RESUMEN
INTRODUCTION: The introduction of pneumococcal conjugate vaccine (PCV-7) has modified the epidemiology of invasive pneumococcal disease (IPD). Our aim was to investigate the epidemiological features of IPD before and after implementing the use of PCV-7. METHODS: All invasive Streptococcus pneumoniae strains isolated in our hospital from 2000 to 2006 were included. Serotypes were identified and antibiograms were performed in all cases. Data obtained before (2000-2001) and after (2004-2006) authorization of PCV-7 use in Spain were compared. RESULTS: There were 241 cases of IPD. None of the patients with IPD aged 2 years or younger had received PCV-7. PCV-7 coverage in children aged 5 or younger was about 48%. There was a non-significant increase in the incidence of IPD in children (from 53.8 to 57.8 cases/100 000 population), with no change in adults. When IPD incidence was adjusted by the number of blood samples collected, there was a non-significant decrease in both children and adults. Since PCV-7 came on the market, there has been a decrease in vaccine serotypes and an increase in non-vaccine serotypes. The emergent serotypes since that time include 3, 6A, 15, and 19A. Penicillin resistance decreased significantly (p<0.001) from the pre-vaccine period (87.3%) to 2003 (13.8%), and later rose from 2003 through 2006 (41.7%). Erythromycin resistance showed no changes during the study. CONCLUSIONS: The incidence of IPD in children aged 2 years and younger in Gran Canaria has not decreased despite the introduction of PCV-7. However, there has been a reduction in the number of cases related to vaccine serotypes and a significant decrease in penicillin resistance. In contrast, non-vaccine serotype IPD cases have increased. Universal vaccination and the use of new polyvalent vaccines may enhance these effects.
Asunto(s)
Infecciones Neumocócicas/epidemiología , Vacunas Neumococicas , Streptococcus pneumoniae/aislamiento & purificación , Adolescente , Adulto , Antibacterianos/farmacología , Niño , Preescolar , Farmacorresistencia Bacteriana Múltiple , Femenino , Humanos , Incidencia , Lactante , Masculino , Morbilidad/tendencias , Infecciones Neumocócicas/microbiología , Infecciones Neumocócicas/prevención & control , Vigilancia de la Población , Estudios Retrospectivos , Serotipificación , España/epidemiología , Streptococcus pneumoniae/clasificación , Streptococcus pneumoniae/efectos de los fármacos , Streptococcus pneumoniae/inmunología , Vacunación , Vacunas ConjugadasRESUMEN
Introducción: la comercialización de la vacuna neumocócica conjugada (PCV-7) ha modificado la epidemiología de la enfermedad neumocócica invasiva (ENI). Nuestro objetivo fue conocer la epidemiología de la ENI antes y después de su uso. Métodos: se incluyeron todas las cepas de Streptococcus pneumoniae causantes de ENI de 2000 a 2006. Se realizó serotipado y antibiograma. Se compararon los datos obtenidos antes (2000¿2001) y después (2004¿2006) de la comercialización de PCV-7. Resultados: hubo 241 casos de ENI. Ningún paciente menor de 2 años con ENI estaba vacunado. La cobertura vacunal en menores de 5 años fue del 48%. Hubo un incremento no significativo de ENI en niños (de 53,8 a 57,8 casos por 100.000 habitantes), manteniéndose invariable en adultos. Al corregir la incidencia según el número de hemocultivos, se observó un descenso no significativo, tanto en niños como en adultos. Tras la comercialización de PCV-7 hubo un descenso de los serotipos vacunales y un aumento de los no vacunales. Los serotipos emergentes tras la vacuna fueron: 3, 6A, 15 y 19A. La resistencia a penicilina descendió significativamente (p<0,001) desde el período prevacunal (87,3%) hasta 2003 (13,8%), y posteriormente aumentó (41,7% en 2006). La resistencia a eritromicina no varió durante el estudio. Conclusiones: la incidencia de ENI en menores de 2 años en Gran Canaria no ha disminuido a pesar de la vacuna PCV-7. Los casos debidos a serotipos vacunales han disminuido, así como la resistencia a penicilina. En cambio, han aumentado los casos debidos a serotipos no vacunales emergentes. La estrategia de vacunación universal y la adopción de nuevas vacunas polivalentes podrían potenciar estos efectos (AU)
Introduction: The introduction of pneumococcal conjugate vaccine (PCV-7) has modified the epidemiology of invasive pneumococcal disease (IPD). Our aim was to investigate the epidemiological features of IPD before and after implementing the use of PCV-7. Methods: All invasive Streptococcus pneumoniae strains isolated in our hospital from 2000 to 2006 were included. Serotypes were identified and antibiograms were performed in all cases. Data obtained before (2000¿2001) and after (2004¿2006) authorization of PCV-7 use in Spain were compared. Results: There were 241 cases of IPD. None of the patients with IPD aged 2 years or younger had received PCV-7. PCV-7 coverage in children aged 5 or younger was about 48%. There was a non-significant increase in the incidence of IPD in children (from 53.8 to 57.8 cases/100 000 population), with no change in adults. When IPD incidence was adjusted by the number of blood samples collected, there was a non-significant decrease in both children and adults. Since PCV-7 came on the market, there has been a decrease in vaccine serotypes and an increase in non-vaccine serotypes. The emergent serotypes since that time include 3, 6A, 15, and 19A. Penicillin resistance decreased significantly (p<0.001) from the pre-vaccine period (87.3%) to 2003 (13.8%), and later rose from 2003 through 2006 (41.7%). Erythromycin resistance showed no changes during the study. Conclusions: The incidence of IPD in children aged 2 years and younger in Gran Canaria has not decreased despite the introduction of PCV-7. However, there has been a reduction in the number of cases related to vaccine serotypes and a significant decrease in penicillin resistance. In contrast, non-vaccine serotype IPD cases have increased. Universal vaccination and the use of new polyvalent vaccines may enhance these effects (AU)
Asunto(s)
Humanos , Masculino , Femenino , Lactante , Preescolar , Niño , Adolescente , Adulto , Vacunas Neumococicas , Infecciones Neumocócicas/prevención & control , Vacunas Conjugadas , Incidencia , Infecciones Neumocócicas/epidemiología , Vigilancia de la Población , Estudios Retrospectivos , España/epidemiología , VacunaciónRESUMEN
Upper respiratory tract (URT) infections are common and account for more medical visits than any other type of infectious disease. Diagnostic procedures for the following syndromes are included in this report: Streptococcal and nonstreptococcal pharyngitis, laryngeal syndromes, otitis, sinusitis, and others caused by unusual and/or uncommon bacteria or fungi, including Lemierre's disease, Vincent's angina, pharyngeal and peritonsillar abscesses, diphtheria, candidiasis, and zygomycoses. Detailed information is provided on specimen collection and processing, selection of laboratory tests, interpretation of findings, reporting results, additional procedures for uncommon infections, and the use of new techniques. All the information included in this article is contained in the Standard Operating Procedures for Clinical Microbiology (http://www.seimc.org/protocolos/microbiologia/).
Asunto(s)
Técnicas Microbiológicas , Infecciones del Sistema Respiratorio/diagnóstico , Infecciones del Sistema Respiratorio/microbiología , Manejo de Especímenes , Humanos , Laringitis/microbiología , Otitis/microbiología , Faringitis/microbiología , Sinusitis/microbiologíaRESUMEN
Las infecciones del tracto respiratorio superior se hallan entre las más frecuentes, y generan más consultas médicas que cualquier otro tipo de enfermedad infecciosa. Se incluyen los procedimientos de diagnóstico de los siguientes síndromes: faringitis estreptocócica y no estreptocócica, síndromes laríngeos, otitis, sinusitis y otras infecciones causadas por hongos y bacterias raros y/o poco frecuentes: síndrome de Lemierre, angina de Vincent, abscesos faríngeos y periamigdalares, difteria, candidiasis y zigomicosis. Se incluye información detallada sobre la recogida y procesamiento de las muestras, elección de pruebas de laboratorio, criterios de interpretación, información de (..) (AU)
Upper respiratory tract (URT) infections are common and account for more medical visits than any other type of infectious disease. Diagnostic procedures for the following syndromes are included in this report: Streptococcal and nonstreptococcal pharyngitis, laryngeal syndromes, otitis, sinusitis, and others caused by unusual and/or uncommon bacteria or fungi, including Lemierre's disease, Vincent's angina, pharyngeal and peritonsillar abscesses, diphtheria, candidiasis, and zygomycoses. Detailed information is provided on specimen collection and processing, selection of laboratory (AU)
Asunto(s)
Humanos , Infecciones del Sistema Respiratorio/microbiología , Técnicas Microbiológicas/métodos , Manejo de Especímenes/métodos , Faringitis/microbiología , Laringitis/microbiología , Otitis/microbiologíaRESUMEN
We report a kindred with autosomal recessive interleukin-1 receptor-associated kinase 4 (IRAK-4) deficiency in 3 fourth-degree relatives. A diagnosis of IRAK-4 deficiency should be considered in families with invasive bacterial disease, even if the individuals affected are only distantly related, which falsely suggests multigenic or dominant inheritance with low penetrance.
Asunto(s)
Salud de la Familia , Genes Recesivos , Síndromes de Inmunodeficiencia/genética , Péptidos y Proteínas de Señalización Intracelular/deficiencia , Péptidos y Proteínas de Señalización Intracelular/genética , Proteínas Serina-Treonina Quinasas/deficiencia , Proteínas Serina-Treonina Quinasas/genética , Niño , Preescolar , Humanos , Síndromes de Inmunodeficiencia/microbiología , Lactante , Quinasas Asociadas a Receptores de Interleucina-1 , Linaje , Infecciones Neumocócicas/etiología , Recurrencia , España , Infecciones Estafilocócicas/etiologíaRESUMEN
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