scholarly journals Epidemiology of pneumococcal infections in hospitalised adult patients in Lebanon with a highlight on non-invasive disease

2018 ◽  
Vol 12 (02.1) ◽  
pp. 20S
Author(s):  
Rima Moghnieh ◽  
Lyn Awad ◽  
Dania Abdallah ◽  
Rahil Sleiman ◽  
Tamima Jisr ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Pneumococcal Disease ◽  
Clinical Success ◽  
Pneumococcal Vaccination ◽  
Invasive Disease ◽  
Vaccine Uptake ◽  
Resistant Bacteria ◽  
Pneumococcal Infections ◽  
Non Invasive ◽  
Wide Range

Introduction: Streptococcus pneumoniae causes a wide range of infections classified as invasive and non-invasive pneumococcal disease (non-IPD). Methodology: We retrospectively reviewed over a decade the clinical course and outcome of 103 adult subjects infected with S. pneumoniae. Results: The majority of the subjects (92%) were eligible for pneumococcal vaccination, however none were vaccinated. Most of the infective strains caused non-IPD (64%), with CAP being the leading primary infection (49%). Clinical success was achieved in 71% of the cases and microbiological success in 94% of the cases with available documented follow-up cultures. Yet, 19% of the subjects developed superinfections caused by extensive-drug resistant bacteria with the predominance of ventilator-associated pneumonia (13%). Total in-hospital mortality reached 27% and S. pneumoniae infection attributed mortality was 20%. Using multivariate logistic regression, kidney disease and septic shock were independent risk factors for mortality [Odd’s Ratio (OR) = 14.96 (2.34–95.45), p = 0.004; OR = 5.09 (1.33–19.51), p = 0.02, respectively]. On comparing outcome between subjects with IPD and those with non-IPD, death attributed to S. pneumoniae infection was found to be significantly higher in subjects with IPD (23%, p = 0.023). Nevertheless, clinical success and total in-hospital mortality rates were not statistically different between the two groups (p = 0.056, p = 0.174, respectively). Conclusion: S. pneumoniae remains a pathogen causing considerable mortality. In adults, non-IPD should be considered of comparable importance as IPD. Increasing pneumococcal vaccine awareness at the healthcare professional and patient levels is essential for increasing vaccine uptake, thus decreasing the incidence, severity and sequelea of pneumococcal disease.

Pneumococcal disease and vaccination: recent changes to the schedule

2020 ◽  
Vol 31 (3) ◽  
pp. 118-120
Author(s):  
Helen Sisson
Keyword(s):  
Pneumococcal Disease ◽  
Pneumococcal Vaccination ◽  
Invasive Disease ◽  
Vaccination Schedule ◽  
Recent Change ◽  
Immunisation Schedule ◽  
Significant Drop ◽  
Non Invasive ◽  
Fundamental Part ◽  
The Uk

Vaccination against pneumococcal disease has led to a significant drop in cases in the UK. Helen Sisson provides an overview of recent changes to the vaccination schedule Vaccination to protect against infectious diseases is a fundamental part of the practice nurse's role. The immunisation schedule in the UK frequently changes and this emphasises the need for nurses to remain familiar with what the changes are, and why they have occurred. The most recent change to the pneumococcal vaccination schedule at the start of this year provides an opportunity to reflect on the significance of infection with Streptococcus pneumoniae, which can cause non-invasive or invasive disease. The introduction of routine vaccination against pneumococcal disease for children has led to a significant drop in invasive disease in the population as a whole.

scholarly journals Utility of Photodynamic Therapy in Dentistry: Current Concepts

2020 ◽  
Vol 8 (2) ◽  
pp. 43
Author(s):  
Anette Stájer ◽  
Szilvia Kajári ◽  
Márió Gajdács ◽  
Aima Musah-Eroje ◽  
Zoltán Baráth
Keyword(s):  
Photodynamic Therapy ◽  
Clinical Success ◽  
Maxillofacial Surgery ◽  
Treatment Method ◽  
Treatment Modalities ◽  
Oral And Maxillofacial Surgery ◽  
Invasive Treatment ◽  
Advantages And Disadvantages ◽  
Non Invasive ◽  
Wide Range

The significant growth in scientific and technological advancements within the field of dentistry has resulted in a wide range of novel treatment modalities for dentists to use. Photodynamic therapy (PDT) is an emerging, non-invasive treatment method, involving photosensitizers, light of a specific wavelength and the generation of singlet oxygen and reactive oxygen species (ROS) to eliminate unwanted eukaryotic cells (e.g., malignancies in the oral cavity) or pathogenic microorganisms. The aim of this review article is to summarize the history, general concepts, advantages and disadvantages of PDT and to provide examples for current indications of PDT in various subspecialties of dentistry (oral and maxillofacial surgery, oral medicine, endodontics, preventive dentistry, periodontology and implantology), in addition to presenting some images from our own experiences about the clinical success with PDT.

Antibody Response to Pneumococcal Polysaccharide Vaccination Predicts Pneumococcal Disease in Splenectomized Patients with Hematological Diseases.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1335-1335
Author(s):  
Honar Cherif ◽  
Magnus Bjorkholm ◽  
Mats Kalin ◽  
Helle B. Konradsen ◽  
Ola Landgren
Keyword(s):  
Antibody Response ◽  
Pneumococcal Disease ◽  
Pneumococcal Vaccination ◽  
Immunological Response ◽  
Poor Responders ◽  
Pneumococcal Infections ◽  
Hematological Diseases ◽  
Prophylactic Measures ◽  
Increased Risk ◽  
Antibody Titers

Abstract Patients with hematological diseases undergoing diagnostic or therapeutic splenectomy are at increased risk of acquiring fulminant pneumococcal infections. Vaccination is a straightforward option in reducing these infections. Certain patient subgroups showing inadequate immunological response to pneumococcal vaccination may be candidates for alternative prophylactic measures. We prospectively studied the antibody response to vaccination with 23-valent pneumococcal capsular polysaccharide vaccine (Pneumovax N) in splenectomized patients with hematological disorders in relation to clinical characteristics and pneumococcal disease. A total of 76 splenectomized patients (Hodgkin s lymphoma 26, indolent lymphoma 10, aggressive lymphoma 8, immune hemolytic anemia 6, immune thrombocytopenic purpura 22, and others 4) with a median age of 52 years (range 18–82) were included. Antibody titers were determined using an enzyme-linked immunosorbent assay before and 12 months after vaccination. A weak immunological response was observed in 27 (35%) patients (poor responders) and an adequate response in 49 (65%) (good responders). During the follow-up period of 5–9 years after vaccination and despite repeated revaccination in many cases, a total of 5 episodes of microbiologically verified pneumococcal infections were reported in poor responders, while only one episode was noted among good responders (p=.01). Underlying malignant hematological diseases were more frequent among poor responders than among good responders (p=.002). The distribution of patients according to age, gender, immunoglobulin levels, time between splenectomy and vaccination (<1 year>), time between preceding chemotherapy/radiotherapy and vaccination (<6 months>) and/or previous radiotherapy did not differ between poor and good responders. In conclusion, a significant number of splenectomized patients with hematological diseases respond poorly to pneumococcal vaccination and have a significantly increased risk of post-splenectomy pneumococcal infections despite vaccination. In the absence of clinical parameters that can reliably predict a poor antibody response, measurement of antibody titers 12 months after vaccination seems to be the most adequate method for identification of patients in this subgroup. Poor responders may be offered other prophylactic measures such as antibiotic prophylaxis and/or immunization with pneumococcal conjugate vaccines. Studies to further elucidate the last alternative are ongoing.

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 Pneumococcal disease: emergence of serotypes 19A and 7F following conjugate pneumococcal vaccination in a Mexican hospital

2011 ◽  
Vol 6 (06) ◽  
pp. 516-520 ◽  
Author(s):  
Enrique Chacon-Cruz ◽  
Yazbeck Velazco-Mendez ◽  
Samuel Navarro-Alvarez ◽  
Rosa Maria Rivas-Landeros ◽  
Maria Luisa Volker ◽  
...  
Keyword(s):  
Pneumococcal Disease ◽  
Pneumococcal Vaccination ◽  
Pleural Empyema ◽  
Invasive Disease ◽  
Vaccination Schedule ◽  
Disease Emergence ◽  
Northern Border ◽  
Before And After ◽  
Serotype Identification ◽  
Heptavalent Pneumococcal Conjugate Vaccine

Introduction: Mexico  was  the  first  country  to  initiate  massive  vaccination  with   heptavalent  pneumococcal  conjugate  vaccine  (PCV-7)  in  children.  There  is  no  information  regarding  pneumococcal  invasive  disease  (PID)  in  children  before  and  after  implementation  of  PCV-7  in  Mexico  or elsewhere  in  Latin America. Methodology: During  October  2005 to September  2010, active  surveillance  for  pediatric  PID  was  initiated  at  Tijuana  General  Hospital. Only culture-confirmed cases from sterile  fluids  were  included in the study.  Serotype identification was also performed.  Results: Twenty-eight pediatric PID cases were confirmed. Streptococcus pneumoniae was the main  cause  of  pleural  empyema  (n = 13). It was also the  second most common cause  of  confirmed  bacterial  meningitis  (n = 10),  followed  by  Neisseria  meningitidis (n = ?),  and  the  only  cause  of  otomastoiditis  with  bacterial  isolation  (n = 5).  Vaccine-associated  serotypes  decreased  from  54%  before  PCV-7  introduction  to  the  vaccination  schedule,  to  only  5.6%  after  PCV-7  implementation. Serotypes  19A  and  7F  (47%  and  33%  respectively)  were  predominant  following  PCV-7  vaccination. Conclusions: Serotype  substitution  in  PID  is  present  in the  northern  border  of  Mexico  following  PCV-7  vaccination  in  children.

scholarly journals Non-invasive pneumococcal disease and antimicrobial resistance: vaccine implications

2002 ◽  
Vol 128 (1) ◽  
pp. 21-27 ◽  
Author(s):  
M. H. KYAW ◽  
S. CLARKE ◽  
I. G. JONES ◽  
H. CAMPBELL
Keyword(s):  
Antimicrobial Resistance ◽  
Clinical Isolate ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Laboratory Data ◽  
Age Groups ◽  
Invasive Disease ◽  
Polysaccharide Vaccine ◽  
Conjugate Vaccines ◽  
Non Invasive

We reviewed laboratory data on non-invasive pneumococcal isolates reported from all diagnostic laboratories in Scotland during the period 1988–99. Of 4491 isolates from hospitalized patients, 654 (64·7%) were from sputum, 79 (7·8%) from the nasopharynx and 278 (27·5%) from other superficial sites. The serogroups included in the 23-valent polysaccharide vaccine caused 96–9% of all non-invasive disease in all age groups. The 7-, 9-, and 11-valent conjugated vaccine serogroups were responsible for 87–94%, 85–93%, 74–81% and 75–84% of non-invasive disease respectively in age groups <2 years, [les ]5 years, [ges ]65 years and all ages. The coverage of non-susceptible penicillin and erythromycin non-invasive isolates was >99% and >95% with the 23-valent polysaccharide and 7–11-valent conjugate vaccines respectively. The eight most common serogroups were 23, 9, 6, 19, 14, 3, 15 and 11 (in descending order). The serogroups associated with antimicrobial resistance in non-invasive disease were similar to those found in invasive disease. The finding of a similar serogroup distribution in both invasive and non-invasive disease (regardless of the site of clinical isolate), is consistent with serogroups colonizing non-sterile sites and having the potential to invade. The availability of conjugated vaccines reinforces the importance of systematic surveillance to determine accurately and regularly the coverage of pneumococcal serogroups and types causing both invasive and non-invasive disease.

scholarly journals A Streptococcus pneumoniae (pneumococcus) -infekciók ezer arca

2015 ◽  
Vol 156 (44) ◽  
pp. 1769-1777
Author(s):  
Bálint Gergely Szabó ◽  
Katalin Szidónia Lénárt ◽  
Béla Kádár ◽  
Andrea Gombos ◽  
Balázs Dezsényi ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
High Risk ◽  
Pneumococcal Vaccination ◽  
Invasive Disease ◽  
Active Immunization ◽  
Clinical Aspects ◽  
Pneumococcal Infections ◽  
High Risk Patients ◽  
Incidence And Mortality ◽  
Risk Patients

Incidence and mortality rates of infections caused by Streptococcus pneumoniae (pneumococcus) are high worldwide and in Hungary among paediatric as well as adult populations. Pneumococci account for 35–40% of community acquired adult pneumonias requiring hospitalization, while 25–30% of Streptococcus pneumoniae pneumonias are accompanied by bacteraemia. 5–7% of all infections are fatal but this rate is exponentially higher in high risk patients and elderly people. Mortality could reach 20% among patients with severe invasive pneumococcal infections. Complications may develop despite administration of adequate antibiotics. The authors summarize the epidemiology of pneumococcal infections, pathogenesis of non-invasive and invasive disease and present basic clinical aspects through demonstration of four cases. Early risk stratification, sampling of hemocultures, administration of antibiotics and wider application of active immunization could reduce the mortality of invasive disease. Anti-pneumococcal vaccination is advisable for adults of ≥50 years and high risk patients of ≥18 years who are susceptible to pneumococcal disease. Orv. Hetil., 2015, 156(44), 1769–1777.

scholarly journals Pneumococcal vaccine uptake and vaccine effectiveness in older adults with invasive pneumococcal disease in Germany

2020 ◽  
Author(s):  
Stephanie R Perniciaro ◽  
Mark van der Linden
Keyword(s):  
Older Adults ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Vaccine ◽  
Pneumococcal Disease ◽  
Pneumococcal Vaccination ◽  
Polysaccharide Vaccine ◽  
Vaccine Effectiveness ◽  
Vaccine Uptake ◽  
Age Group ◽  
The Past

Background - Invasive pneumococcal disease (IPD) in people ≥60 years old is on the rise in Germany. There has been a recommendation for pneumococcal vaccination in this age group since 1998. Methods - We determined the vaccination status of people ≥60 years old with IPD in Germany. We assessed vaccine effectiveness (VE) of the recommended 23-valent polysaccharide vaccine (PPV23). Results - The rate of pneumococcal vaccination in older adults with IPD is low, 26%, with only 16% of people receiving a pneumococcal vaccine within the past 5 years. Age- and sex- adjusted vaccine effectiveness (VE) for PPV23 was 37% (95% confidence interval 12% - 55%). For people vaccinated with PPV23 less than 2 years prior to IPD, VE was -20% (-131% - 34%), between 2-4 years prior to IPD, VE was 56% (20% - 76%), and 47% (17% - 63%) for those vaccinated ≥5 years ago. Excluding serotype 3, overall VE for the remaining serotypes in PPV23 was 63% (49% - 74%). For people receiving PPV23 within the past 2 years, VE against all serotypes except 3 was 49% (12% - 71%); for people vaccinated between 2-4 years prior to IPD 66% (37% - 82%); for those vaccinated ≥5 years ago, 69% (50% - 81%). VE of PPV23 against serotype 3 IPD only was -110% (-198% - -47%). Conclusions - To reduce IPD in older adults in Germany, we must increase the rate of pneumococcal vaccine uptake. For 22/23 serotypes, PPV23 was effective. Serotype 3 remains a major problem.

scholarly journals Effect of childhood pneumococcal conjugate vaccination on invasive disease in older adults of 10 European countries: implications for adult vaccination

Thorax ◽  
2018 ◽  
Vol 74 (5) ◽  
pp. 473-482 ◽  
Author(s):  
Germaine Hanquet ◽  
Pavla Krizova ◽  
Palle Valentiner-Branth ◽  
Shamez N Ladhani ◽  
J Pekka Nuorti ◽  
...  
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Indirect Effects ◽  
Pneumococcal Disease ◽  
Meta Analysis ◽  
Pneumococcal Vaccination ◽  
Invasive Disease ◽  
European Countries ◽  
Childhood Vaccination ◽  
Rate Ratios

BackgroundPneumococcal conjugate vaccines (PCVs) have the potential to prevent pneumococcal disease through direct and indirect protection. This multicentre European study estimated the indirect effects of 5-year childhood PCV10 and/or PCV13 programmes on invasive pneumococcal disease (IPD) in older adults across 13 sites in 10 European countries, to support decision-making on pneumococcal vaccination policies.MethodsFor each site we calculated IPD incidence rate ratios (IRR) in people aged ≥65 years by serotype for each PCV10/13 year (2011–2015) compared with 2009 (pre-PCV10/13). We calculated pooled IRR and 95% CI using random-effects meta-analysis and PCV10/13 effect as (1 − IRR)*100.ResultsAfter five PCV10/13 years, the incidence of IPD caused by all types, PCV7 and additional PCV13 serotypes declined 9% (95% CI −4% to 19%), 77% (95% CI 67% to 84%) and 38% (95% CI 19% to 53%), respectively, while the incidence of non-PCV13 serotypes increased 63% (95% CI 39% to 91%). The incidence of serotypes included in PCV13 and not in PCV10 decreased 37% (95% CI 22% to 50%) in six PCV13 sites and increased by 50% (95% CI −8% to 146%) in the four sites using PCV10 (alone or with PCV13). In 2015, PCV13 serotypes represented 20–29% and 32–53% of IPD cases in PCV13 and PCV10 sites, respectively.ConclusionOverall IPD incidence in older adults decreased moderately after five childhood PCV10/13 years in 13 European sites. Large declines in PCV10/13 serotype IPD, due to the indirect effect of childhood vaccination, were countered by increases in non-PCV13 IPD, but these declines varied according to the childhood vaccine used. Decision-making on pneumococcal vaccination for older adults must consider the indirect effects of childhood PCV programmes. Sustained monitoring of IPD epidemiology is imperative.

Serotype incidence and antibiotic susceptibility of Streptococcus pneumoniae causing invasive disease in Scotland, 1999–2002

2005 ◽  
Vol 54 (4) ◽  
pp. 327-331 ◽  
Author(s):  
B C Denham ◽  
S C Clarke
Keyword(s):  
Streptococcus Pneumoniae ◽  
Antibiotic Susceptibility ◽  
Pneumococcal Disease ◽  
Invasive Disease ◽  
Reference Laboratory ◽  
Conjugate Vaccines ◽  
Non Invasive ◽  
Antibiotic Susceptibility Patterns ◽  
The Uk ◽  
Susceptibility Patterns

Pneumococcal disease remains an important cause of invasive and non-invasive disease in Scotland and elsewhere. The Scottish Meningococcus and Pneumococcus Reference Laboratory receives isolates of Streptococcus pneumoniae from diagnostic laboratories around Scotland. Here, the serogroups/types and antibiotic-susceptibility patterns of invasive isolates received between 1999 and 2002 are described. There were a total of 1741 invasive isolates received, the most common serogroups/types being 14 (19.8 %), 9 (10.2 %), 6 (8.3 %), 19 (7.9 %), 23 (7.9 %), 4 (6.5 %), 8 (6.4 %), 3 (5.7 %), 1 (3.8 %), 7 (3.8 %) and 18 (3.4 %). Importantly, serotypes 7 and 8 are not represented in the 7-, 9- and 11-valent pneumococcal conjugate polysaccharide vaccines. There were 67 (3.8 %) isolates considered penicillin non-susceptible, although no penicillin resistance (MIC ⩾ 0.002 mg ml−1) was recorded. One hundred and ninety-four (11.1 %) isolates, predominantly of serotype 14, were resistant to erythromycin, and 12 (0.7 %) were resistant to ciprofloxacin. This information provides an important dataset that will prove essential prior to and during the implementation of pneumococcal conjugate vaccines in the UK.

Sign in / Sign up

Export Citation Format

Share Document