Pneumococcal disease manifestation in children before and after vaccination: what's new?
| Autor: | Ruth Minamisava, Ana Lucia Andrade, Cristiana M. Toscano, Paulo Sucasas Costa, João Guimarães de Andrade |
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| Rok vydání: | 2011 |
| Předmět: |
Male
Bacteremia Peritonitis medicine.disease_cause Pneumococcal Infections Pneumococcal Vaccines Streptococcus pneumoniae medicine Humans Serotyping Child Respiratory Tract Infections Vaccines Conjugate General Veterinary General Immunology and Microbiology Respiratory tract infections business.industry Meningitis Pneumococcal Vaccination Public Health Environmental and Occupational Health Bacterial pneumonia Infant medicine.disease Pneumococcal infections Pneumonia Infectious Diseases Latin America Viral pneumonia Child Preschool Immunology Hemolytic-Uremic Syndrome Molecular Medicine Female business |
| Zdroj: | Vaccine. 29 |
| ISSN: | 1873-2518 |
| Popis: | Pneumococcal infections remain a relevant cause of morbidity and mortality in children, especially in countries where vaccination has not been introduced. In contrast to the common belief by many pediatricians, the most important pneumococcal infections are of the respiratory tract and not invasive diseases. The recent pandemic of the H1N1 virus prompted studies to better understand the interaction between the influenza virus, Streptococcus pneumoniae, and pneumonia outcomes. Radiological findings of bacteremic pneumonia have been well investigated and besides the typical alveolar consolidation, a broad spectrum of atypical patterns has been reported. Molecular techniques, such as real-time polymerase chain reaction (PCR), can improve the detection of S. pneumoniae in sterile fluids, mainly in regions where previous antibiotic therapy is a common practice. In the post vaccination era, new manifestations of pneumococcal invasive disease, such as hemolytic uremic syndrome, have increased in association with parapneumonic empyema. Moreover, serotypes not included in PCV7, particularly serotypes 1, 3, 5, 7F, and 19A, have been among the most common isolates in pneumococcal disease. In Latin America, pneumococcal primary peritonitis has been described as an important clinical syndrome in a growing proportion of patients, mainly in girls. The development of newer and more specific diagnostic markers to distinguish bacterial and viral pneumonia are urgently sought, and will be especially pertinent after the introduction of pneumococcal conjugate vaccines with expanded serotypes. Such markers would minimize inappropriate diagnosis of false positive cases and treatment with antibacterial agents, while increasing positive predictive values for diagnosis of bacterial pneumonia. The extension of serotype coverage with the new conjugate vaccines is promising for pneumococcal infections and coverage against antibiotic-resistant strains. |
| Databáze: | OpenAIRE |
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