S. pneumoniae isolados da nasofaringe de crianças sadias e com pneumonia: taxa de colonização e suscetibilidade aos antimicrobianos

Rey, Luís; Wolf, Bart; Moreira, José Luciano Bezerra; Verhoef, J.; Farhat, Calil Kairalla

doi:10.1590/s0021-75572002000200008

Cited by 20 publications

(46 citation statements)

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“…8,4,[10][11][12] Of this study, seven (54%) of the 13 children less than 2 years old had suffered IPD due to SpNSPn. It is possible that this high level of penicillin resistance is partially due to the fact that HIV+ patients are often given antimicrobial treatment.…”

Section: %mentioning

confidence: 72%

“…The majority of these refer to colonization of the airways by Sp, since the difficulties in isolating the bacteria from cultures from people with pneumonia are well known. 4,[9][10][11][12][13] The only study published in Brazil on Sp serotypes identified from HIV+ children demonstrated that nasopharyngeal colonization of 112 children was no greater than that described in the literature for healthy children. 3 In our study, serotype 14 was the most frequent (four cases) and was also the serotype that exhibited greatest resistance to penicillin, which confirms data published in Brazilian literature.…”

Section: Resultsmentioning

confidence: 92%

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Doença pneumocócica invasiva em crianças e adolescentes soropositivos para HIV

Mattei¹,

Falleiros-Carvalho²,

Cavalcante³

2008

J. Pediatr. (Rio J.)

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Objective: Invasive pneumococcal disease (IPD) primarily affects children less than 5 years old, the elderly and certain at-risk groups; especially people infected by the human immunodeficiency virus (HIV). The objective of this study was to analyze invasive pneumococcal diseases (IPD) in children and adolescents infected by the human immunodeficiency virus (HIV), with relation to morbidity, the case fatality ratio, pneumococcus serotypes, susceptibility to penicillin and ceftriaxone and to the proportion of susceptible and resistant Streptococcus pneumoniae (Sp) included in the 7-valent pneumococcal conjugate vaccine that has already been licensed. Methods:A total of 19 cases of IPD were identified among HIV seropositive patients aged from 1 month to 20 years and hospitalized between 1993 and 2000. Data were recorded on standardized charts containing information on age, clinical diagnosis and progression, serotypes and the susceptibility to penicillin and ceftriaxone of the Sp strains identified in cultures. When the minimum inhibitory concentration was < 0.1 mcg/mL, Sp were defined as susceptible to penicillin (SpSPn), and all other strains were defined as not susceptible (SpNSPn). Results:Of the 19 HIV seropositive cases with IPD, 16 (84%) had pneumonia and three (16%), had meningitis; 13 (68%) cases were children less than 2 years old and 16 (84%) were less than 5 years old. The case fatality ratio was 10%. Seven (54%) of the 13 cases less than 2 years old were SpNSPn and 10 (77%) were caused by serotypes covered by the 7-valent pneumococcal conjugate vaccine. From the 10 isolated serotypes the most frequent were 14, 6B and 23F, all them susceptible to ceftriaxone. From the three patients with meningitis, two were caused by SpNSPn. Conclusion:In this study most of the IPD occurred in children less than 2 years old; 77% of the strains and 86% of the serotypes of SpNSPn were covered by the 7-valent pneumococcal conjugate vaccine.J Pediatr (Rio J). 2008;84(3):276-280: Pneumococcus, Streptococcus pneumoniae, children, adolescents, HIV seropositive, meningitis, pneumonia, invasive pneumococcal disease, antipneumococcal vaccine.

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Section: %mentioning

confidence: 72%

Section: Resultsmentioning

confidence: 92%

Doença pneumocócica invasiva em crianças e adolescentes soropositivos para HIV

Mattei¹,

Falleiros-Carvalho²,

Cavalcante³

2008

J. Pediatr. (Rio J.)

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“…Rey et al 15 , em estudo realizado em Fortaleza (CE), em 1998, determinaram a prevalência de colonização de nasofaringe em crianças sadias, admitidas em postos de vacinação, crianças de creches e crianças com pneumonia. No grupo de crianças sadias recrutadas em postos de vacinação, a prevalência de colonização de nasofaringe pelo pneumococo foi de 49%, enquanto no grupo de crianças de creches, a prevalência foi muito mais alta (72%).…”

Section: Discussionunclassified

“…Como ambos os grupos foram submetidos à coleta pela mesma técnica, no mesmo período, ficou claro que a freqüência à creche é um fator de risco para colonização. No entanto, mesmo considerando-se que o material foi obtido de nasofaringe, os resultados do estudo de Rey et al 15 mostram que a prevalência de colonização em Fortaleza é muito mais alta do que a encontrada em Taubaté, deixando clara a variação da prevalência de colonização em diversas regiões geográ-ficas.…”

Section: Discussionunclassified

Colonização de orofaringe por Streptococcus pneumoniae em crianças de creches municipais de Taubaté-SP: correlação entre os principais sorotipos e a vacina pneumocócica conjugada heptavalente

Lucarevschi¹,

Baldacci

Bricks

et al. 2003

J. Pediatr. (Rio J.)

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Objective: Streptococcus pneumoniae usually colonizes the oropharynx of healthy people. Oropharyngeal carriage is related to the invasion of adjacent structures and to the development of invasive disease. A descriptive cross-sectional study was performed aiming at verifying the prevalence of oropharyngeal colonization by S. pneumoniae in children attending day care centers in the city of Taubaté -SP; verifying the frequency of S. pneumoniae serotypes in isolated strains; and relating the most frequent serotypes to the composition of the conjugated heptavalent pneumococcal vaccine currently in use.Methods: from June 29 to December 15 1998, samples of oropharyngeal material were collected from 987 children, ranging from 8 to 71 months old, enrolled in day care centers in Taubaté -SP. The identification of S. pneumoniae was based on the observation of the colonies that presented partial hemolysis in agar-blood and agarblood with gentamycin plates and on the observation of inhibited growth around the optochin disc. Serotyping was performed by the Quellung reaction, using specific antiserum, provided by the Centers for Disease Control and Prevention (Atlanta, GA/USA), and the Danish nomenclature system.Results: as a result, S. pneumoniae was isolated from the oropharynx in 209 out of 987 children (colonization rate of 21.2%). Twenty eight serotypes were identified. The seven most frequent serotypes were: 6A/6B (21.5%), 19F (14.8%), 18C (7.4%), 23F (7.4%), 9V (6.7%), 14 (5.2%), 10A (4.4%). Except for serotype 10A, all the other six are included in the vaccine. The only vaccine serotype which was not found was serotype 4.Conclusion: agreement of 63% between the oropharynx colonizer serotypes and the serotypes present in the vaccine was found. ResumoObjetivos: o Streptococcus pneumoniae habitualmente coloniza a orofaringe de pessoas sadias. O estado de portador assintomático está relacionado à invasão de estruturas adjacentes e ao surgimento de doença invasiva. Foi realizado estudo transversal, descritivo, objetivando verificar a prevalência de colonização de orofaringe pelo S. pneumoniae em crianças que freqüentam creches no município de Taubaté, SP, verificar a freqüência de sorotipos de Streptococcus pneumoniae nas cepas isoladas e relacionar os sorotipos mais freqüen-tes com os sorotipos presentes na composição da vacina pneumocócica heptavalente conjugada atualmente em uso.Métodos: foram coletados, de 29 de junho a 15 de dezembro de 1998, 987 swabs de orofaringe de crianças entre 8 e 71 meses de idade, matriculadas nas creches municipais de Taubaté, SP. A identificação do S. pneumoniae foi baseada na observação das colônias que apresentassem hemólise parcial nos meios AS e AS-G, e pela observação da inibição do crescimento ao redor do disco de optoquina. A sorotipagem foi realizada pela reação de Quellung, utilizando anti-soros específi-cos, e adotado o sistema de nomenclatura dinamarquês.Resultados: o Streptococcus pneumoniae foi isolado em 209 das 987 crianças (taxa de colonização= 21,1%). Vinte e oito s...

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“…4 In Brazil, 30% of children under two are colonized with S. pneumoniae. 1,4,10,21 The rate of pneumococcal nasopharyngeal colonization (PNC) in infants attending child day care centers is about 60%. 17 A recent study showed that children exposed to smoking were more likely to have their nasopharynx colonized with acute middle ear infection pathogens (Moraxella catarrhalis, Haemophilus influenzae, and pneumococcus).…”

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confidence: 99%

Fatores de risco e proteção à infecção respiratória aguda em lactentes

Lopes

Berezin

2009

Rev. Saúde Pública

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OBJECTIVE:To analyze the effectiveness of maternal pneumococcal polysaccharide vaccine and the risk and protective factors for acute respiratory infections in infants. METHODS:Nested cross-sectional study of a clinical trial evaluating children of 139 women selected in a public prenatal care unit in the municipality of São Paulo, Southeastern Brazil, from 2005 to 2006. Subjects were randomly assigned to three groups: non-immunized (n=46); immunized with pneumococcal polysaccharide vaccine in the last trimester of pregnancy (n=42); and immunized with the vaccine immediately after childbirth (n=45). Infants were followed up for infections presumably caused by pneumococcus at the age of three and six months and nasopharyngeal samples were collected. Risk factors such as smokers living in the same household, siblings and exclusive maternal breastfeeding were investigated. RESULTS:The pneumococcal polysaccharide vaccine did not provide protection against pneumococcus infections. However, exclusive maternal breastfeeding until the age of six months protected infants against respiratory infections (OR= 7.331). Pneumococcal nasopharyngeal colonization at the age of three or six months increased the likelihood of occurrence of respiratory infections (OR= 2.792). CONCLUSIONS:Exclusive breastfeeding for six months protects infants against presumably pneumococcal infections regardless of pneumococcal vaccination. DESCRIpTORS Acute respiratory infections in infants Lopes CRC & Berezin ENAcute respiratory infections are a major cause of morbidity in children especially in infants younger than six months. Nasopharyngeal colonization with Streptococcus pneumoniae can lead to invasive respiratory infections. 4 The main pathogenic bacteria of acute respiratory infections is pneumococcus.In developing countries it is estimated that pneumococcus causes more than 1 million death a year in children under five, mostly due to pneumonia, 11,15,16,22 at a rate of two children dying per hour in Latin America. In 2007, pneumococcal disease killed 8,000 children in Brazil. aThe main predisposing factors for respiratory infections are: attendance of child day care centers, passive smoking, children of mothers with low schooling, overcrowding, and early termination of breastfeeding. Infants with these factors are more likely to develop respiratory infections, particularly S. pneumoniae infections. 4 In Brazil, 30% of children under two are colonized with S. pneumoniae. 1,4,10,21 The rate of pneumococcal nasopharyngeal colonization (PNC) in infants attending child day care centers is about 60%. 17 A recent study showed that children exposed to smoking were more likely to have their nasopharynx colonized with acute middle ear infection pathogens (Moraxella catarrhalis, Haemophilus influenzae, and pneumococcus). 20

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S. pneumoniae isolados da nasofaringe de crianças sadias e com pneumonia: taxa de colonização e suscetibilidade aos antimicrobianos

Abstract: Pneumococcal carriage rate was higher in healthy children than in children with pneumonia. Penicillin and cotrimoxazole resistance rates were high, especially among those attending day-care centers.

Cited by 20 publications

References 11 publications

Doença pneumocócica invasiva em crianças e adolescentes soropositivos para HIV

Doença pneumocócica invasiva em crianças e adolescentes soropositivos para HIV

Colonização de orofaringe por Streptococcus pneumoniae em crianças de creches municipais de Taubaté-SP: correlação entre os principais sorotipos e a vacina pneumocócica conjugada heptavalente

Fatores de risco e proteção à infecção respiratória aguda em lactentes

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