Clinical Characteristics and Outcome of Patients with Invasive Pneumococcal Disease, Puy-de-Dôme, France, 1994–1998

2001 ◽  
Vol 20 (5) ◽  
pp. 299-308 ◽  
Author(s):  
H. Laurichesse ◽  
J. P. Romaszko ◽  
L. T. Nguyen ◽  
B. Souweine ◽  
V. Poirier ◽  
...  
2018 ◽  
Vol Volume 11 ◽  
pp. 2461-2469 ◽  
Author(s):  
Kang Cai ◽  
Yizhong Wang ◽  
Zhongqin Guo ◽  
Xiaonan Xu ◽  
Huajun Li ◽  
...  

2001 ◽  
Vol 20 (5) ◽  
pp. 0299-0308 ◽  
Author(s):  
H. Laurichesse ◽  
J. P. Romaszko ◽  
L. T. Nguyen ◽  
B. Souweine ◽  
V. Poirier ◽  
...  

2011 ◽  
Vol 22 (4) ◽  
pp. 137-141 ◽  
Author(s):  
Jennie Johnstone ◽  
Gregory J. Tyrrell ◽  
Thomas J. Marrie ◽  
Sipi Garg ◽  
James D. Kellner ◽  
...  

The objective of this study was to describe the epidemiology, clinical characteristics, microbiology and outcomes of patients of all ages withStreptococcus pneumoniaemeningitis between 2000 and 2004; two years pre- and postintroduction of anS pneumoniae7-valent conjugate vaccine program in Alberta in children younger than two years of age. The high mortality rate associated withS pneumoniaemeningitis, despite appropriate therapy, suggests that prevention ofS pneumoniaemeningitis is critical. Despite implementation of a PCV-7 program in Alberta, rates ofS pneumoniaemeningitis in children younger than two years of age is still high. Thus, continued research into safe and efficacious vaccines covering a broader range ofS pneumoniaeserotypes is necessary.OBJECTIVE: To describe the epidemiology, clinical characteristics, microbiology and outcomes of patients of all ages withStreptococcus pneumoniaemeningitis two years pre- and postintroduction of aS pneumoniae7-valent conjugate vaccine program in Alberta in children <2 years of age.METHODS: Between 2000 and 2004, all cases of invasive pneumococcal disease in Alberta were identified. From this cohort, patients withS pneumoniaemeningitis were identified by chart review. Clinical data, laboratory data and in-hospital outcomes were collected.RESULTS: Of the 1768 cases of invasive pneumococcal disease identified between 2000 and 2004, 110 (6.2%) hadS pneumoniaemeningitis. The overall incidence was 0.7 per 100,000 persons and remained unchanged over the study period. The rate in children <2 years of age appeared to fall over time, from 10.5 per 100,000 persons in 2000 to five per 100,000 persons in 2004, although there was insufficient evidence of a statistically significant time trend within any age group. Overall, the mean age was 30 years and 47% were male. In-hospital mortality was 20%, ranging from 6% in those ≤2 years of age to 31% for those ≥18 years of age, despite appropriate antimicrobial therapy.CONCLUSION: The high mortality rate associated withS pneumoniaemeningitis suggests that prevention by vaccination is critical. In children <2 years of age, there was a downward trend in the rate ofS pneumoniaemeningitis after implementation of theS pneumoniae7-valent conjugate vaccine program, but rates were still high.


2020 ◽  
Vol 71 (8) ◽  
pp. e235-e243 ◽  
Author(s):  
Zahin Amin-Chowdhury ◽  
Sarah Collins ◽  
Carmen Sheppard ◽  
David Litt ◽  
Norman K Fry ◽  
...  

Abstract Background England is experiencing a rapid increase in invasive pneumococcal disease (IPD) caused by serotypes 8, 12F, and 9N; their clinical characteristics and outcomes have not been described. Methods Public Health England conducts national IPD surveillance. Cases due to emerging serotypes were compared with those included in the 13-valent pneumococcal conjugate vaccine (PCV13) and the remaining non-PCV13 serotypes. Results There were 21 592 IPD cases during 2014–15 to 2017–18, including 20 108 (93.1%) with serotyped isolates and 17 450 (86.8%) with completed questionnaires. PCV13 serotypes were responsible for 20.1% (n = 4033), while serotype 8 (3881/20 108 [19.3%]), 12F (2365/20 108 [11.8%]), and 9N (1 296/20 108 [6.4%]) were together responsible for 37.5% of cases. Invasive pneumonia was the most common presentation (11 424/16 346 [69.9%]) and, overall, 67.0% (n = 11 033) had an underlying comorbidity. The median age (interquartile range) at IPD due to serotypes 8 (59 [45–72] years) and 12F (56 [41–70] years) was lower than serotype 9N (67 [53–80] years), PCV13 serotypes (68 [52–81] years), and remaining non-PCV13 serotypes (70 [53–82] years). Serotype 9N IPD cases also had higher comorbidity prevalence (748/1087 [68.8%]) compared to serotype 8 (1901/3228 [58.9%]) or 12F (1042/1994 [52.3%]), and higher case fatality (212/1128 [18.8%]) compared to 8.6% (291/3365) or 10.0% (209/2086), respectively. Conclusions Serotypes 8 and 12F were more likely to cause IPD in younger, healthier individuals and less likely to be fatal, while serotype 9N affected older adults with comorbidities and had higher case fatality.


Author(s):  
Jordi Càmara ◽  
Inmaculada Grau ◽  
Aida González-Díaz ◽  
Fe Tubau ◽  
Laura Calatayud ◽  
...  

Abstract Objectives To analyse the clonal dynamics and clinical characteristics of adult invasive pneumococcal disease (IPD) caused by MDR and penicillin-non-susceptible (PNS) pneumococci in Spain. Methods All adult IPD episodes were prospectively collected (1994–2018). Streptococcus pneumoniae isolates were serotyped, genotyped and tested for antimicrobial susceptibility. Changes in the incidence of IPD were analysed and risk factors contributing to MDR were assessed by logistic regression. Results Of 2095 IPD episodes, 635 (30.3%) were caused by MDR/PNS isolates. Over the study period, the incidence of MDR/PNS-IPD decreased (IRR 0.70; 95% CI 0.53–0.93) whereas that of susceptible isolates remained stable (IRR 0.96; 95% CI 0.80–1.16). A reduction of resistance rates to penicillin (–19.5%; 95% CI –37% to 2%) and cefotaxime (–44.5%; 95% CI –64% to –15%) was observed. Two clones, Spain9V-ST156 and Denmark14-ST230, accounted for 50% of current resistant disease. Among current MDR/PNS isolates, 45.8% expressed serotypes not covered by the upcoming PCV15/PCV20 vaccines. MDR/PNS episodes were associated with older patients with comorbidities, nosocomial acquisition and higher 30 day mortality. MDR/PNS pneumococci were not independently associated with 30 day mortality in multivariate analysis [OR 0.826 (0.648–1.054)]. Conclusions Our study shows an overall reduction of MDR/PNS isolates in adults after the introduction of pneumococcal conjugate vaccines. However, a significant proportion of current resistant isolates are not covered by any of the upcoming PCV15/PCV20 vaccines. The burden of resistant disease is related to older patients with underlying conditions and caused by two major clones. Our data show that MDR is not a statistically significant factor related to increased mortality.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Paula O. Narváez ◽  
Salome Gomez-Duque ◽  
Juan E. Alarcon ◽  
Paula C. Ramirez-Valbuena ◽  
Cristian C. Serrano-Mayorga ◽  
...  

Abstract Background The incidence of invasive pneumococcal disease (IPD) varies depending on a number of factors, including vaccine uptake, in both children and adults, the geographic location, and local serotype prevalence. There are limited data about the burden of Streptococcus pneumoniae (Spn), serotype distribution, and clinical characteristics of adults hospitalized due to IPD in Colombia. The objectives of this study included assessment of Spn serotype distribution, clinical characteristics, mortality, ICU admission, and the need for mechanical ventilation. Methods This was an observational, retrospective, a citywide study conducted between 2012 and 2019 in Bogotá, Colombia. We analyzed reported positive cases of IPD from 55 hospitals in a governmental pneumococcal surveillance program. Pneumococcal strains were isolated in each hospital and typified in a centralized laboratory. This is a descriptive study stratified by age and subtypes of IPD obtained through the analysis of medical records. Results A total of 310 patients with IPD were included, of whom 45.5% were female. The leading cause of IPD was pneumonia (60%, 186/310), followed by meningitis. The most frequent serotypes isolated were 19A (13.87%, 43/310) and 3 (11.94%, 37/310). The overall hospital mortality rate was 30.3% (94/310). Moreover, 52.6% (163/310 patients) were admitted to the ICU, 45.5% (141/310) required invasive mechanical ventilation and 5.1% (16/310) non-invasive mechanical ventilation. Conclusion Pneumococcal pneumonia is the most prevalent cause of IPD, with serotypes 19A and 3 being the leading cause of IPD in Colombian adults. Mortality due to IPD in adults continues to be very high.


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