Infección neumocócica en pacientes oncohematológicos tras la introducción de la vacuna conjugada / Pneumococcal infections in oncohematological patients after the introduction of conjugate vaccine

Objetivo. Precisar la clínica y los serotipos predominantes en las infecciones neumocócicas incidentes en pacientes oncohematológicos tras la introducción de la vacuna conjugada heptavalente. Pacientes y métodos. erie de casos prospectiva (enero 2006- mayo 2011) de la totalidad de casos de infección, incidentes en pacientes oncohematológicos de más de 17 años de edad, en los que se aisló Streptococcus pneumoniae. Resultados. Se detectaron 131 episodios de infección neumocócica, incidentes en 122 pacientes (mediana de edad: 67 años). El 50% se relacionó con atención sanitaria/nosocomial. El 39,7% fueron neumonías y el 45,1% infecciones del tracto respiratorio bajo sin condensación radiológica. Con respecto a los 803 casos de infección neumocócica, incidentes durante el mismo periodo en pacientes sin enfermedad oncohematológica, los pacientes oncohematológicos fueron más frecuentemente varones (p<0,001), presentaron neumonías con índices de FINE más altos (p<0,001), una mortalidad no atribuible a la infección menor (p<0,006) y una mayor probabilidad de sensibilidad disminuida a levofloxacino (p=0,043). Predominaron los serotipos no vacunales. Conclusiones. Las infecciones neumocócicas incidentes en pacientes oncohematológicos se presentan predominantemente en varones, afectos de cánceres de pulmón. Se relacionan con la atención sanitaria, pero no con exposición reciente a quimioterapia o neutropenia. Tras la introducción de la vacuna pediátrica heptavalente conjugada predominan los serotipos no vacunales(AU)

Objectives. To know the symptoms and predominant serotypes of pneumococcal infection in patients with oncohematological illness after introduction of 7-valent pneumococcal conjugate vaccine. Patients and methods. A prospective study (january 2006-may 2011) was made of all the incident cases of infection in oncohematological patients over 17 years of age in whom Streptococcus pneumoniae was isolated. Results. A total of 131 episodes of incident cases of pneumococcal infection in 122 patients (median age of 67 years) were detected. Of these, 50% were related to health/nosocomial care (P<.001), 39.7% pneumonias and 45.1% lower respiratory tract infections, without radiological condensation. In comparison to the 803 incident cases of pneumococcal infection during the same period as in patients without oncohematological disease, the oncohematological patients were more frequently males (P<.001), had pneumonia episodes with higher FINE scores (P<.001), lower risk of death non-directly associated with pneumococcal infection (P=.006) and showed reduced susceptibility to levofloxacin (P=.043). Non-vaccine serotypes predominated. Conclusions. Pneumococcal infections in oncohematological patients are more frequent in males, mainly with lung neoplasms. They are heath care related, but not related to chemotherapy or neutropenia. After the introduction of heptavalent conjugate vaccines in pediatrics, the non-vaccine serotypes predominate(AU)

Pneumococcal infections in oncohematological patients after the introduction of conjugate vaccine.

OBJECTIVES: To know the symptoms and predominant serotypes of pneumococcal infection in patients with oncohematological illness after introduction of 7-valent pneumococcal conjugate vaccine. PATIENTS AND METHODS: A prospective study (january 2006-may 2011) was made of all the incident cases of infection in oncohematological patients over 17 years of age in whom Streptococcus pneumoniae was isolated. RESULTS: A total of 131 episodes of incident cases of pneumococcal infection in 122 patients (median age of 67 years) were detected. Of these, 50% were related to health/nosocomial care (P<.001), 39.7% pneumonias and 45.1% lower respiratory tract infections, without radiological condensation. In comparison to the 803 incident cases of pneumococcal infection during the same period as in patients without oncohematological disease, the oncohematological patients were more frequently males (P<.001), had pneumonia episodes with higher FINE scores (P<.001), lower risk of death non-directly associated with pneumococcal infection (P=.006) and showed reduced susceptibility to levofloxacin (P=.043). Non-vaccine serotypes predominated. CONCLUSIONS: Pneumococcal infections in oncohematological patients are more frequent in males, mainly with lung neoplasms. They are heath care related, but not related to chemotherapy or neutropenia. After the introduction of heptavalent conjugate vaccines in pediatrics, the non-vaccine serotypes predominate.

[Usefulness of a new fast technique for detection of pneumococcal antigen in the diagnosis of community pneumonia]. / Utilidad de una nueva técnica rápida de detección de antígeno neumocócico en el diagnóstico de la neumonía comunitaria.

With the objective of analyzing the usefulness of a new technique of fast detection of pneumococcal antigen in urine (Binax NOW Streptococcus pneumoniae urinary antigen test) 163 community pneumonia episodes were reviewed. The test was positive in 30 cases, and gave rise to therapeutic implications in 12 patients. The global sensitivity was 57%, being superior in patients with HIV infection (70%), and the specificity was 91.6%. In 16 episodes it was the only diagnostic test of pneumococcal infection. The determination of pneumococcal antigen through this technique is a useful tool for the diagnosis of community pneumonia, mainly due its high specificity.