ABSTRACT
Background: Occult bacteremia (OB) is one of the possible diagnoses of children younger than 3 years with fever without source in the emergency room. Objective: describe OB in the era after introduction of pneumococcal vaccine in Chile. Patients and Methods: Prospective descriptive review of data of children with possible OB diagnosis, referred from the emergency department between 2010-2013. Results: Possible OB was diagnosed on 391 patients. 233 had focus, mainly respiratory virus and urinary tract infection. On 158 patients, probable BO was diagnosed, 20 had proven OB from which 15 had positive blood culture for Streptococcus pneumoniae. From these, 7 were fully or partially vaccinated. The serotype was identified on 14 cases: 6 were PCV10 vaccine serotypes (none of them vaccinated), 2 were serotype related (both partially vaccinated) and 6 were non vaccine serotypes (partially or totally vaccinated). Discussion: It is necessary to improve diagnostic methods for respiratory viruses and urinary tract infections and try to expand coverage of pneumococcal conjugated vaccines in the pediatric population in order to reduce the risk of invasive pneumococcal disease in Chile.
Introducción: La bacteriemia oculta (BO) es uno de los diagnósticos que se plantean en los niños bajo 3 años de edad que se presentan con fiebre sin foco en el servicio de urgencia. Objetivo: Describir el diagnóstico de BO luego de la introducción de la vacunación universal para Streptococcus pneumoniae en Chile. Materiales y Métodos: Revisión descriptiva de seguimiento prospectivo de datos de niños con diagnóstico de BO posible derivados del SU entre 2010 y 2013. Resultados: Se diagnosticó BO posible en 391 pacientes. En 233 pacientes se encontró foco, siendo infecciones respiratorias virales e infección urinaria las más frecuentes. En 158 pacientes se diagnosticó BO probable, en 20 BO probada y 15 tuvieron hemocultivos positivos para S. pneumoniae. De estos últimos 7 estaban total o parcialmente vacunados. Se identificó serotipo en 14 casos: 6 serotipos vaccinales incluidos en PCV10 (ninguno vacunado), 2 serotipos relacionados (ambos parcialmente protegido) y 6 serotipos no vaccinales (parcial o totalmente vacunados). Discusión: Es necesario mejorar las técnicas diagnósticas de infecciones respiratorias virales e infección urinaria e intentar ampliar la cobertura de las vacunas neumocóccicas conjugadas en la población pediátrica, para reducir el riesgo de enfermedades neumocóccicas invasoras en Chile.
Subject(s)
Humans , Infant , Child, Preschool , Pneumococcal Infections/microbiology , Respiratory Tract Infections/microbiology , Urinary Tract Infections/microbiology , Bacteremia/microbiology , Heptavalent Pneumococcal Conjugate Vaccine/administration & dosage , Pneumococcal Infections/prevention & control , Chile , Prospective Studies , Bacteremia/prevention & controlABSTRACT
Typhoid fever, a serious systemic infection caused by Salmonella enterica serovar Typhi, breaks out in developing countries. However, existing vaccines only induce relatively low protective effects with humoral responses and do not stimulate secondary immune response, especially to young people. The objective of this study is to evaluate the immunogenicity of the vaccine containing virulence capsular polysaccharide (Vi) conjugated with the optimal ratios of non-toxic variant of diphtheria toxin (CRM(197)) in mice. Six-week-old BALB/c female mice were injected intraperitoneally three times at intervals of 14 days and sera were collected on days 0, 14, 28, 42 and 56 post-injection. The efficacy of the vaccine was evaluated by comparing between negative control group injected with PBS and vaccine groups injected with Vi or Vi-CRM(197) conjugate of different ratio. Vi and CRM(197)-specific antibody responses were evaluated using enzyme-linked immunosorbent assay. The result showed that Vi-CRM(197)-1 group revealed the highest and significant Vi-specific IgG immune responses among the other groups and Vi group (p < 0.01). In conclusion, Vi-CRM(197)-1 conjugate vaccine induced the highest humoral immune response in mice and may be used as an effective vaccine to replace the existing typhoid vaccine for infants under 2 years old.
Subject(s)
Animals , Child, Preschool , Female , Humans , Infant , Mice , Antibody Formation , Developing Countries , Diphtheria Toxin , Enzyme-Linked Immunosorbent Assay , Immunity, Humoral , Immunoglobulin G , Salmonella enterica , Salmonella typhi , Salmonella , Typhoid Fever , Typhoid-Paratyphoid Vaccines , Vaccines , VirulenceABSTRACT
OBJECTIVE:To investigate the long-term toxicity of repeated intramuscular injection of Escherichia coli O157∶H7 polysaccharide-conjugated vaccine(O157) in rats so as to provide safety evidence for clinical trials.METHODS:A total of 48 SD rats were randomly assigned to receive either 0.5 mL vaccine(containing 25 ?g polysaccharides) (immunization group,n=24) or phosphate buffered solution (PBS,control group,n=24) with the same volume for 3 times at a dose interval of two weeks.Sacrifice of 6 rats in each group were scheduled at 2 weeks after first immunization,and at 1,3,and 5 weeks after the third immunization,respectively for observation and determination of hematological and biochemical parameters,histopathology,specific antibody,myeloid tissue,the tissues in injection sites,etc.RESULTS:Compared with control group,immunization group showed no significant pathological change except the dynamic regular change of some hematological parameters induced by the immunization,and no immunologic system damage was observed.CONCLUSION:Repeated intramuscular injection with O157 vaccine in rats wouldn't cause overt toxicity and local irritation.