    Science.gov (United States)

    Davido, B; Batista, R; Michelon, H; Lepainteur, M; Bouchand, F; Lepeule, R; Salomon, J; Vittecoq, D; Duran, C; Escaut, L; Sobhani, I; Paul, M; Lawrence, C; Perronne, C; Chast, F; Dinh, A

    2017-04-01

    Carbapenem-resistant Enterobacteriaceae (CRE) or vancomycin-resistant enterococci (VRE) carriage present a major public health challenge. Decolonization strategies are lacking. We aimed to evaluate the impact of faecal microbiota transplantation (FMT) on a cohort of patients with digestive tract colonization by CRE or VRE. Eight patients were included: six carrying CRE and two colonized by VRE. One month after FMT, two patients were free from CRE carriage, and another patient was free from VRE after three months. In our experience, this strategy is safe. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  6. Factors associated with the occurrence of hearing loss after pneumococcal meningitis

    DEFF Research Database (Denmark)

    Worsøe, Lise Lotte; Caye-Thomasen, P.; Brandt, C.T.

    2010-01-01

    -tone hearing threshold levels were compared with normative data. Results. Of 240 patients examined by use of audiometry, 129 (54%) had a hearing deficit, and 50 (39%) of these 129 patients were not suspected of hearing loss at discharge from hospital. Of the 240 patients, 16 (7%) had profound unilateral...... is common after pneumococcal meningitis, and audiometry should be performed on all those who survive pneumococcal meningitis. Important risk factors for hearing loss are advanced age, female sex, severity of meningitis, and bacterial serotype...

  7. Population-based surveillance for invasive pneumococcal disease in homeless adults in Toronto.

    Directory of Open Access Journals (Sweden)

    Agron Plevneshi

    Full Text Available BACKGROUND: Identification of high-risk populations for serious infection due to S. pneumoniae will permit appropriately targeted prevention programs. METHODS: We conducted prospective, population-based surveillance for invasive pneumococcal disease and laboratory confirmed pneumococcal pneumonia in homeless adults in Toronto, a Canadian city with a total population of 2.5 M, from January 1, 2002 to December 31, 2006. RESULTS: We identified 69 cases of invasive pneumococcal disease and 27 cases of laboratory confirmed pneumococcal pneumonia in an estimated population of 5050 homeless adults. The incidence of invasive pneumococcal disease in homeless adults was 273 infections per 100,000 persons per year, compared to 9 per 100,000 persons per year in the general adult population. Homeless persons with invasive pneumococcal disease were younger than other adults (median age 46 years vs 67 years, P<.001, and more likely than other adults to be smokers (95% vs. 31%, P<.001, to abuse alcohol (62% vs 15%, P<.001, and to use intravenous drugs (42% vs 4%, P<.001. Relative to age matched controls, they were more likely to have underlying lung disease (12/69, 17% vs 17/272, 6%, P = .006, but not more likely to be HIV infected (17/69, 25% vs 58/282, 21%, P = .73. The proportion of patients with recurrent disease was five fold higher for homeless than other adults (7/58, 12% vs. 24/943, 2.5%, P<.001. In homeless adults, 28 (32% of pneumococcal isolates were of serotypes included in the 7-valent conjugate vaccine, 42 (48% of serotypes included in the 13-valent conjugate vaccine, and 72 (83% of serotypes included in the 23-valent polysaccharide vaccine. Although no outbreaks of disease were identified in shelters, there was evidence of clustering of serotypes suggestive of transmission of pathogenic strains within the homeless population. CONCLUSIONS: Homeless persons are at high risk of serious pneumococcal infection. Vaccination, physical structure changes

  8. Effectiveness of the 13-valent pneumococcal conjugate vaccine against invasive pneumococcal disease in South African children: a case-control study.

    Science.gov (United States)

    Cohen, Cheryl; von Mollendorf, Claire; de Gouveia, Linda; Lengana, Sarona; Meiring, Susan; Quan, Vanessa; Nguweneza, Arthermon; Moore, David P; Reubenson, Gary; Moshe, Mamokgethi; Madhi, Shabir A; Eley, Brian; Hallbauer, Ute; Finlayson, Heather; Varughese, Sheeba; O'Brien, Katherine L; Zell, Elizabeth R; Klugman, Keith P; Whitney, Cynthia G; von Gottberg, Anne

    2017-03-01

    The 13-valent pneumococcal conjugate vaccine (PCV13) was designed to include disease-causing serotypes that are important in low-income and middle-income countries. Vaccine effectiveness estimates are scarce in these settings. South Africa replaced PCV7 with PCV13 in 2011 using a 2 + 1 schedule. We aimed to assess the effectiveness of two or more doses of PCV13 against invasive pneumococcal disease in children with HIV infection and in those not infected with HIV. Cases of invasive pneumococcal disease in children aged 5 years or younger were identified through national laboratory-based surveillance. Isolates were serotyped with the Quellung reaction or PCR. We sought in-hospital controls for every case, matched for age, HIV status, and study site. We aimed to enrol four controls for every case not infected with HIV and six controls for every case with HIV infection (case-control sets). With conditional logistic regression, we calculated vaccine effectiveness as a percentage, with the equation 1 - [adjusted odds ratio for vaccination] × 100. We included data from an earlier investigation of PCV7 to assess vaccine effectiveness in children exposed to but not infected with HIV and in malnourished children not infected with HIV. Between January, 2012, and December, 2014, we enrolled children aged 16 weeks or older to our study: 240 were cases not infected with HIV, 75 were cases with HIV infection, 1118 were controls not infected with HIV, and 283 were controls with HIV infection. The effectiveness of two or more doses of PCV13 against PCV13-serotype invasive pneumococcal disease was 85% (95% CI 37 to 96) among 11 case-control sets of children not infected with HIV and 91% (-35 to 100) among three case-control sets of children with HIV infection. PCV13 effectiveness among 26 case-control sets of children not infected with HIV was 52% (95% CI -12 to 79) against all-serotype invasive pneumococcal disease and 94% (44 to 100) for serotype 19A. Vaccine

  9. Severe pneumococcal pneumonia: impact of new quinolones on prognosis

    Directory of Open Access Journals (Sweden)

    Meybeck Agnes

    2011-03-01

    Full Text Available Abstract Background Most guidelines have been proposing, for more than 15 years, a β-lactam combined with either a quinolone or a macrolide as empirical, first-line therapy of severe community acquired pneumonia (CAP requiring ICU admission. Our goal was to evaluate the outcome of patients with severe CAP, focusing on the impact of new rather than old fluoroquinolones combined with β-lactam in the empirical antimicrobial treatments. Methods Retrospective study of consecutive patients admitted in a 16-bed general intensive care unit (ICU, between January 1996 and January 2009, for severe (Pneumonia Severity Index > or = 4 community-acquired pneumonia due to non penicillin-resistant Streptococcus pneumoniae and treated with a β-lactam combined with a fluoroquinolone. Results We included 70 patients of whom 38 received a β-lactam combined with ofloxacin or ciprofloxacin and 32 combined with levofloxacin. Twenty six patients (37.1% died in the ICU. Three independent factors associated with decreased survival in ICU were identified: septic shock on ICU admission (AOR = 10.6; 95% CI 2.87-39.3; p = 0.0004, age > 70 yrs. (AOR = 4.88; 95% CI 1.41-16.9; p = 0.01 and initial treatment with a β-lactam combined with ofloxacin or ciprofloxacin (AOR = 4.1; 95% CI 1.13-15.13; p = 0.03. Conclusion Our results suggest that, when combined to a β-lactam, levofloxacin is associated with lower mortality than ofloxacin or ciprofloxacin in severe pneumococcal community-acquired pneumonia.

  10. A model for predicting bacteremia in patients with community-acquired pneumococcal pneumonia: a retrospective observational study.

    Science.gov (United States)

    Washio, Yasuyoshi; Ito, Akihiro; Kumagai, Shogo; Ishida, Tadashi; Yamazaki, Akio

    2018-01-30

    Pneumococcal pneumonia causes high morbidity and mortality among adults. This study aimed to identify risk factors for bacteremic pneumococcal pneumonia, and to construct a prediction model for the development of bacteremia in patients with community-acquired pneumococcal pneumonia. We retrospectively analyzed data from patients hospitalized with community-acquired pneumococcal pneumonia between April 2007 and August 2015. Logistic regression models were applied to detect risk factors for pneumococcal bacteremia, and a receiver operating characteristic curve was used to devise a prediction model. Based on the results of sputum cultures, urine antigen tests, and/or blood cultures, 389 patients were diagnosed with pneumococcal pneumonia, 46 of whom had bacteremia. In the multivariate analysis, age  20 mg/dL were identified as independent risk factors for the development of pneumococcal bacteremia. The bacteremia prediction score based on receiver operating characteristic curve analysis had a sensitivity of 0.74 and a specificity of 0.78 in patients with two risk factors. The area under the receiver operating characteristic curve was 0.77 (95% confidence interval (CI), 0.70-0.85). Age < 65 years, hypoalbuminemia, IRVS, and high C-reactive protein level on admission are independent risk factors for the development of bacteremia in patients with community-acquired pneumococcal pneumonia. A prediction model based on these four risk factors could help to identify patients with community-acquired pneumococcal pneumonia at high risk of developing bacteremia; this can be used to guide antibiotic choices. UMIN-CTR UMIN 000004353 . Registered 7 October 2010. Retrospectively registered.

  11. Minimum incidence of adult invasive pneumococcal disease in Blantyre, Malawi an urban african setting: a hospital based prospective cohort study.

    Science.gov (United States)

    Bar-Zeev, Naor; Mtunthama, Neema; Gordon, Stephen B; Mwafulirwa, Gershom; French, Neil

    2015-01-01

    Invasive pneumococcal disease causes substantial morbidity and mortality in Africa. Evaluating population level indirect impact on adult disease of pneumococcal conjugate vaccine (PCV) programmes in infants requires baseline population incidence rates but these are often lacking in areas with limited disease surveillance. We used hospital based blood culture and cerebrospinal fluid surveillance to calculate minimal incidence of invasive pneumococcal disease in the adult (≥15 years old) population of Blantyre, a rapidly growing urban centre in southern Malawi, in the period preceding vaccine introduction. Invasive pneumococcal disease incidence in Blantyre district was high, mean 58.1 (95% confidence interval (CI): 53.7, 62.7) per 100,000 person years and peaking among 35 to 40 year olds at 108.8 (95%CI: 89.0, 131.7) mirroring the population age prevalence of HIV infection. For pneumococcal bacteraemia in urban Blantyre, mean incidence was 60.6 (95% CI: 55.2, 66.5) per 100,000 person years, peaking among 35 to 40 year olds at 114.8 (95%CI: 90.3, 143.9). We suspected that our surveillance may under-ascertain the true burden of disease, so we used location data from bacteraemic subjects and projected population estimates to calculate local sub-district incidence, then examined the impact of community level socio-demographic covariates as possible predictors of local sub-district incidence of pneumococcal and non-pneumococcal pathogenic bacteraemia. Geographic heterogeneity in incidence was marked with localised hotspots but ward level covariates apart from prison were not associated with pneumococcal bacteraemia incidence. Modelling suggests that the current sentinel surveillance system under-ascertains the true burden of disease. We outline a number of challenges to surveillance for pneumococcal disease in our low-resource setting. Subsequent surveillance in the vaccine era will have to account for geographic heterogeneity when evaluating population level indirect

  12. Minimum incidence of adult invasive pneumococcal disease in Blantyre, Malawi an urban african setting: a hospital based prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Naor Bar-Zeev

    Full Text Available Invasive pneumococcal disease causes substantial morbidity and mortality in Africa. Evaluating population level indirect impact on adult disease of pneumococcal conjugate vaccine (PCV programmes in infants requires baseline population incidence rates but these are often lacking in areas with limited disease surveillance. We used hospital based blood culture and cerebrospinal fluid surveillance to calculate minimal incidence of invasive pneumococcal disease in the adult (≥15 years old population of Blantyre, a rapidly growing urban centre in southern Malawi, in the period preceding vaccine introduction. Invasive pneumococcal disease incidence in Blantyre district was high, mean 58.1 (95% confidence interval (CI: 53.7, 62.7 per 100,000 person years and peaking among 35 to 40 year olds at 108.8 (95%CI: 89.0, 131.7 mirroring the population age prevalence of HIV infection. For pneumococcal bacteraemia in urban Blantyre, mean incidence was 60.6 (95% CI: 55.2, 66.5 per 100,000 person years, peaking among 35 to 40 year olds at 114.8 (95%CI: 90.3, 143.9. We suspected that our surveillance may under-ascertain the true burden of disease, so we used location data from bacteraemic subjects and projected population estimates to calculate local sub-district incidence, then examined the impact of community level socio-demographic covariates as possible predictors of local sub-district incidence of pneumococcal and non-pneumococcal pathogenic bacteraemia. Geographic heterogeneity in incidence was marked with localised hotspots but ward level covariates apart from prison were not associated with pneumococcal bacteraemia incidence. Modelling suggests that the current sentinel surveillance system under-ascertains the true burden of disease. We outline a number of challenges to surveillance for pneumococcal disease in our low-resource setting. Subsequent surveillance in the vaccine era will have to account for geographic heterogeneity when evaluating population

  13. Serotype-Specific and Age-Dependent Generation of Pneumococcal Polysaccharide-Specific Memory B-Cell and Antibody Responses to Immunization with a Pneumococcal Conjugate Vaccine▿

    Science.gov (United States)

    Clutterbuck, Elizabeth A.; Oh, Sarah; Hamaluba, Mainga; Westcar, Sharon; Beverley, Peter C. L.; Pollard, Andrew J.

    2008-01-01

    Glycoconjugate vaccines have dramatically reduced the incidence of encapsulated bacterial diseases in toddlers under 2 years of age, but vaccine-induced antibody levels in this age group wane rapidly. We immunized adults and 12-month-old toddlers with heptavalent pneumococcal conjugate vaccine to determine differences in B-cell and antibody responses. The adults and 12-month-old toddlers received a pneumococcal conjugate vaccine. The toddlers received a second dose at 14 months of age. The frequencies of diphtheria toxoid and serotype 4, 14, and 23F polysaccharide-specific plasma cells and memory B cells were determined by enzyme-linked immunospot assay. The toddlers had no preexisting polysaccharide-specific memory B cells or serum immunoglobulin G (IgG) antibody but had good diphtheria toxoid-specific memory responses. The frequencies of plasma cells and memory B cells increased by day 7 (P < 0.0001) in the adults and the toddlers following a single dose of conjugate, but the polysaccharide responses were significantly lower in the toddlers than in the adults (P = 0.009 to <0.001). IgM dominated the toddler antibody responses, and class switching to the IgG was serotype dependent. A second dose of vaccine enhanced the antibody and memory B-cell responses in the toddlers but not the ex vivo plasma cell responses. Two doses of pneumococcal conjugate vaccine are required in toddlers to generate memory B-cell frequencies and antibody class switching for each pneumococcal polysaccharide equivalent to that seen in adults. PMID:18032593

  14. Prevalence of Staphylococcus aureus toxins and nasal carriage in furuncles and impetigo.

    Science.gov (United States)

    Durupt, F; Mayor, L; Bes, M; Reverdy, M-E; Vandenesch, F; Thomas, L; Etienne, J

    2007-12-01

    The precise role of Staphylococcus aureus toxins and nasal carriage in common skin infections remains unclear. To seek correlations between toxin expression, S. aureus nasal carriage and clinical manifestations in patients with community-acquired furuncles and impetigo. From November 2004 to August 2005, we studied clinical data and bacteriological samples prospectively collected from 121 patients presenting with furuncles or impetigo. Sixty-four patients (31 with furuncles and 33 with impetigo) had S. aureus-positive skin culture. Panton-Valentine leukocidin (PVL) genes were present in 13 of 31 (42%) isolates from furuncles and were associated with epidemic furunculosis. Exfoliative toxin genes were present in 10 of 10 (100%) and 12 of 21 (57%) bullous and nonbullous impetigo isolates, respectively. Nasal carriage of S. aureus was found in 58% of patients overall. It was strongly associated with chronic furunculosis but not with simple furuncles (88% vs. 29%, P impetigo are associated with exfoliative toxins. Staphylococcus aureus nasal carriage is associated with the chronicity of furuncles.

  15. Nasal carriage of Staphylococcus aureus treated with topical mupirocin (pseudomonic acid) in a children's hospital

    NARCIS (Netherlands)

    U. Frank; W. Lenz; E. Damrath; I. Kappstein; F. D. Daschner

    1989-01-01

    textabstract2% mupirocin ointment applied intra-nasally for 5 days was assessed for elimination of nasal carriage of Staphylococcus aureus in 31 staff members in a children's hospital. Three volunteers failed to complete the trial because of side effects, i.e. buccal reddening and swelling, and

  16. Prevalence and risk factors for carriage of ESBL-producing Enterobacteriaceae in Amsterdam

    NARCIS (Netherlands)

    Reuland, E A|info:eu-repo/dai/nl/325855633; Al Naiemi, N; Kaiser, A M; Heck, M; Kluytmans, J A J W|info:eu-repo/dai/nl/323262139; Savelkoul, P H M; Elders, P J M; Vandenbroucke-Grauls, C M J E

    OBJECTIVES: The objectives of this study were to determine the prevalence of carriage of ESBL-producing Enterobacteriaceae (ESBL-E) in a representative sample of the general adult Dutch community, to identify risk factors and to gain understanding of the epidemiology of these resistant strains.

  17. ESBL carriage in pig slaughterhouse workers is associated with occupational exposure

    NARCIS (Netherlands)

    Dohmen, W.; Gompel, Van L.; Schmitt, H.; Liakopoulos, A.; Heres, L.; Urlings, B.A.; Mevius, D.; Bonten, M.J.M.; Heederik, D.J.J.

    2017-01-01

    We investigated the prevalence of extended-spectrum β-lactamase (ESBL) carriage in slaughterhouse workers and the association with occupational exposure to slaughter animals and products. Stool samples from 334 employees in a Dutch pig slaughterhouse were obtained. Presence of ESBL was determined by

  18. 47 CFR 76.504 - Limits on carriage of vertically integrated programming.

    Science.gov (United States)

    2010-10-01

    ... programming. 76.504 Section 76.504 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST... Limits on carriage of vertically integrated programming. (a) Except as otherwise provided in this section... national video programming services owned by the cable operator or in which the cable operator has an...

  19. 29 CFR 4.118 - Contracts for carriage subject to published tariff rates.

    Science.gov (United States)

    2010-07-01

    ... Application of the McNamara-O'Hara Service Contract Act Specific Exclusions § 4.118 Contracts for carriage..., railway line or oil or gas pipeline where published tariff rates are in effect”. In order for this... is actually governed by published tariff rates in effect pursuant to State or Federal law for such...

  20. Eradication of carriage with methicillin-resistant Staphylococcus aureus: determinants of treatment failure

    NARCIS (Netherlands)

    Ammerlaan, Heidi S. M.; Kluytmans, Jan A. J. W.; Berkhout, Hanneke; Buiting, Anton; de Brauwer, Els I. G. B.; van den Broek, Peterhans J.; van Gelderen, Paula; Leenders, Sander A. C. A. P.; Ott, Alewijn; Richter, Clemens; Spanjaard, Lodewijk; Spijkerman, Ingrid J. B.; van Tiel, Frank H.; Voorn, G. Paul; Wulf, Mireille W. H.; van Zeijl, Jan; Troelstra, Annet; Bonten, Marc J. M.; van de Berg, C. M. F.; Bosman, J.; Bremer, A.; Bril, W.; Commeren, D.; van Essen, G.; Gigengack-Baars, A.; van Kasteren, M. M. E.; Lommerse, E. J. M.; Mascini, E.; Renders, N. H. M.; van Rijen, M.; Schellekens, J.; Smeets, E.; Sprangers, T.; Vandenbroucke-Grauls, C. M. J. E.; Verbon, A.; Verduin, K.; Wagenvoort, J. H. T.; van Wijngaarden, P.

    2011-01-01

    Using data from an observational study in which the effectiveness of a guideline for eradication of methicillin-resistant Staphylococcus aureus (MRSA) carriage was evaluated, we identified variables that were associated with treatment failure. A multivariate logistic regression model was performed

  1. Nasal Carriage of Staphylococcus aureus in Australian (pre-clinical and clinical) Medical Students

    NARCIS (Netherlands)

    E. Stubbs; M. Pegler; A. Vickery; C. Harbour

    1994-01-01

    textabstractThe nasal carriage of Staphylococcus aureus in 808 Australian medical students was studied. Five groups of students experienced varying degrees of clinical exposure in a hospital environment ranging from 0 to 42 months. The overall percentage of carriers among the five groups did not

  2. What factors affect the carriage of epinephrine auto-injectors by teenagers?

    Directory of Open Access Journals (Sweden)

    Macadam Clare

    2012-02-01

    Full Text Available Abstract Background Teenagers with allergies are at particular risk of severe and fatal reactions, but epinephrine auto-injectors are not always carried as prescribed. We investigated barriers to carriage. Methods Patients aged 12-18 years old under a specialist allergy clinic, who had previously been prescribed an auto-injector were invited to participate. Semi-structured interviews explored the factors that positively or negatively impacted on carriage. Results Twenty teenagers with food or venom allergies were interviewed. Only two patients had used their auto-injector in the community, although several had been treated for severe reactions in hospital. Most teenagers made complex risk assessments to determine whether to carry the auto-injector. Most but not all decisions were rational and were at least partially informed by knowledge. Factors affecting carriage included location, who else would be present, the attitudes of others and physical features of the auto-injector. Teenagers made frequent risk assessments when deciding whether to carry their auto-injectors, and generally wanted to remain safe. Their decisions were complex, multi-faceted and highly individualised. Conclusions Rather than aiming for 100% carriage of auto-injectors, which remains an ambitious ideal, personalised education packages should aim to empower teenagers to make and act upon informed risk assessments.

  3. Carriage of Staphylococcus aureus in Thika Level 5 Hospital, Kenya : a cross-sectional study

    NARCIS (Netherlands)

    Aiken, Alexander M; Mutuku, Irene M; Sabat, Artur J; Akkerboom, Viktoria; Mwangi, Jonah; Scott, J Anthony G; Morpeth, Susan C; Friedrich, Alexander W; Grundmann, Hajo

    2014-01-01

    BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is an important nosocomial pathogen but little is known about its circulation in hospitals in developing countries. We aimed to describe carriage of S.aureus amongst inpatients in a mid-sized Kenyan government hospital. METHODS: We

  4. What factors affect the carriage of epinephrine auto-injectors by teenagers?

    Science.gov (United States)

    Macadam, Clare; Barnett, Julie; Roberts, Graham; Stiefel, Gary; King, Rosemary; Erlewyn-Lajeunesse, Michel; Holloway, Judith A; Lucas, Jane S

    2012-02-02

    Teenagers with allergies are at particular risk of severe and fatal reactions, but epinephrine auto-injectors are not always carried as prescribed. We investigated barriers to carriage. Patients aged 12-18 years old under a specialist allergy clinic, who had previously been prescribed an auto-injector were invited to participate. Semi-structured interviews explored the factors that positively or negatively impacted on carriage. Twenty teenagers with food or venom allergies were interviewed. Only two patients had used their auto-injector in the community, although several had been treated for severe reactions in hospital. Most teenagers made complex risk assessments to determine whether to carry the auto-injector. Most but not all decisions were rational and were at least partially informed by knowledge. Factors affecting carriage included location, who else would be present, the attitudes of others and physical features of the auto-injector. Teenagers made frequent risk assessments when deciding whether to carry their auto-injectors, and generally wanted to remain safe. Their decisions were complex, multi-faceted and highly individualised. Rather than aiming for 100% carriage of auto-injectors, which remains an ambitious ideal, personalised education packages should aim to empower teenagers to make and act upon informed risk assessments.

  5. The reliability of the Extra Load Index as a measure of relative load carriage economy.

    Science.gov (United States)

    Hudson, Sean; Cooke, Carlton; Lloyd, Ray

    2017-09-01

    The aim of this study was to measure the reliability of the extra load index (ELI) as a method for assessing relative load carriage economy. Seventeen volunteers (12 males, 5 females) performed walking trials at 3 km·h-1, 6 km·h-1 and a self-selected speed. Trial conditions were repeated 7 days later to assess test-retest reliability. Trials involved four 4-minute periods of walking, each separated by 5 min of rest. The initial stage was performed unloaded followed in a randomised order by a second unloaded period and walking with backpacks of 7 and 20 kg. Results show ELI values did not differ significantly between trials for any of the speeds (p = 0.46) with either of the additional loads (p = 0.297). The systematic bias, limits of agreement and coefficients of variation were small in all trial conditions. We conclude the ELI appears to be a reliable measure of relative load carriage economy. Practitioner Summary: This paper demonstrates that the ELI is a reliable measure of load carriage economy at a range of walking speeds with both a light and heavy load. The ELI, therefore, represents a useful tool for comparing the relative economy associated with different load carriage systems.

  6. Effect of mupirocin treatment on nasal, pharyngeal, and perineal carriage of Staphylococcus aureus in healthy adults.

    NARCIS (Netherlands)

    H.F.L. Wertheim (Heiman); J. Verveer (Jeroen); H.A.M. Boelens (Hélène); A.F. van Belkum (Alex); H.A. Verbrugh (Henri); M.C. Vos (Margreet)

    2005-01-01

    textabstractNasal carriage of Staphylococcus aureus is an important risk factor for S. aureus infections. Mupirocin nasal ointment is presently the treatment of choice for decolonizing the anterior nares. However, recent clinical trials show limited benefit from mupirocin prophylaxis in preventing

  7. Biofilm formation, gel and esp gene carriage among recreational beach Enterococci.

    Science.gov (United States)

    Asmat, Ahmad; Dada, Ayokunle Christopher; Gires, Usup

    2014-06-12

    Biofilm production, gel and esp gene carriage was enumerated among forty six vancomycin resistant enterococci (VRE) and vancomycin susceptible enterococci (VSE) beach isolates. A higher proportion (61.54%) of biofilm producers was observed among beach sand as compared to beach water enterococci isolates (30%) indicating that enterococci within the sand column may be more dependent on biofilm production for survival than their beach water counterparts. Correlation analysis revealed strongly negative correlation (r=-0.535, p=0.015) between vancomycin resistance and biofilm formation. Given the observation of high prevalence of biofilm production among beach sand and the concomitant absence of esp gene carriage in any of the isolate, esp gene carriage may not be necessary for the production of biofilms among beach sand isolates. On the whole beach sand and water isolates demonstrated clearly different prevalence levels of vancomycin resistance, biofilm formation, esp and gel gene carriage. Application of these differences may be found useful in beach microbial source tracking studies. Tested starved cells still produced biofilm albeit at lower efficiencies. Non-dividing enterococci in beach sand can survive extended periods of environmental hardship and can resume growth or biofilm production in appropriate conditions thus making them infectious agents with potential health risk to recreational beach users.

  8. Epidemiology and antibiotic sensitivity of Staphylococcus aureus nasal carriage in children in Hungary.

    Science.gov (United States)

    Laub, Krisztina; Tóthpál, Adrienn; Kardos, Szilvia; Dobay, Orsolya

    2017-03-01

    The aim of this study was to assess the Staphylococcus aureus nasal carriage rate in healthy children all over Hungary and to specify some risk factors, the antibiotic resistance patterns of the bacteria, and their genetic relatedness. In total, 878 children (aged 3-6 years) were screened at 21 day-care centers in 16 different cities in Hungary, between February 2009 and December 2011. Samples taken from both nostrils were cultured on blood agar, and suspected S. aureus isolates were identified by β-hemolysis, catalase positivity, clump test, and nucA PCR. Methicillin-resistant strains were screened by mecA and mecC PCR. Antibiotic susceptibility was determined by agar dilution or gradient test strips. Pulsed-field gel electrophoresis was used for genotyping. S. aureus carriage rate was found to be 21.3%, which correlates well with international data. We found no statistically significant correlation between the gender or the sibling status and S. aureus carriage. All isolates were sensitive to oxacillin, trimethoprim-sulfamethoxazole, and mupirocin. The resistance rates for erythromycin, ciprofloxacin, clindamycin, gentamicin, and tetracycline were 7.5%, 0.5%, 1.1%, 3.7%, and 4.3%, respectively. The isolates showed very high genetic diversity. In summary, carried S. aureus isolates are more sensitive to antibiotics compared with clinical isolates in Hungary, and methicillin-resistant S. aureus carriage rate is very low yet.

  9. Nasopharyngeal carriage of respiratory pathogens in Warao Amerindians: significant relationship with stunting

    NARCIS (Netherlands)

    Verhagen, L.M.; Hermsen, M.; Rivera-Olivero, I.A.; Sisco, M.C.; Jonge, M.I. de; Hermans, P.W.M.; Waard, J.H. de

    2017-01-01

    OBJECTIVE: To assess risk factors for nasopharyngeal carriage of potential pathogens in geographically isolated Warao Amerindians in Venezuela. METHODS: In this point prevalence survey, nasopharyngeal swabs were obtained from 1064 Warao Amerindians: 504 children aged 0-4 years, 227 children aged

  10. Nasopharyngeal carriage of respiratory pathogens in Warao Amerindians: significant relationship with stunting.

    Science.gov (United States)

    Verhagen, Lilly M; Hermsen, Meyke; Rivera-Olivero, Ismar A; Sisco, María Carolina; de Jonge, Marien I; Hermans, Peter W M; de Waard, Jacobus H

    2017-04-01

    To assess risk factors for nasopharyngeal carriage of potential pathogens in geographically isolated Warao Amerindians in Venezuela. In this point prevalence survey, nasopharyngeal swabs were obtained from 1064 Warao Amerindians: 504 children aged 0-4 years, 227 children aged 5-10 years and 333 caregivers. Written questionnaires were completed to obtain information on demographics and environmental risk factors. Anthropometric measurements were performed in children aged 0-4 years. Carriage rates of Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae and Moraxella catarrhalis were 51%, 7%, 1% and 13%, respectively. Crowding index, method of cooking and tobacco exposure were not associated with increased carriage. In multivariable analysis, an increase in height-for-age Z score (i.e. improved chronic nutritional status) was associated with decreased odds of S. pneumoniae colonisation (OR 0.76, 95% CI 0.70-0.83) in children aged 0-4 years. Better knowledge of demographic and environmental risk factors facilitates better understanding of the dynamics of colonisation with respiratory bacteria in an Amerindian population. Poor chronic nutritional status was associated with increased pathogen carriage in children <5 years of age. The high rates of stunting generally observed in indigenous children may fuel the acquisition of respiratory bacteria that can lead to respiratory and invasive disease. © 2017 John Wiley & Sons Ltd.

  11. Long-term cortisol levels are not associated with nasal carriage of Staphylococcus aureus

    NARCIS (Netherlands)

    Manenschijn, L.; Jetten, A.M.; Wamel, W.J.B. van; Tavakol, M.; Koper, J.W.; Akker, E.L.T. van den; Belkum, A. van; Rossum, E.F.C. van

    2012-01-01

    Staphylococcus aureus (S. aureus) colonizes the anterior nares in part of the population and the persistent carrier state is associated with increased infection risk. Knowledge concerning the determinants of S. aureus nasal carriage is limited. Previously, we found that glucocorticoid receptor

  12. Dried saliva spots : A robust method for detecting Streptococcus pneumoniae carriage by PCR

    NARCIS (Netherlands)

    Krone, Cassandra L.; Oja, Anna E.; van de Groep, Kirsten|info:eu-repo/dai/nl/413649776; Sanders, Elisabeth A M|info:eu-repo/dai/nl/126771960; Bogaert, Debby|info:eu-repo/dai/nl/264105834; Trzcinski, Krzysztof|info:eu-repo/dai/nl/323349609

    2016-01-01

    The earliest studies in the late 19th century on Streptococcus pneumoniae (S. pneumoniae) carriage used saliva as the primary specimen. However, interest in saliva declined after the sensitive mouse inoculation method was replaced by conventional culture, which made isolation of pneumococci from the

  13. Validation of an instrumented dummy to assess mechanical aspects of discomfort during load carriage.

    Directory of Open Access Journals (Sweden)

    Patrick D Wettenschwiler

    Full Text Available Due to the increasing load in backpacks and other load carriage systems over the last decades, load carriage system designs have to be adapted accordingly to minimize discomfort and to reduce the risk of injury. As subject studies are labor-intensive and include further challenges such as intra-subject and inter-subject variability, we aimed to validate an instrumented dummy as an objective laboratory tool to assess the mechanical aspects of discomfort. The validation of the instrumented dummy was conducted by comparison with a recent subject study. The mechanical parameters that characterize the static and dynamic interaction between backpack and body during different backpack settings were compared. The second aim was to investigate whether high predictive power (coefficient of determination R2>0.5 in assessing the discomfort of load carriage systems could be reached using the instrumented dummy. Measurements were conducted under static conditions, simulating upright standing, and dynamic conditions, simulating level walking. Twelve different configurations of a typical load carriage system, a commercially available backpack with a hip belt, were assessed. The mechanical parameters were measured in the shoulder and the hip region of the dummy and consisted of average pressure, peak pressure, strap force and relative motion between the system and the body. The twelve configurations consisted of three different weights (15kg, 20kg, and 25kg, combined with four different hip belt tensions (30N, 60N, 90N, and 120N. Through the significant (p<0.05 correlation of the mechanical parameters measured on the dummy with the corresponding values of the subject study, the dummy was validated for all static measurements and for dynamic measurements in the hip region to accurately simulate the interaction between the human body and the load carriage system. Multiple linear regressions with the mechanical parameters measured on the dummy as independent

  14. Faecal carriage of Staphylococcus aureus in the hospital and community setting: a systematic review

    Directory of Open Access Journals (Sweden)

    Shantelle eClaassen-Weitz

    2016-05-01

    Full Text Available Background and rationale: Staphylococcus aureus faecal carriage has been identified as a potential source for nosocomial transmission and a risk factor for disease development. This systematic review determined the overall S. aureus (including methicillin susceptible and resistant S. aureus (MSSA and MRSA faecal carriage rates within the community and healthcare settings.Methodology: Peer-reviewed articles indexed in Medline, Scopus, Academic Search Premier, Africa-Wide Information, CINAHL, and Web of Science were identified using applicable and controlled vocabulary through to 11 November 2015. Eligible studies were ascertained by three independent reviewers. Random-effects meta-analyses of proportions were performed to determine S. aureus, MSSA and MRSA faecal carriage rates reported by eligible studies.Results: Twenty six studies were included in this review. The pooled estimates for S. aureus, MSSA and MRSA faecal carriage were 26 % (95 % confidence interval (CI: 16.8 % - 36.3 %, 86 % (95 % confidence interval (CI: 65.9 % - 97.9 % and 10 % (95 % CI: 0.7 % - 27.0 %, respectively. Faecal S. aureus carriage rates increased on average from 10 % to 65 % during the first eight weeks of life, followed by an average carriage rate of 64 % at six months and 46 % at one year of life. Genotyping techniques were employed mainly in studies conducted in developed countries and comprised largely of gel-based techniques. Six studies reported on the role of S. aureus faecal strains in diarrhoea (n = 2 and the risk for acquiring infections (n = 4. Eight of the 26 studies included in this review performed antibiotic susceptibility testing of S. aureus faecal isolates.Conclusion: This study provides evidence that screening for S. aureus faecal carriage, at least in populations at high risk, could be an effective measure for the prevention of S. aureus transmission and infection in the healthcare and community setting. More well-structured studies need to be

  15. Fine-tuning of choline metabolism is important for pneumococcal colonization

    NARCIS (Netherlands)

    Johnston, C.; Hauser, C.; Hermans, P.W.M.; Martin, B.; Polard, P.; Bootsma, H.J.; Claverys, J.P.

    2016-01-01

    The human pathogen Streptococcus pneumoniae (the pneumococcus) is rare in having a strict requirement for the amino alcohol choline, which decorates pneumococcal teichoic acids. This process relies on the lic locus, containing the lic1 and lic2 operons. These operons produce eight proteins that

  16. Prevention of pneumococcal disease in mice immunized with conserved surface-accessible proteins.

    Science.gov (United States)

    Hamel, Josée; Charland, Nathalie; Pineau, Isabelle; Ouellet, Catherine; Rioux, Stéphane; Martin, Denis; Brodeur, Bernard R

    2004-05-01

    The development of a vaccine against Streptococcus pneumoniae has been complicated by the existence of at least 90 antigenically distinct capsular serotypes. Common protein-based vaccines could represent the best strategy to prevent pneumococcal infections, regardless of serotype. In the present study, the immunoscreening of an S. pneumoniae genomic library allowed the identification of a novel immune protein target, BVH-3. We demonstrate that immunization of mice with BVH-3 elicits protective immunity against experimental sepsis and pneumonia. Sequence analysis revealed that the bvh-3 gene is highly conserved within the species. Since the BVH-3 protein shows homology at its amino-terminal end with other pneumococcal proteins, it was of interest to determine if protection was due to the homologous or to the protein-specific regions. Immunoprotection studies using recombinant BVH-3 and BVH-3-related protein fragments as antigens allowed the localization of surface-exposed and protective epitopes at the protein-specific carboxyl termini, thus establishing that BVH-3 is distinct from other previously reported protective protein antigens. Immunization with a chimeric protein comprising the carboxyl-terminal regions of BVH-3 and of a BVH-3-related protein improved the protection by targeting two surface pneumococcal components. Thus, BVH-3 and the chimeric protein hold strong promise as vaccine components to control pneumococcal disease.

  17. 75 FR 48707 - Proposed Vaccine Information Materials for Pneumococcal Conjugate Vaccine and Human...

    Science.gov (United States)

    2010-08-11

    ... representative in the case of a child) receiving vaccines covered under the National Vaccine Injury Compensation... children. PCV13 replaces a previous conjugate vaccine (PCV7), which protected against 7 pneumococcal types... children with certain chronic illnesses may get a different vaccine called PPSV23. There is a separate...

  18. PNEUMOCOCCAL ANTIGEN PERSISTENCE IN SPUTUM FROM PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA

    NARCIS (Netherlands)

    BOERSMA, WG; LOWENBERG, A; HOLLOWAY, Y; KUTTSCHRUTTER, H; SNIJDER, JAM; KOETER, GH

    The purpose of this study was to establish the diagnostic value of pneumococcal capsular antigen by comparing this with the results of Gram stain and culture in representative and nonrepresentative sputa during follow-up in patients with community-acquired pneumonia. Antigen was detected by a latex

  19. The Streptococcus pneumoniae Capsule Is Required for Full Virulence in Pneumococcal Endophthalmitis

    OpenAIRE

    Melissa E Sanders; Norcross, Erin W.; Robertson, Zachary M.; Moore, Quincy C.; Fratkin, Jonathan; Marquart, Mary E.

    2011-01-01

    The role of capsule in pneumococcal endophthalmitis was tested in vivo using a clinical ocular strain and an isogenic capsule-deficient mutant. Results showed that the presence of capsule was required for full clinical severity and for full bacterial survival in the vitreous.

  20. C1 inhibitor treatment improves host defense in pneumococcal meningitis in rats and mice

    NARCIS (Netherlands)

    Zwijnenburg, Petra J. G.; van der Poll, Tom; Florquin, Sandrine; Polfliet, Machteld M. J.; van den Berg, Timo K.; Dijkstra, Christine D.; Roord, John J.; Hack, C. Erik; van Furth, A. Marceline

    2007-01-01

    In spite of antibiotic treatment, pneumococcal meningitis continues to be associated with significant morbidity and mortality. The complement system is a key component of innate immunity against invading pathogens. However, activation of complement is also involved in tissue damage, and complement

  1. Cost-effectiveness of new pneumococcal conjugate vaccines in Turkey: a decision analytical model

    Directory of Open Access Journals (Sweden)

    Bakır Mustafa

    2012-11-01

    Full Text Available Abstract Background Streptococcus pneumoniae infections, which place a considerable burden on healthcare resources, can be reduced in a cost-effective manner using a 7-valent pneumococcal conjugate vaccine (PCV-7. We compare the cost effectiveness of a 13-valent PCV (PCV-13 and a 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV with that of PCV-7 in Turkey. Methods A cost-utility analysis was conducted and a decision analytical model was used to estimate the proportion of the Turkish population Results PCV-13 and PHiD-CV are projected to have a substantial impact on pneumococcal disease in Turkey versus PCV-7, with 2,223 and 3,156 quality-adjusted life years (QALYs and 2,146 and 2,081 life years, respectively, being saved under a 3+1 schedule. Projections of direct medical costs showed that a PHiD-CV vaccination programme would provide the greatest cost savings, offering additional savings of US$11,718,813 versus PCV-7 and US$8,235,010 versus PCV-13. Probabilistic sensitivity analysis showed that PHiD-CV dominated PCV-13 in terms of QALYs gained and cost savings in 58.3% of simulations. Conclusion Under the modeled conditions, PHiD-CV would provide the most cost-effective intervention for reducing pneumococcal disease in Turkish children.

  2. Formulation, stability and immunogenicity of a trivalent pneumococcal protein vaccine formulated with aluminum salt adjuvants.

    Science.gov (United States)

    Ljutic, Belma; Ochs, Martina; Messham, Benjamin; Ming, Marin; Dookie, Annie; Harper, Kevin; Ausar, Salvador F

    2012-04-19

    We investigated the immunogenicity, stability and adsorption properties of an experimental pneumococcal vaccine composed of three protein vaccine antigens; Pneumococcal histidine triad protein D, (PhtD), Pneumococcal choline-binding protein A (PcpA) and genetically detoxified pneumolysin D1 (PlyD1) formulated with aluminum salt adjuvants. Immunogenicity studies conducted in BALB/c mice showed that antibody responses to each antigen adjuvanted with aluminum hydroxide (AH) were significantly higher than when adjuvanted with aluminum phosphate (AP) or formulated without adjuvant. Lower microenvironment pH and decreased strength of antigen adsorption significantly improved the stability of antigens. The stability of PcpA and PlyD1 assessed by RP-HPLC correlated well with the immunogenicity of these antigens in mice and showed that pretreatment of the aluminum hydroxide adjuvant with phosphate ions improved their stability. Adjuvant dose-ranging studies showed that 28 μg Al/dose to be the concentration of adjuvant resulting in optimal immunogenicity of the trivalent vaccine formulation. Taken together, the results of theses studies suggest that the type of aluminum salt, strength of adsorption and microenvironment pH have a significant impact on the immunogenicity and chemical stability of an experimental vaccine composed of the three pneumococcal protein antigens, PhtD, PcpA, and PlyD1. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Interleukin-18 gene-deficient mice show enhanced defense and reduced inflammation during pneumococcal meningitis.

    NARCIS (Netherlands)

    Zwijnenburg, P.J.G.; Poll, van der T.; Florquin, S; Akira, S; Takeda, K; Roord, J.J.; Furth, van A.M.

    2003-01-01

    To determine the role of endogenous interleukin-18 (IL-18) in pneumococcal meningitis, meningitis was induced in IL-18 gene-deficient (IL-18(-/-)) and wild-type (WT) mice by intranasal inoculation of Streptococcus pneumoniae with hyaluronidase. Induction of meningitis resulted in an upregulation of

  4. French Hajj pilgrims' experience with pneumococcal infection and vaccination: A knowledge, attitudes and practice (KAP) evaluation.

    Science.gov (United States)

    Sridhar, Shruti; Belhouchat, Khadidja; Drali, Tassadit; Benkouiten, Samir; Parola, Philippe; Brouqui, Philippe; Gautret, Philippe

    2015-01-01

    Transmission of respiratory infections poses a major public health challenge during the Hajj and Umrah in the Kingdom of Saudi Arabia. Acquisition of Streptococcus pneumoniae during Hajj has been studied in the past and recommendations for vaccination against S. pneumoniae have been made for high risk groups. The purpose of this study was to assess the knowledge and attitudes of French Hajj pilgrims towards pneumococcal vaccination. Adult pilgrims departing from Marseille, France to Mecca for the 2014 Hajj season were administered a face-to-face questionnaire to ascertain their knowledge and attitudes towards pneumococcal vaccination before departing for Hajj. A total of 300 participants took part. Their overall knowledge about the severity of pneumonia and the existence of the vaccine was very low. Out of 101 participants who had an indication for pneumococcal vaccination, irrespective of their travel status, only 7% were advised to have the vaccine by their general practitioner. These results reinforce the need for better dissemination of information either before or during the pre-travel counselling. The visit to the travel clinic for receiving the mandatory meningococcal vaccination for Hajj is a good opportunity to update routine immunizations, including pneumococcal vaccination. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Cost-effectiveness of polysaccharide pneumococcal vaccination in people aged 65 and above in Poland.

    Science.gov (United States)

    Grzesiowski, Pawel; Aguiar-Ibáñez, Raquel; Kobryń, Aleksandra; Durand, Laure; Puig, Pierre-Emmanuel

    2012-10-01

    Invasive pneumococcal disease is associated with substantial morbidity, mortality and cost implications, which could be reduced by vaccination. To assess the cost-effectiveness of a 23-valent pneumococcal vaccine in the elderly (65 and older) in Poland. A Markov model with a 1-year cycle length was developed, allowing up to 10 cohorts to enter the model over the lifetime horizon (35 years). In the base case, costs and benefits were assessed using the public health care payer (NFZ) perspective. The analysis included routine vaccination of all elderly and high-risk (HR) elderly versus no vaccination. The analysis assumed that the government would reimburse 50% of the vaccine price. Costs and benefits were discounted 5%, with costs expressed in 2009 Polish Zloty (PLN). Extensive sensitivity analyses were carried out. PPV23 vaccination targeting all elderly and HR elderly in Poland would avoid 8,935 pneumococcal infections, 2,542 hospitalisations, 671 deaths and 5,886 infections, 1,673 hospitalisations and 441 deaths respectively. The incremental cost per QALY gained would be PLN 3,382 in all elderly and PLN2,148 in HR elderly. Vaccinating adults 65 and older regardless of risk status with a 23-valent pneumococcal vaccine, is cost-effective, resulting in clinical and economic benefits including a non-negligible reduction of ambulatory doctor visits, hospitalizations and, deaths in Poland.

  6. Human L-ficolin recognizes phosphocholine moieties of pneumococcal teichoic acid

    DEFF Research Database (Denmark)

    Vassal-Stermann, Emilie; Lacroix, Monique; Gout, Evelyne

    2014-01-01

    Human L-ficolin is a soluble protein of the innate immune system able to sense pathogens through its fibrinogen (FBG) recognition domains and to trigger activation of the lectin complement pathway through associated serine proteases. L-Ficolin has been previously shown to recognize pneumococcal c...

  7. Staphylococcus aureus and Streptococcus pneumoniae interaction and response to pneumococcal vaccination: Myth or reality?

    Science.gov (United States)

    Reiss-Mandel, Aylana; Regev-Yochay, Gili

    2016-01-01

    S. aureus and S. pneumoniae are both common pathogens that are also carried by a large proportion of healthy individuals in the nasal and nasopharyngeal spaces. A negative association between carriage of S. aureus and S. pneumoniae has been reported in children in various epidemiologic studies from different geographical regions. Most studies found that the negative association between S. pneumoniae and S. aureus was significant only for carriage of vaccine-type S. pneumoniae strains. In this review, we summarize the various suggested mechanisms of this suggested bacterial interference, and the clinical implications reported following PCV introduction to date in various geographical regions.

  8. Cost-effectiveness analysis of 10- and 13-valent pneumococcal conjugate vaccines in Peru.

    Science.gov (United States)

    Mezones-Holguin, Edward; Canelo-Aybar, Carlos; Clark, Andrew David; Janusz, Cara Bess; Jaúregui, Bárbara; Escobedo-Palza, Seimer; Hernandez, Adrian V; Vega-Porras, Denhiking; González, Marco; Fiestas, Fabián; Toledo, Washington; Michel, Fabiana; Suárez, Víctor J

    2015-05-07

    To evaluate the cost-effectiveness of introducing the 10-valent pneumococcal conjugate vaccine (PCV10) versus the 13-valent PCV (PCV13) to the National Immunization Schedule in Peru for prevention of pneumococcal disease (PD) in children <5 years of age. The integrated TRIVAC vaccine cost-effectiveness model from the Pan American Health Organization's ProVac Initiative (version 2.0) was applied from the perspective of the Government of Peru. Twenty successive cohorts of children from birth to 5 years were evaluated. Clinical outcomes were pneumococcal pneumonia (PP), pneumococcal meningitis (PM), pneumococcal sepsis (PS) and acute otitis media from any causes (AOM). Measures included prevention of cases, neurological sequelae (NS), auditory sequelae (AS), deaths and disability adjusted life years (DALYs). A sensitivity analyses was also performed. For the 20 cohorts, net costs with PCV10 and PCV13 were US$ 363.26 million and US$ 408.26 million, respectively. PCV10 prevented 570,273 AOM; 79,937 PP; 2217 PM; 3049 PS; 282 NS; 173 AS; and 7512 deaths. PCV13 prevented 419,815 AOM; 112,331 PN; 3116 PM; 4285 PS; 404 NS; 248 AS; and 10,386 deaths. Avoided DALYs were 226,370 with PCV10 and 313,119 with PCV13. Saved treatment costs were US$ 37.39 million with PCV10 and US$ 47.22 million with PCV13. Costs per DALY averted were US$ 1605 for PCV10, and US$ 1304 for PCV13. Sensitivity analyses showed similar results. PCV13 has an extended dominance over PCV10. Both pneumococcal vaccines are cost effective in the Peruvian context. Although the net cost of vaccination with PCV10 is lower, PCV13 prevented more deaths, pneumococcal complications and sequelae. Costs per each prevented DALY were lower with PCV13. Thus, PCV13 would be the preferred policy; PCV10 would also be reasonable (and cost-saving relative to the status quo) if for some reason 13-valent were not feasible. Copyright © 2015. Published by Elsevier Ltd.

  9. ESBL carriage in pig slaughterhouse workers is associated with occupational exposure.

    Science.gov (United States)

    Dohmen, W; VAN Gompel, L; Schmitt, H; Liakopoulos, A; Heres, L; Urlings, B A; Mevius, D; Bonten, M J M; Heederik, D J J

    2017-07-01

    We investigated the prevalence of extended-spectrum β-lactamase (ESBL) carriage in slaughterhouse workers and the association with occupational exposure to slaughter animals and products. Stool samples from 334 employees in a Dutch pig slaughterhouse were obtained. Presence of ESBL was determined by selective plating, microarray analysis, and gene sequencing. Questionnaires were used to collect personal and occupational information. The overall prevalence of ESBL carriage was 4·8% (16/334). All ESBL-producing isolates were Escherichia coli. The ESBL genes detected were bla CTX-M-1 (n = 8), bla CTX-M-15 (n = 3), bla CTX-M-27 (n = 2), bla CTX-M-24 (n = 1), bla CTX-M-55 (n = 1), and bla SHV-12 (n = 1). A higher prevalence of ESBL was seen in workers in jobs with as tasks 'removal of lungs, heart, liver, tongue' (33%), and 'removal of head and spinal cord' (25%). For further analysis, participants were divided in two groups based on potential exposure to ESBL as related to their job title. One group with an assumed higher exposure to ESBL (e.g. stable work, stabbing, dehairing, removal of organs) and another group with an assumed lower exposure to ESBL (e.g. refrigeration, packaging and expedition). In the 'higher exposure' group, ten out of 95 (10·5%) were carrying ESBL vs. six out of 233 (2·6%) in the 'lower exposure' group. Human ESBL carriage was significantly associated with job exposure in the slaughterhouse (OR 4·5, CI 1·6-12·6). Results suggest that ESBL carriage in slaughterhouse workers overall is comparable with the Dutch population. Within the slaughterhouse population a difference in carriage exists depending on their position along the slaughter line and tasks involved.

  10. Methicillin-resistant Staphylococcus aureus nasal carriage among patients and healthcare workers in a hospital in Kelantan, Malaysia.

    Science.gov (United States)

    Al-Talib, Hassanain; Yean, Chan Yean; Hasan, Habsah; Nik Zuraina, N M N; Ravichandran, Manickam

    2013-01-01

    Staphylococcus aureus nasal carriage is a common source of nosocomial infection and colonization. The aim of the present study was to assess the burden of methicillin-resistant S. aureus nasal carriage, its association with factors of interest including its genetic relationships. The prevalence of S. aureus nasal carriage was found to be 28.7%. This study showed that patients with a history of previous antibiotic intake, nasogastric tube, and longer hospitalization had a significantly high risk of being MRSA nasal carriers. The genetic relationship of all 34 nasal MRSA isolates revealed four major clusters of isolates, and there was a relationship between MRSA isolated from inpatients and healthcare workers.

  11. The post-vaccine microevolution of invasive Streptococcus pneumoniae

    NARCIS (Netherlands)

    Cremers, A.J.H.; Mobegi, F.M.; Jonge, M.I. de; Hijum, S.A.F.T. van; Meis, J.F.; Hermans, P.W.M.; Ferwerda, G.; Bentley, S.D.; Zomer, A.L.

    2015-01-01

    The 7-valent pneumococcal conjugated vaccine (PCV7) has affected the genetic population of Streptococcus pneumoniae in pediatric carriage. Little is known however about pneumococcal population genomics in adult invasive pneumococcal disease (IPD) under vaccine pressure. We sequenced and serotyped

  12. Forecasting invasive pneumococcal disease trends after the introduction of 13-valent pneumococcal conjugate vaccine in the United States, 2010-2020.

    Science.gov (United States)

    Link-Gelles, Ruth; Taylor, Thomas; Moore, Matthew R

    2013-05-24

    Pneumococcal vaccines are highly effective at preventing invasive pneumococcal disease (IPD), a leading cause of global morbidity. Because pneumococcal vaccines can be expensive, it is useful to estimate what impact might be expected from their introduction. Our objective was to develop a statistical model that could predict rates of IPD following introduction of 13-valent pneumococcal conjugate vaccine (PCV13) in the U.S. We used active surveillance data to design and validate a Poisson model forecasting the reductions in IPD observed after U.S. introduction of 7-valent pneumococcal conjugate vaccine (PCV7) in 2000. We used this model to forecast rates of IPD from 2010 to 2020 in the presence of PCV13. Because increases in non-PCV7-type IPD were evident following PCV7 introduction, we evaluated varying levels of increase in non-PCV13-type IPD ("serotype replacement") by sensitivity analyses. A total of 43,507 cases of IPD were identified during 1998-2009; cases from this period were used to develop the model, which accurately predicted indirect effects of PCV7 in adults, as well as serotype replacement. Assuming that PCV13 provides similar protection against PCV13 serotypes as PCV7 did against PCV7 serotypes, the base-case model predicted approximately 168,000 cases of IPD prevented from 2011 to 2020. When serotype replacement was varied in sensitivity analyses from 0 to levels comparable to that seen with serotype 19A (the most common replacement serotype since PCV7 was introduced), the model predicted 167,000-170,000 cases prevented. The base-case model predicted rates of IPD in children under five years of age decreasing from 21.9 to 9.3 cases per 100,000 population. This model provides a "benchmark" for assessing progress in the prevention of IPD in the years after PCV13 introduction. The amount of serotype replacement is unlikely to greatly affect the overall number of cases prevented by PCV13. Published by Elsevier Ltd.

  13. Development of a whole cell pneumococcal vaccine: BPL inactivation, cGMP production, and stability.

    Science.gov (United States)

    Gonçalves, Viviane M; Dias, Waldely O; Campos, Ivana B; Liberman, Celia; Sbrogio-Almeida, Maria E; Silva, Eliane P; Cardoso, Celso P; Alderson, Mark; Robertson, George; Maisonneuve, Jean-François; Tate, Andrea; Anderson, Porter; Malley, Richard; Fratelli, Fernando; Leite, Luciana C C

    2014-02-19

    Pneumococcal infections impose a large burden of disease on the human population, mainly in developing countries, and the current pneumococcal vaccines offer serotype-specific protection, but do not cover all pathogenic strains, leaving populations vulnerable to disease caused by non-vaccine serotypes. The pneumococcal whole cell vaccine is a low-cost strategy based on non-capsular antigens common to all strains, inducing serotype-independent immunity. Therefore, we developed the process for the cGMP production of this cellular vaccine. Initially, three engineering runs and two cGMP runs were performed in 60-L bioreactors, demonstrating the consistency of the production process, as evaluated by the growth curves, glucose consumption and metabolite formation (lactate and acetate). Cell recovery by tangential filtration was 92 ± 13 %. We optimized the conditions for beta-propiolactone (BPL) inactivation of the bacterial suspensions, establishing a maximum cell density of OD600 between 27 and 30, with a BPL concentration of 1:4000 (v/v) at 150 rpm and 4 °C for 30 h. BPL was hydrolyzed by heating for 2h at 37 °C. The criteria and methods for quality control were defined using the engineering runs and the cGMP Lots passed all specifications. cGMP vaccine Lots displayed high potency, inducing between 80 and 90% survival in immunized mice when challenged with virulent pneumococci. Sera from mice immunized with the cGMP Lots recognized several pneumococcal proteins in the extract of encapsulated strains by Western blot. The cGMP whole cell antigen bulk and whole cell vaccine product lots were shown to be stable for up to 12 and 18 months, respectively, based upon survival assays following i.p. challenge. Our results show the consistency and stability of the cGMP whole cell pneumococcal vaccine lots and demonstrate the feasibility of production in a developing country setting. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. INFLUENZA AND PNEUMOCOCCAL VACCINATION IN HEMATOLOGICAL MALIGNANCIES: A SYSTEMATIC REVIEW OF EFFICACY, EFFECTIVENESS AND SAFETY

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    Giuseppe La Torre

    2016-09-01

    Full Text Available Background The risk of getting influenza and pneumococcal disease is higher in cancer patients and serum antibody levels tend to be lower in patients with hematological malignancy. Objective To asses flu and pneumococcal vaccinations efficacy, effectiveness and safety in onco-hematological patients. Methods Two systematic reviews and possible meta-analysis were conducted to summarize the results of all primary study in scientific literature about flu and pneumococcal vaccine in onco-hematological patients. Literature searches were performed using Pub-Med and Scopus databases. StatsDirect 2.8.0 was used for the analysis. Results 23 and 26 studies were collected respectively for flu and pneumococcal vaccinations. Protection rate of booster dose was 30% (95% CI = 6.2- 61% for H1N1. Pooled prevalence protection rate of H3N2 and B was available for meta-analysis only for first dose, 42.6% (95% CI = 23.2 – 63.3 % and 39.6 % (95% CI = 26%- 54.1% for H3N2 and B, respectively. Response rate of booster dose resulted 35% (95% CI = 19.7-51.2% for H1N1, 23% (95% CI = 16.6-31.5% for H3N2, 29% (95% CI = 21.3- 37% for B. Conclusion Despite low rate of response, flu and pneumococcal vaccines are worthwhile for patients with hematological malignancies. Patients undergoing chemotherapy in particular rituximab, splenectomy, transplant recipient had lower and impaired response. No serious adverse events were reported for both vaccines.

  15. Streptococcus pneumoniae serotype-2 childhood meningitis in Bangladesh: a newly recognized pneumococcal infection threat.

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    Samir K Saha

    Full Text Available BACKGROUND: Streptococcus pneumoniae is a leading cause of meningitis in countries where pneumococcal conjugate vaccines (PCV targeting commonly occurring serotypes are not routinely used. However, effectiveness of PCV would be jeopardized by emergence of invasive pneumococcal diseases (IPD caused by serotypes which are not included in PCV. Systematic hospital based surveillance in Bangladesh was established and progressively improved to determine the pathogens causing childhood sepsis and meningitis. This also provided the foundation for determining the spectrum of serotypes causing IPD. This article reports an unprecedented upsurge of serotype 2, an uncommon pneumococcal serotype, without any known intervention. METHODS AND FINDINGS: Cases with suspected IPD had blood or cerebrospinal fluid (CSF collected from the beginning of 2001 till 2009. Pneumococcal serotypes were determined by capsular swelling of isolates or PCR of culture-negative CSF specimens. Multicenter national surveillance, expanded from 2004, identified 45,437 patients with suspected bacteremia who were blood cultured and 10,618 suspected meningitis cases who had a lumber puncture. Pneumococcus accounted for 230 culture positive cases of meningitis in children <5 years. Serotype-2 was the leading cause of pneumococcal meningitis, accounting for 20.4% (45/221; 95% CI 15%-26% of cases. Ninety eight percent (45/46 of these serotype-2 strains were isolated from meningitis cases, yielding the highest serotype-specific odds ratio for meningitis (29.6; 95% CI 3.4-256.3. The serotype-2 strains had three closely related pulsed field gel electrophoresis types. CONCLUSIONS: S. pneumoniae serotype-2 was found to possess an unusually high potential for causing meningitis and was the leading serotype-specific cause of childhood meningitis in Bangladesh over the past decade. Persisting disease occurrence or progressive spread would represent a major potential infection threat since serotype-2

  16. Type I interferon protects against pneumococcal invasive disease by inhibiting bacterial transmigration across the lung.

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    Kim S LeMessurier

    Full Text Available Streptococcus pneumoniae infection is a leading cause of bacterial pneumonia, sepsis and meningitis and is associated with high morbidity and mortality. Type I interferon (IFN-I, whose contribution to antiviral and intracellular bacterial immunity is well established, is also elicited during pneumococcal infection, yet its functional significance is not well defined. Here, we show that IFN-I plays an important role in the host defense against pneumococci by counteracting the transmigration of bacteria from the lung to the blood. Mice that lack the type I interferon receptor (Ifnar1 (-/- or mice that were treated with a neutralizing antibody against the type I interferon receptor, exhibited enhanced development of bacteremia following intranasal pneumococcal infection, while maintaining comparable bacterial numbers in the lung. In turn, treatment of mice with IFNβ or IFN-I-inducing synthetic double stranded RNA (poly(I:C, dramatically reduced the development of bacteremia following intranasal infection with S. pneumoniae. IFNβ treatment led to upregulation of tight junction proteins and downregulation of the pneumococcal uptake receptor, platelet activating factor receptor (PAF receptor. In accordance with these findings, IFN-I reduced pneumococcal cell invasion and transmigration across epithelial and endothelial layers, and Ifnar1 (-/- mice showed overall enhanced lung permeability. As such, our data identify IFN-I as an important component of the host immune defense that regulates two possible mechanisms involved in pneumococcal invasion, i.e. PAF receptor-mediated transcytosis and tight junction-dependent pericellular migration, ultimately limiting progression from a site-restricted lung infection to invasive, lethal disease.

  17. Genetic factors regulating lung vasculature and immune cell functions associate with resistance to pneumococcal infection.

    Directory of Open Access Journals (Sweden)

    Magda S Jonczyk

    Full Text Available Streptococcus pneumoniae is an important human pathogen responsible for high mortality and morbidity worldwide. The susceptibility to pneumococcal infections is controlled by as yet unknown genetic factors. To elucidate these factors could help to develop new medical treatments and tools to identify those most at risk. In recent years genome wide association studies (GWAS in mice and humans have proved successful in identification of causal genes involved in many complex diseases for example diabetes, systemic lupus or cholesterol metabolism. In this study a GWAS approach was used to map genetic loci associated with susceptibility to pneumococcal infection in 26 inbred mouse strains. As a result four candidate QTLs were identified on chromosomes 7, 13, 18 and 19. Interestingly, the QTL on chromosome 7 was located within S. pneumoniae resistance QTL (Spir1 identified previously in a linkage study of BALB/cOlaHsd and CBA/CaOlaHsd F2 intercrosses. We showed that only a limited number of genes encoded within the QTLs carried phenotype-associated polymorphisms (22 genes out of several hundred located within the QTLs. These candidate genes are known to regulate TGFβ signalling, smooth muscle and immune cells functions. Interestingly, our pulmonary histopathology and gene expression data demonstrated, lung vasculature plays an important role in resistance to pneumococcal infection. Therefore we concluded that the cumulative effect of these candidate genes on vasculature and immune cells functions as contributory factors in the observed differences in susceptibility to pneumococcal infection. We also propose that TGFβ-mediated regulation of fibroblast differentiation plays an important role in development of invasive pneumococcal disease. Gene expression data submitted to the NCBI Gene Expression Omnibus Accession No: GSE49533 SNP data submitted to NCBI dbSNP Short Genetic Variation http://www.ncbi.nlm.nih.gov/projects/SNP/snp_viewTable.cgi?handle=MUSPNEUMONIA.

  18. Death or survival from invasive pneumococcal disease in Scotland: associations with serogroups and multilocus sequence types

    Science.gov (United States)

    Lamb, Karen; Diggle, Mathew; Robertson, Chris; Greenhalgh, David; Mitchell, Tim J.; Smith, Andrew; Jefferies, Johanna M. C.; Clarke, Stuart C.; McMenamin, Jim; Edwards, Giles F. S.

    2011-01-01

    We describe associations between death from invasive pneumococcal disease (IPD) and particular serogroups and sequence types (STs) determined by multilocus sequence typing (MLST) using data from Scotland. All IPD episodes where blood or cerebrospinal fluid (CSF) culture isolates were referred to the Scottish Haemophilus, Legionella, Meningococcal and Pneumococcal Reference Laboratory (SHLMPRL) from January 1992 to February 2007 were matched to death certification records by the General Register Office for Scotland. This represented 5959 patients. The median number of IPD cases in Scotland each year was 292. Deaths, from any cause, within 30 days of pneumococcal culture from blood or CSF were considered to have IPD as a contributing factor. Eight hundred and thirty-three patients died within 30 days of culture of Streptococcus pneumoniae from blood or CSF [13.95 %; 95 % confidence interval (13.10, 14.80)]. The highest death rates were in patients over the age of 75. Serotyping data exist for all years but MLST data were only available from 2001 onward. The risk ratio of dying from infection due to particular serogroups or STs compared to dying from IPD due to all other serogroups or STs was calculated. Fisher’s exact test with Bonferroni adjustment for multiple testing was used. Age adjustment was accomplished using the Cochran–Mantel–Haenszel test and 95 % confidence intervals were reported. Serogroups 3, 11 and 16 have increased probability of causing fatal IPD in Scotland while serogroup 1 IPD has a reduced probability of causing death. None of the 20 most common STs were significantly associated with death within 30 days of pneumococcal culture, after age adjustment. We conclude that there is a stronger association between a fatal outcome and pneumococcal capsular serogroup than there is between a fatal outcome and ST. PMID:21393453

  19. SHOULD WE PROTECT THE CHILDREN AGAINST PNEUMOCOCCAL INFECTION?

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    A.A. Baranov

    2008-01-01

    Full Text Available Diseases caused by streptococcus are a serious issue for the health care worldwide mostly due to wide spread, high lethal risk in the event of the severe run, increasing resistance of pneumococcus to antibacterial therapy, troubles with high efficiency of vaccines as pertaining to the special structure of the pathogen. Every year 1,6 mln people die of the diseases caused by pneumococcus worldwide, 50-70% of whom are children under 5 years. The highest morbidity falls onto the infants under 2 and younger and the elderly people. HIV infection and other immunodeficiency states increase the chance to get infected with pneumococcus caused diseases. There is a wide variety of pneumococci (about 90 serotypes which have different degrees of virulence and pathogenesis. It is evident that on the one hand vaccines offered for the struggle against this dangerous infection should protect against the most widely spread and harmful serotypes and on the other hand should have a high degree of efficiency and safety for the one to be vaccinated. Today healthcare services make use of 7-valent conjugate polysaccharide-baleuronic vaccine (PCVB7 and nonconjugate polysaccharide vaccine against 23 serotypes. 23-valent vaccines are designed for the adolescent and elderly people, yet it is not licensed for the application among patients aged under2 who are the primary target group for the vaccination. PCVB7 incorporated serotypes causing invasive pneumococcal diseases among children in 60-85% of cases. The vaccine is well tolerated and deemed to be safe. It forms an express immune response (cellular, humoral, mucosal and also reduces the nasopharyngeal bacteria carrying. This vaccine is highly immunogenic across all the age groups yet it is not licensed for the application among children under 5, including infants (under 12 months. Acknowledging high importance of diseases caused by pneumococci among infants, high efficiency and safety of PCVB7 in the given age group who

  20. Induced hypothermia is protective in a rat model of pneumococcal pneumonia associated with increased adenosine triphosphate availability and turnover

    NARCIS (Netherlands)

    Beurskens, Charlotte J. P.; Aslami, Hamid; Kuipers, Maria T.; Horn, Janneke; Vroom, Margreeth B.; van Kuilenburg, André B. P.; Roelofs, Joris J. T. H.; Schultz, Marcus J.; Juffermans, Nicole P.

    2012-01-01

    Objective: To determine the effect of induced hypothermia on bacterial growth, lung injury, and mitochondrial function in a rat model of pneumococcal pneumosepsis. Design: Animal study. Setting: University research laboratory. Subjects: Male Sprague-Dawley rats. Interventions: Subjects were

  1. Epidemiology of pediatric pneumococcal meningitis and bacteremia in Latin America and the Caribbean: a systematic review and meta-analysis.

    Science.gov (United States)

    Ciapponi, Agustín; Elorriaga, Natalia; Rojas, Juan Ignacio; Romano, Marina; Martí, Sebastián García; Bardach, Ariel; Ruvinsky, Silvina

    2014-09-01

    Pneumococcal meningitis and bacteremia pose a significant disease burden in Latin America and the Caribbean (LAC). To perform a systematic review of studies of pediatric pneumococcal meningitis and non-pneumonia, non-meningitis pneumococcal bacteremia in LAC, we conducted an exhaustive search from 2000 to 2010 in electronic databases and grey literature. Pairs of independently selected reviewers assessed the quality and extracted the studies' data. A STROBE-based checklist was used to assess the risk of bias in observational studies. Meta-analyses were performed. Of 1218 retrieved studies, 39 were included. In children <5 years, the pooled 95% confidence interval (CI) percentage of pneumococcal etiology out of cases studied with cerebrospinal fluid/blood cultures was 6.0% (95% CI: 3.3-9.5) for meningitis and 8.0% (95% CI: 5.3-12.4) for bacteremia. The incidences per 100,000 children were 4.7 (95% CI: 3.2-6.1) and 3.9 (95% CI: 2.0-5.9) for pneumococcal meningitis and non-pneumonia, non-meningitis bacteremia, respectively. The mortality was 8.3 (95% CI: 0.0-21.0) and 0.5 (95% CI: 0.3.0-0.6)/100,000 for meningitis and sepsis, respectively. The case fatality ratio was 33.2% (95% CI: 21.3-46.2) for meningitis and 29.0% (95% CI: 21.9-36.8) for sepsis. The pooled serotype distribution from SIREVA surveillance data showed that 14, 5, 6B (for meningitis) and 14, 6B, 19F (for bacteremia) were the most frequent serotypes, all included in licensed vaccines. Pneumococcal meningitis and bacteremia are important causes of morbidity and mortality in LAC children <5 years of age. This systematic review provided evidence about the burden of pneumococcal disease and the serotype distribution to assess the impact the pneumococcal vaccines and to assist decision makers in the region.

  2. Influence of Host Genetics and Environment on Nasal Carriage of Staphylococcus aureus in Danish Middle-Aged and Elderly Twins

    DEFF Research Database (Denmark)

    Andersen, Paal Skytt; Pedersen, Jacob Krabbe; Fode, Peder

    2012-01-01

    Background. Nasal carriage is a major risk factor for Staphylococcus aureus infection. Approximately, one-quarter of adults carry S. aureus. However, the role of host genetics on S. aureus nasal carriage is unknown. Methods. Nasal swabs were obtained from a national cohort of middle-aged and elde......Background. Nasal carriage is a major risk factor for Staphylococcus aureus infection. Approximately, one-quarter of adults carry S. aureus. However, the role of host genetics on S. aureus nasal carriage is unknown. Methods. Nasal swabs were obtained from a national cohort of middle...... exhibited only a modest influence on the S. aureus carrier state of middle-aged and elderly individuals....

  3. [Nasopharyngeal carriage of Streptococcus pneumoniae in healthy children and multidrug resistance].

    Science.gov (United States)

    Bayer, Müjgan; Aslan, Gönül; Emekdaş, Gürol; Kuyucu, Necdet; Kanik, Arzu

    2008-04-01

    Nasopharyngeal carriage of Streptococcus pneumoniae plays an important role for the development of invasive disease and the spread of resistant strains within the community. The aims of this study were to determine the carriage rate of nasopharyngeal S. pneumoniae at healthy school children, to search the susceptibility of the strains to various antibiotics and to evaluate the risk factors for nasopharyngeal carriage of penicillin-resistant pneumococci. A total of 1440 healthy children (age range: 6-13 years old) attending to three primary schools which were chosen randomly in Mersin province (Mediterranean region of Turkey) were included to the study between April 2003 to March 2004. The isolation and identification of S. pneumoniae strains from nasopharyngeal samples were performed by conventional culture methods. Antibiotic sensitivity tests were done according to the Clinical Laboratory Standards Institute directions by disk diffusion method, and penisilin MIC values were detected by E-test (AB Biodisk, Solna, Sweden). S.pneumoniae were isolated from 201 (13.9) of the children. The susceptibility rate of the isolates to penicilin was found as 87.1% (n:175), while 12% (n:24) of the strains yielded intermediate and 1% (n:2) yielded high resistance against penicilin. Overall percentages of resistance to trimethoprim-sulfamethoxazole (TMP-SMX) and macrolides were 30% and 4%, respectively. Two out of eight erythromycin (E) resistant strains showed inducible MLS(B) (macrolide, lincosamide and streptogramin B) type while six showed M (due to active efflux system) type of resistance. Resistance to meropenem, vancomycin, ceftriaxone and ciprofloxacin were not detected. Of S. pneumoniae isolates, 20% were found resistant to only one antibiotic (two strains to penicilin; 39 strains to TMP-SMX), 8.9% to two antibiotics (16 strains to penicillin+TMP-SMX; two strains to penicillin+E) and 2.9% to three or more antibiotics (five strains to penicillin+E+TMP-SMX; one strain to

  4. Variable performance of models for predicting methicillin-resistant Staphylococcus aureus carriage in European surgical wards.

    Science.gov (United States)

    Lee, Andie S; Pan, Angelo; Harbarth, Stephan; Patroni, Andrea; Chalfine, Annie; Daikos, George L; Garilli, Silvia; Martínez, José Antonio; Cooper, Ben S

    2015-02-27

    Predictive models to identify unknown methicillin-resistant Staphylococcus aureus (MRSA) carriage on admission may optimise targeted MRSA screening and efficient use of resources. However, common approaches to model selection can result in overconfident estimates and poor predictive performance. We aimed to compare the performance of various models to predict previously unknown MRSA carriage on admission to surgical wards. The study analysed data collected during a prospective cohort study which enrolled consecutive adult patients admitted to 13 surgical wards in 4 European hospitals. The participating hospitals were located in Athens (Greece), Barcelona (Spain), Cremona (Italy) and Paris (France). Universal admission MRSA screening was performed in the surgical wards. Data regarding demographic characteristics and potential risk factors for MRSA carriage were prospectively collected during the study period. Four logistic regression models were used to predict probabilities of unknown MRSA carriage using risk factor data: "Stepwise" (variables selected by backward elimination); "Best BMA" (model with highest posterior probability using Bayesian model averaging which accounts for uncertainty in model choice); "BMA" (average of all models selected with BMA); and "Simple" (model including variables selected >50% of the time by both Stepwise and BMA approaches applied to repeated random sub-samples of 50% of the data). To assess model performance, cross-validation against data not used for model fitting was conducted and net reclassification improvement (NRI) was calculated. Of 2,901 patients enrolled, 111 (3.8%) were newly identified MRSA carriers. Recent hospitalisation and presence of a wound/ulcer were significantly associated with MRSA carriage in all models. While all models demonstrated limited predictive ability (mean c-statistics MRSA-positive individuals despite screening fewer patients than the Stepwise model. Moreover, the Simple model improved

  5. Immunogenicity of a 23-valent pneumococcal polysaccharide vaccine in elderly residents of a long-term care facility

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    M. Teresa Valenzuela B.

    Full Text Available S. pneumoniae is a significant cause of community-acquired pneumonia in the elderly, and accounts for the majority of the pneumonia deaths among the elderly. We conducted this randomized double-blind study to evaluate the immune response to a 23-valent pneumococcal polysaccharide vaccine and the persistence of antibodies two years after the vaccination in an elderly population in Santiago, Chile. A total of 118 elderly nursing home residents received either the pneumococcal or a tetanus control vaccine. Serum samples were taken at enrolment, at two months, and at two years post-vaccination. Pre-vaccination anti-pneumococcal antibody geometric mean concentrations (GMC were similar in both study groups, with increased levels of antibodies found only against serotype 14. The pneumococcal vaccine was highly immunogenic at 2 months, and titers remained high two years after the vaccination for the 10 serotypes studied in this elderly population. The results thus support the benefits of this pneumococcal vaccine in this elderly population who are at increased risk of invasive pneumococcal disease.

  6. A Retrospective Study of the Clinical Burden of Hospitalized All-Cause and Pneumococcal Pneumonia in Canada

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    Shelly A. McNeil

    2016-01-01

    Full Text Available Background. Routine vaccination against Streptococcus pneumoniae is recommended in Canada for infants, the elderly, and individuals with chronic comorbidity. National incidence and burden of all-cause and pneumococcal pneumonia in Canada (excluding Quebec were assessed. Methods. Incidence, length of stay, and case-fatality rates of hospitalized all-cause and pneumococcal pneumonia were determined for 2004–2010 using ICD-10 discharge data from the Canadian Institutes for Health Information Discharge Abstract Database. Population-at-risk data were obtained from the Statistics Canada census. Temporal changes in pneumococcal and all-cause pneumonia rates in adults ≥65 years were analyzed by logistic regression. Results. Hospitalization for all-cause pneumonia was highest in children 70 years and declined significantly from 1766/100,000 to 1537/100,000 per year in individuals aged ≥65 years (P<0.001. Overall hospitalization for pneumococcal pneumonia also declined from 6.40/100,000 to 5.08/100,000 per year. Case-fatality rates were stable (11.6% to 12.3%. Elderly individuals had longer length of stay and higher case-fatality rates than younger groups. Conclusions. All-cause and pneumococcal pneumonia hospitalization rates declined between 2004 and 2010 in Canada (excluding Quebec. Direct and indirect effects from pediatric pneumococcal immunization may partly explain some of this decline. Nevertheless, the burden of disease from pneumonia remains high.

  7. Burden of Severe Pneumonia, Pneumococcal Pneumonia and Pneumonia Deaths in Indian States: Modelling Based Estimates

    Science.gov (United States)

    Farooqui, Habib; Jit, Mark; Heymann, David L.; Zodpey, Sanjay

    2015-01-01

    The burden of severe pneumonia in terms of morbidity and mortality is unknown in India especially at sub-national level. In this context, we aimed to estimate the number of severe pneumonia episodes, pneumococcal pneumonia episodes and pneumonia deaths in children younger than 5 years in 2010. We adapted and parameterized a mathematical model based on the epidemiological concept of potential impact fraction developed CHERG for this analysis. The key parameters that determine the distribution of severe pneumonia episode across Indian states were state-specific under-5 population, state-specific prevalence of selected definite pneumonia risk factors and meta-estimates of relative risks for each of these risk factors. We applied the incidence estimates and attributable fraction of risk factors to population estimates for 2010 of each Indian state. We then estimated the number of pneumococcal pneumonia cases by applying the vaccine probe methodology to an existing trial. We estimated mortality due to severe pneumonia and pneumococcal pneumonia by combining incidence estimates with case fatality ratios from multi-centric hospital-based studies. Our results suggest that in 2010, 3.6 million (3.3–3.9 million) episodes of severe pneumonia and 0.35 million (0.31–0.40 million) all cause pneumonia deaths occurred in children younger than 5 years in India. The states that merit special mention include Uttar Pradesh where 18.1% children reside but contribute 24% of pneumonia cases and 26% pneumonia deaths, Bihar (11.3% children, 16% cases, 22% deaths) Madhya Pradesh (6.6% children, 9% cases, 12% deaths), and Rajasthan (6.6% children, 8% cases, 11% deaths). Further, we estimated that 0.56 million (0.49–0.64 million) severe episodes of pneumococcal pneumonia and 105 thousand (92–119 thousand) pneumococcal deaths occurred in India. The top contributors to India’s pneumococcal pneumonia burden were Uttar Pradesh, Bihar, Madhya Pradesh and Rajasthan in that order. Our

  8. Invasive pneumococcal disease in children aged younger than 5 years in India: a surveillance study.

    Science.gov (United States)

    Manoharan, Anand; Manchanda, Vikas; Balasubramanian, Sundaram; Lalwani, Sanjay; Modak, Meera; Bai, Sushama; Vijayan, Ajith; Shet, Anita; Nagaraj, Savitha; Karande, Sunil; Nataraj, Gita; Yewale, Vijay N; Joshi, Shrikrishna A; Iyer, Ranganathan N; Santosham, Mathuram; Kahn, Geoffrey D; Knoll, Maria Deloria

    2017-03-01

    Invasive pneumococcal disease continues to be a major cause of morbidity and mortality among children younger than 5 years of age in India. We aimed to provide nationally representative data for the pattern of disease due to Streptococcus pneumoniae, trends in the serotype of invasive pneumococci, and invasive pneumococci antimicrobial resistance patterns, in India. In this prospective hospital-based and retrospective laboratory-based surveillance study, we prospectively enrolled children aged younger than 5 years with suspected or proven invasive pneumococcal disease from 18 hospitals or institutional centres and retrospectively included laboratory-confirmed pneumococcal isolates from ten sentinel laboratories, together representing 11 states in India. Eligibility criteria were fever higher than 38°C without localising symptoms, clinical presentation of suspected meningitis or pneumonia, and evidence of radiographic pneumonia. We cultured blood and other normally sterile body fluids, reconfirmed and serotyped pneumococcal isolates, and established antimicrobial susceptibility using standard study protocols. Between Jan 1, 2011, and June 30, 2015, we enrolled 4377 patients. Among 361 (8%) patients with culture-proven pneumococcal disease, all clinical data were known for 226 (63%); among these patients, 132 (58%) presented with pneumonia, 78 (35%) presented with meningitis, and 16 (7%) had other clinical conditions. 131 (3%) died overall and 29 (8%) patients with invasive pneumococcal disease died. Serotypes 14 (52 [14%] of 361), 1 (49 [14%]), 5 (37 [10%]), and 19F (33 [9%]) were the most common. Penicillin non-susceptibility occurred in isolates from 29 (8%) patients, co-trimoxazole resistance occurred in 239 (66%), erythromycin resistance occurred in 132 (37%), and chloramphenicol resistance occurred in 33 (9%). We found multidrug resistance in 33 (9%) of 361 patients. The proportion of positive blood cultures, number of isolates, geographical representation

  9. Immunoglobulin G deficiency in United kingdom children with invasive pneumococcal disease.

    Science.gov (United States)

    Stanford, Elaine; Ladhani, Shamez; Borrow, Ray; Waight, Pauline; Slack, Mary; George, Robert; Balmer, Paul; Miller, Elizabeth; Helbert, Matthew

    2011-06-01

    This study aimed to determine whether nonprotective, convalescent pneumococcal serotype-specific immunoglobulin G (IgG) concentrations in children with invasive pneumococcal disease (IPD) might be associated with an underlying IgG deficiency. The first 200 convalescent blood samples from children with IPD that were submitted for pneumococcal antibody testing also had total serum IgG concentrations measured. Pneumococcal IgG testing was performed for 12 serotypes (1, 3, 5, 7, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, and 23F); serotype-specific pneumococcal IgG concentrations IgG deficiency was defined as total serum IgG ≥2 standard deviations below the mean for age. Nineteen of 172 children (11.0%) with sufficient serum had IgG deficiency although serum IgG concentrations were only marginally below the lower limit for age and all 19 had IgG concentrations >2.0 g/L. IgG deficiency was associated with younger age at disease (median, 5.2 [interquartile range, 2.3-13.5] vs. 12.5 [7.4-17.0] months; P = 0.005) and nonprotective convalescent antibody concentrations against the infecting serotype (10/13 [77%] vs. 51/105 [49%]; P = 0.05). There was a correlation between IgG deficiency and the number of serotypes against which children had nonprotective pneumococcal antibody concentrations, particularly among vaccinated cases (P IgG deficiency (3/19 [16%] vs. 11/53 [7%], P = 0.20), although this association was not statistically significant. Three children with IgG deficiency who were retested 3 to 5 months later had normal serum IgG concentrations. Although 11% of children with IPD had IgG deficiency, total serum IgG concentrations were reassuringly only marginally below the reference range and were within the normal range in those who were retested, suggesting a transient deficiency rather than a serious underlying primary immunodeficiency.

  10. Oral Candida spp carriage and periodontal diseases in HIV-infected patients in Ribeirão Preto, Brazil.

    Science.gov (United States)

    Lourenço, Alan Grupioni; Ribeiro, Ana Elisa Rodrigues Alves; Nakao, Cristiano; Motta, Ana Carolina Fragoso; Antonio, Luana Grupioni Lourenço; Machado, Alcyone Artioli; Komesu, Marilena Chinali

    2017-06-01

    The majority of HIV-infected patients develop Candida spp-associated clinical oral lesions. Studies have shown that asymptomatic oral colonization of Candida spp may lead to oral lesions or become a source of disseminated infections. The aim of this study was to verify the effects of periodontal conditions on Candida spp prevalence and Candida spp carriage in the oral cavity of HIV-infected patients compared to non-infected patients. Twenty-five patients not infected with HIV and 48 HIV-infected patients were classified according to periodontal conditions as being periodontal healthy or with periodontal disease. Candida spp carriage and classification were performed in oral rinse samples. Viral load and CD4+ T lymphocyte (CD4+L) counts were performed in blood samples from HIV-infected patients. No differences in Candida spp prevalence related to HIV status or periodontal condition were detected. However, Candida spp carriage was increased in periodontally affected HIV-infected patients when compared to periodontally healthy HIV-infected patients (p= 0.04). Periodontally healthy HIV-infected patients presented Candida spp carriage in similar levels as healthy or periodontally affected non-HIV-infected patients. Candida spp carriage was correlated with CD4+L counting in HIV-infected patients. We concluded that periodontal disease is associated with increased Candida spp carriage in HIV-infected patients and may be a predisposing factor to clinical manifestations of candidiasis.

  11. Revaccination with a 23-Valent Pneumococcal Polysaccharide Vaccine Induces Elevated and Persistent Functional Antibody Responses in Adults Aged ⩾65 Years

    National Research Council Canada - National Science Library

    Susan B. Manoff; Charles Liss; Michael J. Caulfield; Rocio D. Marchese; Jeffrey Silber; John Boslego; Sandra Romero-Steiner; Gowrisankar Rajam; Nina E. Glass; Cynthia G. Whitney; George M. Carlone

    2010-01-01

    .... We compared revaccination with 23-valent pneumococcal polysaccharide vaccine (PN23) with primary vaccination for eliciting initial and persistent functional antibody responses. Methods. Subjects aged...

  12. Host immunity in the protective response to nasal immunization with a pneumococcal antigen associated to live and heat-killed Lactobacillus casei

    National Research Council Canada - National Science Library

    Vintiñi, Elisa O; Medina, Marcela S

    2011-01-01

    .... Search for effective vaccine continues and some serotype independent pneumococcal proteins are considered as candidates for the design of new vaccines, especially a mucosal vaccine, since pneumococci...

  13. Fluoroquinolone-resistant Escherichia coli carriage in long-term care facility.

    Science.gov (United States)

    Maslow, Joel N; Lee, Betsy; Lautenbach, Ebbing

    2005-06-01

    We conducted a cross-sectional study to determine the prevalence of, and risk factors for, colonization with fluoroquinolone (FQ)-resistant Escherichia coli in residents in a long-term care facility. FQ-resistant E. coli were identified from rectal swabs for 25 (51%) of 49 participants at study entry. On multivariable analyses, prior FQ use was the only independent risk factor for FQ-resistant E. coli carriage and was consistent for FQ exposures in the previous 3, 6, 9, or 12 months. Pulsed-field gel electrophoresis of FQ-resistant E. coli identified clonal spread of 1 strain among 16 residents. Loss (6 residents) or acquisition (7 residents) of FQ-resistant E. coli was documented and was associated with de novo colonization with genetically distinct strains. Unlike the case in the hospital setting, FQ-resistant E. coli carriage in long-term care facilities is associated with clonal spread.

  14. SWOT analysis for safer carriage of bulk liquid chemicals in tankers.

    Science.gov (United States)

    Arslan, Ozcan; Er, Ismail Deha

    2008-06-15

    The application of strengths, weaknesses, opportunities and threats (SWOT) analysis to formulation of strategy concerned with the safe carriage of bulk liquid chemicals in maritime tankers was examined in this study. A qualitative investigation using SWOT analysis has been implemented successfully for ships that are designed to carry liquid chemicals in bulk. The originality of this study lies in the use of SWOT analysis as a management tool to formulate strategic action plans for ship management companies, ship masters and officers for the carriage of dangerous goods in bulk. With this transportation-based SWOT analysis, efforts were made to explore the ways and means of converting possible threats into opportunities, and changing weaknesses into strengths; and strategic plans of action were developed for safer tanker operation.

  15. Carriage frequency, diversity and methicillin resistance of Staphylococcus aureus in Danish small ruminants

    DEFF Research Database (Denmark)

    Eriksson, Jacob; Gongora, Carmen Espinosa; Stamphøj, Inga

    2013-01-01

    . This study provides novel data about the occurrence of S. aureus in small ruminants, revealing high carriage frequency and diversity in these animals. The finding of mecC in ovine ST130 isolates suggests that sheep may be a reservoir of this new emerging MRSA clone of suspected animal origin. Inclusion......The ecology of Staphylococcus aureus in animals has recently gained attention by the research community due to the emergence of livestock-associated methicillin-resistant strains (MRSA). We investigated carriage frequency and clonal diversity of S. aureus in 179 sheep and 17 goats in Denmark using...... spa typing and MLST. S. aureus was detected in 74 sheep (41%) and 11 goats (64%). The isolates belonged to 26 spa types (including six novel spa types) and 12 STs (including three novel STs). The most common lineage was ST133, which was found in 65% sheep and 55% goats. MRSA was found in three animals...

  16. THE PROBLEMS OF MANAGEMENT OF LOGISTIC AND CARRIAGE PROCESSES IN THE INTERNATIONAL ENVIRONMENT

    Directory of Open Access Journals (Sweden)

    Mária Pomffyová

    2013-06-01

    Full Text Available Managing of logistic and carriage processes in the manufacturing enterprises are as much effectively executed as common possibilities of their own information and communication technologies and their application´s rate are effectively utilized. In the small and medium enterprises (SME, divisions or responsible specialists that have to manage such processes do not always exist. It is the cause that exact specification of information and communication processes creating information management support absents or is inaccurately determined. We pointed on the frequently occurring case when the data format is not supported with enterprise information systems. In 2012, we were researching how information supports of logistic and carriage processes are made in the small and medium enterprises. We were trying to find out some difficulties as well as causes occurred by cooperation between manufacturing enterprises in the international environment to do them more effectively. We have summarized our researching in this article.

  17. Throat Carriage Rate and Antimicrobial Resistance of Streptococcus pyogenes In Rural Children in Argentina.

    Science.gov (United States)

    Delpech, Gastón; Sparo, Mónica; Baldaccini, Beatriz; Pourcel, Gisela; Lissarrague, Sabina; García Allende, Leonardo

    2017-03-01

    The aim of this study was to determine the prevalence of asymptomatic carriers of group A β-hemolytic streptococci (GAS) in children living in a rural community and to investigate the association between episodes of acute pharyngitis and carrier status. Throat swabs were collected from September to November 2013 among children 5-13 years of age from a rural community (Maria Ignacia-Vela, Argentina). The phenotypic characterization of isolates was performed by conventional tests. Antimicrobial susceptibility was assayed for penicillin, tetracycline, chloramphenicol, erythromycin, and clindamycin (disk diffusion). The minimum inhibitory concentration was determined for penicillin, cefotaxime, tetracycline, and erythromycin. The carriage of β-hemolytic streptococci was detected in 18.1% of participants, with Streptococcus pyogenes in 18 participants followed by S. dysgalactiae ssp. equisimilis in 5. The highest proportion of GAS was found in 8 to 10-year-old children. No significant association between the number of episodes of acute pharyngitis suffered in the last year and the carrier state was detected (p>0.05). Tetracycline resistance (55.5%) and macrolide-resistant phenotypes (11.1%) were observed. Resistance to penicillin, cefotaxime, or chloramphenicol was not expressed in any streptococcal isolate. The present study demonstrated significant throat carriage of GAS and the presence of group C streptococci (S. dysgalactiae ssp. equisimilis) in an Argentinian rural population. These results point out the need for continuous surveillance of GAS and non-GAS carriage as well as of antimicrobial resistance in highly susceptible populations, such as school-aged rural children. An extended surveillance program including school-aged children from different cities should be considered to estimate the prevalence of GAS carriage in Argentina.

  18. Rate of Carriage, Serotype Distribution and Penicilin Resistance of Streptococcus pneumoniae in Healty Children

    OpenAIRE

    ŞENER, Burçin

    1999-01-01

    The purpose of this study was to define carriage rates for Streptococcus pneumoniae in a given population in Ankara and also to determine the sertypes and penicilin resistance of these strains. Oropharyngeal swabs were taken from a total of 661 children between 1 and 11 years of age living in a province of Ankara between January 1995 and January 1997. Serotyping was performed by detection of the Quellung reaction. Penicilin susceptibilities of the isolates were screened by agar dilution metho...

  19. Higher prevalence of coagulase-negative staphylococci carriage among reclaimed water spray irrigators.

    Science.gov (United States)

    Goldstein, Rachel Rosenberg; Kleinfelter, Lara; He, Xin; Micallef, Shirley A; George, Ashish; Gibbs, Shawn G; Sapkota, Amy R

    2017-10-01

    Coagulase negative staphylococci (CoNS) are leading causes of nosocomial infections and community-acquired methicillin-resistant CoNS (MRCoNS) infections are increasing. CoNS have been previously detected in reclaimed water. To date, no studies have evaluated the prevalence of CoNS carriage among humans exposed to reclaimed water in the U.S. We examined the prevalence and odds of CoNS and antibiotic-resistant CoNS carriage in spray irrigators exposed to reclaimed water compared to controls. We collected nasal and dermal swab samples from 19 reclaimed water spray irrigation workers (n=96 total samples) and 24 controls (n=92 total samples). Samples were analyzed for CoNS using culture-based assays. Isolates were confirmed using biochemical tests and PCR. Antimicrobial susceptibility testing was performed using disk diffusion. Data were analyzed by two-sample proportion tests, logistic regression, and generalized linear mixed effects models. The prevalence of CoNS, antibiotic-resistant CoNS, and MRCoNS carriage among spray irrigation workers was 79% (15/19), 32% (6/19), and 16% (3/19), compared to 13% (3/24), 4% (1/24), and 0% (0/24) of controls. Spray irrigators were more likely to be carriers of CoNS (p<0.01), antibiotic-resistant CoNS (p<0.01), and MRCoNS (p=0.02) compared to controls. The odds of CoNS carriage significantly increased with exposure to reclaimed water (p=0.04) even accounting for changes over time (p=0.05). Our data highlight the need to further examine the potential dissemination of CoNS and antibiotic-resistant CoNS from reclaimed water into the environment and human communities and related public health implications. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Nasal Carriage of Staphylococcus intermedius in Humans in Contact with Dogs

    OpenAIRE

    Harvey, R G; Marples, R. R.; Noble, W. C.

    2011-01-01

    A study of staphylococci isolated from the anterior nares of 16 owners of dogs with atopic dermatitis and 13 veterinary practice staff in constant contact with dogs was conducted. There was one persistent nasal carrier and four transient nasal carriers of Staphylococcus intermedius. This carriage rate is higher than previously reported and presumably contributes to the presence of antibodies to S. intermedius in about 20 per cent of the normal population. Thus transfer of S. intermedius from ...