Invasive Pneumococcal Disease in Healthy Adults: Increase of Empyema Associated with the Clonal-Type Sweden1-ST306

Grau, Inmaculada; Ardanuy, Carmen; Calatayud, Laura; Rolo, Dora; Domenech, Arnau; Liñares, Josefina; Pallarés, Román

doi:10.1371/journal.pone.0042595

Cited by 40 publications

(35 citation statements)

References 38 publications

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“…Among the adult patients, the most prevalent risk factor for Ser5 IPD acquisition was smoking, followed by alcohol abuse. These data are in accordance with previous publi- cations, reinforcing the notion that these are important predisposing factors for IPD acquisition, especially in young adults without comorbid conditions (27). COPD, cardiovascular diseases, and diabetes were the most common underlying conditions among our older adults with Ser5 IPD, whereas malignancies and other immunosuppressed conditions were less frequent.…”

Section: Discussionsupporting

confidence: 92%

Serotype 5 Pneumococci Causing Invasive Pneumococcal Disease Outbreaks in Barcelona, Spain (1997 to 2011)

et al. 2013

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fIn this study, we analyzed the clinical and molecular epidemiology of invasive serotype 5 (Ser5) pneumococcal isolates in four teaching hospitals in the Barcelona, Spain, area (from 1997 to 2011). Among 5,093 invasive pneumococcal isolates collected, 134 (2.6%) Ser5 isolates were detected. Although the overall incidence of Ser5-related invasive pneumococcal disease (IPD) was low (0.25 cases/100,000 inhabitants), three incidence peaks were detected: 0.63/100,000 in 1999, 1.15/100,000 in 2005, and 0.37/ 100,000 in 2009. The rates of Ser5 IPD were higher among young adults (18 to 64 years old) and older adults (>64 years old) in the first two peaks, whereas they were higher among children in 2009. The majority (88.8%) of the patients presented with pneumonia. Comorbid conditions were present in young adults (47.6%) and older adults (78.7%), the most common comorbid conditions being chronic obstructive pulmonary disease (20.6% and 38.3%, respectively) and cardiovascular diseases (11.1% and 38.3%, respectively). The mortality rates were higher among older adults (8.5%). All Ser5 pneumococci tested were fully susceptible to penicillin, cefotaxime, erythromycin, and ciprofloxacin. The resistance rates were 48.5% for co-trimoxazole, 6.7% for chloramphenicol, and 6% for tetracycline. Two major related sequence types (STs), ST1223 (n ‫؍‬ 65) and ST289 (n ‫؍‬ 61), were detected. The

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Section: Discussionsupporting

confidence: 92%

Serotype 5 Pneumococci Causing Invasive Pneumococcal Disease Outbreaks in Barcelona, Spain (1997 to 2011)

et al. 2013

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“…Among hospitalized adults with IPD in Spain, 6.9–15.0 % were diagnosed with PnEmp (Table 2) [17, 47]. …”

Section: Resultsmentioning

confidence: 99%

Pneumococcal empyema and complicated pneumonias: global trends in incidence, prevalence, and serotype epidemiology

Fletcher

Schmitt

Syrochkina³

et al. 2014

Eur J Clin Microbiol Infect Dis

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This review evaluates the serotype epidemiology of complicated pneumococcal pneumonia (CPP) during the period 1990–2012. PubMed and EMBASE were searched using the terms “empyema”, “complicated pneumonia”, “pleural infection”, “necrotizing pneumonia”, “pleural effusion”, “parapneumonic effusion”, “pneumatocele”, or “lung abscess”; “pneumococcal” or “Streptococcus pneumoniae”; and “serotype” for studies on the epidemiology of complicated pneumonias published from January 1, 1990 to October 1, 2013. Studies with data on incidence and serotypes were included; reviews, case reports, and conference abstracts were excluded. Of 152 papers, 84 fitted the inclusion criteria. A few pneumococcal serotypes were predominant causes of CPP, particularly serotypes 1, 19A, 3, 14, and 7F. CPP was a more common manifestation of pneumococcal disease among older (>2 years old) than younger children. The data support increases in both reported incidence rates and proportions of CPP in children and adults during the period 1990–2012; specific increases varied by geographic region. The proportions of serotype 3 and, particularly in Asia, serotype 19A CPP have increased, whereas most studies show declines in serotype 14. Serotype 1 has been a predominant cause of CPP since 1990, while antibiotic resistance was infrequent among serotype 1 isolates. The reported incidence and proportions of CPP among pneumonia cases steadily increased from 1990 to 2012. Several factors might account for these increases, including enhanced disease detection due to a higher index of suspicion, more sophisticated diagnostic assays, and changes in the prevalence of serotypes with capacity to invade the pleural space that were not targeted by the 7-valent pneumococcal conjugate vaccine (PCV7).

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“…12 Interestingly, the recent report in Spain in 2012 found a higher PCV13serotype prevalence in healthy adults (82%) than in patients with co-morbidity (56%). 13 These healthy adults with IPD, however, were often smokers or alcohol abusers. As pneumococcal serotypes vary in different geographic location, 14,15 development of one unique vaccine for worldwide use is challenging.…”

Section: Discussionmentioning

confidence: 99%

Serotype distribution and antibiotic susceptibility of invasiveStreptococcus pneumoniaeisolates in patients aged 50 years or older in Thailand

Srifeungfung

Phongsamart

Tribuddharat

et al. 2013

Human Vaccines & Immunotherapeutics

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As the 13-valent pneumococcal conjugate vaccine (PCV13) has been approved for use in adults aged 50 y and older, we evaluated vaccine-serotype coverage rate in Thai adult patients with invasive pneumococcal infections before the vaccine was widely used. Of the 157 S. pneumoniae isolates from normal sterile sites during January 2005 to September 2012, 150 (95%) from blood, mean patients' age 69.6 (range 50-89) years, the overall serotype coverage by PCV13 was 58%. The vaccine covered 50%, 56%, 59%, and 68% of the invasive isolates from patients aged 50-59, 60-69, 70-79, and ≥80 y, respectively. The most common vaccine serotypes were 6B (17%), 19A (9%), 18C (5%), and 23F (4%). The susceptibility rates of penicillin and ceftriaxone were 95% and 96% for nonmeningitis criteria; and 46% and 92% for meningitis criteria, respectively. The susceptibilities to other antibiotics were: chloramphenicol 76%, clindamycin 80%, erythromycin 57%, levofloxacin 100%, ofloxacin 94%, tetracycline 39%, trimethoprim/sulfamethoxazole 37%, linezolid 99%, and vancomycin 100%, respectively. These data served as a reference for monitoring of vaccine serotype coverage with future increased vaccine utilization.

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Invasive Pneumococcal Disease in Healthy Adults: Increase of Empyema Associated with the Clonal-Type Sweden1-ST306

Cited by 40 publications

References 38 publications

Serotype 5 Pneumococci Causing Invasive Pneumococcal Disease Outbreaks in Barcelona, Spain (1997 to 2011)

Serotype 5 Pneumococci Causing Invasive Pneumococcal Disease Outbreaks in Barcelona, Spain (1997 to 2011)

Pneumococcal empyema and complicated pneumonias: global trends in incidence, prevalence, and serotype epidemiology

Serotype distribution and antibiotic susceptibility of invasiveStreptococcus pneumoniaeisolates in patients aged 50 years or older in Thailand

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