RESUMO
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.
Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana , Infecções Pneumocócicas/microbiologia , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas/imunologia , Streptococcus pneumoniae/classificação , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Estudos Prospectivos , Estações do Ano , SorogrupoRESUMO
No disponible
Assuntos
Adulto , Criança , Feminino , Humanos , Masculino , Transplante de Órgãos , Vacina contra Sarampo-Caxumba-Rubéola/uso terapêutico , Vacinas contra Hepatite B/uso terapêutico , Vacinas contra Hepatite A/uso terapêutico , Vacinas contra Influenza/uso terapêutico , Vacinas contra Poliovirus/uso terapêutico , Vacina contra Varicela/uso terapêutico , Vacina contra Difteria, Tétano e Coqueluche/uso terapêutico , Vacinas Anti-Haemophilus/uso terapêutico , Vacinas Pneumocócicas/uso terapêutico , Transplantados , Terapia de Imunossupressão , Imunossupressores/uso terapêutico , Vacinas Atenuadas/uso terapêutico , Vacinas de Produtos Inativados/uso terapêutico , Corticosteroides/uso terapêutico , Vacinas , Imunização Secundária , Vacinação , Doenças TransmissíveisRESUMO
No disponible