scholarly journals Streptococcus pneumoniaemeningitis in Alberta pre- and postintroduction of the 7-valent pneumococcal conjugate vaccine

2011 ◽  
Vol 22 (4) ◽  
pp. 137-141 ◽  
Author(s):  
Jennie Johnstone ◽  
Gregory J. Tyrrell ◽  
Thomas J. Marrie ◽  
Sipi Garg ◽  
James D. Kellner ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Mortality Rate ◽  
Conjugate Vaccine ◽  
Invasive Pneumococcal Disease ◽  
High Mortality ◽  
Clinical Characteristics ◽  
Pneumococcal Disease ◽  
Laboratory Data ◽  
Appropriate Therapy ◽  
Meningitis In Children

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.

scholarly journals Characteristics of Invasive Pneumococcal Disease Caused by Emerging Serotypes After the Introduction of the 13-Valent Pneumococcal Conjugate Vaccine in England: A Prospective Observational Cohort Study, 2014–2018

2020 ◽  
Vol 71 (8) ◽  
pp. e235-e243 ◽  
Author(s):  
Zahin Amin-Chowdhury ◽  
Sarah Collins ◽  
Carmen Sheppard ◽  
David Litt ◽  
Norman K Fry ◽  
...  
Keyword(s):  
Conjugate Vaccine ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Conjugate Vaccine ◽  
Clinical Characteristics ◽  
Pneumococcal Disease ◽  
Case Fatality ◽  
Observational Cohort Study ◽  
Prospective Observational Cohort Study ◽  
Common Presentation ◽  
Observational Cohort

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.

scholarly journals Retrospective study of prognostic factors in pediatric invasive pneumococcal disease

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e2941 ◽  
Author(s):  
Nan-Chang Chiu ◽  
Hsin Chi ◽  
Chun-Chih Peng ◽  
Hung-Yang Chang ◽  
Daniel Tsung-Ning Huang ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Mortality Rate ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Large Scale ◽  
Small Sample Size ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Small Sample ◽  
Significant Prognostic Factor

Streptococcus pneumoniaeremains the leading causative pathogen in pediatric pneumonia and bacteremia throughout the world. The invasive pneumococcal disease (IPD) is known as isolation ofS. pneumoniaefrom a normally sterile site (e.g., blood, cerebrospinal fluid, synovial fluid, pericardial fluid, pleural fluid, or peritoneal fluid). The aim of this study is to survey the clinical manifestations and laboratory results of IPD and identify the prognostic factors of mortality. From January 2001 to December 2006, a retrospective review of chart was performed in a teaching hospital in Taipei. The hospitalized pediatric patients with the diagnosis of pneumonia, arthritis, infectious endocarditis, meningitis or sepsis were recruited. Among them, 50 patients were pneumococcal infections proved by positive culture results or antigen tests. Clinical manifestations, laboratory data and hospitalization courses were analyzed. The median age was 3.5-year-old and there were 30 male patients (60%). Eight patients (16%) had underlying disease such as leukemia or congenital heart disease. Hemolytic uremic syndrome (HUS) was observed in ten patients and extracorporeal membrane oxygenation (ECMO) was performed in three patients. Leukocytosis, elevated C-reactive protein and AST level were noted in most of the patients. The overall mortality rate was 10%. We found that leukopenia, thrombocytopenia and high CRP level were significant predictors for mortality. In conclusion,S. pneumoniaeremains an important health threat worldwide and IPD is life-threatening with high mortality rate. We found leukopenia, thrombocytopenia, and high CRP levels to be associated with mortality in pediatric IPD, and these factors are worthy of special attention at admission. Although we failed to identify a statistically significant prognostic factor in multivariate analysis due to relatively small sample size, we suggest an aggressive antibiotic treatment in patients with these factors at admission. Further large-scale studies are warranted.

Long-term Impact of Pneumococcal Conjugate Vaccines on Invasive Disease and Pneumonia Hospitalizations in Indigenous and Non-Indigenous Australians

2019 ◽  
Vol 70 (12) ◽  
pp. 2607-2615
Author(s):  
Kelley N Meder ◽  
Sanjay Jayasinghe ◽  
Frank Beard ◽  
Aditi Dey ◽  
Martyn Kirk ◽  
...  
Keyword(s):  
Indigenous People ◽  
Conjugate Vaccine ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Conjugate Vaccine ◽  
Pneumococcal Disease ◽  
Laboratory Data ◽  
Community Acquired Pneumonia ◽  
Indirect Impact ◽  
Long Term Impact

Abstract Background Universal pneumococcal conjugate vaccine (PCV) programs began in Indigenous Australian children in 2001 and all children in 2005, changing to 13-valent PCV (PCV13) in 2011. We used laboratory data for invasive pneumococcal disease (IPD) and coded hospitalizations for noninvasive pneumococcal community-acquired pneumonia (PnCAP) to evaluate long-term impact. Methods Annual incidence (per 100 000 population) was calculated for age-specific total IPD, PCV13 non–7-valent PCV (PCV7) serotypes, and PnCAP by Indigenous status. Incidence in the pre–universal PCV7 (2002–2004), early PCV7 (2005–2007), pre-PCV13 (2008 to mid-2011), and post-PCV13 (mid-2011 to 2016) periods was used to calculate incidence rate ratios (IRRs). Results In the total population, all-age incidence of IPD declined from 11.8 pre-PCV7 to 7.1 post-PCV13 (IRR, 0.61 [95% confidence interval {CI}, .59–.63]) but for PnCAP declined among ages &lt;1 year (IRR, 0.34 [95% CI, .25–.45]) and 1–4 years (IRR, 0.50 [95% CI, .43–.57]) but increased significantly among age ≥5 years (IRRs, 1.08–1.14). In Indigenous people, baseline PCV13 non-PCV7 IPD incidence was 3-fold higher, amplified by a serotype 1 epidemic in 2011. By 2015–2016, although incidence of IPD and PnCAP in children aged &lt;5 years decreased by 38%, neither decreased in people aged ≥5 years. Conclusions Fifteen years post-PCV and 5 years post-PCV13, direct and indirect impact on IPD and PnCAP differed by age and between Indigenous and non-Indigenous people, with potential implications for long-term PCV impact in comparable settings. Fifteen years after pneumococcal conjugate vaccine (PCV) introduction and 5 years post-PCV13, direct and indirect impact on invasive pneumococcal disease and pneumococcal community-acquired pneumonia differed by age and between Indigenous and non-Indigenous people, with potential implications for long-term PCV impact in comparable settings.

scholarly journals Gram-Positive Diplococci in a Cerebrospinal Fluid Gram Stain

2016 ◽  
Vol 3 (4) ◽  
Author(s):  
Jennifer P. Collins ◽  
Lars F. Westblade ◽  
Evan J. Anderson
Keyword(s):  
Cerebrospinal Fluid ◽  
Streptococcus Pneumoniae ◽  
Conjugate Vaccine ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Conjugate Vaccine ◽  
Pneumococcal Disease ◽  
Blood Cultures ◽  
Gram Stain ◽  
Gram Positive ◽  
Clear Area

Abstract A 5-month-old girl presented with meningitis after receiving amoxicillin for bilateral otitis media. The cerebrospinal fluid (CSF) Gram stain suggested Streptococcus pneumoniae: Gram-positive diplococci with a surrounding clear area indicative of a bacterial capsule. Her CSF and blood cultures grew penicillin-resistant S pneumoniae serotype 35B. This serotype is not included in the 13-valent pneumococcal conjugate vaccine (PCV-13) and has been identified as a cause of invasive pneumococcal disease in the post-PCV-13 era.

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