RESUMEN
During a pneumococcal disease outbreak in a pediatric psychiatric unit in a hospital in Rhode Island, USA, 6 (30%) of 20 patients and staff were colonized with Streptococcus pneumoniae serotype 15A, which is not included in pneumococcal vaccines. The outbreak subsided after implementation of antimicrobial drug prophylaxis and enhanced infection control measures.
Asunto(s)
Infección Hospitalaria/epidemiología , Brotes de Enfermedades , Unidades Hospitalarias , Infecciones Neumocócicas/epidemiología , Streptococcus pneumoniae/clasificación , Humanos , Pruebas de Sensibilidad Microbiana , Rhode Island/epidemiología , Factores de Riesgo , Serotipificación , Streptococcus pneumoniae/efectos de los fármacos , Streptococcus pneumoniae/genéticaRESUMEN
OBJECTIVES: Several outbreaks of serogroup B meningococcal disease have occurred among university students in recent years. In the setting of high coverage of the quadrivalent meningococcal conjugate vaccine and prior to widespread use of serogroup B meningococcal vaccines among adolescents, we conducted surveys to characterize the prevalence and molecular characteristics of meningococcal carriage among university students. METHODS: Two cross-sectional oropharyngeal carriage surveys were conducted among undergraduates at a Rhode Island university. Isolates were characterized using slide agglutination, real-time polymerase chain reaction (rt-PCR), and whole genome sequencing. Adjusted prevalence ratios and 95% confidence intervals were calculated using Poisson regression to determine risk factors for carriage. RESULTS: A total of 1837 oropharyngeal specimens were obtained from 1478 unique participants. Overall carriage prevalence was 12.7-14.6% during the two survey rounds, with 1.8-2.6% for capsular genotype B, 0.9-1.0% for capsular genotypes C, W, or Y, and 9.9-10.8% for nongroupable strains by rt-PCR. Meningococcal carriage was associated with being male, smoking, party or club attendance, recent antibiotic use (inverse correlation), and recent respiratory infections. CONCLUSIONS: In this university setting, the majority of meningococcal carriage was due to nongroupable strains, followed by serogroup B. Further evaluation is needed to understand the dynamics of serogroup B carriage and disease among university students.
Asunto(s)
Portador Sano/epidemiología , Neisseria meningitidis Serogrupo B/aislamiento & purificación , Neisseria meningitidis/aislamiento & purificación , Estudiantes , Universidades/estadística & datos numéricos , Antígenos Bacterianos/inmunología , Portador Sano/microbiología , Estudios Transversales , Brotes de Enfermedades/prevención & control , Brotes de Enfermedades/estadística & datos numéricos , Femenino , Genotipo , Humanos , Masculino , Infecciones Meningocócicas/epidemiología , Infecciones Meningocócicas/microbiología , Infecciones Meningocócicas/prevención & control , Vacunas Meningococicas/administración & dosificación , Vacunas Meningococicas/inmunología , Tipificación Molecular , Neisseria meningitidis/genética , Neisseria meningitidis/inmunología , Neisseria meningitidis Serogrupo B/genética , Neisseria meningitidis Serogrupo B/inmunología , Orofaringe/microbiología , Distribución de Poisson , Reacción en Cadena de la Polimerasa , Prevalencia , Rhode Island/epidemiología , Factores de Riesgo , Serogrupo , Factores Sexuales , Adulto JovenRESUMEN
BACKGROUND: The rapid detection of respiratory viral infections is associated with several positive health outcomes. However, little is known about the availability of rapid respiratory viral testing in acute care hospital laboratories. METHODS: A survey was sent to 13 hospital laboratories assessing results' turnaround time, the number of ordered tests and positive results. RESULTS: Rapid viral panel (RVP), respiratory syncytial virus (RSV), and rapid influenza testing was available in 9 of 13, 13 of 13, and 13 of 13 hospitals, respectively. Results were available within 24 hours of specimen collection in 1 of 9 hospitals for RVP; RSV and rapid influenza results were available within 12 hours in 8 of 13 and 13 of 13 hospitals, respectively. CONCLUSIONS: Rapid diagnosis of respiratory viral infections in RI acute care hospitals can be made for influenza and RSV. However, rapid results for other respiratory viruses are unavailable in most of RI hospitals. [Full article available at http://rimed.org/rimedicaljournal-2017-09.asp].