RESUMO
The introduction of pneumococcal conjugate vaccines (PCV7 and PCV13) in children has led to a change in the pattern of pneumococcal serotypes causing pneumococcal disease in adults. The aim of this study is to analyze the distribution of pneumococcal serotypes in adults with bacteremic pneumococcal community-acquired pneumonia (BPP) after the introduction of PCVs in childhood, and the impact of age and comorbidity on this distribution. We conducted an observational study of all adults hospitalized with BPP between 2001 and 2014, in two tertiary hospitals. Overall, we identified 451 cases of BPP (2001-2005: 194, 2006-2010: 134, 2011-2014: 123). The rate of appearance of new cases decreased over the study period. In 70% of the cases, the serotypes found were among those included in PCV13. The most prevalent serotypes were 3 (23.1%), 7F (14.6%), 19A (8.4%) and 1 (7.5%). There was a significant trend to decrease in the percentage of BPP cases due to PCV7 from period 2001-2005 to 2011-2014 (pâ¯=â¯0.0166) and a significant trend to increase in the six serotypes added to form PCV 13 (pâ¯=â¯0.0003). Serotype 3 was the most frequent in patients who developed complications during hospitalization. We did not detect a significant increase in cases caused by non-PCV13 serotypes. The most frequent non-PCV13 serotype was 22F. In conclusion, a significant proportion of adults continue to develop BPP with vaccine serotypes despite infant pneumococcal vaccination. There is a need for further strategies to reduce the current burden of this disease on adults.
Assuntos
Vacina Pneumocócica Conjugada Heptavalente/administração & dosagem , Vacinas Pneumocócicas/administração & dosagem , Pneumonia Pneumocócica/microbiologia , Streptococcus pneumoniae/classificação , Adulto , Idoso , Idoso de 80 Anos ou mais , Bacteriemia/epidemiologia , Bacteriemia/microbiologia , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Pneumocócica/epidemiologia , Prevalência , Estudos Prospectivos , Sorogrupo , Espanha/epidemiologia , Centros de Atenção Terciária , VacinaçãoAssuntos
Doenças Transmissíveis Emergentes/tratamento farmacológico , Doenças Transmissíveis Emergentes/epidemiologia , Farmacorresistência Bacteriana Múltipla , Mycobacterium tuberculosis/efeitos dos fármacos , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/epidemiologia , Adolescente , Adulto , Criança , Doenças Transmissíveis Emergentes/microbiologia , Farmacorresistência Bacteriana Múltipla/genética , Emigrantes e Imigrantes , Guiné Equatorial/etnologia , Feminino , Genes Bacterianos , Humanos , Masculino , Pessoa de Meia-Idade , Epidemiologia Molecular , Mutação , Mycobacterium tuberculosis/genética , Mycobacterium tuberculosis/isolamento & purificação , Espanha/epidemiologia , Tuberculose Pulmonar/microbiologia , Adulto JovemRESUMO
The usefulness of single-enzyme amplified-fragment length polymorphism (AFLP) analysis for the subtyping of Mycobacterium kansasii type I isolates was evaluated. This simplified technique classified 253 type I strains into 12 distinct clusters. The discriminating power of this technique was high, and the technique easily distinguished between the epidemiologically unrelated control strains and our clinical isolates. Overall, the technique was relatively rapid and technically simple, yet it gave reproducible and discriminatory results. This technique provides a powerful typing tool which may be helpful in solving many questions concerning the reservoirs, pathogenicities, and modes of transmission of these isolates.
Assuntos
Mycobacterium kansasii/isolamento & purificação , Sequência de Bases , Impressões Digitais de DNA/métodos , Primers do DNA , DNA Bacteriano/genética , DNA Bacteriano/isolamento & purificação , Eletroforese em Gel de Campo Pulsado , Humanos , Mycobacterium kansasii/classificação , Mycobacterium kansasii/genética , Reação em Cadeia da Polimerase/métodos , Polimorfismo Genético , Polimorfismo de Fragmento de Restrição , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
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