scholarly journals Clinical Profile of Invasive Pneumococcal Disease in Patan Hospital, Nepal

2012 ◽  
Vol 9 (1) ◽  
pp. 45-49 ◽  
Author(s):  
U D Chhetri ◽  
S Shrestha ◽  
R Pradhan ◽  
A Shrestha ◽  
N Adhikari ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Pneumococcal Infection ◽  
Clinical Profile ◽  
Female Ratio ◽  
Sensitivity Pattern ◽  
Case Files ◽  
Antibiotics Sensitivity ◽  
Almost All

Background Pneumococcal infection is one of the leading causes of pneumonia, meningitis and septicemia in developing countries. It accounts for one million deaths each year in children. Objectives The objective of this study is to see the clinical profile of invasive pneumococcal disease, antibiotics sensitivity pattern and prevalent serotypes in children admitted at Patan Hospital. Methods This is a retrospective analytical study conducted in the department of Paediatrics, Patan hospital. The lab data of those children who grew pneumococci in their blood, cerebrospinal fluid or body fluids over a period of 3 years (January 2007 to Dec 2009) were collected and the case files were then studied. Results Out of 42 cases of invasive pneumococcal diseases studied admitted diagnoses included pneumonia, febrile seizure, bacteremia or septicemia, meningitis, acute gastroenteritis and glomerulonephritis. Twenty seven of them were children under five. The male to female ratio was 1.7:1. On investigation 64%, 52% and 5% of the patients had leucocytosis, anaemia, and leucopenia respectively. Twenty six of them had radiological changes suggestive of pneumonia. Streptococcus pneumoniae grew in 38 blood samples, 5 cerebrospinal fluid and 3 pleural fluids. Almost all of these isolates were sensitive to penicillin, cefotaxime, amoxycillin, choloramphenicol, erythromycin and ofloxacin and resistant to cotrimoxazole and gentamicin.Pneumococcal serotypes found in our study were 1, 14, 5, 23B, 6B, 8, 9A, 9V, 10A, 15 and 23F (11 serotypes). ConclusionsPenicillin is still the most effective antibiotic for streptococcal infection in our study. Of the pneumococcal serotypes identified; 36% were covered by the 7-valent pneumococcal conjugate vaccine, 54% each by PCV-10 and PCV-13, and 72% by the e 23 valent vaccines.http://dx.doi.org/10.3126/kumj.v9i1.6262 Kathmandu Univ Med J 2011;9(1):45-9

scholarly journals Pediatric Invasive Pneumococcal Disease Three Years after PCV13 Introduction in the National Immunization Plan—The Continued Importance of Serotype 3

2021 ◽  
Vol 9 (7) ◽  
pp. 1428
Author(s):  
Catarina Silva-Costa ◽  
Joana Gomes-Silva ◽  
Lúcia Prados ◽  
Mário Ramirez ◽  
José Melo-Cristino ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Antimicrobial Resistance ◽  
Conjugate Vaccine ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Molecular Methods ◽  
Vaccine Uptake ◽  
Serotype Distribution ◽  
Conjugate Vaccines ◽  
National Immunization

The introduction of pneumococcal conjugate vaccines PCV7 and PCV13 led to decreases in incidence of pediatric invasive pneumococcal disease (pIPD) and changes in serotype distribution. We evaluated the consequences of higher vaccine uptake after the introduction of PCV13 in the National Immunization Plan (NIP) in 2015. Besides culture and conventional serotyping, the use of molecular methods to detect and serotype pneumococci in both pleural and cerebrospinal fluid samples contributed to 30% of all pIPD (n = 232) in 2015–2018. The most frequently detected serotypes were: 3 (n = 59, 26%), 10A (n = 17, 8%), 8 (n = 16, 7%) and 19A (n = 10, 4%). PCV13 serotypes still accounted for 46% of pIPD cases. Serotypes not included in any currently available conjugate vaccine (NVT) are becoming important causes of pIPD, with the increases in serotypes 8 and 33F being of particular concern given the importance of serotype 8 in adult IPD and the antimicrobial resistance of serotype 33F isolates. This study highlights the importance of using molecular methods in pIPD surveillance since these allowed a better case ascertainment and the identification of serotype 3 as the leading cause of pIPD. Even in a situation of vaccine uptake >95% for 3 years, PCV13 serotypes remain important causes of pIPD.

scholarly journals Invasive Pneumococcal Disease: Still Lots to Learn and a Need for Standardized Data Collection Instruments

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
T. J. Marrie ◽  
G. J. Tyrrell ◽  
Sumit R. Majumdar ◽  
Dean T. Eurich
Keyword(s):  
Pulmonary Embolism ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Functional Limitations ◽  
Clinical Information ◽  
Population Based ◽  
Homeless Persons ◽  
Preventative Measures ◽  
Almost All ◽  
Time Of Admission

Background.Large studies of invasive pneumococcal disease (IPD) are frequently lacking detailed clinical information.Methods.A population-based 15-year study of IPD in Northern Alberta.Results.2435 patients with a mean age of 54.2 years formed the study group. Males outnumbered females and Aboriginal and homeless persons were overrepresented. High rates of smoking, excessive alcohol use, and illicit drug use were seen. Almost all (87%) had a major comorbidity and 15% had functional limitations prior to admission. Bacteremia, pneumonia, and meningitis were the most common major manifestations of IPD. Almost half of the patients had alteration of mental status at the time of admission and 22% required mechanical ventilation. Myocardial infarction, pulmonary embolism, and new onset stroke occurred in 1.7, 1.3, and 1.1% of the patients, respectively; of those who had echocardiograms, 35% had impaired ventricular function. The overall in-hospital mortality was 15.6%.Conclusions.IPD remains a serious infection in adults. In addition to immunization, preventative measures need to consider the sociodemographic features more carefully. A standard set of data need to be collected so that comparisons can be made from study to study. Future investigations should target cardiac function and pulmonary embolism prevention in this population.

scholarly journals Cigarette Smoke Attenuates the Nasal Host Response to Streptococcus pneumoniae and Predisposes to Invasive Pneumococcal Disease in Mice

2016 ◽  
Vol 84 (5) ◽  
pp. 1536-1547 ◽  
Author(s):  
Pamela Shen ◽  
Mathieu C. Morissette ◽  
Gilles Vanderstocken ◽  
Yang Gao ◽  
Muhammad Hassan ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Cigarette Smoke ◽  
Invasive Pneumococcal Disease ◽  
Bacterial Infections ◽  
Pneumococcal Disease ◽  
Pneumococcal Infection ◽  
Cigarette Smoke Exposure ◽  
Upper Respiratory Tract ◽  
Content Type ◽  
Pneumococcal Colonization

Streptococcus pneumoniaeis a leading cause of invasive bacterial infections, with nasal colonization an important first step in disease. While cigarette smoking is a strong risk factor for invasive pneumococcal disease, the underlying mechanisms remain unknown. This is partly due to a lack of clinically relevant animal models investigating nasal pneumococcal colonization in the context of cigarette smoke exposure. We present a model of nasal pneumococcal colonization in cigarette smoke-exposed mice and document, for the first time, that cigarette smoke predisposes to invasive pneumococcal infection and mortality in an animal model. Cigarette smoke increased the risk of bacteremia and meningitis without prior lung infection. Mechanistically, deficiency in interleukin 1α (IL-1α) or platelet-activating factor receptor (PAFR), an important host receptor thought to bind and facilitate pneumococcal invasiveness, did not rescue cigarette smoke-exposed mice from invasive pneumococcal disease. Importantly, we observed cigarette smoke to attenuate nasal inflammatory mediator expression, particularly that of neutrophil-recruiting chemokines, normally elicited by pneumococcal colonization. Smoking cessation during nasal pneumococcal colonization rescued nasal neutrophil recruitment and prevented invasive disease in mice. We propose that cigarette smoke predisposes to invasive pneumococcal disease by suppressing inflammatory processes of the upper respiratory tract. Given that smoking prevalence remains high worldwide, these findings are relevant to the continued efforts to reduce the invasive pneumococcal disease burden.

scholarly journals Invasive pneumococcal infection in South and West England

1998 ◽  
Vol 120 (2) ◽  
pp. 117-123 ◽  
Author(s):  
M. D. SMITH ◽  
J. STUART ◽  
N. J. ANDREWS ◽  
W. A. TELFER BRUNTON ◽  
K. A. V. CARTWRIGHT
Keyword(s):  
Blood Culture ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Statistical Significance ◽  
Pneumococcal Infection ◽  
Vaccine Uptake ◽  
Pneumococcal Infections ◽  
Sex Structure ◽  
Catchment Population ◽  
Admission Rates

Variation in the incidence of invasive pneumococcal disease across South and West England, in 1995, was measured through a survey of microbiology laboratories. A 100% response rate was achieved. The incidence by laboratory varied between 5·2 and 20·4 per 100000 catchment population (P<0·001). Adjusting for pneumococcal vaccine uptake rate in over 65 year olds, hospital admission rates, blood culture system used and for the age and sex structure of the population, did not account for this variation. When blood culture sampling rates were included in a logistic regression model, the variation between laboratories was much less and of lower statistical significance (P=0·019). Higher rates of blood culture sampling were associated with a higher incidence of invasive pneumococcal disease. Consistently high sampling should be encouraged because a higher diagnostic rate should result in more selective prescribing of antibiotics, and secondly because improved ascertainment of severe pneumococcal infections is a prerequisite for the evaluation of new pneumococcal conjugate vaccines.

scholarly journals Clinical Profile and Sensitivity Pattern of Salmonella Serotypes in Children: A Hospital Based Study

2011 ◽  
Vol 31 (3) ◽  
pp. 180-183 ◽  
Author(s):  
BG Joshi ◽  
K Keyal ◽  
R Pandey ◽  
BM Shrestha
Keyword(s):  
Salmonella Enterica ◽  
Enteric Fever ◽  
Wide Spectrum ◽  
Clinical Profile ◽  
Age Group ◽  
Cross Sectional ◽  
Female Ratio ◽  
Sensitivity Pattern ◽  
Study Results ◽  
Culture Positive

Introduction: Enteric fever is a systemic infection caused by the bacteria, Salmonella enterica serovar Typhi (S.typhi) and Salmonella enterica serovara Paratyphi (S. paratyphi A, B and C). Most of the burden of the disease is limited to the developing world and the disease still has the issues like wide spectrum of clinical presentation and multidrug resistance. Objectives: This study was done to analyze the clinical profile and antibiotic sensitivity pattern in the cases of culture positive enteric fever. Methods: A prospective cross-sectional study was conducted in Civil Service Hospital from February 2010 to January 2011 in the paediatric population in the age group of 2 to 14 years. Children with Salmonella species isolated in blood culture were included in the study. Results: Out of the 40 children with culture positive enteric fever, male to female ratio was 1.3:1 with common age group between 11-14 years. S typhi was isolated in 25 cases while S. paratyphi in 15 cases. Clinical features of S. typhi and S. paratyphi were indistinguishable. Both S.typhi and S. paratyphi were found to be 100% sensitive to drugs like Ceftriaxone, Cefotaxime, Cefixime and Chloramphenicol. Sensitivity to Ofloxacin was 100% in S. paratyphi and 92% in S.typhi. Similarly sensitivity of Azithromycin was 92% and 93% for S.typhi and S. paratyphi respectively. Conclusion: Salmonella serotype is still 100 % sensitive to third generation cephalosporin. Some percentage of resistance is seen with Ofloxacin in S. typhi and with Azithromycin in both S.typhi and S. paratyphi. Key words: Enteric fever; S.typhi; S.paratyphi; Sensitivity DOI: http://dx.doi.org/10.3126/jnps.v31i3.4382 J Nep Paedtr Soc 2011;31(3): 180-183

Risk factor analysis for pneumococcal meningitis in adults with invasive pneumococcal infection

2010 ◽  
Vol 138 (9) ◽  
pp. 1353-1358 ◽  
Author(s):  
I. BURCKHARDT ◽  
F. BURCKHARDT ◽  
M. VAN DER LINDEN ◽  
C. HEEG ◽  
R. R. REINERT
Keyword(s):  
Risk Factors ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Pneumococcal Meningitis ◽  
Pneumococcal Infection ◽  
Case Fatality ◽  
Developed Countries ◽  
Population Based ◽  
Reference Centre ◽  
Serotype 1

SUMMARYPneumococcal meningitis is a subgroup of invasive pneumococcal disease with a case-fatality rate of up to 30% and long-term sequelae in more than 50% of cases in adults in developed countries. We aimed to determine risk factors for this particular form of pneumococcal disease. We conducted a prospective population-based laboratory study of invasive pneumococcal disease in adults in North-Rhine-Westphalia, Germany from February 2001 to August 2006. All isolates underwent serotyping and susceptibility testing at the National Reference Centre for Streptococci in Aachen, Germany. Data were analysed using multiple linear regression. A total of 1043 isolates from bacteraemia and 131 isolates from meningitis were included into the study. Serotype 23F and being female were independent risk factors for pneumococcal meningitis. Being ⩾60 years and serotype 1 were associated with a reduced odds ratio. Season, penicillin and macrolide resistance were not statistically associated with CNS involvement.

scholarly journals Distribution and Variation of Serotypes and Pneumococcal Surface Protein A Clades of Streptococcus pneumoniae Strains Isolated From Adult Patients With Invasive Pneumococcal Disease in Japan

2021 ◽  
Vol 11 ◽  
Author(s):  
Bin Chang ◽  
Yuki Kinjo ◽  
Masatomo Morita ◽  
Kosuke Tamura ◽  
Hiroshi Watanabe ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Protein A ◽  
Surface Protein ◽  
Vaccine Serotypes ◽  
Pneumococcal Surface Protein A ◽  
Clade 1 ◽  
Almost All ◽  
Candidate Antigen

Pneumococcal surface protein A (PspA) is a surface protein of Streptococcus pneumoniae that may be a candidate antigen for new pneumococcal vaccines. This study investigates the distribution of PspA clades of the causative strains of adult invasive pneumococcal disease (IPD) in Japan. Of the 1,939 strains isolated from cases of adult IPD during 2014–2019, the PspA clades of 1,932 (99.6%) strains were determined, and no pspA was detected in the remaining 7 strains (0.4%). PspA clades 1–6 were detected in 786 (40.5%), 291 (15.0%), 443 (22.8%), 369 (19.0%), 33 (1.7%), and 6 (0.3%) strains, respectively. New PspA clades (0.2%) were identified in two non-typeable and two serotype 35B pneumococci. The proportions of clade 1 and clade 2 showed significantly decreased and increased trends, respectively. Furthermore, the PspA clade of pneumococcal strains was partially serotype- and sequence type-dependent. The majority of strains belonging to serotypes contained in both the 13-valent pneumococcal conjugate vaccine (PCV13) and the 23-valent pneumococcal polysaccharide vaccine (PPSV23) belonged to PspA clades 1 or 3. In contrast, the distribution of clades in non-vaccine serotypes was wider than that of vaccine serotype pneumococci. Our findings demonstrate that almost all pneumococcal strains from adult IPD express PspA clades 1–4, especially for non-vaccine serotypes. These results may be useful for the development of a new pneumococcal vaccine with PspA.

scholarly journals The epidemiology of pneumococcal infection in children in the developing world

1999 ◽  
Vol 354 (1384) ◽  
pp. 777-785 ◽  
Author(s):  
Brian Greenwood
Keyword(s):  
Young Children ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Developing World ◽  
Pneumococcal Infection ◽  
Field Trials ◽  
Industrialized Countries ◽  
Pneumococcal Infections ◽  
Increased Risk ◽  
Meningitis In Children

Pneumonia causes about three million deaths a year in young children, nearly all of which are in developing countries. Streptococcus pneumoniae (the pneumococcus) is the most important bacterial cause of pneumonia in young children and so is likely to be responsible for a high proportion of these deaths. The pneumococcus is also responsible for a substantial proportion of the 100 000–500 000 deaths that occur from meningitis in children each year. The incidence of invasive pneumococcal disease in children in the developing world is several times higher than in industrialized countries. This discrepancy may, in part, be due to socio–economic differences but genetic factors may also play a role. Children with sickle cell disease have a substantially increased risk of invasive pneumococcal infection and a search is being made for other possible genetic risk factors. Infection with human immunodeficiency virus (HIV) also predisposes to invasive pneumococcal disease and so the incidence of this disease in young children is expected to rise as increasing numbers of African and Asian children are born with a perinatally acquired HIV infection. Until recently, pneumococcal infections could be treated effectively with penicillin, a cheap and safe antibiotic. However, pneumococci that are resistant to penicillin are becoming prevalent in many countries, necessitating a change to more costly antibiotics which may be beyond the reach of the health services of poor, developing counties. The spread of antibiotic resistance has provided an added stimulus to the development of vaccines that might be able to prevent pneumococcal disease in infants. Recently developed polysaccharide–protein conjugate vaccines show promise and are now undergoing field trials. How deployment of these vaccines will influence the balance between invasive pneumococcal infections and asymptomatic nasopharyngeal carriage of pneumococci is uncertain.

scholarly journals Incidence of invasive pneumococcal disease and distribution of capsular types of pneumococci in Denmark, 1989–94

1996 ◽  
Vol 117 (3) ◽  
pp. 411-416 ◽  
Author(s):  
S. V. Nielsen ◽  
J. Henrichsen
Keyword(s):  
Cerebrospinal Fluid ◽  
Streptococcus Pneumoniae ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Susceptibility Testing ◽  
The Elderly ◽  
Invasive Disease ◽  
Annual Number ◽  
Elderly Age ◽  
Capsular Typing

SummaryDuring the period 1989–94, 4620 strains ofStreptococcus pneumoniae(4063 from blood and 557 from cerebrospinal fluid), from cases of invasive disease in Denmark, were received for capsular typing and penicillin susceptibility testing. During the study period the incidence of bacteraemic pneumococcal disease increased from 10 to 18 cases per 100000 inhabitants per year. The highest rates were seen in the very young, age less than 5 years (23/100000/year, in 1994), and in the elderly, age greater than 60 years (55/100000/year, in 1994). The annual number of cases of meningitis did not vary.Overall, 92% (93% blood, 87% CSF) of isolates and 94% of all childhood isolates belonged to the 23 vaccine types. The capsular types occurring most commonly among the 4123 pneumococcal strains from adults were types 1, 4, 14, 6A+6B, 7F, 9V, 3, 12F, and 8 (in order of frequency). The ten most frequently occurring types from children (6A+6B, 18C, 14, 1, 7F, 19F, 9V, 4, and 23F) covered 84% of the cases of bacteraemia and meningitis. Reduced susceptibility to penicillin was rare (< 1%).

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