RESUMEN
The aim was to analyse invasive pneumococcal disease (IPD) serotypes in children aged ⩽17 years according to clinical presentation and antimicrobial susceptibility. We conducted a prospective study (January 2012-June 2016). IPD cases were diagnosed by culture and/or real-time polymerase chain reaction (PCR). Demographic, microbiological and clinical data were analysed. Associations were assessed using the odds ratio (OR) and 95% confidence intervals (CI). Of the 253 cases, 34.4% were aged <2 years, 38.7% 2-4 years and 26.9% 5-17 years. Over 64% were 13-valent pneumococcal conjugate vaccine (PCV13) serotypes. 48% of the cases were diagnosed only by real-time PCR. Serotypes 3 and 1 were associated with complicated pneumonia (P < 0.05) and non-PCV13 serotypes with meningitis (OR 7.32, 95% CI 2.33-22.99) and occult bacteraemia (OR 3.6, 95% CI 1.56-8.76). Serotype 19A was more frequent in children aged <2 years and serotypes 3 and 1 in children aged 2-4 years and 5-17 years, respectively. 36.1% of cases were not susceptible to penicillin and 16.4% were also non-susceptible to cefotaxime. Serotypes 14, 24F and 23B were associated with non-susceptibility to penicillin (P < 0.05) and serotypes 11, 14 and 19A to cefotaxime (P < 0.05). Serotype 19A showed resistance to penicillin (P = 0.002). In conclusion, PCV13 serotypes were most frequent in children aged ⩽17 years, mainly serotypes 3, 1 and 19A. Non-PCV13 serotypes were associated with meningitis and occult bacteraemia and PCV13 serotypes with pneumonia. Non-susceptibility to antibiotics of non-PCV13 serotypes should be monitored.
Asunto(s)
Antibacterianos/farmacología , Farmacorresistencia Bacteriana , Infecciones Neumocócicas/microbiología , Infecciones Neumocócicas/prevención & control , Vacunas Neumococicas/inmunología , Streptococcus pneumoniae/clasificación , Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Estudios Prospectivos , Estaciones del Año , SerogrupoRESUMEN
No disponible
Asunto(s)
Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Masculino , Difteria/epidemiología , Difteria/historia , Difteria/mortalidad , Difteria/prevención & control , Difteria/terapia , Toxoide Diftérico/uso terapéutico , Toxoide Diftérico/efectos adversos , Toxoide Diftérico/administración & dosificación , Antitoxina Diftérica/uso terapéutico , Monitoreo Epidemiológico/tendencias , Antitoxina Diftérica/inmunología , Vacuna contra Difteria, Tétanos y Tos Ferina/uso terapéutico , Vacuna contra Difteria y Tétanos/uso terapéutico , Vacuna contra Difteria, Tétanos y Tos Ferina/administración & dosificación , Vacuna contra Difteria y Tétanos/administración & dosificación , Vacunación , Resultado del Tratamiento , Estudios Seroepidemiológicos , España/epidemiología , Europa (Continente)/epidemiologíaRESUMEN
No disponible
Asunto(s)
Adolescente , Adulto , Anciano , Niño , Femenino , Humanos , Masculino , Tos Ferina/epidemiología , Tos Ferina/historia , Tos Ferina/mortalidad , Tos Ferina/terapia , Vacuna contra Difteria, Tétanos y Tos Ferina/uso terapéutico , Monitoreo Epidemiológico/tendencias , Embarazo , Mortalidad del Niño , Vacunación , Vacunación Masiva , Bordetella pertussis/patogenicidad , Vacuna contra Difteria, Tétanos y Tos Ferina/administración & dosificación , Resultado del Tratamiento , Estudios Epidemiológicos , España/epidemiologíaRESUMEN
No disponible
Asunto(s)
Anciano , Femenino , Humanos , Masculino , Gripe Humana/complicaciones , Gripe Humana/diagnóstico , Gripe Humana/epidemiología , Gripe Humana/mortalidad , Gripe Humana/transmisión , Gripe Humana/prevención & control , Vacunas contra la Influenza/uso terapéutico , Vacunas contra la Influenza/inmunología , Monitoreo Epidemiológico/tendencias , Resultado del Tratamiento , Hospitalización , Vacunas de Productos Inactivados , Vacunas de Productos Inactivados/uso terapéutico , Grupos de Riesgo , Estudios Epidemiológicos , España/epidemiologíaRESUMEN
No disponible
Asunto(s)
Adolescente , Adulto , Femenino , Humanos , Masculino , Varicela/complicaciones , Varicela/epidemiología , Varicela/mortalidad , Herpes Zóster/epidemiología , Vacuna contra la Varicela/inmunología , Vacuna contra la Varicela/uso terapéutico , Vacuna contra la Varicela/administración & dosificación , Monitoreo Epidemiológico/tendencias , Varicela/prevención & control , Estudios Epidemiológicos , Migrantes , Hospitalización/economía , Resultado del Tratamiento , Huésped Inmunocomprometido , Grupos de Riesgo , Vacunación Masiva , Programas de Inmunización , España/epidemiologíaRESUMEN
No disponible
Asunto(s)
Adolescente , Adulto , Femenino , Humanos , Masculino , Sarampión/epidemiología , Rubéola (Sarampión Alemán)/epidemiología , Parotiditis/epidemiología , Vacuna Antisarampión/administración & dosificación , Vacuna Antisarampión/uso terapéutico , Vacuna contra la Rubéola/administración & dosificación , Vacuna contra la Rubéola/uso terapéutico , Vacuna contra la Parotiditis/administración & dosificación , Vacuna contra la Parotiditis/uso terapéutico , Monitoreo Epidemiológico/tendencias , Vacuna contra la Parotiditis , Vacuna contra el Sarampión-Parotiditis-Rubéola/uso terapéutico , Vacuna contra el Sarampión-Parotiditis-Rubéola , Grupos de Riesgo , Resultado del Tratamiento , España/epidemiologíaRESUMEN
No disponible
Asunto(s)
Adulto , Anciano , Femenino , Humanos , Masculino , Varicela/prevención & control , Herpes Zóster/prevención & control , Vacuna contra la Varicela/administración & dosificación , Vacuna contra la Varicela/inmunología , Vacuna contra la Varicela/uso terapéutico , Herpes Zóster/epidemiología , Vacuna contra el Herpes Zóster/administración & dosificación , Vacuna contra el Herpes Zóster/inmunología , Vacuna contra el Herpes Zóster/uso terapéutico , Monitoreo Epidemiológico/tendencias , Herpesvirus Humano 3/patogenicidad , Herpes Zóster/complicaciones , Neuralgia Posherpética/prevención & control , Neuralgia Posherpética/diagnóstico , Neuralgia Posherpética/epidemiología , Factores de Riesgo , Huésped Inmunocomprometido , Resultado del Tratamiento , Estudios Epidemiológicos , España/epidemiologíaRESUMEN
No disponible
Asunto(s)
Adolescente , Adulto , Niño , Femenino , Humanos , Lactante , Masculino , Infecciones Meningocócicas/epidemiología , Infecciones Meningocócicas/etiología , Infecciones Meningocócicas/transmisión , Vacunas Meningococicas/uso terapéutico , Vacunas Meningococicas/administración & dosificación , Vacunas Meningococicas/efectos adversos , Vacunas Meningococicas/inmunología , Monitoreo Epidemiológico/tendencias , Vacunas Conjugadas/uso terapéutico , Neisseria meningitidis Serogrupo C , Neisseria meningitidis Serogrupo A , Neisseria meningitidis Serogrupo W-135 , Neisseria meningitidis Serogrupo Y , Neisseria meningitidis Serogrupo B , Programas de Inmunización , Control Sanitario de Viajeros , Huésped Inmunocomprometido , España/epidemiologíaRESUMEN
No disponible
Asunto(s)
Adulto , Femenino , Humanos , Embarazo , Complicaciones Infecciosas del Embarazo/prevención & control , Toxoide Tetánico/uso terapéutico , Vacuna contra la Rubéola/uso terapéutico , Vacuna contra la Varicela/uso terapéutico , Vacunas contra la Influenza/uso terapéutico , Vacuna Antisarampión/uso terapéutico , Vacuna contra la Parotiditis/uso terapéutico , Vacuna contra Difteria, Tétanos y Tos Ferina/uso terapéutico , Monitoreo Epidemiológico/tendencias , Tétanos/prevención & control , Rubéola (Sarampión Alemán)/prevención & control , Varicela/prevención & control , Parotiditis/prevención & control , Sarampión/prevención & control , Gripe Humana/prevención & control , Tos Ferina/prevención & control , Enfermedades del Recién Nacido , Mortalidad Fetal , España/epidemiologíaRESUMEN
The purpose of this study was to evaluate the cost-effectiveness of the strategy of controlling the contacts of tuberculosis patients with latent tuberculosis infection by means of treatment with rifampin for 4 months or isoniazid for 9 months. The cost was the sum of the cost of treating latent tuberculosis infection in all contacts plus the cost of treating tuberculosis in whom the disease was not avoided. The effectiveness was expressed as cases avoided. The efficacy adopted was 90 % for rifampin for 4 months and 93 % for isoniazid for 9 months. We carried out a sensitivity analysis for efficacies of rifampin for 4 months of 80 %, 75 %, 69 % and 65 %. Of the 1,002 patients studied, 139 were treated with rifampin for 4 months and 863 were treated with isoniazid for 9 months. The cost-effectiveness was
Asunto(s)
Antituberculosos/administración & dosificación , Isoniazida/administración & dosificación , Rifampin/administración & dosificación , Tuberculosis/tratamiento farmacológico , Adulto , Antituberculosos/economía , Trazado de Contacto , Análisis Costo-Beneficio , Femenino , Humanos , Isoniazida/economía , Tuberculosis Latente , Masculino , Estudios Retrospectivos , Rifampin/economía , España/epidemiología , Tuberculosis/economía , Tuberculosis/epidemiología , Tuberculosis/prevención & controlRESUMEN
Passive immunity against measles decreases during the first months of life. The objective of this study was to determine titres of measles antibodies in children aged 9-14 months and their mothers before vaccination, and the children's response to vaccination. Blood samples were collected by capillary puncture before and 28 days after vaccination. Samples were obtained between February and June 2007 during an ongoing measles outbreak. Titres of specific measles IgG antibodies were determined by enzyme-linked immunosorbent assay. Seroconversion was defined as the presence of antibodies after vaccination in subjects without antibodies before vaccination. Maternal antibodies were present in 37·7% of all 69 children included and in 45·1% of children aged 9 months. Of the 51 children in whom a second sample was obtained, 31 (60·8%) were seronegative before vaccination and 61·3% seroconverted. Interference of maternal antibodies was 30%. Advancing the first dose of measles vaccination from 15 to 12 months is a correct strategy, given the increase in the time of susceptibility of infants to measles.
Asunto(s)
Anticuerpos Antivirales/sangre , Vacuna Antisarampión/inmunología , Virus del Sarampión/inmunología , Sarampión/inmunología , Vacunación/métodos , Factores de Edad , Anticuerpos Antivirales/inmunología , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Esquemas de Inmunización , Lactante , Masculino , Sarampión/prevención & control , Vacuna Antisarampión/administración & dosificación , Estudios Seroepidemiológicos , España , Factores de TiempoRESUMEN
Serotype 3 is one of the most often detected pneumococcal serotypes in adults and it is associated with serious disease. In contrast, the isolation of serotype 3 by bacterial culture is unusual in children with invasive pneumococcal disease (IPD). The purpose of this study was to learn the serotype distribution of IPD, including culture-negative episodes, by using molecular methods in normal sterile samples. We studied all children<5 years of age with IPD admitted to two paediatric hospitals in Catalonia, Spain, from 2007 to 2009. A sequential real-time polymerase chain reaction (PCR) approach was added to routine methods for the detection and serotyping of pneumococcal infection. Among 257 episodes (219 pneumonia, 27 meningitis, six bacteraemia and five others), 33.5% were identified by culture and the rest, 66.5%, were detected exclusively by real-time PCR. The most common serotypes detected by culture were serotypes 1 (26.7%) and 19A (25.6%), and by real-time PCR, serotypes 1 (19.8%) and 3 (18.1%). Theoretical coverage rates by the PCV7, PCV10 and PCV13 vaccines were 10.5, 52.3 and 87.2%, respectively, for those episodes identified by culture, compared to 5.3, 31.6 and 60.2% for those identified only by real-time PCR. Multiplex real-time PCR has been shown to be useful for surveillance studies of IPD. Serotype 3 is underdiagnosed by culture and is important in paediatric IPD.
Asunto(s)
Técnicas Bacteriológicas/métodos , Infecciones Neumocócicas/epidemiología , Infecciones Neumocócicas/microbiología , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Streptococcus pneumoniae/clasificación , Streptococcus pneumoniae/aislamiento & purificación , Preescolar , Femenino , Humanos , Lactante , Masculino , Prevalencia , Serotipificación , España/epidemiología , Streptococcus pneumoniae/genéticaRESUMEN
We carried out a matched case-control study to analyze the possible association between exposure to the children and the risk of suffering herpes-zoster in adulthood. Cases of herpes zoster in immunocompetent healthy patients aged ≥ 25 years seen in the dermatology department of the Sagrado Corazón Hospital in 2007-2008 were matched with four controls. Data were analyzed using conditional logistic regression. 153 cases and 604 matched controls were included. Contacts with children were significantly associated with a reduction in the risk of suffering herpes zoster in adulthood (adjusted OR 0.56 [0.37-0.85]). Herpes-zoster vaccination in immunocompetent people aged ≥ 50 years could counteract the possible negative effects of mass varicella vaccination in childhood on the epidemiology of herpes zoster in adults.
Asunto(s)
Herpes Zóster/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Femenino , Herpes Zóster/inmunología , Vacuna contra el Herpes Zóster/administración & dosificación , Vacuna contra el Herpes Zóster/inmunología , Humanos , Masculino , Persona de Mediana Edad , Medición de Riesgo , España/epidemiologíaRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Esquemas de Inmunización , 51352 , Control de Enfermedades Transmisibles/métodos , Pautas de la Práctica en Medicina , Salud del Adolescente , Salud del AdultoRESUMEN
The objective of our study was to evaluate the effectiveness of the 23-valent pneumococcal polysaccharide vaccine (PPV) in preventing hospital admission for community-acquired pneumonia (CAP) in people ≥65 yrs of age. We conducted a matched case-control study in patients with CAP admitted to five Spanish hospitals. Cases were persons aged ≥65 yrs admitted to hospital through the emergency department, who presented a clinical and radiological pattern compatible with pneumonia, assessed using established criteria. We matched each case with three control subjects by sex, age (±5 yrs), date of hospitalisation (±30 days) and underlying disease. The study period was May 1, 2005 to January 31, 2007. The PPV immunisation status of cases and controls was investigated. Adjusted ORs for vaccination were calculated using logistic regression analysis. A total of 489 cases and 1,467 controls were included in the final analysis. The overall adjusted vaccination effectiveness for all patients was 23.6% (95% CI 0.9-41.0). The adjusted vaccination effectiveness for immunosuppressed patients was 21.0% (95% CI -18.7-47.5). Our results suggest that the PPV may potentially reduce hospitalisations for pneumonia in the elderly and supports vaccination programmes in this age group.
Asunto(s)
Vacunas Neumococicas/inmunología , Anciano , Estudios de Casos y Controles , Control de Enfermedades Transmisibles , Infecciones Comunitarias Adquiridas , Femenino , Geriatría/métodos , Hospitalización , Humanos , Masculino , Neumonía Neumocócica/prevención & control , Análisis de Regresión , España , Resultado del Tratamiento , VacunaciónRESUMEN
Serotypes causing invasive pneumococcal disease (IPD) in children aged <2 years in Catalonia (Spain) before and after licensing of the 7-valent pneumococcal conjugated vaccine (7vPCV) were assessed, using samples taken during 1997-1999 and 2005-2007 respectively. The distribution of serotypes causing IPD within these groups was obtained by serotyping strains sent by 22 Catalan hospitals to the Carlos III Health Institute, Madrid. Between 1997-99 and 2005-2007, the proportion of vaccine serotypes causing IPD in Catalonia fell from 70.54% to 31.67% (p <0.0001). The proportion of vaccine-related serotypes, mainly serotype 19A, increased from 9.82% to 32.50% (p <0.0001). The proportion of non-vaccine, non-related serotypes (serotypes not related to vaccine serotypes) rose from 19.64% to 35.83% (p <0.05). Within this group, the proportions of serotype 24F increased significantly. There has been a change in the distribution of serotypes isolated from cases of IPD in children <2 years old in Catalonia, comprising a reduction in the proportion of 7-valent vaccine serotypes, a rise in vaccine-related serotypes, especially 19A, and a smaller rise in non-vaccine, non-related serotypes, especially serotype 24F. A new 13-valent vaccine will cover 77.91% of the serotypes causing IPD in children <2 years old in Catalonia from 2005 to 2007.
Asunto(s)
Infecciones Neumocócicas/epidemiología , Infecciones Neumocócicas/microbiología , Vacunas Neumococicas/inmunología , Streptococcus pneumoniae/clasificación , Streptococcus pneumoniae/aislamiento & purificación , Técnicas de Tipificación Bacteriana , Femenino , Vacuna Neumocócica Conjugada Heptavalente , Humanos , Lactante , Recién Nacido , Masculino , Infecciones Neumocócicas/prevención & control , Prevalencia , Serotipificación , España/epidemiologíaRESUMEN
Taking the results of a prospective cohort study by our group that evaluated the effectiveness of the inactivated subunit virosomal influenza vaccine (Inflexal V), Crucell-Berna) in the prevention of influenza-related diseases and the reduction of its negative economic consequences, the economic costs and benefits for the family of vaccinating a theoretical cohort of 1000 healthy children aged 3-14 years with no risk factors with one dose of vaccine during the yearly health examination were quantiified. The economic analysis was carried out from the family perspective and the time horizon of the study was established at 6 months. In the base case, the net present value was 21,551.62 euros (21.5 euros per vaccinated child), and the benefit-cost ratio was 2.15, meaning that 1.15 euros is saved per euro invested.
Asunto(s)
Vacunas contra la Influenza/economía , Vacunación/economía , Vacunas de Virosoma/economía , Adolescente , Niño , Preescolar , Análisis Costo-Beneficio , Costos y Análisis de Costo , Familia , Humanos , Examen Físico , Vacunas de Productos Inactivados/economía , Vacunas de Subunidad/economíaRESUMEN
BACKGROUND: Maintaining high vaccination coverages is necessary in order to control vaccine-preventable diseases. We studied vaccination coverages in a representative sample of 630 children aged <3 years in Catalonia in order to determine the relationship between vaccination coverages and socioeconomic factors. METHODS: Sampling was carried out in a representative sample of the health regions in Catalonia stratified according to habitat. A sample of 630 parents of children aged <3 years born in October 2001 were interviewed by telephone. Information collected included sociodemographic data, type of health care provider (public or private) and information on vaccination coverage for the basic plus booster immunization series (BBI) which consisted of: four DTP, four OPV, one MMR and the doses of Hib and MenC necessary according to age of administration of the first dose. RESULTS: A total of 87.62% of the children were vaccinated with the BBI series, and no statistically significant differences in coverage between public (87.93%) and private (88.30%) paediatric providers, or between social classes (high: 87.58%, low: 88.81%) were found. Vaccination coverage was associated with attending a day-care centre (OR: 1.89; 95% CI: 1.12-3.21) and maternal university education (OR: 1.84; 95% CI: 1.01-3.33). CONCLUSION: Vaccination coverages are high and are similar between types of provider, probably due to preventive policies which have made a concerted effort to ensure universal vaccination.
Asunto(s)
Actitud Frente a la Salud , Programas de Inmunización/estadística & datos numéricos , Padres/psicología , Sector Privado , Sector Público , Preescolar , Estudios Transversales , Humanos , Entrevistas como Asunto , Estudios Retrospectivos , España , Vacunas/administración & dosificaciónRESUMEN
No disponible