Infection ostéo articulaire à pneumocoque chez un sujet apparemment sain

Les infections ostéo-articulaires (IOA) àStreptococcus pneumoniae sont rares chez les adultessains et elles surviennent, souvent, sur un terraind'immunodépression ou de pathologie articulaire.Nous rapportons ici un cas d'arthrite septiquesubaiguë de l'épaule à Streptococcus pneumoniaeobjectivée chez un sujet âgé, sain et chez qui on n'apas objectivé de pathologies sous jacentes qui enpourraient être responsable. Ainsi, le Streptococcuspneumoniae doit être évoqué devant toute infectionostéo articulaire, essentiellement chez les vieillards,même en l'absence des facteurs favorisantsclassiquement associés

Etude de la sensibilite aux antibiotiques et des genes de resistance aux macrolides de streptococcus pneumoniae isole en milieu pediatrique tunisien

L'emergence de souches resistantes pose des problemes therapeutiques.Le but de cette etude etait de preciser : les caracteristiques epidemiologiques des souches de S. pneumoniae isolees chez l'enfant; leur sensibilite aux antibiotiques et les genes de resistance aux macrolides. L'etude a porte sur 422 souches non repetitives de S. pneumoniae isolees de 2000 a 2008. Les souches invasives (43;3) provenaient essentiellement de LCR (50;2) et d'hemocultures (34;4); la majorite des souches non invasives (56;6) de prelevements pulmonaires (76;5). Le pneumocoque de sensibilite diminuee a la penicilline G (PSDP) representait 53;3des souches (n=225) et 12;8avaient une resistance de haut niveau.29;6avaient une sensibilite diminuee a l'amoxicilline et 15;1au cefotaxime. 60;6des souches etaient resistantes a l'erythromycine et 59;6a la lincomycine. L'etude parPCR des genes de resistance a montre que parmi les 66 souches testees; 62 hebergeaient le gene ermB; 3 le gene mefA et une souche les 2 genes. Les PSDP etaient beaucoup plus resistants aux differents antibiotiques testes que les pneumocoques sensibles a la penicilline; ceci complique la prise en charge therapeutique de ces infections et justifie leur prevention par l'utilisation d'un vaccin anti-pneumococcique efficace

Carriage Rates; Circulating Serotypes and Antibiotic Resistance among Streptococcus Pneumoniae in Healthy Infants in Yei; South Sudan

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 mortality associated with Streptococcus pneumoniae. There is an urgent need to strengthen microbiological and public health services

Pneumococcal disease in sub-Saharan African children: what is the effectiveness of the pneumococcal conjugate vaccine?

Streptococcus pneumoniae is still a leading cause of morbidity and mortality among children in developing countries. Young children represent a high-risk group for severe pneumococcal disease; not only because of their physio-logical susceptibility but also because polysaccharide vaccines are not effective for them. Pneumococcal conjugate vaccines have shown a high protection against pneumococcal diseases all over the world. Therefore; the expanded use of this vaccine must be considered as a major world health priority

The burden of pneumococcal disease in children advances in the fight of this epidemic

Streptococcus pneumoniae; the most important cause of acute otitis media; pneumonia; septicaemia and meningitis worldwide; comes in 90 different serotypes. Only a few serotypes cause most of the serious disease. Different serotypes are distinguished by differences in the complex sugars that made up the bacteria's capsule that provide protection against the host's specific defenses. The burden of invasive pneumococcal disease in South Africa subjects is estimated to be 100 - 200 per 100 000. The conjugate pneumococcal vaccine has been shown to be effective in reducing invasive pneumococcal disease due to vaccine serotypes in all countries where it has been introduced. This benefit has extended to unvaccinated subjects. Reduction in penicillin resistant pneumococcus related to vaccine serotypes has been recorded. Replacement disease by non vaccine serotype has eroded the benefit of the vaccine. Industry; donors and governments need to interact to ensure accelerated implementation of this vaccine in developing countries

Invasive pneumococcal disease in a cohort of HIV-1 infected female prostitutes living in Nairobi

A cohort of predominantly HIV seropositive female prostitutes has been followed for a two year period. 54 episodes of invasive pneumococcal disease (ISpD) have been diagnosed in 41 patients; of which 28 were bacteraemic. All patients were seropositive for HIV. Pneumonia was the most common presentation in 34(64); then maxillary sinusitis in 11 (21) and occult bacteraemia in 8 (15). Nine of the patients (22) had proven recurrent disease despite appropriate therapy; most of these episodes were with different serotypes suggesting that this is reinfection rather than relapse. The mean CD4 count of first episode ISpD was 325 showing that that this is an early HIV-related problem. The estimated inicdence rate was 30/1000 person years of observation and it was the most common life-threatening problem seen in the cohort in the study period. All patients survived with standard penicillin or ampicillin treatment. The pneumococcus is an important but under-recognised cause of HIV-related disease in Africa. Presentation can be atypical but the response to appropriate therapy good