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1.
Infectio ; 25(2): 108-113, abr.-jun. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1250076

ABSTRACT

RESUMEN Introducción: Las infecciones neumocócicas son una de las causas más importantes de enfermedades en niños menores de 5 años en Colombia. Objetivo: Calcular la mortalidad por neumonía y por todas las causas en niños menores de 5 años en Colombia. Métodos: Estudio ecológico, los principales desenlaces del estudio fue mortalidad por todas las causas y neumonía (CIE-10 J12-18). Resultados: Durante el año 2005 al 2016 se encontraron un total de 122.074 muertes por todas las causas, de las cuales 13359 (10.94%) correspondieron a muerte por neumonía, 750 a meningitis (0.61%) y 17.511 a muerte por otras causas respiratorias (14.34%). Conclusiones: Se ha observado una disminución de la mortalidad en las tasas de mortalidad por todas las causas, y las demás estudiadas en este artículo.


ABSTRACT Introduction: Pneumococcal infections are one of the most important causes of diseases in children under 5 years old in Colombia. Objective: Evaluate mortality from pneumonia and all causes in children under 5 years old in Colombia. Methods: Ecological study, the main outcomes of the study was all-cause mortality and pneumonia (ICD-10 J12-18). Results: During 2005 to 2016, a total of 122,074 deaths were found for all causes, of which 13,359 (10.94%) corresponded to death due to pneumonia, 750 to meningitis (0.61%) and 17,511 to death due to other respiratory causes (14.34% ). Conclusions: A decrease in mortality has been observed in all-cause mortality rates, and the others studied death causes in this article.


Subject(s)
Humans , Male , Female , Child, Preschool , Pneumococcal Infections , Pneumonia , Mortality , Vaccines , Cause of Death , Colombia , Pneumococcal Vaccines , Meningitis
3.
Rev. habanera cienc. méd ; 20(2): e3759, mar.-abr. 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1251799

ABSTRACT

Introducción: La colonización nasofaríngea por neumococo se define como el momento inicial en el que la bacteria se aloja en la nasofaringe del individuo. Objetivo: Estimar la proporción de factores de riesgo asociados a la colonización nasofaríngea por neumococo en niños vacunados con vacunas conjugadas antineumocócicas (PCV). Material y Métodos: Un año después de la vacunación antineumócocica mediante un ensayo clínico fase II/III, controlado, aleatorizado y doble ciego en niños de 1 a 5 años, se ejecutó un estudio de seguimiento con un diseño casos y controles, tipo caso-caso. El horizonte temporal fue desde noviembre de 2015 hasta abril de 2016. Se incluyó 50 por ciento del total de vacunados en el estudio experimental. El universo lo constituyó los 1 135 niños vacunados en el ensayo clínico. Se siguió un muestreo aleatorio simple y se incluyeron 555 sujetos. Se realizó una encuesta y una toma de muestra de exudado nasofaríngeo. Se presentaron tablas de frecuencias. Se utilizó la razón de prevalencia como medida de asociación. Se calcularon los intervalos de confianza a 95 por ciento para cada proporción. Resultados: Tener entre 2 y 5 años actúa como factor protector para la colonización nasofaríngea con respecto al niño pequeño. Convivir con personas mayores de 65 años constituye un factor de riesgo significativamente relacionado con la colonización nasofaríngea. Conclusiones: La introducción de vacunas antineumocócicas en niños preescolares puede impactar de manera significativa la carga de colonización y en la trasmisión de la enfermedad neumocócica(AU)


Introduction: Nasopharyngeal colonization by pneumococci is defined as the initial moment when the bacterium lodges in the nasopharynx of the person. Objective: To estimate the proportion of risk factors associated with nasopharyngeal colonization by pneumococci in children vaccinated with conjugate pneumococcal vaccines (CPV). Material and Methods: One year after pneumococcal vaccination, a follow-up case-case-control study was conducted in children aged 1-5 years by means of a phase II/III controlled, randomized, double-blind clinical trial. The time horizon was from November 2015 to April 2016. The study included 50 percent of the total of children vaccinated during the experimental study. The universe consisted of 1135 children who were vaccinated during the clinical trial. A simple random sampling that included 555 persons was applied. A survey was conducted and nasopharyngeal exudate samples were taken. Tables of frequencies were presented. Prevalence ratio was used as a measure of association. Also, 95 percent confidence intervals were calculated for each proportion. Results: Being between the ages of 2-5 years acts as protective factor against nasopharyngeal colonization with respect to the young child. Living with persons older than 65 years is a significantly associated risk factor with nasopharyngeal colonization. Conclusions: The introduction of pneumococcal vaccines in pre-school children can have a significant impact on colonization burden and the transmission of pneumococcal diseases(AU)


Subject(s)
Humans , Child, Preschool , Pneumococcal Infections , Simple Random Sampling , Pneumococcal Vaccines , Case-Control Studies , Risk Factors , Prevalence Ratio
4.
Rev. cuba. invest. bioméd ; 40(1): e930, ene.-mar. 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1289453

ABSTRACT

Introducción: Las enfermedades infecciosas del tracto respiratorio se encuentran entre las primeras causas de entidades respiratorias en edades extremas de la vida. Objetivo: Describir las bases inmunológicas de la enfermedad y el nuevo candidato vacunal conjugado antineumocócico PCV7-TT desarrollado en Cuba. Métodos: Se realizó una búsqueda en las bases de datos Medline, Pubmed, SciELO, LILACS, Cochrane Library y Web of Science, de documentos publicados entre mayo del 2018 y marzo del 2020. Se seleccionaron los 64 artículos de mayor relevancia y novedad. Resultados: Streptococcus pneumoniae es el agente etiológico de la enfermedad neumocócica; se le atribuye alrededor de un millón de defunciones anuales, principalmente en países en vías de desarrollo. Es un coco Gram-positivo, anaerobio facultativo y encapsulado que se encuentra dividido en 48 serogrupos y 97 serotipos tipificados. Presenta varios factores de virulencia que garantizan su mecanismo de patogenicidad; uno de los más importantes es el polisacárido capsular que constituye la diana de las vacunas antineumocócicas conjugadas y no conjugadas existentes. En el presente artículo se consideró la proteína de superficie C del neumococo como un posible candidato en la investigación y desarrollo de vacunas preventivas. Asimismo, las vesículas extracelulares podría ser un posible candidato para adyuvante vacunal con fines preventivos y terapéuticos. Conclusiones: El neumococo es un problema de salud a nivel global y el uso de vacunas conjugadas antineumocócicas constituye la herramienta más eficaz para su prevención. El candidato vacunal PCV7-TT desarrollado en Cuba es seguro, bien tolerado, inmunogénico y no inferior a las vacunas actualmente registradas(AU)


Introduction: Infectious diseases of the respiratory tract are among the leading causes of respiratory conditions in patients at extreme ages. Objective: Describe the immunological bases of the disease and the new conjugate pneumococcal vaccine candidate PCV7-TT developed in Cuba. Methods: A search was conducted in the databases Medline, Pubmed, SciELO, LILACS, Cochrane Library and Web of Science for documents published from May 2018 to March 2020. The 64 most relevant and novel papers were selected. Results: Streptococcus pneumoniae is the causative agent of pneumococcal disease, a condition causing about one million deaths a year worldwide, mainly in developing countries. It is a Gram-positive facultative anaerobic encapsulated coccus divided into 48 serogroups and 97 typified serotypes. Several virulence factors ensure its pathogenicity mechanism. One of the most important of these is the capsular polysaccharide constituting the target of the existing conjugate and non-conjugate pneumococcal vaccines. The study considered pneumococcal surface protein C as a possible candidate for the research and development of preventive vaccines. On the other hand, extracellular vesicles could be a possible vaccine adjuvant candidate for preventive and therapeutic use. Conclusions: Pneumococcus is a global health problem, and the use of conjugate pneumococcal vaccines is the most effective tool for its prevention. The vaccine candidate PCV7-TT developed in Cuba is safe, well-tolerated, immunogenic and not inferior to the vaccines so far registered(AU)


Subject(s)
Humans , Polysaccharides , Streptococcus pneumoniae , Communicable Diseases , Pneumococcal Vaccines , Virulence Factors , Extracellular Vesicles , Membrane Proteins
5.
Article in Chinese | WPRIM | ID: wpr-879878

ABSTRACT

OBJECTIVE@#To analyze the clinical data of children with invasive pneumococcal disease (IPD) or noninvasive pneumococcal disease (NIPD), and to provide a reference for clinical diagnosis and treatment.@*METHODS@#A retrospective analysis was performed on the medical data and the drug susceptibility test results of isolated strains of 518 children who were hospitalized due to @*RESULTS@#The children with IPD had a median age of 2.2 years, and the children aged ≤5 years accounted for 80.0%. For the children with IPD, the main type of infection was meningitis which was observed in 19 children (54.3%), and the most common underlying disease was hematological malignancy in 8 children (22.9%); 14 children (40.0%) were admitted to the pediatric intensive care unit (PICU), 18 children (51.4%) experienced complications, and 8 children (22.9%) died. For the children with NIPD, the median age was 1.2 years; the main type of infection was pneumonia in 429 children (88.8%), and the most common underlying disease was congenital heart disease in 60 children (12.4%); 60 children (12.4%) were admitted to the PICU, 102 children (21.1%) experienced complications, and 11 children (2.3%) died. The IPD group had significantly higher incidence rate of complications, PICU admission rate, and mortality rate than the NIPD group (@*CONCLUSIONS@#SP infection is common in children under 5 years of age, and the children with underlying diseases including hematological malignancy are at high risk for IPD. Although the complication rate, PICU admission rate, and mortality rate of NIPD children are lower than those of IPD children, they still cannot be ignored. Penicillin may be used as an empirical treatment for children with NIPD, but not for those with IPD.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Child , Child, Preschool , Humans , Incidence , Infant , Intensive Care Units, Pediatric , Pneumococcal Infections/drug therapy , Pneumococcal Vaccines , Retrospective Studies , Streptococcus pneumoniae
6.
Brasília; s.n; 8 jun. 2020.
Non-conventional in Portuguese | PIE, LILACS, BRISA, PIE | ID: biblio-1100298

ABSTRACT

O Informe Diário de Evidências é uma produção do Ministério da Saúde que tem como objetivo acompanhar diariamente as publicações científicas sobre tratamento farmacológico e vacinas para a COVID-19. Dessa forma, são realizadas buscas estruturadas em bases de dados biomédicas, referente ao dia anterior desse informe. Não são incluídos estudos pré-clínicos (in vitro, in vivo, in silico). A frequência dos estudos é demonstrada de acordo com a sua classificação metodológica (revisões sistemáticas, ensaios clínicos randomizados, coortes, entre outros). Para cada estudo é apresentado um resumo com avaliação da qualidade metodológica. Essa avaliação tem por finalidade identificar o grau de certeza/confiança ou o risco de viés de cada estudo. Para tal, são utilizadas ferramentas já validadas e consagradas na literatura científica, na área de saúde baseada em evidências. Cabe ressaltar que o documento tem caráter informativo e não representa uma recomendação oficial do Ministério da Saúde sobre a temática. Foram encontrados 13 artigos.


Subject(s)
Humans , Pneumonia, Viral/drug therapy , Coronavirus Infections/drug therapy , Betacoronavirus/drug effects , Acetylcysteine/therapeutic use , Technology Assessment, Biomedical , gamma-Globulins/therapeutic use , Immunoglobulins/therapeutic use , Methylprednisolone/therapeutic use , BCG Vaccine , Influenza Vaccines , Famotidine/therapeutic use , Autohemotherapy , Chloroquine/therapeutic use , Colchicine/therapeutic use , Interferon-alpha/therapeutic use , Ritonavir/therapeutic use , Pneumococcal Vaccines , Lopinavir/therapeutic use , Observational Study , Nitric Oxide/therapeutic use
8.
Brasília, DF; Ministério da Saúde; 1; 2020. 51 p. ilus.
Monography in Portuguese | ColecionaSUS, LILACS, ColecionaSUS, Inca, PIE | ID: biblio-1099590

ABSTRACT

Essa síntese teve como objetivo levantar opções para prevenção de complicações da doença falciforme, e informar sobre avanços na implementação da política no país. Seguem as opções descritas na síntese que já fazem parte das recomendações do Ministério da Saúde: Promover a antibioticoterapia profilática e a vacinação anti-pneumocócica; Promover o uso de hidroxiureia para prevenção e tratamento de complicações da doença falciforme; Promover o uso de ultrassonografia Doppler Transcraniano (DTC) e transfusão sanguínea para a prevenção primária de acidente vascular cerebral (AVC); Promover a educação em saúde para as pessoas com doença falciforme e seus cuidadores sobre medidas para reduzir as complicações


Subject(s)
Humans , Antibiotic Prophylaxis , Pneumococcal Vaccines , Hydroxyurea/therapeutic use , Anemia, Sickle Cell/complications , Anemia, Sickle Cell/prevention & control , Anemia, Sickle Cell/therapy , Blood Transfusion , Health Education , Ultrasonography, Doppler, Transcranial
9.
Yonsei Medical Journal ; : 243-250, 2020.
Article in English | WPRIM | ID: wpr-811471

ABSTRACT

PURPOSE: We aimed to analyze the surveillance reports of adverse events (AEs) due to different types of pneumococcal vaccines, in addition to detecting and validating signals of pneumococcal vaccines by comparing AEs with labels.MATERIALS AND METHODS: We analyzed the percentages of AEs according to vaccine type [pneumococcal polysaccharide vaccines (PPSVs) and pneumococcal conjugate vaccines (PCVs)] in children and adults using data from the Korea Adverse Event Reporting System (KAERS) database from 2005 to 2016. A signal was defined as an AE that met all three indices of data mining: proportional reporting ratio (PRR), reporting odds ratio (ROR), and information component (IC). We validated the detected signals by calculating sensitivity, specificity, as well as positive and negative predictive values of the signals against label information.RESULTS: Of the 39933 AE reports on vaccination, 5718 (7.0%) were related to pneumococcal vaccine. The most frequent AE after vaccination with PPSV was fever (23.9%) in children and injection-site reaction in adults. The most frequent AE after vaccination with PCV in children was pharyngitis (26.2%). In total, 13 AEs met all three indices for signal detection. Among these, hypotension, apathy, sepsis, and increased serum glutamic oxaloacetic transaminase level were not listed on vaccine labels. In validation analysis, PRR and ROR performed slightly better than IC for adults who were vaccinated with PPSVs.CONCLUSION: Overall, 13 new signals of PPSVs, including four signals not listed on the labels, were detected. Further research based on additional AE reports is required to confirm the validity of these signals for children.


Subject(s)
Adult , Apathy , Aspartate Aminotransferases , Child , Data Mining , Fever , Humans , Hypotension , Korea , Odds Ratio , Pharyngitis , Pneumococcal Vaccines , Sensitivity and Specificity , Sepsis , Vaccination , Vaccines , Vaccines, Conjugate
10.
Article in Korean | WPRIM | ID: wpr-811288

ABSTRACT

An increase in the number of patients with infectious diseases in Korea, can be attributed to various factors, such as the prevalence of new infectious diseases of the 21st century, the re-emergence of past infectious diseases, an increase in the number of elderly individuals, patients with chronic diseases, immune deficiency, and globalization. In this context, vaccination becomes vital for the adult population. Although, the guidelines for adult immunization are currently being updated, the rate of adult vaccination remains lower than that of infant vaccination. At present, the major challenges for increasing the rate of adult immunization include negative views on the need for some immunizations and a lack of understanding of group immunity among the youth. Consequently, a successful immunization program will be required to direct efforts towards educating patients and spreading awareness. Based on the current guidelines and practical applications, varicella zoster; Japanese encephalitis; tetanus, diphtheria, and pertussis; pneumococcus; measles, mumps, and rubella; and hepatitis A vaccines could effectively be considered for adult vaccination.


Subject(s)
Adolescent , Adult , Aged , Chickenpox , Chronic Disease , Communicable Diseases , Diphtheria , Encephalitis, Japanese , Hepatitis A Vaccines , Herpes Zoster , Humans , Immunization Programs , Immunization , Infant , Internationality , Korea , Measles , Mumps , Pneumococcal Vaccines , Prevalence , Rubella , Streptococcus pneumoniae , Tetanus , Vaccination , Whooping Cough
11.
Chinese Journal of Epidemiology ; (12): 1945-1979, 2020.
Article in Chinese | WPRIM | ID: wpr-877520

ABSTRACT

Pneumococcal disease is a serious global public health problem and a leading cause of morbidity and mortality of children and adults in China. Antibiotics are commonly used to treat pneumococcal disease. However, antibiotic resistance to Streptococcus pneumoniae has become a severe problem around the world due to widespread antibiotic use. Immunoprophylaxis of pneumococcal disease with pneumococcal vaccines is therefore of great importance. In this article, we review the etiology, clinical presentation, epidemiology, and disease burden of pneumococcal disease and the vaccinology of pneumococcal vaccines. Our review is based on the Expert Consensus on Immunoprophylaxis of Pneumococcal Disease (2017 version), the Pneumococcal Vaccines WHO Position Paper (2019), and recent national and international scientific advances. This consensus article aims to provide public health and vaccination staff with appropriate evidence for pneumococcal vaccine use and to improve professional capacity for pneumococcal disease prevention and control.


Subject(s)
Adult , Child , China/epidemiology , Consensus , Humans , Pneumococcal Infections/prevention & control , Pneumococcal Vaccines/therapeutic use , Streptococcus pneumoniae/immunology , Vaccines, Conjugate/administration & dosage
12.
Article in Chinese | WPRIM | ID: wpr-877507

ABSTRACT

Pneumococcal disease is a serious global public health problem and a leading cause of morbidity and mortality of children and adults in China. Antibiotics are commonly used to treat pneumococcal disease. However, antibiotic resistance to


Subject(s)
Adult , Child , China , Consensus , Humans , Pneumococcal Infections/prevention & control , Pneumococcal Vaccines , Streptococcus pneumoniae , Vaccines, Conjugate
13.
Arch. argent. pediatr ; 117(4): 373-376, ago. 2019. ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1054939

ABSTRACT

La meningitis bacteriana recurrente es un fenómeno muy poco frecuente en los niños. Las fracturas de la base del cráneo y los implantes cocleares son factores predisponentes importantes, y el agente aislado con mayor frecuencia es el Streptococcus pneumoniae. La implementación de la vacuna neumocócica conjugada de 13 serotipos (VNC13) redujo la incidencia de enfermedades neumocócicas invasivas. La incidencia de enfermedades neumocócicas intercurrentes en pacientes vacunados suele estar relacionada con afecciones predisponentes preexistentes. En este artículo, presentamos un caso de meningitis neumocócica recurrente en una paciente con un implante coclear que sufrió un traumatismo craneoencefálico luego de haber recibido la vacunación completa con la VNC13. La paciente tuvo tres episodios de meningitis en el transcurso de un año. Se detectó la presencia de S. pneumoniae en el cultivo de líquido cefalorraquídeo (LCR) en el primer y tercer episodios, y mediante la prueba de reacción en cadena de la polimerasa (PCR, por su sigla en inglés) en el segundo episodio. Se realizó una intervención neuroquirúrgica luego del tercer episodio de meningitis, y la paciente no tuvo problemas de recurrencias durante los siguientes dos años. Hasta donde sabemos, en la bibliografía no se han descrito casos de meningitis de serotipo 1 por S. pneumoniae luego de la inmunización completa con PCV13.


Recurrent bacterial meningitis is a very rare phenomenon in children. Skull base fractures and cochlear implant are the important predisposing factors and, Streptococcus pneumoniae is the most frequently isolated agent. Implementation of 13-valent conjugated pneumococcal vaccine (PCV13) has reduced the occurence of invasive pneumococcal diseases. Vaccination breakthrough is typically related to underlying predisposing conditions. Herein, we reported recurrent pneumococcal meningitis in a patient with a cochlear implant who experienced a head trauma after being fully vaccinated with PCV13. The patient experienced three meningitis episodes within one year. S.pneumoniae was determined on CSF culture in the first and third episodes and detected by PCR at the second episode. Neurosurgical intervention was performed after the third meningitis episode, and the patient had no recurrence problems for the following two years. To our knowledge, breakthrough S.pneumoniae serotype 1 meningitis after full PCV13 immunization has not been reported elsewhere in the literature.


Subject(s)
Humans , Female , Child, Preschool , Streptococcus pneumoniae , Meningitis, Pneumococcal , Cochlear Implantation , Pneumococcal Vaccines , Brain Injuries, Traumatic
14.
Article in Korean | WPRIM | ID: wpr-787510

ABSTRACT

BACKGROUND: This study was aimed to analyze the status and effects of influenza vaccine (IV) and pneumococcal vaccine (PV) in hospitalized patients in a University Hospital with chronic conditions.METHODS: The study is based on the medical records of 3,279 inpatients in pulmonary center of Yeungnam University Medical Center (Korea) between October 2015 and September 2016. The subjects were divided into two groups by age (under 65 years old and over 65 years old), and the preventive effects of IV and PV were analyzed by comparing vaccination rate, hospitalized period, pneumonia attach rate, and mortality rate. Vaccination data were obtained from the Korea Centers for Disease Control and Prevention web system. The chi-squared test, linear regression analysis and logistic regression analysis were used to analyze factors associated with the types of vaccinations and underlying medial factors.RESULTS: In the group under 65 years old, those without any vaccination had higher mortality rate. In addition, patients with IV vaccination were more likely to have shorter hospitalized periods. On the contrary, a group of people without any vaccination, hospitalized period increased. However, in the group of over 65 years old with various underlying conditions, the mortality rate was higher when IV or both IV and PV were vaccinated.CONCLUSION: The preventive effects show the opposite results in two age groups. This study indicates that the vaccines are more effective in the group under 65 years old than the group over 65 years old with chronic conditions.


Subject(s)
Academic Medical Centers , Hospitalization , Humans , Influenza Vaccines , Influenza, Human , Inpatients , Korea , Linear Models , Logistic Models , Medical Records , Mortality , Pneumococcal Vaccines , Pneumonia , Vaccination , Vaccines
15.
Article in English | WPRIM | ID: wpr-762441

ABSTRACT

BACKGROUND: Several factors contribute to differences in Streptococcus pneumoniae serotype distribution. We investigated the serotype distribution and antimicrobial resistance of S. pneumoniae isolated between 2014 and 2016 in Korea. METHODS: We collected a total of 1,855 S. pneumoniae isolates from 44 hospitals between May 2014 and May 2016, and analyzed the serotypes by sequential multiplex PCR. We investigated the distribution of each serotype by patient age, source of the clinical specimen, and antimicrobial resistance pattern. RESULTS: The most common serotypes were 11A (10.1%), followed by 19A (8.8%), 3 (8.5%), 34 (8.1%), 23A (7.3%), and 35B (6.2%). The major invasive serotypes were 3 (12.6%), 19A (7.8%), 34 (7.8%), 10A (6.8%), and 11A (6.8%). Serotypes 10A, 15B, 19A, and 12F were more common in patients ≤5 years old, while serotype 3 was more common in patients ≥65 years old compared with the other age groups. The coverage rates of pneumococcal conjugate vaccine (PCV)7, PCV10, PCV13, and pneumococcal polysaccharide vaccine 23 were 11.8%, 12.12%, 33.3%, and 53.6%, respectively. Of the 1,855 isolates, 857 (46.2%) were multi-drug resistant (MDR), with serotypes 11A and 19A predominant among the MDR strains. The resistance rates against penicillin, cefotaxime, and levofloxacin were 22.8%, 12.5%, and 9.4%, respectively. CONCLUSIONS: There were significant changes in the major S. pneumoniae serotypes in the community. Non-PCV13 serotypes increased in patients ≤5 years old following the introduction of national immunization programs with the 10- and 13-polyvalent vaccines.


Subject(s)
Cefotaxime , Humans , Immunization Programs , Korea , Levofloxacin , Multiplex Polymerase Chain Reaction , Penicillins , Pneumococcal Vaccines , Pneumonia , Serogroup , Streptococcus pneumoniae , Streptococcus , Vaccines
16.
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1088681

ABSTRACT

La neumonía adquirida en la comunidad en adultos, es un importante problema de salud pública. En América Latina son muy escasas las publicaciones que documenten su incidencia. Esta comunicación breve proporciona datos preliminares sobre la incidencia (105 persona/año) de neumonías en adultos hospitalizados. La base de datos de una institución médica privada de Uruguay, posibilitó la estimación de la incidencia de esa patología, antes de la implementación de la vacuna conjugada neumocóccica (VCN) en la infancia y luego de su aplicación. En 1.688 pacientes con neumonía los mayores de 64 años predominaron y su incidencia fue de 1.938 en el período prevacunación, descendiendo significativamente a 1.365 luego de la VCN. A pesar de la posible protección indirecta de la vacunación, la información presentada alerta sobre la persistencia de morbimortalidad por neumonía en adultos mayores.


Pneumonia in adults poses severe health risks, but data on its burden still lacks in Latin American countries including Uruguay. To fill this gap preliminary information on hospitalized pneumonia incidence in adults was analyzed. A data base from a private medical institution enabled to estimate, pre and post pneumococcal conjugate vaccine incidences (105 person/year), by age groups. Out of 1 688 adults hospitalized due to pneumonia, the group aged >64 yers predominated. For the same age group, a significant difference (1.938 vs. 1.365) was observed on incidences before and after conjugate vaccine application in children. Although more robust information on adult pneumonia hospitalizations are required to confirm indirect vaccine effect, these data alert on pneumonia persistence which requires preventive measures.


A pneumonia adquirida na comunidade em adultos é um grande problema de saúde pública. Na América Latina existem muito poucas publicações que documentam sua incidência. Esta breve comunicação fornece dados preliminares sobre a incidência (105 pessoas / ano) de pneumonias em adultos hospitalizados. O banco de dados de uma instituição médica privada no Uruguai possibilitou estimar a incidência dessa patologia, antes da implementação da vacina conjugada pneumocócica (VCN) na infância e após sua aplicação. Em 1.688 pacientes com pneumonia, aqueles com mais de 64 anos de idade predominaram e sua incidência foi de 1.938 no período de pré-vacinação, descendo significativamente para 1.365 após a VCN. Apesar da possível proteção indireta da vacinação, as informações apresentadas alertam sobre a persistência da morbimortalidade por pneumonia em idosos.


Subject(s)
Humans , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Pneumonia/epidemiology , Pneumococcal Vaccines/therapeutic use , Hospitalization/statistics & numerical data , Pneumonia/prevention & control , Uruguay , Comparative Study , Incidence , Retrospective Studies , Age Distribution , Controlled Before-After Studies , Interrupted Time Series Analysis
17.
J. bras. pneumol ; 44(5): 361-366, Sept.-Oct. 2018. tab, graf
Article in English | LILACS | ID: biblio-975944

ABSTRACT

ABSTRACT Objective: To evaluate Streptococcus pneumoniae serotypes isolated from an inpatient population at a tertiary care hospital, in order to determine the theoretical coverage of the 13-valent pneumococcal conjugate vaccine (PCV13) and the 23-valent pneumococcal polysaccharide vaccine (PPV23). Methods: This was a cross-sectional study involving 118 inpatients at the Hospital São Lucas, in the city of Porto Alegre, Brazil, whose cultures of blood, cerebrospinal fluid, or other sterile body fluid specimens, collected between January 2005 and December 2016, yielded pneumococcal isolates. The theoretical vaccine coverage was studied in relation to the serotypes identified in the sample and their relationship with those contained in the pneumococcal vaccines available in Brazil. Results: The majority of the population was male (n = 66; 55.9%), with a median age of 57 years (interquartile range: 33-72 years). The most common manifestation was pneumonia, and the pneumococcus was most commonly isolated from blood cultures. More than one fourth of the study population had some degree of immunosuppression (n = 34; 28.8%). Of the total sample, 39 patients (33.1%) died. There were no significant associations between mortality and comorbidity type, ICU admission, or need for mechanical ventilation. The theoretical vaccine coverage of PPV23 alone and PCV13 plus PPV23 was 31.4% and 50.8%, respectively. Conclusions: If the patients in this sample had been previously vaccinated with PCV13 plus PPV23, theoretically, 50.8% of the cases of invasive pneumococcal disease that required hospital admission could potentially have been prevented. Invasive pneumococcal disease should be prevented by vaccination not only of children and the elderly but also of adults in their economically productive years, so as to reduce the socioeconomic costs, morbidity, and mortality still associated with the disease, especially in underdeveloped countries.


RESUMO Objetivo: Avaliar os sorotipos de Streptococcus pneumoniae isolados de uma população internada em um hospital terciário para verificar a cobertura vacinal teórica das vacinas conjugada pneumocócica 13-valente (VCP13) e pneumocócica polissacarídica 23-valente (VPP23). Métodos: Estudo transversal envolvendo 118 pacientes internados no Hospital São Lucas, na cidade de Porto Alegre (RS), cujas amostras de cultura de sangue, líquor ou outro líquido estéril apresentaram isolados de pneumococos entre janeiro de 2005 e dezembro de 2016. A cobertura vacinal teórica foi estudada em relação aos sorotipos observados na amostra e sua relação com os contidos nas vacinas pneumocócicas disponíveis no Brasil. Resultados: A maioria da população era masculina (n = 66; 55,9%), com mediana de idade de 57 anos (intervalo interquartil: 33-72 anos). O agravo mais frequente foi pneumonia, e o pneumococo foi mais frequentemente isolado em hemocultura. Mais de um quarto da população estudada tinha algum grau de imunossupressão (n = 34; 28,8%). Na amostra geral, 39 pacientes (33,1%) foram a óbito. Não houve associações significativas do número de óbitos com o tipo de comorbidades, internação em UTI ou necessidade de ventilação mecânica. A cobertura vacinal teórica da VPP23 e da combinação VCP13 + VPP23 foi de 31,4% e 50,8%, respectivamente. Conclusões: Nesta amostra, se os pacientes tivessem sido previamente vacinados com a combinação VCP13 seguida de VPP23, teoricamente, 50,8% dos casos de doença pneumocócica invasiva que necessitaram de internação hospitalar poderiam ter sido prevenidos potencialmente. Essa doença deve ser prevenida com a vacinação não só de crianças e idosos, mas também de adultos em idade economicamente ativa, para reduzir o custo socioeconômico, a morbidade e a mortalidade ainda associados à doença, especialmente em países subdesenvolvidos.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Pneumococcal Infections/microbiology , Streptococcus pneumoniae/classification , Pneumococcal Vaccines/administration & dosage , Pneumococcal Infections/mortality , Probability Theory , Streptococcus pneumoniae/immunology , Brazil , Cross-Sectional Studies , Tertiary Care Centers , Inpatients
19.
Rev. cuba. salud pública ; 44(2)abr.-jun. 2018.
Article in Spanish | LILACS, CUMED | ID: biblio-901568

ABSTRACT

El proceso de investigación y evaluación de nuevos productos y tecnologías necesita de la combinación de enfoques teóricos y metodológicos transdiciplinarios para la gestión y consecución de los objetivos. La estrategia de investigación, desarrollo y evaluación de la nueva vacuna cubana contra neumococo combina las perspectivas de Ciencia en Equipo e Introducción acelerada de nuevas vacunas. Se presenta como debate la adopción de estos marcos en el contexto de evaluación de productos de la biotecnológicos y se ejemplifica su aplicación al Proyecto Neumococo. Se enfatiza en cómo la eliminación de obstáculos en la obtención de un producto de alta complejidad científica y tecnológica y la conformación de un cuerpo de evidencias científicas robustas que soportan su uso y comercialización, constituyen los principales resultados aportados por los que asumen el enfoque de ciencia en equipo, en favor de una toma de decisiones oportunas y eficientes para la introducción acelerada de nuevas vacunas en Cuba(AU)


The process of research and evaluation of new products and technologies requires the combination of theoretical and methodological transdisciplinary approaches for the management and achievement of the objectives. The research, development and evaluation strategy of the new Cuban pneumococcal vaccine combines the perspectives of Team Science and Accelerated introduction of new vaccines. The adoption of these frameworks in the context of evaluation of biotechnological products is presented as a debate and the application to the Pneumococcal Project is exemplified. Emphasis is on how the elimination of obstacles in obtaining a product of high scientific and technological complexity, and the conformation of a body of robust scientific evidence that supports its use and commercialization constitute the main results contributed by those who assume the team science approach, in favor of timely and efficient decision making for the accelerated introduction of new vaccines in Cuba(AU)


Subject(s)
Humans , Pneumococcal Vaccines/therapeutic use , Research Groups , Cuba
20.
Med. infant ; 25(2): 128-132, Junio 2018. tab, ilus
Article in Spanish | LILACS | ID: biblio-909059

ABSTRACT

Los microorganismos más frecuentemente responsables de la otitis media aguda (OMA) (Streptococcus pneumoniae y Haemophilus influenzae) son los mismos en los países en vías de desarrollo que en los desarrollados. En los países que administraron la vacuna antineumocócica conjugada, los neumococos disminuyeron como causa de OMA, pero con el tiempo comenzaron a resurgir, sobre todo a expensas de cepas pertenecientes a serotipos no incluidos en la vacuna. El objetivo de este trabajo fue documentar el cambio generado en la bacteriología de la OMA a partir de la incorporación en el calendario oficial argentino de la vacuna conjugada antineumocócica 13-valente en el año 2012. Se realizaron dos estudios prospectivos, descriptivos, transversales, uno previo a la incorporación de la vacuna al calendario nacional (mayo 2009-agosto 2010) donde la población estudiada no se encontraba cubierta para S. pneumoniae y otro posterior, donde la mayoría de los pacientes se encontraban inmunizados (enero-diciembre 2016). Se obtuvieron 433 muestras de 324 pacientes en el primer período y 461 de 246 pacientes en el segundo. Se aisló un total de 326 bacterias en el primer período y 388 en el segundo. Los microorganismos respectivamente aislados en ambos períodos fueron S. pneumoniae (39,5-21,1%), H. influenzae (37,4-44,6%), Moraxella catarrhalis (6,1-7,5%), Staphylococcus aureus (8,6-9,8%), Streptococcus pyogenes (3,0-5,9%), Turicella otitidis (1,8-2,1%), Pseudomonas aeruginosa (0,9-4,1%) y otros (2,4-4,9%). Los neumococos pertenecientes a serotipos vacunales sufrieron una disminución significativa, especialmente el 6A, 9V, 14, 18C, 19A, mientras que los serotipos no vacunales aumentaron significativamente, en particular el 15B, el 11A, el 7C, el 16F y el 22F (AU)


Organisms most frequently responsible for acute otitis media (AOM) (Streptococcus pneumoniae and Haemophilus influenzae) are the same in developing countries as in developed ones. In countries that administered the pneumococcal conjugate vaccine, pneumococci decreased as a cause of AOM, but over time began to re-emerge, especially due to strains belonging to serotypes not included in the vaccine. The objective of this work was to document the change generated in the bacteriology of the OMA from the incorporation of the 13-valent pneumococcal conjugate vaccine in 2012 in the official Argentinean calendar. Two prospective, descriptive, cross-sectional studies were carried out prior to the incorporation of the vaccine into the national calendar (May 2009-August 2010), where the population studied was not covered for S. pneumoniae and a subsequent one, where most of the patients were immunized (January 2016-December 2016). We obtained 433 samples from 324 patients in the first period and 461 from 246 patients in the second. A total of 326 bacteria were isolated in the first period and 388 in the second. The microorganisms respectively isolated in both periods were S.pneumoniae (39.5-21.1%), H.influenzae (37.4-44.6%), Moraxella catarrhalis (6.1-7.5%), Staphylococcus aureus (8.6-9.8%), Streptococcus pyogenes (3.0-5.9%), Turicella otitidis (1.8-2.1%), Pseudomonas aeruginosa (0.9-4.1%) and others (2.4-4.9%). Pneumococci belonging to vaccine serotypes suffered a significant decrease, especially 6A, 9V, 14, 18C, 19A, while nonvaccine serotypes increased significantly, particularly 15B, 11A, 7C, 16F, and 22F (AU)


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Otitis Media/etiology , Otitis Media/microbiology , Pneumococcal Vaccines/administration & dosage , Streptococcus pneumoniae/classification , Streptococcus pneumoniae/isolation & purification , Cross-Sectional Studies , Prospective Studies
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