Enfermedad neumoccócica invasora en recién nacidos, antes y después de la vacunación universal con vacuna conjugada 7 y 13 valente en Uruguay / Pneumococcal invasive disease in newborns before and after 7-valent and 13-valent universal pneumococcal vaccination in Uruguay
Rev. chil. infectol
; 32(2): 167-174, abr. 2015. tab
Article
in Spanish
| LILACS
| ID: lil-747519
Responsible library:
CL1.1
ABSTRACT
Introduction:
Streptococcus pneumoniae infections are not frequent in neonates, but presents high morbidity and mortality. In 2008, the 7-valent pneumococcal conjugate vaccine (PCV) was introduced in the childhood vaccination schedule and then replaced by 13-valent PCV in 2010. First dose is given at 2 months of age. Protection of neonates is expected with universal vaccination.Objective:
To describe the clinical presentation, microbiology and outcome of neonates with pneumococcal invasive infections (PII) detected in two hospitals in Uruguay in 2001-2007 (pre-vaccination), 2008 (intervention) and 2009-2013 (post-vaccination).Methods:
A descriptive, retrospective study was done at Pereira Rossell Hospital and Paysandú Hospital. All isolates of S. pneumoniae obtained from normally sterile fluids were included. Data were obtained from the clinical records and the microbiology laboratory. A statistical analysis with absolute frequencies, relative, rates and relative risk was performed.Results:
25 neonates were enrolled with diagnosis of sepsis (n = 13), meningitis (n = 9), bacteremia (n = 1), pneumonia with empyema (n = 1) and pneumonia (n = 1). The incidence of PII in the prevaccination period was 19/25, with a rate of 0.30/1,000 births, compared to post-vaccination rate of 0.04/1,000. The relative risk was 5.9. 6/20 (30%) cases of death were reported (meningitis n = 3; sepsis n = 2; empyema n = 1). Most common serotypes were 5 and 1 (14/25) and 24/25 strains were susceptible to penicillin.Discussion:
The symptoms were indistinguishable to infections caused by other pathogens. PII cases decreased and no deaths occurred in the post-vaccination period. No increase in non-vaccine serotypes was observed.RESUMEN
Introducción:
Streptococcus pneumoniae infrecuentemente produce infecciones en recién nacidos (RN), presentando elevada morbi-mortalidad. En Uruguay, en 2008 se incorporó al calendario de inmunizaciones infantil la vacuna conjugada neumocóccica (VCN) 7 valente, (sustituída por VCN13 en 2010). La vacunación comienza a los dos meses de vida. Se espera que la vacunación universal tenga impacto en la protección de RN.Objetivo:
Describir la presentación clínica, microbiología y evolución de RN con enfermedad neumocóccica invasora (ENI), identificados en dos hospitales de Uruguay, años 2001-2007 (pre-vacunación), 2008 (intervención) y 2009-2013 (post-vacunación). Material yMétodos:
Estudio descriptivo, retrospectivo. Lugar Hospital Pereira Rossell y Hospital Paysandú. Se incluyeron todos los aislados de S. pneumoniae a partir de líquidos normalmente estériles. Fuente de datos laboratorios de bacteriología e historias clínicas. Análisis estadístico frecuencias absolutas, relativas, tasas y riesgo relativo.Resultados:
RN con ENI 25, sepsis (n 13), meningitis (n 9), bacteriemia (n 1), neumonía con empiema (n 1), neumonía (n 1). Incidencia de ENI en el período pre-vacunación 19/25, tasa 0,30/1.000 nacimientos; tasa post-vacunación 0,04/1.000. Riesgo relativo 5,9. Fallecimientos 6/20 (30%) meningitis (n 3), sepsis (n 2), empiema (n 1). Los serotipos más frecuentes fueron 5 y 1 (14/25). Susceptibles a penicilina 24/25.Discusión:
Los síntomas fueron indistinguibles de infecciones causadas por otros patógenos. Disminuyeron los casos de ENI y no ocurrieron fallecimientos en el período post-vacunación. No aumentaron los serotipos no vacunales.
Full text:
Available
Collection:
International databases
Health context:
Sustainable Health Agenda for the Americas
/
SDG3 - Health and Well-Being
/
SDG3 - Target 3.3 End transmission of communicable diseases
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SDG3 - Target 3.2 Reduce avoidable death in newborns and children under 5
Health problem:
Goal 10: Communicable diseases
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Target 3.2: Reduce avoidable death in newborns and children under 5
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Meningitis
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Pneumonia
/
Infections
Database:
LILACS
Main subject:
Pneumococcal Infections
/
Streptococcus pneumoniae
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Pneumococcal Vaccines
/
Heptavalent Pneumococcal Conjugate Vaccine
Type of study:
Etiology study
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Observational study
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Prognostic study
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Risk factors
Limits:
Humans
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Infant
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Infant, Newborn
Country/Region as subject:
South America
/
Uruguay
Language:
Spanish
Journal:
Rev. chil. infectol
Journal subject:
Communicable Diseases
Year:
2015
Document type:
Article
Affiliation country:
Uruguay
Institution/Affiliation country:
Universidad de la República Oriental del Uruguay/UY