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1.
N Engl J Med ; 388(5): 427-438, 2023 02 02.
Artigo em Inglês | MEDLINE | ID: mdl-36724329

RESUMO

BACKGROUND: In September 2015, the four-component, protein-based meningococcal serogroup B vaccine (4CMenB; Bexsero) became available for private purchase in Spain. METHODS: We conducted a nationwide matched case-control study to assess the effectiveness of 4CMenB in preventing invasive meningococcal disease in children. The study included all laboratory-confirmed cases of invasive meningococcal disease in children younger than 60 months of age between October 5, 2015, and October 6, 2019, in Spain. Each case patient was matched with four controls according to date of birth and province. 4CMenB vaccination status of the case patients and controls was compared with the use of multivariate conditional logistic regression. RESULTS: We compared 306 case patients (243 [79.4%] with serogroup B disease) with 1224 controls. A total of 35 case patients (11.4%) and 298 controls (24.3%) had received at least one dose of 4CMenB. The effectiveness of complete vaccination with 4CMenB (defined as receipt of at least 2 doses, administered in accordance with the manufacturer's recommendations) was 76% (95% confidence interval [CI], 57 to 87) against invasive meningococcal disease caused by any serogroup, and partial vaccination was 54% (95% CI, 18 to 74) effective. Complete vaccination resulted in an effectiveness of 71% (95% CI, 45 to 85) against meningococcal serogroup B disease. Vaccine effectiveness with at least one dose of 4CMenB was 64% (95% CI, 41 to 78) against serogroup B disease and 82% (95% CI, 21 to 96) against non-serogroup B disease. With the use of the genetic Meningococcal Antigen Typing System, serogroup B strains that were expected to be covered by 4CMenB were detected in 44 case patients, none of whom had been vaccinated. CONCLUSIONS: Complete vaccination with 4CMenB was found to be effective in preventing invasive disease by serogroup B and non-serogroup B meningococci in children younger than 5 years of age.


Assuntos
Infecções Meningocócicas , Vacinas Meningocócicas , Neisseria meningitidis Sorogrupo B , Criança , Humanos , Lactente , Estudos de Casos e Controles , Infecções Meningocócicas/microbiologia , Infecções Meningocócicas/prevenção & controle , Vacinas Meningocócicas/uso terapêutico , Neisseria meningitidis , Espanha
2.
BMC Public Health ; 11: 899, 2011 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-22129083

RESUMO

BACKGROUND: Physicians of the Spanish Influenza Sentinel Surveillance System report and systematically swab patients attended to their practices for influenza-like illness (ILI). Within the surveillance system, some Spanish regions also participated in an observational study aiming at estimating influenza vaccine effectiveness (cycEVA study). During the season 2009-2010, we estimated pandemic influenza vaccine effectiveness using both the influenza surveillance data and the cycEVA study. METHODS: We conducted two case-control studies using the test-negative design, between weeks 48/2009 and 8/2010 of the pandemic season. The surveillance-based study included all swabbed patients in the sentinel surveillance system. The cycEVA study included swabbed patients from seven Spanish regions. Cases were laboratory-confirmed pandemic influenza A(H1N1)2009. Controls were ILI patients testing negative for any type of influenza. Variables collected in both studies included demographic data, vaccination status, laboratory results, chronic conditions, and pregnancy. Additionally, cycEVA questionnaire collected data on previous influenza vaccination, smoking, functional status, hospitalisations, visits to the general practitioners, and obesity. We used logistic regression to calculate adjusted odds ratios (OR), computing pandemic influenza vaccine effectiveness as (1-OR)*100. RESULTS: We included 331 cases and 995 controls in the surveillance-based study and 85 cases and 351 controls in the cycEVA study. We detected nine (2.7%) and two (2.4%) vaccine failures in the surveillance-based and cycEVA studies, respectively. Adjusting for variables collected in surveillance database and swabbing month, pandemic influenza vaccine effectiveness was 62% (95% confidence interval (CI): -5; 87). The cycEVA vaccine effectiveness was 64% (95%CI: -225; 96) when adjusting for common variables with the surveillance system and 75% (95%CI: -293; 98) adjusting for all variables collected. CONCLUSION: Point estimates of the pandemic influenza vaccine effectiveness suggested a protective effect of the pandemic vaccine against laboratory-confirmed influenza A(H1N1)2009 in the season 2009-2010. Both studies were limited by the low vaccine coverage and the late start of the vaccination campaign. Routine influenza surveillance provides reliable estimates and could be used for influenza vaccine effectiveness studies in future seasons taken into account the surveillance system limitations.


Assuntos
Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Vacinas contra Influenza/uso terapêutico , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Avaliação de Resultados em Cuidados de Saúde , Vigilância da População , Adolescente , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Vírus da Influenza A Subtipo H1N1/imunologia , Influenza Humana/virologia , Masculino , Pessoa de Meia-Idade , Espanha/epidemiologia , Adulto Jovem
3.
Artigo em Espanhol | IBECS | ID: ibc-80131

RESUMO

Introducción Uno de los principales problemas en el diagnóstico de la gripe es el tipo de muestra y la edad del paciente. En general, la mayoría de las técnicas diagnósticas se han mostrado muy efectivas en los pacientes pediátricos y en los aspirados nasofaríngeos. Sin embargo, su eficacia se ha mostrado mucho menor en la población adulta y los frotis faríngeos. Objetivo Se ha realizado un estudio prospectivo comparativo sobre la eficacia de una técnica de RT-PCRtr (reverse transcription polymerase chain reaction in real time ‘reacción en cadena de la polimerasa en transcripción reversa en tiempo real’) comercial, un enzimoinmunoanálisis (EIA) y el cultivo celular shell-vial (SV) en la detección de virus gripales A y B en 125 frotis faríngeos de pacientes adultos con sospecha clínica de gripe durante la temporada 2007–2008.Material y métodos A los frotis faríngeos se les realizó la detección antigénica gripal mediante un EIA dot-blot comercial. Para la RT-PCRtr se extrajo el ácido ribonucleico de 200μl de la muestra mediante el sistema de extracción automatizado EZ1 virus Mini Kit v2.0. La amplificación genómica se realizó mediante una RT-PCRtr utilizando el sistema comercial automatizado OneStep RT-PCR FluA + FluB y el SmartCycler como sistema de amplificación. Las muestras se inocularon en 2 viales de la línea celular Madin-Darby de riñón canino. El tiempo de respuesta se calculó como el transcurrido entre la llegada de la muestra hasta la obtención del resultado definitivo. Resultados El sistema EIA detectó 27 muestras positivas (21,6%), la RT-PCRtr 62 muestras positivas (49,6%) y el cultivo SV 56 muestras positivas (44,8%). De las 62 muestras positivas, el EIA detectó (..) (AU)


Introduction The age of the patients and the type of sample are major problems in the diagnosis of influenza. Most available diagnostic techniques are highly effective in pediatric patients and in nasopharyngeal aspirates. However, in the adult population and using throat swabs, these techniques are much less reliable. Aim We performed a prospective study comparing the efficacy of a commercial real-time reverse transcription PCR assay (RT-PCR) with that of an enzyme immunoassay (EIA) or shell vial culture (SV) in the detection of influenza A and B viruses in 125 throat swabs from adults with clinically suspected influenza during the 2007–2008 flu season. Material and methods Throat swabs were subjected to rapid antigen detection for influenza viruses by means of a commercial dot-blot EIA. For the RT-PCR technique, RNA was extracted from 200μL of each sample by the automated extraction system, EZ1 virus minikit (version 2.0). Genomic amplification of the extracted viral RNA was carried out using the OneStep RT-PCR FluA+FluB automated system with the SmartCycler amplification system. Each sample was inoculated into 2 SV of the MDCK cell line. Turnaround times were calculated from the time specimens were received in the laboratory to the time the result was reported to clinicians. Results The EIA system detected 27 (21.6%) positive samples, RT-PCR 62 (49.6%) positive samples, and SV 56 (44.8%) positive samples. Among the 62 positive samples, EIA detected 27 (43.5%), RT-PCR 62 (100%) and SV 56 (90.3%). With the use of RT-PCR, 38.4% of the (..) (AU)


Assuntos
Humanos , Animais , Adulto , Cães , Técnicas Imunoenzimáticas , Antígenos Virais/análise , Influenza Humana/virologia , Faringe/virologia , RNA Viral/análise , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , Viremia/virologia , Técnica Indireta de Fluorescência para Anticorpo , Vírus da Influenza A/isolamento & purificação , Vírus da Influenza B/isolamento & purificação , Influenza Humana/diagnóstico , Estudos Prospectivos , Sensibilidade e Especificidade , Viremia/diagnóstico , Viremia/imunologia
4.
Enferm Infecc Microbiol Clin ; 28(2): 95-8, 2010 Feb.
Artigo em Espanhol | MEDLINE | ID: mdl-19477042

RESUMO

INTRODUCTION: The age of the patients and the type of sample are major problems in the diagnosis of influenza. Most available diagnostic techniques are highly effective in pediatric patients and in nasopharyngeal aspirates. However, in the adult population and using throat swabs, these techniques are much less reliable. AIM: We performed a prospective study comparing the efficacy of a commercial real-time reverse transcription PCR assay (RT-PCR) with that of an enzyme immunoassay (EIA) or shell vial culture (SV) in the detection of influenza A and B viruses in 125 throat swabs from adults with clinically suspected influenza during the 2007-2008 flu season. MATERIAL AND METHODS: Throat swabs were subjected to rapid antigen detection for influenza viruses by means of a commercial dot-blot EIA. For the RT-PCR technique, RNA was extracted from 200 microL of each sample by the automated extraction system, EZ1 virus minikit (version 2.0). Genomic amplification of the extracted viral RNA was carried out using the OneStep RT-PCR FluA+FluB automated system with the SmartCycler amplification system. Each sample was inoculated into 2 SV of the MDCK cell line. Turnaround times were calculated from the time specimens were received in the laboratory to the time the result was reported to clinicians. RESULTS: The EIA system detected 27 (21.6%) positive samples, RT-PCR 62 (49.6%) positive samples, and SV 56 (44.8%) positive samples. Among the 62 positive samples, EIA detected 27 (43.5%), RT-PCR 62 (100%) and SV 56 (90.3%). With the use of RT-PCR, 38.4% of the adults studied were diagnosed on the same day samples were received. Among the total, 67.2% of diagnostic results were obtained within the first 24 hours; turnaround time was 1.1 days. CONCLUSION: The real-time RT-PCR method studied displayed high sensitivity and specificity in the detection of influenza virus in adult patients, when compared with the conventional techniques. With real-time RT-PCR, large numbers of samples can be rapidly tested and results provided the same day samples are received.


Assuntos
Antígenos Virais/análise , Sistemas Computacionais , Técnicas Imunoenzimáticas , Vírus da Influenza A/isolamento & purificação , Vírus da Influenza B/isolamento & purificação , Influenza Humana/virologia , Faringe/virologia , RNA Viral/análise , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , Viremia/virologia , Cultura de Vírus , Adulto , Animais , Linhagem Celular/virologia , Cães , Técnica Indireta de Fluorescência para Anticorpo , Humanos , Vírus da Influenza A/genética , Vírus da Influenza A/crescimento & desenvolvimento , Vírus da Influenza A/imunologia , Vírus da Influenza B/genética , Vírus da Influenza B/crescimento & desenvolvimento , Vírus da Influenza B/imunologia , Influenza Humana/diagnóstico , Influenza Humana/imunologia , Estudos Prospectivos , Sensibilidade e Especificidade , Viremia/diagnóstico , Viremia/imunologia , Cultura de Vírus/instrumentação
5.
J Clin Microbiol ; 45(6): 2064-7, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17409213

RESUMO

We describe an unusual cluster of Corynebacterium striatum infections in 21 patients with chronic obstructive pulmonary disease (COPD) admitted to a medium-size respiratory unit. Eleven isolates from eight patients occurred simultaneously within a month. C. striatum is a potentially pathogenic microorganism with the ability to produce nosocomial infectious outbreaks and respiratory colonization in patients with advanced COPD.


Assuntos
Infecções por Corynebacterium/epidemiologia , Corynebacterium/classificação , Infecção Hospitalar/epidemiologia , Surtos de Doenças , Doença Pulmonar Obstrutiva Crônica/complicações , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/farmacologia , Corynebacterium/efeitos dos fármacos , Corynebacterium/isolamento & purificação , Infecções por Corynebacterium/microbiologia , Infecção Hospitalar/microbiologia , Feminino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/microbiologia , Espanha/epidemiologia
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