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Pneumococcal invasive disease

A R Domínguez-Alegría, V Pintado, I Barbolla
Invasive pneumococcal disease is a severe infection that mainly affects patients with associated comorbidity. The paediatric conjugate vaccination has resulted in a change in the adult vaccination strategy. The antibiotic resistance of pneumococcus is not currently a severe problem. Nevertheless, the World Health Organisation has included pneumococcus among the bacteria whose treatment requires the introduction of new drugs, such as ceftaroline and ceftobiprole. Although the scientific evidence is still limited, the combination of beta-lactams and macrolides is recommended as empiric therapy for bacteraemic pneumococcal pneumonia...
February 12, 2018: Revista Clínica Española
Bin Chang, Masatomo Morita, Ken-Ichi Lee, Makoto Ohnishi
Streptococcus pneumoniae colonizes the nasopharyngeal mucus in healthy individuals and can cause otitis media, pneumonia, and invasive pneumococcal diseases. In this study, we analyzed the S. pneumoniae strains that caused 19 pneumonia episodes in long-term inpatients with severe underlying disease in a hospital during a period of 14 months (from January 2014 to February 2015). Serotyping and whole genome sequencing analyses revealed that 18 of the 19 pneumonia cases were caused by S. pneumoniae strains belonging to 3 genetically distinct groups: clonal complex (CC) 9999, sequence type (ST) 282, and ST166...
February 14, 2018: Journal of Clinical Microbiology
Sarah L Reeves, Alison C Tribble, Brian Madden, Gary L Freed, Kevin J Dombkowski
BACKGROUND: Children with sickle cell anemia (SCA) are at increased risk for invasive pneumococcal disease; antibiotic prophylaxis significantly reduces this risk. We calculated the proportion of children with SCA who received ≥300 days of antibiotic prophylaxis and identified predictors of such receipt. METHODS: Children aged 3 months to 5 years with SCA were identified by the presence of 3 or more Medicaid claims with a diagnosis of SCA within a calendar year (2005-2012) in Florida, Illinois, Louisiana, Michigan, South Carolina, and Texas...
February 5, 2018: Pediatrics
Andrew D Wiese, Marie R Griffin, William Schaffner, C Michael Stein, Robert A Greevy, Edward F Mitchel, Carlos G Grijalva
Background: Although certain opioid analgesics have immunosuppressive properties and increase the risk for infections in animals, the clinical effects of prescription opioid use on infection risk among humans are unknown. Objective: To test the hypothesis that prescription opioid use is an independent risk factor for invasive pneumococcal disease (IPD). Design: Nested case-control study. Setting: Tennessee Medicaid database linked to Medicare and Active Bacterial Core surveillance system databases (1995 to 2014)...
February 13, 2018: Annals of Internal Medicine
Dominic Thorrington, Leo van Rossum, Mirjam Knol, Hester de Melker, Hans Rümke, Eelko Hak, Albert Jan van Hoek
BACKGROUND: Streptococcus pneumoniae causes morbidity and mortality among all ages in The Netherlands. To reduce this burden, infants in The Netherlands receive the 10-valent pneumococcal conjugated vaccine (PCV10), but older persons are not targeted. We assessed the impact and cost-effectiveness of vaccination with 23-valent pneumococcal polysaccharide vaccine (PPV23) or 13-valent PCV (PCV13) among all those aged 60, 65 or 70 and/or in combination with replacing PCV10 with PCV13 in the infant vaccination programme...
2018: PloS One
Lander Willem, Adriaan Blommaert, Germaine Hanquet, Nancy Thiry, Joke Bilcke, Heidi Theeten, Jan Verhaegen, Herman Goossens, Philippe Beutels
Streptococcus pneumoniae causes a high disease burden including pneumonia, meningitis and septicemia. Both a polysaccharide vaccine targeting 23 serotypes (PPV23) and a 13-valent conjugate vaccine (PCV13) are indicated for persons aged over 50 years. We developed and parameterized a static multi-cohort model to estimate the incremental cost-effectiveness and budget-impact of these vaccines at different uptake levels. Using three different vaccine efficacy scenarios regarding non-invasive pneumococcal pneumonia and extensive uni- and multivariate sensitivity analyses, we found a strong preference for PPV23 over PCV13 in all age groups at willingness to pay levels below €300 000 per quality adjusted life year (QALY)...
February 8, 2018: Human Vaccines & Immunotherapeutics
Vesa Lindström, Janne Aittoniemi, Urpu Salmenniemi, Helena Käyhty, Heini Huhtala, Maija Itälä-Remes, Marjatta Sinisalo
Patients with chronic lymphocytic leukemia (CLL) are at a high risk for infections caused by Streptococcus pneumoniae. A pneumococcal conjugate vaccine (PCV) can induce a significant antibody response for some CLL patients. In this study we investigated antibody persistence after PCV7 in patients with CLL. The study material comprised 24 patients with CLL and 8 immunocompetent controls. The median antibody concentrations five years after PCV7 were lower for six pneumococcal serotypes in patients with CLL compared to controls, but the difference was not statistically significant...
February 8, 2018: Human Vaccines & Immunotherapeutics
Masahiro Chiba, Kazuo Oshimi, Toshihiro Matsukawa, Kouhei Okada, Takuto Miyagishima
A 68-year-old female with smoldering multiple myeloma (IgG-κ type) was admitted to the hospital owing to general fatigue, fever, and pain in the right leg. On the day following admission, she developed shock, and a blood culture revealed Streptococcus pneumoniae. She was diagnosed with septic shock and invasive pneumococcal disease (IPD). She received antibiotics and intravenous immunoglobulin and improved after several days. She had a history of recurrent IPD and had received the pneumococcal polysaccharide vaccine 23 (PPSV23) 2 years earlier...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Dominic Thorrington, Nick Andrews, Julia Stowe, Elizabeth Miller, Albert Jan van Hoek
BACKGROUND: The seven-valent pneumococcal conjugate vaccine (PCV) was introduced in England in September 2006, changing to the 13-valent vaccine in April 2010. PCV impact on invasive pneumococcal disease (IPD) has been extensively reported, but less described is its impact on the burden of pneumonia, sepsis and otitis media in the hospital. METHODS: Using details on all admissions to hospitals in England, we compared the incidence of pneumococcal-specific and syndromic disease endpoints in a 24-month pre-PCV period beginning April 2004 to the 24-month period ending March 2015 to derive incidence rate ratios (IRRs)...
February 8, 2018: BMC Medicine
Anna Sangil Betriu, María J Arranz, Roberto Güerri-Fernández, Maite Perez, Helena Monzon, Antoni Payeras, Marta Andres, Jorge Torviso, Laura Ibañez, Javier Garau, Esther Calbo
BACKGROUND: The pathogenesis of IPD remains unknown, especially among middle-aged individuals without risk factors (WRF). OBJECTIVES: The aim of the present study was to investigate the role of single nucleotide polymorphisms (SNP) within key genes involved in innate immune response on IPD susceptibility. METHODS: Forty-three SNPs within 10 immunological genes were investigated in a cohort of 144 Caucasian IPD patients and 280 ethnically matched controls...
January 30, 2018: Infection, Genetics and Evolution
James John, Kripa Shanker Kasudhan, Reba Kanungo, Savitri Sharma, Vaishali Dohe, K Prashanth
BACKGROUND: Streptococcus pneumoniae continues to cause morbidity and mortality across the globe, with developing countries bearing the brunt of the disease. It is mainly responsible for meningitis, pneumonia and septicaemia primarily in children, elderly and immunocompromised persons. Colonisation and persistence in the human nasopharynx occur during early childhood, and it appears to be prerequisite for invasive pneumococcal disease (IPD). Factors that help in persistent colonisation and subsequent invasion are ill understood...
October 2017: Indian Journal of Medical Microbiology
Juthaporn Cowan, Thuy Linh Do, Sacha Desjardins, Karamchand Ramotar, Vicente Corrales-Medina, Donald William Cameron
Background: Patients with humoral immune deficiency are susceptible to invasive pneumococcal disease (IPD). This study estimates the prevalence of underlying hypogammaglobulinemia in admitted IPD cases and examines whether IPD cases had received preventative treatment. Methods: All adult IPD cases (Streptococcus pneumoniae in blood or cerebrospinal fluid) admitted to The Ottawa Hospital (TOH) from January 2013 to December 2015 were identified through the Eastern Ontario Regional Laboratory...
February 1, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Leen Moens, Philippe Hermand, Tine Wellens, Greet Wuyts, Rita Derua, Etienne Waelkens, Carine Ysebaert, Fabrice Godfroid, Xavier Bossuyt
Serotype-independent protein-based pneumococcal vaccines represent attractive alternatives to capsular polysaccharide-based vaccines. The aim of this study was to identify novel immunogenic proteins from Streptococcus pneumoniae that may be used in protein-based pneumococcal vaccine. An immunoproteomics approach and a humanized severe combined immunodeficient mouse model were used to identify S. pneumoniae proteins that are immunogenic for the human immune system. Among the several proteins identified, SP1683 was selected, recombinantly produced, and infection and colonization murine models were used to evaluate the capacity of SP1683 to elicit protective responses, in comparison to known pneumococcal immunogenic proteins (PhtD and detoxified pneumolysin, dPly)...
February 5, 2018: Human Vaccines & Immunotherapeutics
Shamez N Ladhani, Sarah Collins, Abdelmajid Djennad, Carmen L Sheppard, Ray Borrow, Norman K Fry, Nicholas J Andrews, Elizabeth Miller, Mary E Ramsay
BACKGROUND: Pneumococcal conjugate vaccines (PCVs) have substantially reduced the incidence of invasive pneumococcal disease caused by vaccine serotypes; however, replacement disease with non-PCV serotypes remains a concern. We describe the population effect of the seven-valent and 13-valent PCVs (PCV7 and PCV13) on invasive pneumococcal disease in England and Wales. METHODS: Using national invasive pneumococcal disease surveillance data for 2016/17, we compared incidence rate ratios (IRRs) against pre-PCV13 (2008/09-2009/10) and pre-PCV7 (2000/01-2005/06) baselines...
January 25, 2018: Lancet Infectious Diseases
Hassan El Khatib, Amal Naous, Soha Ghanem, Ghassan Dbaibo, Mariam Rajab
Guillain-Barre Syndrome, an acute flaccid paralysis known to be caused by recent Gastro-intestinal infections mainly campylobacter, and Respiratory infections mainly mycoplasma pneumoniae and influenza. One reported case of severe invasive pneumococcal disease in a 68 year old female, that presented with Austrian's triad of meningitis, pneumonia and endocarditis, and progressed to develop Guillain Barre syndrome, an association never been documented before. We present a case of 13 year old male, presented with hypoactivity and inability to bare his own weight, developed septic shock due to pneumococcus with Acute Respiratory Distress Syndrome, and was found to have neurological findings of Guillain-Barre Syndrome...
2018: IDCases
Erika van der Maten, Bryan van den Broek, Marien I de Jonge, Kim J W Rensen, Marc J Eleveld, Aldert L Zomer, Amelieke J H Cremers, Gerben Ferwerda, Ronald de Groot, Jeroen D Langereis, Michiel van der Flier
Pneumococcal capsular serotype is an important determinant of complement resistance and invasive disease potential, but other virulence factors have also been found to contribute. Pneumococcal surface protein C (PspC), a highly variable virulence protein that binds complement factor H to evade C3 opsonization, is divided into two subgroups: choline-bound subgroup I and LPxTG-anchored subgroup II. The prevalence of different PspC subgroups in invasive pneumococcal disease (IPD) and functional differences in complement evasion are unknown...
January 29, 2018: Infection and Immunity
Joseph A Lewnard, Noga Givon-Lavi, Paula A Tähtinen, Ron Dagan
Background: All-cause otitis media (OM) incidence has declined in numerous settings following introduction of pneumococcal conjugate vaccines (PCVs) despite increases in carriage of non-vaccine pneumococcal serotypes escaping immune pressure. To understand the basis for declining incidence, we assessed the intrinsic capacity of pneumococcal serotypes to cause OM independently and in polymicrobial infections involving nontypeable Haemophilus influenzae (NTHi) using samples obtained from middle ear fluid and nasopharyngeal cultures before PCV7/13 rollout...
January 29, 2018: Infection and Immunity
Kyong-Hee Lee, Kiyozumi Suzuki, Masashi Tsuru, Arifumi Takazawa
No abstract text is available yet for this article.
January 25, 2018: Infection
Nicola Principi, Giuseppe Di Cara, Ilaria Bizzarri, Chiara Isidori, Paola Borgia, Costanza Mignini, Marco Saponara, Alberto Argentiero, Susanna Esposito
Starting from 2010, the 13-valent pneumococcal conjugate vaccine (PCV13) was introduced in several countries. This paper discusses some of the problems recently emerged after PCV13 use and their clinical impact. The impact of PCV13 has been relevant and has saved millions of children and adults by severe infectious diseases. However, it seems likely that in the future, effectiveness of the vaccine might be even higher than that presently evidenced. This is because long-term administration of PCV13 to the pediatric population can favor a more extensive reduction of nasopharyngeal colonization with vaccine serotypes of both vaccinated and unvaccinated subjects and further reduce invasive pneumococcal disease in all the individuals (herd immunity)...
January 24, 2018: Current Infectious Disease Reports
Paul J Collini, Martin A Bewley, Mohamed Mohasin, Helen M Marriott, Robert F Miller, Anna-Maria Geretti, Apostolos Beloukas, Athanasios Papadimitropoulos, Robert C Read, Mahdad Noursadeghi, David H Dockrell
Rationale People living with HIV (PLWH) are at significantly increased risk of invasive pneumococcal disease, despite long-term antiretroviral therapy (ART). The mechanism explaining this observation remains undefined. Objectives We hypothesized apoptosis-associated microbicidal mechanisms, required to clear intracellular pneumococci that survive initial phagolysosomal killing, are perturbed. Methods Alveolar macrophages (AM) were obtained by bronchoalveolar lavage (BAL) from healthy donors or HIV-1-seropositive donors on long-term ART with undetectable plasma viral load...
January 24, 2018: American Journal of Respiratory and Critical Care Medicine
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