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1.
Medicine (Baltimore) ; 99(2): e18504, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31914021

RESUMEN

We aimed to evaluate the clinical significance of bacterial coexistence and the coinfection dynamics between bacteria and respiratory viruses among young children. We retrospectively analyzed clinical data from children aged < 5 years hospitalized with a community-acquired single respiratory viral infection of influenza, adenovirus, or RSV during 2 recent consecutive influenza seasons. Remnant respiratory specimens were used for bacterial PCR targeting Moraxella catarrhalis, Haemophilus influenzae, Streptococcus pneumoniae, and Staphylococcus aureus.A total of 102 children were included; median age was 0.8 years and 44.1% had underlying comorbidities. Overall, 6.8% (7/102) of cases were classified as severe diseases requiring intensive care unit admission and/or mechanical ventilation and ranged from 8.8% for a patient with RSV and 7.6% for those with adenovirus to 0% for those with influenza viruses. The overall viral-bacterial codetection rate was 59.8% (61/102); M catarrhalis was the most frequent (33.3%), followed by H influenzae (31.4%). Influenza cases showed higher bacterial codetection rates (80.0%; 8/10) compared with those with adenoviruses (69.2%; 9/13) and RSV (55.7%; 44/79). S pneumoniae and H influenzae codetections were associated with reduced severity (aOR, 0.24; 95% CI, 0.07-0.89), and reduced risk of wheezing (aOR, 0.36; 95% CI, 0.13-0.98), respectively.We observed the interactions between respiratory viruses and bacteria and the clinical significance of viral-bacterial coexistence in upper airway on disease severity. Future study will be necessary to elucidate the active interactions between different viruses and bacteria and give clues to risk stratified strategy in the management of respiratory infections among young children.


Asunto(s)
Adenoviridae/aislamiento & purificación , Haemophilus influenzae/aislamiento & purificación , Infecciones del Sistema Respiratorio/microbiología , Infecciones del Sistema Respiratorio/virología , Infecciones por Adenoviridae/diagnóstico , Infecciones por Adenoviridae/virología , Bacterias/genética , Preescolar , Coinfección/microbiología , Coinfección/virología , Infecciones Comunitarias Adquiridas/diagnóstico , Infecciones Comunitarias Adquiridas/microbiología , Infecciones Comunitarias Adquiridas/virología , Femenino , Hospitalización , Humanos , Lactante , Recién Nacido , Gripe Humana/diagnóstico , Gripe Humana/virología , Masculino , Prevalencia , Ruidos Respiratorios/diagnóstico , Ruidos Respiratorios/etiología , Infecciones por Virus Sincitial Respiratorio/diagnóstico , Infecciones por Virus Sincitial Respiratorio/virología , Virus Sincitiales Respiratorios/genética , Infecciones del Sistema Respiratorio/diagnóstico , Infecciones del Sistema Respiratorio/epidemiología , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Staphylococcus aureus/aislamiento & purificación , Streptococcus pneumoniae/aislamiento & purificación , Virus/genética
2.
Artículo en Japonés | MEDLINE | ID: mdl-31856573

RESUMEN

Streptococcus pneumoniae is one of the major bacterial pathogens of community-acquired pneumonia. Immunochromatographic assay tests are used to detect pneumococcal capsular antigen. In many cases, They can be read visually. The Alere™ reader (Reader), which was developed in October 2018 by Alere Medical Co., Ltd. (currently, Abbott Diagnostics Medical Co., Ltd.) for interpreting BinaxNOW™ Streptococcus pneumoniae test (BinaxNOW™), quickly displays the results of the immunochromatographic tests, objectively and accurately, as it was launched for the purpose of streamlining laboratory workflow. The performance of the reader was evaluated by using urine samples from 100 patients, who were ordered pneumococcal urine antigen test from September 2018 to February 2019 at our hospital. Of the 100 samples, 14 were visually positive and 19 were reader positive. All visually positive samples generated reader positive result. Because 1 of the 5 cases which indicated a negative visual determination and positive reader determination was a sample with strong viscosity and turbidity, it was retested after centrifugation at 3,000×g for 10 min, resulting in negative reader determination. In 2 cases, S. pneumoniae were detected in sputum gram stains and culture tests. 5 discrepant samples were all visually and reader positive after concentration by centrifugal ultrafiltration. A questionnaire about visual interpretation was conducted among 31 individuals, by using urine from day 0 to day 4 collected from the patients whose test result was visually negative, reader positive and sputum culture positive at day 0. As a result, the number of operators who determined visually positive was 0 on day 0 (0%), 16 on day 1 (51.6%), 13 on day 2 (41.9%), 2 on day 3 (6.5%), and 0 on day 4 (0%). There were individual differences in ability to interpret low level positive result visually. On the other hand, reader can remove individual differences among operators from the interpretation of BinaxNOW™ and interpret positive result earlier than visual interpretation. Therefore reader was considered to be useful tool in clinical settings.


Asunto(s)
Infecciones Comunitarias Adquiridas , Neumonía Neumocócica , Streptococcus pneumoniae , Antígenos Bacterianos , Pruebas Diagnósticas de Rutina , Humanos , Neumonía Neumocócica/diagnóstico , Streptococcus pneumoniae/aislamiento & purificación
3.
Pan Afr Med J ; 33: 239, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31692895

RESUMEN

Introduction: Streptococcus pneumonia is a leading cause of bacterial pneumonia, meningitis and sepsis in children, and pneumococcal carriage is an important source of horizontal spread of these pathogens within the community. Methods: A questionnaire was addressed to parents for the collection of sociodemographic and medical information. Nasopharyngeal swabbing was processed using a molecular method. We used logistic regression models to examine independent associations between pneumococcal carriage and potential risk factors. All associations with a p-value of < 0.25 in the bivariate regression analyses were subsequently entered in the multivariate regression model. Results: A total of 637 children aged 1 to 59 months admitted for acute respiratory infection were included. The rate of respiratory virus carriage was 76%, whereas that of bacteria was 47% and that of bacteria-virus co-colonization was 42%. A bivariate analysis showed that carriage was not related to gender, father's or mother's education level, father's occupation, type of housing or lighting, or passive exposure to cigarette smoking in the house. It was also not linked to complete vaccination with PCV-13 or PPSV-23 and antibiotic treatment prior to hospitalization. A multivariate analysis showed that carriage was related to age greater than 3 months, maternal occupation, house flooring type, and co-colonization of another bacterium and virus. Conclusion: These results can be helpful to understand the dynamics of pneumococcal nasopharyngeal colonization; they confirm the interest of vaccinating infants before the age of 3 months with appropriate vaccine to prevent spread nasopharyngeal colonization and pneumococcal diseases in children.


Asunto(s)
Portador Sano/epidemiología , Nasofaringe/microbiología , Infecciones del Sistema Respiratorio/epidemiología , Streptococcus pneumoniae/aislamiento & purificación , Antibacterianos/administración & dosificación , Portador Sano/microbiología , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Masculino , Niger , Infecciones Neumocócicas/epidemiología , Infecciones Neumocócicas/microbiología , Vacunas Neumococicas/administración & dosificación , Infecciones del Sistema Respiratorio/microbiología , Factores de Riesgo , Encuestas y Cuestionarios
5.
Genes (Basel) ; 10(9)2019 09 06.
Artículo en Inglés | MEDLINE | ID: mdl-31500179

RESUMEN

We used whole genome sequencing (WGS) analysis to investigate the population structure of 877 Streptococcus pneumoniae isolates from five carriage studies from 2002 (N = 346), 2010 (N = 127), 2013 (N = 153), 2016 (N = 187) and 2018 (N = 64) in UK households which covers the period pre-PCV7 to post-PCV13 implementation. The genomic lineages seen in the population were determined using multi-locus sequence typing (MLST) and PopPUNK (Population Partitioning Using Nucleotide K-mers) which was used for local and global comparisons. A Roary core genome alignment of all the carriage genomes was used to investigate phylogenetic relationships between the lineages. The results showed an influx of previously undetected sequence types after vaccination associated with non-vaccine serotypes. A small number of lineages persisted throughout, associated with both non-vaccine and vaccine types (such as ST199), or that could be an example of serotype switching from vaccine to non-vaccine types (ST177). Serotype 3 persisted throughout the study years, represented by ST180 and Global Pneumococcal Sequencing Cluster (GPSC) 12; the local PopPUNK analysis and core genome maximum likelihood phylogeny separated them into two clades, one of which is only seen in later study years. The genomic data showed that serotype replacement in the carriage studies was mostly due to a change in genotype as well as serotype, but that some important genetic lineages, previously associated with vaccine types, persisted.


Asunto(s)
Portador Sano/microbiología , Genoma Bacteriano , Programas de Inmunización/estadística & datos numéricos , Infecciones Neumocócicas/microbiología , Streptococcus pneumoniae/genética , Adolescente , Adulto , Portador Sano/epidemiología , Niño , Preescolar , Composición Familiar , Vacuna Neumocócica Conjugada Heptavalente/uso terapéutico , Humanos , Filogenia , Infecciones Neumocócicas/epidemiología , Infecciones Neumocócicas/prevención & control , Infecciones Neumocócicas/transmisión , Vacunas Neumococicas/uso terapéutico , Serogrupo , Streptococcus pneumoniae/inmunología , Streptococcus pneumoniae/aislamiento & purificación , Reino Unido
6.
Rinsho Shinkeigaku ; 59(9): 584-588, 2019 Sep 25.
Artículo en Japonés | MEDLINE | ID: mdl-31474646

RESUMEN

A 53-year-old man was referred to our hospital because of fever and disturbed consciousness with a left-sided toothache from 5 days ago. Neurological examinations revealed a low level of consciousness, nuchal rigidity, bilateral mydriasis, and positive Babinski sign. A lumbar puncture yielded clouded fluid with a WBC 22,698/µl (polynuclear cell 98%), 681 mg/dl of protein and 0 mg/dl of glucose. The antigen of Streptococcus pneumoniae in urine and cerebrospinal fluid (CSF) were positive. Streptococcus pneumoniae was isolated from CSF culture. Brain CT on admission showed a communicating hydrocephalus. Diagnosis of pneumococcal meningitis with hydrocephalus was made and we treated with ceftriaxone and dexamethasone. The lumbar drainage placed at L 3/4 level became occluded, thus, extra-ventricular drainage was performed. Intracranial pressure (ICP) was 20 cmH2O upon insertion of the ICP sensor. At Day 2, the ICP decreased to 10 cmH2O and never increased during his course of hospitalization. Repeat brain CT showed no hydrocephalus. He responded to antimicrobial therapy and became lucid and afebrile. At Day 4, the extra-ventricular drainage was removed because of bleeding from right choroid plexus on brain CT. We treated with antimicrobial therapy until Day 21. He was transferred to another hospital for rehabilitation with mild neurological sequelae at Day 31. The cases presenting with hydrocephalus in the acute phase of bacterial meningitis has a high mortality rate. The presence of hydrocephalus is a poor prognostic factor. Although the therapeutic value of extra-ventricular drainage for hydrocephalus has been unclear, his report represents a case for neurologists to consider performing extra-ventricular drainage for hydrocephalus.


Asunto(s)
Drenaje/métodos , Hidrocefalia/terapia , Meningitis Neumocócica/terapia , Antibacterianos/administración & dosificación , Ceftriaxona/administración & dosificación , Dexametasona/administración & dosificación , Humanos , Hidrocefalia/diagnóstico por imagen , Hidrocefalia/etiología , Masculino , Meningitis Neumocócica/complicaciones , Meningitis Neumocócica/diagnóstico , Meningitis Neumocócica/microbiología , Persona de Mediana Edad , Streptococcus pneumoniae/aislamiento & purificación , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
8.
J Med Microbiol ; 68(10): 1466-1470, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31389781

RESUMEN

Introduction. Streptococcus pneumoniae and Haemophilus influenzae are both commensals of the human nasopharynx with a high capacity to cause upper and lower respiratory tract infections.Aim. Molecular testing of nasopharyngeal samples from children at the primary care paediatric department presenting with acute respiratory tract infections (ARTIs).Methodology. From June 2016 to May 2017, 156 nasopharyngeal swabs from children diagnosed with ARTIs who had been admitted to or followed up as outpatients at the Department of Paediatrics, SANADOR Hospital (Bucharest, Romania) were tested for the presence of S. pneumoniae, H. influenzae, Mycoplasma pneumoniae, Chlamydophila pneumoniae, Legionella pneumophila, Bordetella pertussis and Bordetella parapertussis DNA.Results. S. pneumoniae had the highest detection rate (53.8 %, n=84/156), followed by H. influenzae (41 %, n=64/156) and S. pneumoniae/H. influenzae co-detection (26.2 %, n=41/156).Conclusion. A definitive laboratory diagnosis of these micro-organisms can be made for invasive disease, but there are difficulties in establishing the aetiology for mucosal infection. Molecular detection tests could complement culture-based tests by strengthening their surveillance.


Asunto(s)
Infecciones por Haemophilus/microbiología , Haemophilus influenzae/aislamiento & purificación , Nasofaringe/microbiología , Infecciones Neumocócicas/microbiología , Streptococcus pneumoniae/aislamiento & purificación , Enfermedad Aguda/terapia , Adolescente , Niño , Preescolar , Femenino , Infecciones por Haemophilus/diagnóstico , Infecciones por Haemophilus/terapia , Haemophilus influenzae/genética , Hospitales/estadística & datos numéricos , Humanos , Lactante , Masculino , Infecciones Neumocócicas/diagnóstico , Infecciones Neumocócicas/terapia , Rumanía , Streptococcus pneumoniae/genética
9.
BMC Infect Dis ; 19(1): 697, 2019 Aug 06.
Artículo en Inglés | MEDLINE | ID: mdl-31387529

RESUMEN

BACKGROUND: S. pneumoniae is the leading cause of community-acquired pneumonia in the solid organ transplant recipient (SOTR); nevertheless, the prevalence of colonization and of the colonizing/infecting serotypes has not been studied in this population. In this context, the aim of the present study was to describe the rate, characteristics, and clinical impact of S. pneumoniae nasopharyngeal carriage. METHODS: A prospective observational cohort of Solid Organ Transplant recipients (SOTR) was held at the University Hospital Virgen del Rocío, Seville, Spain with the aim to evaluate the S. pneumoniae colonization and the serotype prevalence in SOTR. Two different pharyngeal swabs samples from 500 patients were included in two different seasonal periods winter and spring/summer. Optochin and bile solubility tests were performed for the isolation of thew strains. Antimicrobial susceptibility studies (MICs, mg/l) of levofloxacin, trimethoprim-sulfamethoxazole, penicillin, amoxicillin, cefotaxime, ceftriaxone, erythromycin, azithromycin and vancomycin for each isolate were determined by E-test strips. Capsular typing was done by sequential multiplex PCR reactions. A multivariate logistic regression analysis of factors potentially associated with pneumococcal nasopharyngeal carriage and disease was performed. RESULTS: Twenty-six (5.6%) and fifteen (3.2%) patients were colonized in winter and spring/summer periods, respectively. Colonized SOT recipients compared to non-colonized patients were more frequently men (79.5% vs. 63.1%, P < 0.05) and cohabitated regularly with children (59% vs. 32.2%, P < 0.001). The most prevalent serotype in both studied periods was 35B. Forty-five percent of total isolates were included in the pneumococcal vaccine PPV23. Trimethoprim-sulfamethoxazole and macrolides were the less active antibiotics. Three patients had non-bacteremic pneumococcal pneumonia, and two of them died. CONCLUSIONS: Pneumococcal colonization in SOTR is low with the most colonizing serotypes not included in the pneumococcal vaccines.


Asunto(s)
Nasofaringe/microbiología , Trasplante de Órganos/efectos adversos , Infecciones Neumocócicas/epidemiología , Streptococcus pneumoniae/aislamiento & purificación , Adulto , Antibacterianos , Niño , Femenino , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Infecciones Neumocócicas/microbiología , Vacunas Neumococicas , Prevalencia , Estudios Prospectivos , Serogrupo , España/epidemiología , Streptococcus pneumoniae/efectos de los fármacos , Streptococcus pneumoniae/patogenicidad , Receptores de Trasplantes/estadística & datos numéricos
10.
Pan Afr Med J ; 32: 203, 2019.
Artículo en Francés | MEDLINE | ID: mdl-31312315

RESUMEN

Pneumococcal meningitis is a global scourge. It is a major cause of morbidity and mortality. In Morocco, 13-valent pneumococcal conjugate vaccine (PCV13) was introduced into the National Immunization Program in October 2010 according to the immunization schedule 2 + 1 and replaced by PCV10 in July 2012, according to the same schedule. Despite the use of the PCV13, which is essential in the fight against pneumococcal disease, the emergence of new non-vaccine serotypes always results in meningitis in children, causing serious sequelae. We report the case of an infant vaccinated with two doses of PCV13 with meningitis caused by Streptococcus pneumoniae serotype 7a. The peculiarity of this case study lies in pneumococcal meningitis due to Streptococcus pneumoniae serotype 7a not included in the PCV13 in an infant immunized by 2 doses of PCV13. We here insist on the need and the importance of an observatory for pneumococcal meningitis and of a wide epidemiological study in order to determine the serotypes in Morocco after the introduction of PCV13 and then of PCV10.


Asunto(s)
Meningitis Neumocócica/diagnóstico , Vacunas Neumococicas/administración & dosificación , Streptococcus pneumoniae/aislamiento & purificación , Humanos , Lactante , Masculino , Meningitis Neumocócica/microbiología , Meningitis Neumocócica/prevención & control , Marruecos , Vacunas Neumococicas/inmunología , Serotipificación , Streptococcus pneumoniae/inmunología , Vacunación
11.
J Med Microbiol ; 68(8): 1173-1188, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31268417

RESUMEN

PURPOSE: Correct serotype identification of Streptococcus pneumoniae (pneumococcus) is important for monitoring disease epidemiology and assessing the impacts of pneumococcal vaccines. Furthermore, correct identification and differentiation of the pathogenic S. pneumoniae from closely related commensal species of the mitis group of the genus Streptococcus are essential for correct serotype identification. METHODOLOGY: A new protocol for determining the existing 98 serotypes of pneumococcus was developed, applying two PCR amplifications and amplicon sequencing, using newly designed internal primers. The new protocol was validated using S. pneumoniae genome sequences, reference strains with confirmed serotypes and clinical isolates, and comparing the results with those from the traditional Quellung reaction or antiserum panel gel precipitation, in addition to real-time PCR analysis. The taxonomic identifications of 422 publicly available (GenBank) genome sequences of S. pneumoniae, Streptococcus pseudopneumoniae and Streptococcus mitis were assessed by whole-genome sequence average nucleotide identity based on blast (ANIb) analysis. RESULTS: The proposed sequetyping protocol generates a 1017 bp whole cpsB region sequence, increasing resolution for serotype identification in pneumococcus isolates. The identifications of all GenBank genome sequences of S. pneumoniae were confirmed, whereas most of the S. pseudopneumoniae and almost all of the S. mitis genome sequences did not fulfil the ANIb thresholds for species-level identification. The housekeeping biomarker gene, groEL, correctly identified S. pneumoniae but often misclassified S. pseudopneumoniae and S. mitis as S. pneumoniae. CONCLUSIONS: These studies affirm the importance of applying reliable identification protocols for S. pneumoniae before serotyping; our protocols provide reliable diagnostic tools, as well as an improved workflow, for serotype identification of pneumococcus and differentiation of serogroup 6 types.


Asunto(s)
Cápsulas Bacterianas/genética , Tipificación Molecular/métodos , Streptococcus pneumoniae/clasificación , Streptococcus pneumoniae/genética , Proteínas Bacterianas/genética , ADN Bacteriano/genética , Genoma Bacteriano/genética , Humanos , Infecciones Neumocócicas/microbiología , Proteínas Tirosina Fosfatasas/genética , Reacción en Cadena en Tiempo Real de la Polimerasa , Análisis de Secuencia de ADN , Serogrupo , Serotipificación/normas , Streptococcus/clasificación , Streptococcus/genética , Streptococcus/aislamiento & purificación , Streptococcus pneumoniae/aislamiento & purificación , Flujo de Trabajo
12.
Lancet ; 394(10200): 757-779, 2019 08 31.
Artículo en Inglés | MEDLINE | ID: mdl-31257127

RESUMEN

BACKGROUND: Pneumonia is the leading cause of death among children younger than 5 years. In this study, we estimated causes of pneumonia in young African and Asian children, using novel analytical methods applied to clinical and microbiological findings. METHODS: We did a multi-site, international case-control study in nine study sites in seven countries: Bangladesh, The Gambia, Kenya, Mali, South Africa, Thailand, and Zambia. All sites enrolled in the study for 24 months. Cases were children aged 1-59 months admitted to hospital with severe pneumonia. Controls were age-group-matched children randomly selected from communities surrounding study sites. Nasopharyngeal and oropharyngeal (NP-OP), urine, blood, induced sputum, lung aspirate, pleural fluid, and gastric aspirates were tested with cultures, multiplex PCR, or both. Primary analyses were restricted to cases without HIV infection and with abnormal chest x-rays and to controls without HIV infection. We applied a Bayesian, partial latent class analysis to estimate probabilities of aetiological agents at the individual and population level, incorporating case and control data. FINDINGS: Between Aug 15, 2011, and Jan 30, 2014, we enrolled 4232 cases and 5119 community controls. The primary analysis group was comprised of 1769 (41·8% of 4232) cases without HIV infection and with positive chest x-rays and 5102 (99·7% of 5119) community controls without HIV infection. Wheezing was present in 555 (31·7%) of 1752 cases (range by site 10·6-97·3%). 30-day case-fatality ratio was 6·4% (114 of 1769 cases). Blood cultures were positive in 56 (3·2%) of 1749 cases, and Streptococcus pneumoniae was the most common bacteria isolated (19 [33·9%] of 56). Almost all cases (98·9%) and controls (98·0%) had at least one pathogen detected by PCR in the NP-OP specimen. The detection of respiratory syncytial virus (RSV), parainfluenza virus, human metapneumovirus, influenza virus, S pneumoniae, Haemophilus influenzae type b (Hib), H influenzae non-type b, and Pneumocystis jirovecii in NP-OP specimens was associated with case status. The aetiology analysis estimated that viruses accounted for 61·4% (95% credible interval [CrI] 57·3-65·6) of causes, whereas bacteria accounted for 27·3% (23·3-31·6) and Mycobacterium tuberculosis for 5·9% (3·9-8·3). Viruses were less common (54·5%, 95% CrI 47·4-61·5 vs 68·0%, 62·7-72·7) and bacteria more common (33·7%, 27·2-40·8 vs 22·8%, 18·3-27·6) in very severe pneumonia cases than in severe cases. RSV had the greatest aetiological fraction (31·1%, 95% CrI 28·4-34·2) of all pathogens. Human rhinovirus, human metapneumovirus A or B, human parainfluenza virus, S pneumoniae, M tuberculosis, and H influenzae each accounted for 5% or more of the aetiological distribution. We observed differences in aetiological fraction by age for Bordetella pertussis, parainfluenza types 1 and 3, parechovirus-enterovirus, P jirovecii, RSV, rhinovirus, Staphylococcus aureus, and S pneumoniae, and differences by severity for RSV, S aureus, S pneumoniae, and parainfluenza type 3. The leading ten pathogens of each site accounted for 79% or more of the site's aetiological fraction. INTERPRETATION: In our study, a small set of pathogens accounted for most cases of pneumonia requiring hospital admission. Preventing and treating a subset of pathogens could substantially affect childhood pneumonia outcomes. FUNDING: Bill & Melinda Gates Foundation.


Asunto(s)
Hospitalización/estadística & datos numéricos , Neumonía Bacteriana/epidemiología , Neumonía Viral/epidemiología , Bangladesh/epidemiología , Teorema de Bayes , Estudios de Casos y Controles , Preescolar , Femenino , Gambia/epidemiología , Infecciones por VIH/epidemiología , Haemophilus influenzae tipo b/aislamiento & purificación , Humanos , Lactante , Recién Nacido , Kenia/epidemiología , Masculino , Malí/epidemiología , Neumonía , Virus Sincitiales Respiratorios/aislamiento & purificación , Índice de Severidad de la Enfermedad , Sudáfrica/epidemiología , Streptococcus pneumoniae/aislamiento & purificación , Tailandia/epidemiología , Zambia/epidemiología
13.
J Med Microbiol ; 68(9): 1383-1390, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31347997

RESUMEN

Introduction. In 2016-2017, there was an increase in the number of paediatric invasive pneumococcal disease (IPD) cases caused by Streptococcus pneumoniae serotype 12F in Chiba Prefecture, Japan. Serotype 12F is one of the major causative serotypes of IPD following the introduction of pneumococcal conjugate vaccine 13 (PCV13), and outbreaks of IPD caused by serotype 12F have recently been reported in several countries.Aim. Our goal here was to clarify the relationship among local outbreak strains and the outbreak strains in other countries, and for this we analysed clinical isolates of S. pneumoniae serotype 12F using several genetic identification methods.Methodology. All reported IPD cases caused by serotype 12F were reviewed and bacterial strains were collected and analysed. We also analysed S. pneumoniae serotype 12F strains isolated from other time periods, geographical areas, cases of adult IPD and respiratory specimens as control strains. Multi-locus sequence typing, PFGE and multi-locus variable number tandem repeat analysis (MLVA) were conducted on all isolates.Results. All 26 S. pneumoniae serotype 12F isolates, including control strains, belonged to a single sequence type (ST4846) that was the specific ST in Japan. All tested strains demonstrated five MLVA patterns and two PFGE patterns.Conclusion. We determined that the 2016-2017 outbreak of IPD in Chiba Prefecture was caused by clonally related isolates of serotype 12F. The continuous monitoring of IPD caused by serotype 12F is important for evaluating the impact of re-emerging pneumococcal serotypes following the PCV13 introduction era, and MLVA could be a useful tool for identification of outbreak strains.


Asunto(s)
Brotes de Enfermedades , Infecciones Neumocócicas/epidemiología , Infecciones Neumocócicas/microbiología , Serogrupo , Streptococcus pneumoniae/clasificación , Streptococcus pneumoniae/aislamiento & purificación , Adolescente , Adulto , Anciano , Niño , Preescolar , Electroforesis en Gel de Campo Pulsado , Femenino , Humanos , Lactante , Japón/epidemiología , Masculino , Persona de Mediana Edad , Repeticiones de Minisatélite , Epidemiología Molecular , Tipificación de Secuencias Multilocus , Streptococcus pneumoniae/genética
14.
Int J Infect Dis ; 85: 135-140, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31150842

RESUMEN

OBJECTIVE: This study was undertaken to determine the serotype distribution and drug susceptibility patterns in pneumococcal isolates recovered from patients with invasive pneumococcal disease (IPD). METHODS: All invasive pneumococcal isolates received between June 2014 and June 2016 were included in the study as part of a national laboratory-based IPD surveillance program. Isolates recovered from clinical specimens of normally sterile body sites were included. RESULTS: A total of 41 different serotypes were identified among the 132 pneumococcal isolates included in this study. The most prevalent serotypes/serogroups were 12 (8.3%), 15 (8.3%), 19F (7.6%), 3 (6.1%), and 19A (6.1%);. It was observed that overall vaccine coverage rates for pneumococcal conjugate vaccines (PCV), PCV7, PCV10 and PCV13 were 15.9%, 24.2% and 37.1% respectively. 56.8% (n=75) of the isolates were non-susceptible to at least one antibiotic and 40.9% (n=54) of the isolates were resistant to PEN (M). 18.9% (n=25) of the isolates were multi-drug resistant (MDR).The case fatality rate was 15.9%. CONCLUSION: Our study results call for broader vaccine coverage, emphasizes the need to introduce the conjugate pneumococcal vaccine for the high risk adult population and stress the importance of continuous surveillance of serotypes and antimicrobial resistance to guide vaccine development and antimicrobial stewardship activities.


Asunto(s)
Farmacorresistencia Bacteriana , Infecciones Neumocócicas/microbiología , Vacunas Neumococicas , Streptococcus pneumoniae/clasificación , Streptococcus pneumoniae/efectos de los fármacos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Omán , Infecciones Neumocócicas/prevención & control , Serogrupo , Streptococcus pneumoniae/aislamiento & purificación , Vacunas Conjugadas , Adulto Joven
15.
Medicine (Baltimore) ; 98(24): e15942, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31192930

RESUMEN

Emergent resistance to antibiotics among Streptococcus pneumoniae isolates is a severe problem worldwide. Antibiotic resistance profiles for S pneumoniae isolates identified from pediatric patients in mainland China remains to be established.The clinical features, antimicrobial resistance, and multidrug resistance patterns of S pneumoniae were retrospectively analyzed at 10 children's hospitals in mainland China in 2016.Among the collected 6132 S pneumoniae isolates, pneumococcal diseases mainly occurred in children younger than 5 years old (85.1%). The resistance rate of S pneumoniae to clindamycin, erythromycin, tetracycline, and trimethoprim/sulfamethoxazole was 95.8%, 95.2%, 93.6%, and 66.7%, respectively. The resistance rates of S pneumoniae to penicillin were 86.9% and 1.4% in non-meningitis and meningitis isolates, while the proportions of ceftriaxone resistance were 8.2% and 18.1%, respectively. Pneumococcal conjugate vaccine was administered to only 4.1% of patients. Penicillin and ceftriaxone resistance, underling diseases, antibiotic resistant risk factors, and poor prognosis appeared more frequently in invasive pneumococcal diseases. The incidence of multidrug resistance (MDR) was 46.1% in patients with invasive pneumococcal disease which was more than in patients with non-invasive pneumococcal disease (18.3%). Patients with invasive pneumococcal disease usually have several MDR coexistence.S pneumoniae isolates showed high resistance to common antibiotics in mainland China. Penicillin and ceftriaxone resistance rate of invasive streptococcal pneumonia patients were significantly higher than that of non-invasive S pneumoniae patients. Alarmingly, 46.1% of invasive clinical isolates were multidrug resistant, so it is important to continued monitor the resistance of S pneumoniae when protein conjugate vaccine (PCV13) is coming in mainland China.


Asunto(s)
Antibacterianos/farmacología , Infecciones Neumocócicas/epidemiología , Streptococcus pneumoniae/aislamiento & purificación , Ceftriaxona/farmacología , Niño , Preescolar , China/epidemiología , Farmacorresistencia Bacteriana Múltiple , Eritromicina/farmacología , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Pruebas de Sensibilidad Microbiana , Penicilinas/farmacología , Infecciones Neumocócicas/microbiología , Estudios Retrospectivos , Streptococcus pneumoniae/efectos de los fármacos , Combinación Trimetoprim y Sulfametoxazol/farmacología
16.
BMC Infect Dis ; 19(1): 495, 2019 Jun 04.
Artículo en Inglés | MEDLINE | ID: mdl-31164085

RESUMEN

BACKGROUND: There is currently no research on the diagnostic value of metagenomic next-generation sequencing (mNGS) for a single pathogens in CSF. The aim of this study was to analyse the value of mNGS for identifying Streptococcus pneumoniae (S. pneumoniae) in paediatric bacterial meningitis. METHODS: Bacterial meningitis (BM) cases from October 23, 2014, to December 31, 2016, and December 1, 2017, to July 31, 2018 at Beijing Children's Hospital were reviewed. Clinical features and pathogens were analysed. RESULTS: We diagnosed 135 patients with BM in this study. A total of 43 S. pneumoniae were identified by combination methods. 26/135 (19.3%) patients had positive results in S. pneumoniae by blood and/or cerebrospinal fluid (CSF) culture. Alere BinaxNow®Streptococcus pneumoniae Antigen test was positive in 35/135(25.9%) cases. 32/135 (23.7%) S. pneumoniae were identified by mNGS. Six CSF samples were identified as S. pneumoniae only by mNGS technology. Taking culture as the gold standard, the sensitivity and specificity of mNGS for diagnosing S. pneumoniae meningitis were 73.1 and 88.1%, respectively. The positive predictive value (PPV) and negative predictive value (NPV) of diagnosing S. pneumoniae meningitis by mNGS were 59.4 and 93.2%, respectively. When comparison between mNGS and combined tests (culture and Alere BinaxNow®Streptococcus pneumoniae Antigen test), the sensitivity and specificity of mNGS for S. pneumoniae identification were 70.3 and 93.9%, the PPV and NPV in the identification of S. pneumoniae by mNGS were 81.4 and 89.3%, respectively. The difference in number of unique reads of S. pneumoniaein from CSF sample (< 14 days onset) and CSF sample (> 14 days from onset) was statistically significant (170.5 VS. 13, P = 0.019). The difference in the collected time of CSF for culture and mNGS was statistically significant (4 days VS. 14 days, P < 0.001). CONCLUSIONS: mNGS has high sensitivity and specificity for S. pneumoniae identification. The pathogen load (number of unique reads) of S. pneumonia is related to the CSF collection time. mNGS was less affected than culture by the use of antibiotics before CSF collection.


Asunto(s)
Secuenciación de Nucleótidos de Alto Rendimiento , Meningitis Bacterianas/diagnóstico , Metagenómica/métodos , Streptococcus pneumoniae/genética , Streptococcus pneumoniae/aislamiento & purificación , Adolescente , Factores de Edad , Antígenos Bacterianos/análisis , Antígenos Bacterianos/sangre , Antígenos Bacterianos/líquido cefalorraquídeo , Antígenos Bacterianos/genética , Niño , Preescolar , Pruebas Diagnósticas de Rutina , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Meningitis Bacterianas/sangre , Meningitis Bacterianas/líquido cefalorraquídeo , Meningitis Bacterianas/microbiología , Pediatría/métodos , Reacción en Cadena de la Polimerasa/métodos , Valor Predictivo de las Pruebas , Sensibilidad y Especificidad
17.
J Infect Chemother ; 25(10): 750-757, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31235348

RESUMEN

The prevalence of nonencapsulated Streptococcus pneumoniae (NESp) has increased with the introduction of pneumococcal conjugate vaccines in children; however, the bacteriological characteristics of NESp have not been sufficiently clarified. In this study, NESp strains isolated from the nasopharyngeal carriage of children from four nursery schools in Japan were analyzed for molecular type, antibiotic susceptibility, and biofilm productivity. A total of 152 putative S. pneumoniae strains were identified by optochin-susceptibility analysis, of which 21 were not serotypeable by slide agglutination, quellung reaction, or multiplex PCR. Among these 21 strains, three were lytA-negative and, therefore, not S. pneumoniae. The remaining 18 strains were positive for lytA, ply, pspK, and bile solubility and were confirmed as NESp. Therefore, the isolation rate of NESp in the S. pneumoniae strains in this study was 12.0% (18/149). Molecular-typing analyses classified five strains as two existing sequence types (STs; ST7502 and ST7786), and 13 strains formed four novel STs. Horizontal spread was suspected, because strains with the same ST were often isolated from the same nursery school. The NESp isolates were generally susceptible to most antimicrobials, with the exception of macrolides; however, all isolates possessed more than one abnormal penicillin-binding protein gene. Furthermore, NESp strains were more effective than encapsulated counterparts at forming biofilms, which showed obvious differences in morphology. These data indicated that NESp strains should be continuously monitored as emerging respiratory pathogens.


Asunto(s)
Antibacterianos/farmacología , Biopelículas/efectos de los fármacos , Infecciones Neumocócicas/terapia , Vacunas Neumococicas/uso terapéutico , Streptococcus pneumoniae/aislamiento & purificación , Antibacterianos/uso terapéutico , Farmacorresistencia Bacteriana/genética , Humanos , Lactante , Recién Nacido , Japón/epidemiología , Pruebas de Sensibilidad Microbiana , Tipificación Molecular/métodos , Mutación , Mucosa Nasal/microbiología , Proteínas de Unión a las Penicilinas/genética , Infecciones Neumocócicas/epidemiología , Infecciones Neumocócicas/microbiología , Prevalencia , Serotipificación , Streptococcus pneumoniae/genética , Streptococcus pneumoniae/inmunología , Factores de Virulencia/genética
18.
J Biol Regul Homeost Agents ; 33(3): 843-847, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31184099

RESUMEN

Streptococcus pneumoniae is a Gram-positive, alpha-hemolytic, facultative anaerobic coccus. It is the most common cause of community acquired pneumonia in adults and infants, and a major cause of morbidity and mortality. It is also a frequent cause of otitis media and sinus infections. It spreads through close person-to-person contact via respiratory droplets. It presents as pneumonia, bacteremia, or meningitis.


Asunto(s)
Infecciones Comunitarias Adquiridas/microbiología , Otitis Media/microbiología , Neumonía Bacteriana/microbiología , Streptococcus pneumoniae/clasificación , Hospitales Universitarios , Humanos , Streptococcus pneumoniae/aislamiento & purificación , Suecia
19.
Microb Genom ; 5(7)2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31184299

RESUMEN

The pneumococcus produces a polysaccharide capsule, encoded by the cps locus, that provides protection against phagocytosis and determines serotype. Nearly 100 serotypes have been identified with new serotypes still being discovered, especially in previously understudied regions. Here we present an analysis of the cps loci of more than 18  000 genomes from the Global Pneumococcal Sequencing (GPS) project with the aim of identifying novel cps loci with the potential to produce previously unrecognized capsule structures. Serotypes were assigned using whole genome sequence data and 66 of the approximately 100 known serotypes were included in the final dataset. Closer examination of each serotype's sequences identified nine putative novel cps loci (9X, 11X, 16X, 18X1, 18X2, 18X3, 29X, 33X and 36X) found in ~2.6  % of the genomes. The large number and global distribution of GPS genomes provided an unprecedented opportunity to identify novel cps loci and consider their phylogenetic and geographical distribution. Nine putative novel cps loci were identified and examples of each will undergo subsequent structural and immunological analysis.


Asunto(s)
Cápsulas Bacterianas/genética , Infecciones Neumocócicas/microbiología , Polisacáridos Bacterianos/genética , Streptococcus pneumoniae/clasificación , Streptococcus pneumoniae/genética , Mapeo Cromosómico/métodos , ADN Bacteriano/genética , Bases de Datos Genéticas , Conjuntos de Datos como Asunto , Genes Bacterianos , Sitios Genéticos , Humanos , Serogrupo , Streptococcus pneumoniae/aislamiento & purificación , Secuenciación Completa del Genoma/métodos
20.
Int J Pediatr Otorhinolaryngol ; 125: 6-10, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31229854

RESUMEN

OBJECTIVE: Two third of children in the world experience otitis media with effusion (OME) at least once in their life. According to the importance of knowing OME reason in pediatrics, beside introduced probable bacterial and viral causal agents, Pseudomonas aeruginosa was evaluated either. METHODS: In this study, 42 middle ear fluid (MEF) samples were collected from pediatrics who confirmed OME by an ears, nose and throat (ENT) specialist. Samples were cultured on bacteriological media for bacterial growth and were either extracted for total DNA and RNA to be tested for introduced bacterial and viral agents with simple and Reverse Transcriptase PCR method within specific primers. RESULTS: Total results from culture and molecular methods showed that the most prevalent infections were Pseudomonas aeruginosa and streptococcus pneumonia with 33.33% and 14.29% respectively. In total, 66.67% of patients were infected with bacteria, 11.9% with test viruses while in 21.42% of patients no infectious agents were detected. Influenza type A was the only virus was detected. CONCLUSION: Pseudomonas aeruginosa was the most prevalent agent while mostly detected in patients who were referred from the tropical and humid region. According to these results, it is highly recommended to know the pattern of OME infection in each area separately for more successful treatment.


Asunto(s)
Otitis Media con Derrame/microbiología , Pseudomonas aeruginosa/aislamiento & purificación , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Masculino , Otitis Media con Derrame/virología , Reacción en Cadena de la Polimerasa , Pseudomonas aeruginosa/genética , ARN Ribosómico 16S , Streptococcus pneumoniae/genética , Streptococcus pneumoniae/aislamiento & purificación
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