ABSTRACT
Introducción. El uso de vacunas conjugadas frente a Streptococcus pneumoniae ocasiona cambios en la epidemio logía de la Enfermedad Neumocócica Invasiva (ENI). El objetivo de este estudio fue analizar la evolución de los serotipos de S. pneumoniae aislados en el Hospital Universitario de Getafe entre 2008 y 2022. Material y métodos. Se estudiaron 313 cepas de S. pneu moniae. El serotipado se realizó mediante el test de aglutina ción por látex (Pneumotest-latex) y la reacción de Quellung. Además, se determinó la concentración mínima inhibitoria (CMI) frente a penicilina, eritromicina y levofloxacino por el método de gradiente de concentración (E-test) según los cri terios de corte EUCAST. Resultados. Los serotipos más frecuentes en todo el pe riodo de estudio fueron 8, 3, 19A, 1, 11A y 22F correspondien do con el 46,6 % de los aislados. Durante los años 2008-2012, los serotipos 3, 1, 19A, 7F, 6C y 11A supusieron en conjunto el 53,6% de los aislamientos. Entre 2013 y 2017 los serotipos 3, 8, 12F, 19A, 22F y 19F representaron el 51% de los aislados. Entre 2018-2022 los serotipos 8, 3, 11A, 15A, 4 y 6C incluyeron al 55,5% de los casos. En total, 5 cepas (1,6%) se mostraron resistentes a penicilina, 64 (20,4%) resistentes a eritromicina y 11 (3,5%) resistentes a levofloxacino. Los niveles de CMI50 y CMI90 frente a los tres antibióticos se mantuvieron estables a lo largo del tiempo. Conclusiones. El uso de vacunas conjugadas condicionó un descenso de los serotipos cubiertos junto con un aumento de los no vacunales. Los patrones de sensibilidad a eritromicina y levofloxacino se mantuvieron relativamente estables. La re sistencia a penicilina fue muy baja, no encontrándose este tipo de cepas resistentes en el último periodo de estudio (AU)
Introduction. The use of conjugate vaccines against Streptococcus pneumoniae originates changes in the invasive pneumococcal disease (IPD). The aim of this study was to in vestigate the evolution of S. pneumoniae serotypes isolated in the Hospital Universitario de Getafe between 2008 and 2022. Material and Methods. 313 of S. pneumoniae strains were studied. Serotyping was carried out by latex agglutina tion (Pneumotest-latex) and the Quellung reaction. In addi tion, the minimal inhibitory concentration (MIC) was deter mined against penicillin, erythromycin and levofloxacin by the concentration gradient method (E-test) according the EUCAST breakpoints. Results. The most frequent serotypes throughout the study period were 8, 3, 19A, 1, 11A and 22F corresponding to 46.6% of the isolates. Along 2008-2012 the serotypes 3, 1, 19A, 7F, 6C and 11A represented altogether 53.6% of the isolates. Between 2013 and 2017 the serotypes 3, 8, 12F, 19A, 22F and 19F grouped 51% of the isolates. During 2018-2022 the serotypes 8, 3, 11A, 15A, 4 and 6C included the 55.5% of the cases. In total 5 strains (1.6%) were penicillin resistant, 64 (20.4%) erythromycin resistant and 11 (3.5%) levofloxacin re sistant. The MIC50 and MIC90 levels maintained stables along the time. Conclusion. The conjugate vaccines use with different se rotype coverage conditioned a decrease of the vaccine-includ ed and an increase of non-covered. Despite these changes, the global antimicrobial susceptibility patterns to erythromycin and levofloxacin maintained relatively stables. The resistance a penicillin was low, not finding this type of resistant strains in the last study period (AU)
Subject(s)
Humans , Pneumococcal Infections/microbiology , Pneumococcal Infections/prevention & control , Streptococcus pneumoniae/classification , Streptococcus pneumoniae/isolation & purification , Heptavalent Pneumococcal Conjugate Vaccine/administration & dosage , Heptavalent Pneumococcal Conjugate Vaccine/immunology , Hospitals, Public , SpainABSTRACT
The objective of our study was to evaluate by pharmacokinetic/pharmacodynamic (PK/PD) analysis, if the antimicrobials used for the treatment of invasive pneumococcal disease (IPD) in adults, including meningitis, are adequate considering the susceptibility profile of S. pneumoniae in Spain after the implantation of PVC13 vaccine. Pharmacokinetic parameters of benzylpenicillin and cefotaxime were obtained from the literature, and susceptibility data of invasive S. pneumoniae strains recovered in 2017 (post-PCV13 vaccination period) were provided by the Public Health Regional Laboratory of Madrid. We have also studied levofloxacin because it is used to treat pneumococcal pneumonia previously to be diagnosed as bacteremic pneumonia. Monte Carlo simulation was used to estimate the probability of target attainment (PTA) and the cumulative fraction of response (CFR). All doses of benzylpenicillin except 2 mU q6h provide a high probability of treatment success for MIC values ≤ 1 mg/L; 4 mU q4h is even useful for MIC values up to 4 mg/L. This high dose, used for the treatment of meningitis, also provides high probability of treatment success for MIC ≤ 0.5 mg/L. At the susceptibility EUCAST breakpoint (≤ 0.5 mg/L), cefotaxime provides a high rate of PD target achievement, even at the lowest dose (1 g q8h). For meningitis, 2 g q6h ensures probabilities of target attainment ≥90% for MIC up to 1 mg/L. Our study confirms that after the implementation of PCV13 vaccine, the treatment with benzylpenicillin and cefotaxime provides high probability of the therapy success of IPD, including meningitis.
Subject(s)
Anti-Bacterial Agents/pharmacokinetics , Pneumococcal Infections/drug therapy , Pneumococcal Vaccines/administration & dosage , Streptococcus pneumoniae/drug effects , Adult , Anti-Bacterial Agents/administration & dosage , Cefotaxime/administration & dosage , Clinical Trials as Topic , Humans , Levofloxacin/administration & dosage , Penicillin G/administration & dosage , Pneumococcal Infections/microbiology , Spain , Streptococcus pneumoniae/physiologyABSTRACT
INTRODUCCIÓN: Streptococcus pneumoniae es una causa importante de morbilidad, y la vacuna es la medida más eficaz para prevenirla. El objetivo de este estudio es analizar la evolución de la enfermedad neumocócica invasora (ENI). MATERIAL Y MÉTODOS: Estudio observacional de los casos de ENI residentes en la Comunidad de Madrid notificados a la Red de Vigilancia Epidemiológica entre los años 2008 y 2015. El caso de ENI se definió como la enfermedad producida por Streptococcus pneumoniae, con aislamiento, detección de ADN o detección de antígeno, en muestras procedentes de sitios normalmente estériles. Las cepas aisladas se enviaron al Laboratorio Regional de Salud Pública para la identificación del serotipo. Los serotipos se clasificaron según su inclusión en la vacuna heptavalente (VCN7), en la vacuna trecevalente pero no en la heptavalente (VCN13 adicional) y no incluidos en la VCN13 (no VCN). Se calcularon las razones de incidencia (RI) comparando los períodos 2011-2012 y 2013-2015 con el período 2008-2010. RESULTADOS: Se notificaron 4.307 casos. El 86,6% fueron serotipados. La RI de ENI para todos los serotipos fue de 0,67 y de 0,67; la RI para los serotipos VCN7 fue de 0,43 y de 0,45; la RI para los VCN13 adicional fue de 0,46 y de 0,25, y la RI para los no VCN fue de 1,01 y de 1,32 en los períodos 2011-2012 y 2013-2015. Los serotipos 8, 9 N, 10A, 23B, 24F y el serogrupo 33 incrementaron su incidencia de manera significativa en el período 2013-2015. Los serotipos 15B y 24F supusieron el 24% de los casos no VCN13 en menores de 5años, los serotipos 8 y 9 N el 51% en población de 5 a 59 años y los serotipos 8 y 22F el 25% en mayores de 59 años. CONCLUSIONES: La incidencia de serotipos no incluidos en vacunas conjugadas ha aumentado, especialmente en menores de 5 años, pero la incidencia total de ENI ha disminuido. Es imprescindible continuar con los programas de vigilancia epidemiológica y microbiológica para valorar el efecto de la vacunación sobre la incidencia de la ENI
INTRODUCTION: Streptococcus pneumoniae is an important cause of morbidity. Vaccination is the most effective measure to prevent it. The aim of this study is to analyse the evolution of invasive pneumococcal disease (IPD). MATERIAL AND METHODS: Observational study of IPD cases notified to the Epidemiological Surveillance Network of the Autonomous Community of Madrid between 2008 and 2015. The IPD case was defined as the disease caused by Streptococcus pneumoniae, with isolation and DNA or antigen detection, in samples from normally sterile sites. The isolated strains were sent to the Regional Public Health Laboratory for identification of the serotype. Serotypes were classified according to their inclusion in the 7-valent conjugate vaccine (PCV7), in the 13-valent vaccine, but not in the 7-valent vaccine (PCV13-additional) and not included in the 13-valent vaccine (non-PCV). The Incidence Rate Ratios (IRRs) were calculated comparing the 2011-2012 and 2013-2015 periods with the 2008-2010 period. RESULTS: 4,307 cases were reported. 86.6% were serotyped. The IRR of IPD was 0.67 and 0.67 for all serotypes; 0.43 and 0.45 for PCV7 serotypes; 0.46 and 0.25 for PCV13-additional serotypes, and 1.01 and 1.32 for non-PCV13 serotypes in the 2011-2012 and 2013-2015 periods. The incidence of serotypes 8, 9 N, 10A, 23B, 24F and serogroup 33 increased significantly in the 2013-2015 period. Serotypes 15B and 24F accounted for 24% of non-PCV13 cases in children under 5 years, serotypes 8 and 9 N for 51% in the population aged 5 to 59 years and serotypes 8 and 22 F for 25% in the population aged over 59 years. CONCLUSIONS: The incidence of serotypes not included in conjugate vaccines has increased, especially in children under 5years, but the total incidence of IPD has decreased. It is important to continue with the epidemiological and microbiological surveillance programmes to assess the effect of vaccination on the incidence of IPD
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Young Adult , Adult , Middle Aged , Heptavalent Pneumococcal Conjugate Vaccine/administration & dosage , Streptococcus pneumoniae/genetics , Pneumococcal Infections/epidemiology , Observational Study , Serotyping , Spain/epidemiology , Incidence , Pneumococcal Infections/microbiology , Pneumococcal Infections/prevention & control , Disease NotificationABSTRACT
BACKGROUND: Chickenpox is a contagious airborne disease. Immunization by varicella vaccine is an effective preventive measure. The objective of this study is to evaluate the impact and effectiveness of a single-dose vaccination against chickenpox at 15 months of age. METHODS: Observational study based on data from the Epidemiological Surveillance System of the Autonomous Community of Madrid from 2001 to 2015. The years were grouped into 4 periods according to epidemic cycles and vaccination schedule: 2001-06, 2007-10, 2011-13 and 2014-15. The impact was calculated as Relative Risk (RR) between the incidence of chickenpox in children between 15 months and 13 years of age between 2011-13 and 2001-06 through Poisson regression using notifications made to the Diseases of Compulsory Declaration (DCD) system, the Sentinel Physicians Network (SPN) and hospital discharge records noted as Minimum Basic Data Set (MBDS). The vaccine effectiveness (VE) was calculated using the screening method and a 1:2 case-control study paired by age and paediatrician in population from 15 months to 13 years and between 2007 and 2015 using SPN source data. RESULTS: The RR2011-13/2001-06 using data from the DCD was 0.14 (95% CI: 0.14 to 0.15), 0.07 (95% CI: 0.06 to 0.08) from SPN and 0.17 (95% CI: 0.15 to 0.20) from MBDS. A total of 338 cases were included in the VE screening obtaining an overall of 76.7% (IC 95%: 71.9 to 80.7%). For a case-control study, 120 cases and 247 controls were recruited obtaining a VE of 92.4% (IC 95%: 80.8 to 97.0%). CONCLUSIONS: The single-dose vaccination against chickenpox at 15 months of age has high impact and effectiveness.
Subject(s)
Chickenpox Vaccine/administration & dosage , Chickenpox Vaccine/immunology , Chickenpox/epidemiology , Chickenpox/prevention & control , Adolescent , Case-Control Studies , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Immunization Schedule , Incidence , Infant , Male , Spain/epidemiology , Treatment OutcomeABSTRACT
INTRODUCTION: Streptococcus pneumoniae is an important cause of morbidity. Vaccination is the most effective measure to prevent it. The aim of this study is to analyse the evolution of invasive pneumococcal disease (IPD). MATERIAL AND METHODS: Observational study of IPD cases notified to the Epidemiological Surveillance Network of the Autonomous Community of Madrid between 2008 and 2015. The IPD case was defined as the disease caused by Streptococcus pneumoniae, with isolation and DNA or antigen detection, in samples from normally sterile sites. The isolated strains were sent to the Regional Public Health Laboratory for identification of the serotype. Serotypes were classified according to their inclusion in the 7-valent conjugate vaccine (PCV7), in the 13-valent vaccine, but not in the 7-valent vaccine (PCV13-additional) and not included in the 13-valent vaccine (non-PCV). The Incidence Rate Ratios (IRRs) were calculated comparing the 2011-2012 and 2013-2015 periods with the 2008-2010 period. RESULTS: 4,307 cases were reported. 86.6% were serotyped. The IRR of IPD was 0.67 and 0.67 for all serotypes; 0.43 and 0.45 for PCV7 serotypes; 0.46 and 0.25 for PCV13-additional serotypes, and 1.01 and 1.32 for non-PCV13 serotypes in the 2011-2012 and 2013-2015 periods. The incidence of serotypes 8, 9N, 10A, 23B, 24F and serogroup 33 increased significantly in the 2013-2015 period. Serotypes 15B and 24F accounted for 24% of non-PCV13 cases in children under 5years, serotypes 8 and 9N for 51% in the population aged 5 to 59years and serotypes 8 and 22F for 25% in the population aged over 59years. CONCLUSIONS: The incidence of serotypes not included in conjugate vaccines has increased, especially in children under 5years, but the total incidence of IPD has decreased. It is important to continue with the epidemiological and microbiological surveillance programmes to assess the effect of vaccination on the incidence of IPD.
Subject(s)
Pneumococcal Infections/microbiology , Streptococcus pneumoniae/classification , Adolescent , Adult , Child , Child, Preschool , Humans , Incidence , Infant , Middle Aged , Pneumococcal Infections/epidemiology , Serogroup , Spain/epidemiology , Time Factors , Urban Health , Young AdultABSTRACT
FUNDAMIENTO Y OBJETIVO: En la Comunidad de Madrid se incluyó la vacuna frente a varicela en el calendario infantil en noviembre del 2006 a los 15 meses de edad. Dicha recomendación se retiró en enero del 2014. Se estima la seroprevalencia de anticuerpos frente al virus tras los 2-3 primeros años desde la inclusión de la vacuna y su evolución desde 1999. MATERIAL Y MÉTODO: Estudio descriptivo transversal. La población diana son los residentes en la Comunidad de Madrid entre 2 y 60 años. La medición de anticuerpos IgG se realizó mediante técnicas de ELISA. Se estima la seroprevalencia según características sociodemográficas mediante regresión logística múltiple. Los resultados se comparan con encuestas previas. Asimismo, se presentan la seroprevalencia y la media geométrica de anticuerpos según el estado vacunal y los antecedentes de la enfermedad. El nivel de confianza utilizado es del 95%. RESULTADOS: Participaron 4.378 sujetos, con una tasa de respuesta del 69%. La seroprevalencia estimada es del 95,3% (IC del 95%, 94,6%-95,9%). Más del 90% de los niños a partir de los 10 años de edad presentan anticuerpos. La seroprevalencia fue mayor en personas con menor nivel educativo. La seroprevalencia de inmunidad vacunal supera el 90% en el primer año tras la vacunación pero en el segundo año desciende hasta el 82,6% (IC del 95%, 56,0-94,7). Se encontraron diferencias significativas con las encuestas anteriores atribuibles a la vacunación universal. DISCUSIÓN: Es necesario continuar la vigilancia epidemiológica para valorar el impacto de la retirada de la recomendación de vacunar a los 15 meses de edad
BACKGROUND AND OBJECTIVE: In November 2006, the Community of Madrid included the chickenpox vaccine into the immunisation schedule for children from 15 months of age. This was withdrawn in January 2014. Seroprevalence of antibodies to the virus is estimated after the first 2-3 years from the inclusion of the vaccine, and as well as its evolution since 1999. MATERIAL AND METHOD: A cross-sectional study was conducted on the target population consisting of residents in the Community of Madrid between 2 and 60 years of age. Measurement of IgG antibodies was performed using an ELISA technique. Seroprevalence was estimated according to sociodemographic characteristics using multiple logistic regressions. The results are compared with previous surveys. Also, the seroprevalence and geometric mean of the antibody according immunisation status and history of the disease are presented. The confidence level used is 95%. RESULTS: A total of 4,378 subjects were included, with a response rate of 69%. The estimated seroprevalence was 95.3% (95% CI: 94.6% - 95.9%). Over 90% of children from the age of 10 have antibodies. The seroprevalence was higher in people with less education. The seroprevalence of immunity vaccine exceeds 90% in the first year after vaccination, but in the second year decreased to 82.6% (95% CI 56.0 - 94.7). Significant differences, attributable to universal vaccination, were found compared to previous surveys. DISCUSSION: Continued surveillance is needed in order to assess the impact of the withdrawal of the recommendation to vaccinate at 15 months
Subject(s)
Humans , Infant , Herpesvirus 3, Human/isolation & purification , Herpes Zoster/immunology , Herpes Zoster Vaccine/administration & dosage , Seroepidemiologic Studies , Cross-Sectional Studies , Epidemiologic Surveillance ServicesABSTRACT
BACKGROUND AND OBJECTIVE: In November 2006, the Community of Madrid included the chickenpox vaccine into the immunisation schedule for children from 15 months of age. This was withdrawn in January 2014. Seroprevalence of antibodies to the virus is estimated after the first 2-3 years from the inclusion of the vaccine, and as well as its evolution since 1999. MATERIAL AND METHOD: A cross-sectional study was conducted on the target population consisting of residents in the Community of Madrid between 2 and 60 years of age. Measurement of IgG antibodies was performed using an ELISA technique. Seroprevalence was estimated according to sociodemographic characteristics using multiple logistic regressions. The results are compared with previous surveys. Also, the seroprevalence and geometric mean of the antibody according immunisation status and history of the disease are presented. The confidence level used is 95%. RESULTS: A total of 4,378 subjects were included, with a response rate of 69%. The estimated seroprevalence was 95.3% (95% CI: 94.6% - 95.9%). Over 90% of children from the age of 10 have antibodies. The seroprevalence was higher in people with less education. The seroprevalence of immunity vaccine exceeds 90% in the first year after vaccination, but in the second year decreased to 82.6% (95% CI 56.0 - 94.7). Significant differences, attributable to universal vaccination, were found compared to previous surveys. DISCUSSION: Continued surveillance is needed in order to assess the impact of the withdrawal of the recommendation to vaccinate at 15 months.
Subject(s)
Antibodies, Viral/blood , Chickenpox Vaccine/immunology , Herpesvirus 3, Human/immunology , Adolescent , Adult , Chickenpox Vaccine/administration & dosage , Child , Child, Preschool , Cross-Sectional Studies , Humans , Immunization Schedule , Infant , Middle Aged , Seroepidemiologic StudiesABSTRACT
Together with AIDS, the burden of hepatitis C virus (HCV) in Spain heads the list of communicable diseases in terms of impact on public health. The aim of this study was to estimate the prevalence of HCV antibodies in the Community of Madrid, assess changes in recent years and analyse associated risk factors. Descriptive cross-sectional study of a target population consisting of Community of Madrid residents aged 16-80 years old. Two-stage cluster sampling was performed, with stratification by socioeconomic status and percentage immigrant population. The sampling frame consisted of public blood extraction centers attached to the Madrid Health Service. Seroprevalence of HCV antibodies, prevalence ratios by age groups in comparison with 1999 survey data and prevalence association with risk factors were assessed using a logistic regression model. Prevalence of HCV antibodies for the age group 16-80 years was 1.8% (95% CI: 1.3-2.5). The age group with the highest prevalence was 41-60 years. In comparison with the 1999 survey, prevalence fell for the age groups 21-30 and 31-40 years and increased for the age group 41-60. Statistically significant associations were found for age, education, history of hepatitis C and consultation regarding liver problems. Seroprevalence of HCV antibodies in the Community of Madrid is similar to that shown in other regions of Spain. It is increasing in older age groups as the population at risk ages. Incidence of hepatitis C may be decreasing considering the decrease in the seroprevalence in the population younger than 40 related to the previous serosurvey.
Subject(s)
Hepatitis C Antibodies/blood , Hepatitis C/epidemiology , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Cross-Sectional Studies , Emigrants and Immigrants/statistics & numerical data , Female , Hepatitis C/immunology , Humans , Logistic Models , Male , Middle Aged , Prevalence , Risk Factors , Seroepidemiologic Studies , Socioeconomic Factors , Spain/epidemiology , Young AdultABSTRACT
Objective. To estimate the prevalence of hepatitis B virus (HBV) infection and vaccine-induced immunity in the region of Madrid, and to analyze their evolution over time. Methods. An observational, analytical, cross-sectional study was carried out in the population aged 16-80 years between 2008 and 2009. This was the last of four seroprevalence surveys in the region of Madrid. The prevalence of HBV infection and vaccine-induced immunity was estimated using multivariate logistic models and were compared with the prevalences in the 1989, 1993 and 1999 surveys. Results. In the population aged 16-80 years, the prevalence of HBV infection was 11.0% (95% CI: 9.8-12.3) and that of chronic infection was 0.7% (95% CI: 0.5-1.1). The prevalence of vaccine-induced immunity in the population aged 16-20 years was 73.0% (95% CI: 70.0-76.0). Compared with previous surveys, there was a decrease in the prevalence of HBV infection. Conclusions. Based on the prevalence of chronic infection (< 1 %), Madrid is a region with low HBV endemicity. Preventive strategies against HBV should especially target the immigrant population (AU)
Objetivo. Estimar la prevalencia de infección por hepatitis B(HB) e inmunidad vacunal en la Comunidad de Madrid y analizar su evolución en el tiempo. Métodos. Estudio observacional analítico transversal en población de 16-80 años, en 2008-2009. Ésta es la última de cuatro encuestas de seroprevalencia. La prevalencia de infección por HB e inmunidad vacunal fue estimada usando modelos logísticos multivariantes y se compararon con las encuestas de 1989, 1993 y 1999. Resultados. En población de 16-80 años, la prevalencia de infección por HB fue 11,0% (IC-95%:9,8-12,3) y 0,7% (IC-95%:0,5-1,1) de infección crónica. La prevalencia de inmunidad vacunal en población de 16-20 años fue 73,0% (IC-95%:70,0-76,0). En comparación con anteriores encuestas la prevalencia de infección disminuyó. Conclusiones. Madrid es una región de baja endemicidad de HB, de acuerdo a la prevalencia de infección crónica (<1%). Las estrategias de prevención de la HB deben dirigirse especialmente a la población inmigrante (AU)
Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Adult , Middle Aged , Aged , Aged, 80 and over , Hepatitis B/chemically induced , Hepatitis B/complications , Hepatitis B/immunology , Hepatitis, Chronic/complications , Hepatitis, Chronic/immunology , Immunization/methods , Immunization/standards , Immunization , Vaccination/methods , Sensitivity and Specificity , Multivariate Analysis , Logistic ModelsABSTRACT
OBJECTIVE: To estimate the prevalence of hepatitis B virus (HBV) infection and vaccine-induced immunity in the region of Madrid, and to analyze their evolution over time. METHODS: An observational, analytical, cross-sectional study was carried out in the population aged 16-80 years between 2008 and 2009. This was the last of four seroprevalence surveys in the region of Madrid. The prevalence of HBV infection and vaccine-induced immunity was estimated using multivariate logistic models and were compared with the prevalences in the 1989, 1993 and 1999 surveys. RESULTS: In the population aged 16-80 years, the prevalence of HBV infection was 11.0% (95% CI: 9.8-12.3) and that of chronic infection was 0.7% (95% CI: 0.5-1.1). The prevalence of vaccine-induced immunity in the population aged 16-20 years was 73.0% (95% CI: 70.0-76.0). Compared with previous surveys, there was a decrease in the prevalence of HBV infection. CONCLUSIONS: Based on the prevalence of chronic infection (<1%), Madrid is a region with low HBV endemicity. Preventive strategies against HBV should especially target the immigrant population.
Subject(s)
Hepatitis B Antibodies/analysis , Hepatitis B Vaccines/immunology , Hepatitis B/epidemiology , Adaptive Immunity , Adolescent , Adult , Aged , Cross-Sectional Studies , Emigrants and Immigrants , Female , Hepatitis B/prevention & control , Hepatitis B, Chronic/epidemiology , Humans , Male , Middle Aged , Seroepidemiologic Studies , Urban Population , Vaccination/statistics & numerical data , Young AdultABSTRACT
En el presente trabajo se han revisado los resultados deseroprevalencia frente a sarampión, rubéola y parotiditis obtenidosen la III Encuesta de Serovigilancia de la Comunidad deMadrid (III ESVCM) realizada en 1999-2000 y la posteriorevolución de estas tres enfermedades en esta región.En la III ESVCM la prevalencia de anticuerpos frente asarampión, rubéola y parotiditis fue respectivamente >90%,>95% y <90%. Pese a los buenos resultados obtenidos pararubéola y sarampión, en los años 2005 y 2006 surgieron enMadrid dos importantes brotes de estas enfermedades. El brotede rubéola de 2005 (460 casos) afectó especialmente a poblacióninmigrante de ambos sexos (procedentes mayoritariamentede América Central y del Sur) y varones adultos españoles. Elbrote de sarampión de 2006 (174 casos) fue importado, una elevadaproporción de casos eran adultos, la mayoría de los pacientesno estaban vacunados y no se observaron diferencias por delsexo. En la Comunidad de Madrid la circulación del virus de laparotiditis ha continuado desde 1999 hasta la actualidad y se handetectado ondas epidémicas en los periodos 2000-2001 y 2006-2007. Durante el período 2006-2007 una importante proporciónde los casos presentaron antecedentes de vacunación.Cada una de estas tres enfermedades presenta característicaspropias. Sin embargo, las tres muestran en común el cambioen la edad de aparición con una frecuencia cada vez mayorde casos entre adultos jóvenes(AU)
In this study results against measles, rubella and mumpsobtained in the III Sero-epidemiological Survey of theAutonomous Region of Madrid, performed in 1999-2000,were related to the posterior evolution of these diseases in thisRegion.The prevalence of antibodies against measles, rubella andmumps was >90%, >95% and <90 %, respectively. Despite ofthe good results obtained for rubella and measles, in 2005 and2006 two important outbreaks of these diseases occurred inMadrid. The rubella outbreak in 2005 (450 cases) affectedespecially to immigrants of both sexes (mainly from Central andSouth America) and Spanish adults males. The 2006 measlesoutbreak (174 cases) was imported, a high proportion of caseswere adults and most of the patients were unvaccinated. Nodifferences according to sex were observed. In Madrid mumpsvirus circulation has continued from 1999 to present. Twoepidemic waves in the periods 2000-2001 and 2006-2007 havebeen detected. During 2006-2007, an important proportion ofcases showed antecedents of vaccination.Each one of these three diseases has typicalcharacteristics. However, the three has in common the changein the age of apparition, with a growing frequency of casesamong young adults(AU)
Subject(s)
Humans , Rubella/epidemiology , Measles/epidemiology , Parotitis/epidemiology , Seroepidemiologic Studies , Health Surveys , Epidemiological Monitoring/trends , Disease Outbreaks , Age DistributionABSTRACT
In this study results against measles, rubella and mumps obtained in the III Sero-epidemiological Survey of the Autonomous Region of Madrid, performed in 1999-2000, were related to the posterior evolution of these diseases in this Region. The prevalence of antibodies against measles, rubella and mumps was >90%, >95% and <90 %, respectively. Despite of the good results obtained for rubella and measles, in 2005 and 2006 two important outbreaks of these diseases occurred in Madrid. The rubella outbreak in 2005 (450 cases) affected especially to immigrants of both sexes (mainly from Central and South America) and Spanish adults males. The 2006 measles outbreak (174 cases) was imported, a high proportion of cases were adults and most of the patients were unvaccinated. No differences according to sex were observed. In Madrid mumps virus circulation has continued from 1999 to present. Two epidemic waves in the periods 2000-2001 and 2006-2007 have been detected. During 2006-2007, an important proportion of cases showed antecedents of vaccination. Each one of these three diseases has typical characteristics. However, the three has in common the change in the age of apparition, with a growing frequency of cases among young adults.
Subject(s)
Antibodies, Viral/blood , Measles/blood , Measles/epidemiology , Mumps/blood , Mumps/epidemiology , Rubella/blood , Rubella/epidemiology , Adolescent , Adult , Child , Child, Preschool , Female , Health Surveys , Humans , Male , Seroepidemiologic Studies , Spain , Urban Health , Young AdultABSTRACT
OBJECTIVE: The aim of this study was to assess the seroprevalence of Toscana virus (TOSV) in the Community of Madrid. METHODS: Samples from two serosurveys obtained during 1993-1994 (2262 individuals) and 1999-2000 (1945 individuals) were studied. Samples were tested by ELISA for TOSV IgG detection. RESULTS: The seroprevalence of TOSV IgG was significantly higher in 1993-1994 (7.2%; 95% CI 6.2-8.4) than in 1999-2000 (5.7%; 95% CI 4.7-6.9) (chi-square, p < 0.05). In both periods, the prevalence increased significantly with age. CONCLUSION: These results confirm that TOSV has been circulating in the Community of Madrid over the last years.
Subject(s)
Antibodies, Viral/blood , Phlebotomus Fever/epidemiology , Sandfly fever Naples virus/immunology , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Child , Child, Preschool , Enzyme-Linked Immunosorbent Assay , Female , Humans , Immunoglobulin G/blood , Male , Middle Aged , Morbidity/trends , Retrospective Studies , Seroepidemiologic Studies , Urban Population/statistics & numerical dataABSTRACT
Este trabajo ha sido presentado en parte en el XII Congreso de la Sociedad Española de Microbiología Clínica y Enfermedades Infecciosas (Valencia del 10 al 13 de mayo de 2006). Objetivo. Valorar la seroprevalencia frente a virus Toscana (VTOS) en la Comunidad de Madrid. Métodos. Se estudiaron muestras de dos encuestas de serovigilancia obtenidas durante 1993-1994 (2.262 individuos) y 1999-2000 (1.945 individuos). Las muestras se procesaron mediante análisis inmunoenzimático (ELISA) para la detección de IgG frente a VTOS. Resultados. La seroprevalencia en 1993-1994 (7,2%; IC 95%: 6,2-8,4) resultó significativamente mayor (x2; p < 0,05) que en 1999-2000 (5,7%; IC 95%: 4,7-6,9). En ambos períodos la prevalencia aumentó significativamente según la edad. Conclusión. Estos resultados confirman la circulación de VTOS en la Comunidad de Madrid durante los últimos años (AU)
Objective. The aim of this study was to assess the seroprevalence of Toscana virus (TOSV) in the Community of Madrid. Methods. Samples from two serosurveys obtained during 1993-1994 (2262 individuals) and 1999-2000 (1945 individuals) were studied. Samples were tested by ELISA for TOSV IgG detection. Results. The seroprevalence of TOSV IgG was significantly higher in 1993-1994 (7.2%; 95% CI 6.2-8.4) than in 1999-2000 (5.7%; 95% CI 4.7-6.9) (chi-square, p < 0.05). In both periods, the prevalence increased significantly with age. Conclusion. These results confirm that TOSV has been circulating in the Community of Madrid over the last years (AU)
Subject(s)
Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Humans , Antibodies, Viral/blood , Sandfly fever Naples virus/immunology , Phlebotomus Fever/epidemiology , Age Distribution , Immunoglobulin G/blood , Morbidity/trends , Retrospective Studies , Seroepidemiologic Studies , Urban Population/statistics & numerical data , Enzyme-Linked Immunosorbent AssaySubject(s)
Cross Infection , Giardiasis/epidemiology , Maternal-Child Health Centers , Adult , Animals , Child, Preschool , Cross Infection/transmission , Female , Giardia lamblia , Giardiasis/transmission , Humans , Infant , SpainABSTRACT
BACKGROUND AND OBJECTIVE: The aim of this study was to describe an outbreak of Q fever in a group of people (day care centre for mental-handicapped individuals) previously exposed to animals in a school-farm. PATIENTS AND METHOD: A retrospective cohort study among the 25 mental-handicapped individuals and the 30 workers of the centre was performed. The information about symptoms and signs and antecedents of exposition was obtained by an epidemiological survey and a clinical-epidemiological case definition was established. Serum samples from 29 people (5 mental-handicapped individuals and 24 workers) were processed for serology (Indirect Immunofluorescence against Coxiella burnetii). RESULTS: Twenty two cases of Q fever were detected. Ten were confirmed by serology (6 of them asymptomatic). More frequent symptoms were fever (100%), anorexia (81.3%), asthenia (68.8%) and non-productive cough (56.3%) among the 16 clinical cases. The risk of acute infection was 8.6 times higher in individuals of the centre that visited the school-farm (95% CI, 1.26-58.27). CONCLUSIONS: The investigation of the epidemiological antecedents allowed to detect and confirm a Q fever outbreak, to identify the probable source of exposition and to orientate the clinical and serological diagnosis.
Subject(s)
Coxiella burnetii/isolation & purification , Disease Outbreaks , Q Fever/epidemiology , Adult , Antibodies, Bacterial/blood , Cohort Studies , Confidence Intervals , Female , Humans , Male , Q Fever/blood , Q Fever/diagnosis , Retrospective Studies , Risk , Seroepidemiologic Studies , Serologic Tests , Spain/epidemiologyABSTRACT
No disponible
Subject(s)
Male , Female , Child , Adult , Humans , Giardiasis/epidemiology , Disease Outbreaks , Giardia lamblia/pathogenicity , Risk Factors , Residential Facilities/statistics & numerical dataABSTRACT
Fundamento y objetivo: El objetivo del estudio ha sido describir un brote de fiebre Q en un colectivo (centro de día para discapacitados psíquicos) con antecedente de exposición a animales en una granja-escuela. Pacientes y método: Se ha realizado un estudio de cohortes retrospectivo entre los 25 usuarios y los 30 trabajadores del centro. Se recabó información referente a exposición, síntomas y signos de enfermedad y se estableció una definición clinicoepidemiológica de caso. En 29 personas (5 usuarios y 24 trabajadores del centro) se procesaron muestras para serología (inmunofluorescencia indirecta para Coxiella burnetii). Resultados: Se detectaron 22 casos de fiebre Q. Diez se confirmaron por serología (6 de ellos asintomáticos). Entre los 16 casos clínicos los síntomas más frecuentes fueron fiebre (100%), anorexia (81,3%), astenia (68,8%) y tos no productiva (56,3%). El riesgo de infección aguda se estimó en 8,6 veces mayor entre las personas del colectivo que acudieron a la granja-escuela (intervalo de confianza del 95%, 1,26-58,27). Conclusiones: La investigación de los antecedentes epidemiológicos permitió detectar y confirmar un brote de fiebre Q, identificar la probable fuente de exposición y orientar el diagnóstico clínico y serológico
Background and objective: The aim of this study was to describe an outbreak of Q fever in a group of people (day care centre for mental-handicapped individuals) previously exposed to animals in a school-farm. Patients and method: A retrospective cohort study among the 25 mental-handicapped individuals and the 30 workers of the centre was performed. The information about symptoms and signs and antecedents of exposition was obtained by an epidemiological survey and a clinical-epidemiological case definition was established. Serum samples from 29 people (5 mental-handicapped individuals and 24 workers) were processed for serology (Indirect Immunofluorescence against Coxiella burnetii). Results: Twenty two cases of Q fever were detected. Ten were confirmed by serology (6 of them asymptomatic). More frequent symptoms were fever (100%), anorexia (81.3%), asthenia (68.8%) and non-productive cough (56.3%) among the 16 clinical cases. The risk of acute infection was 8.6 times higher in individuals of the centre that visited the school-farm (95% CI, 1.26-58.27). Conclusions: The investigation of the epidemiological antecedents allowed to detect and confirm a Q fever outbreak, to identify the probable source of exposition and to orientate the clinical and serological diagnosis
Subject(s)
Male , Female , Humans , Q Fever/epidemiology , Disease Outbreaks , Retrospective Studies , Cohort Studies , Coxiella burnetii/pathogenicity , Animals, Domestic/microbiology , Risk Factors , Anti-Bacterial Agents/therapeutic useABSTRACT
The aim of this study was to discriminate between primary and secondary vaccine failure in children with mumps using IgG avidity testing. Thirty-nine serum samples from children with mumps, confirmed by specific IgM, were studied. The patients were grouped according to their immunization status. The secondary immune response was defined by IgG with an avidity index >32%. A secondary response in infected children previously immunized was considered as a secondary vaccine failure. Vaccinated children presented higher IgG titers and IgG avidity than unvaccinated children. The proportion of secondary immune responses in unvaccinated patients was lower than that obtained in previously vaccinated infected patients. Avidity testing can be a useful tool to detect secondary vaccine failure in mumps.
Subject(s)
Antibodies, Viral/immunology , Antibody Affinity , Immunoglobulin G/immunology , Measles-Mumps-Rubella Vaccine/immunology , Mumps/immunology , Antibodies, Viral/blood , Child , Child, Preschool , Humans , Immunization, Secondary , Immunoglobulin G/blood , Immunoglobulin M/blood , Immunoglobulin M/immunology , Measles-Mumps-Rubella Vaccine/administration & dosage , Treatment FailureABSTRACT
BACKGROUND AND OBJECTIVE: The purpose was to investigate the etiology and epidemiological characteristics of a food-borne infection outbreak in a school dining room. SUBJECTS AND METHOD: Retrospective cohort study. Information about gastrointestinal symptoms and the use of the service of the school dining room was obtained. Coprocultures and detection of Clostridium perfringens enterotoxin in stool samples by means of reverse passive latex agglutination were carried out in 7 ill persons. Relative risks (RR) at 95% confidence intervals (95% CI) were calculated. RESULTS: The attack rate was 17.5% (48/275) and the probability of becoming sick was higher in students who ate at the second shift than in those eating at the first one (RR=13.8; 95% CI: 4.4-43.1). C perfringens enterotoxin was detected in 6 stool samples from patients. A high recount of C perfringens was not observed in those food samples kept frozen after their elaboration. CONCLUSIONS: The determination of C perfringens enterotoxin in feces allowed to confirm the etiologic agent of the outbreak.
