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Bardach A, Ruvinsky S, Palermo MC, Alconada T, Sandoval MM, Brizuela ME, Wierzbicki ER, Cantos J, Gagetti P, Ciapponi A. Invasive pneumococcal disease in Latin America and the Caribbean: Serotype distribution, disease burden, and impact of vaccination. A systematic review and meta-analysis. PLoS One 2024; 19:e0304978. [PMID: 38935748 PMCID: PMC11210815 DOI: 10.1371/journal.pone.0304978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 04/09/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Invasive pneumococcal diseases (IPD) are associated with high morbidity, mortality, and health costs worldwide, particularly in Latin America and the Caribbean (LAC). Surveillance about the distribution of serotypes causing IPD and the impact of pneumococcal vaccination is an important epidemiological tool to monitor disease activity trends, inform public health decision-making, and implement relevant prevention and control measures. OBJECTIVES To estimate the serotype distribution for IPD and the related disease burden in LAC before, during, and after implementing the pneumococcal vaccine immunization program in LAC. METHODS Systematic literature review following Cochrane methods of studies from LAC. We evaluated the impact of the pneumococcal vaccine on hospitalization and death during or after hospitalizations due to pneumococcal disease and serotype-specific disease over time. We also analyzed the incidence of serotyped IPD in pneumococcal conjugate vaccine PCV10 and PCV13. The protocol was registered in PROSPERO (ID: CRD42023392097). RESULTS 155 epidemiological studies were screened and provided epidemiological data on IPD. Meta-analysis of invasive diseases in children <5 years old found that 57%-65% of causative serotypes were included in PCV10 and 66%-84% in PCV13. After PCV introduction, vaccine serotypes declined in IPD, and the emergence of non-vaccine serotypes varied by country. CONCLUSIONS Pneumococcal conjugate vaccines significantly reduced IPD and shifted serotype distribution in Latin America and the Caribbean. PCV10/PCV13 covered 57-84% of serotypes in children under 5, with marked decline in PCV serotypes post-vaccination. Continuous surveillance remains crucial for monitoring evolving serotypes and informing public health action.
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Affiliation(s)
- Ariel Bardach
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
- Centro de Investigaciones Epidemiológicas y Salud Pública (CIESP-IECS), CONICET, Buenos Aires, Argentina
| | - Silvina Ruvinsky
- Departamento de Investigación, Hospital Garrahan, Buenos Aires, Argentina
- Departamento de Evaluación de Tecnologías Sanitarias y Economía de la Salud, Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina
| | - M. Carolina Palermo
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
| | - Tomás Alconada
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
| | - M. Macarena Sandoval
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
| | - Martín E. Brizuela
- Unidad de Pediatría, Hospital General de Agudos Vélez Sarsfield, Buenos Aires, Argentina
| | | | - Joaquín Cantos
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
| | - Paula Gagetti
- Servicio Antimicrobianos, Instituto Nacional de Enfermedades Infecciosas (INEI)-ANLIS ‘‘Dr. Carlos G. Malbrán”, Buenos Aires, Argentina
| | - Agustín Ciapponi
- Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET), Buenos Aires, Argentina
- Centro de Investigaciones Epidemiológicas y Salud Pública (CIESP-IECS), CONICET, Buenos Aires, Argentina
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Streptococcus pneumoniae Serotype 3 in Mexico (1994 to 2017): Decrease of the Unusual Clonal Complex 4909 Lineage following PCV13 Introduction. J Clin Microbiol 2019; 57:JCM.01354-18. [PMID: 30404945 DOI: 10.1128/jcm.01354-18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 10/27/2018] [Indexed: 11/20/2022] Open
Abstract
Streptococcus pneumoniae expressing serotype 3 has a high virulence and a high case fatality ratio. Most studies of serotype 3 pneumococci have focused on a single lineage, the widespread sequence type 180 (ST180). To evaluate the serotype 3 lineages causing infections in Mexico, we characterized 196 isolates recovered from 1994 to 2017. The isolates were mostly susceptible to all antimicrobials tested. A single meningitis isolate was resistant to penicillin, and the resistance to erythromycin was 5.2%. The isolates represented the widely disseminated clonal complex 180 (CC180; n = 140), the unusual CC4909 (n = 42), CC260 (n = 11), and a few singletons (n = 3). CC260 was less frequent among pneumococcal invasive disease isolates than CC180 and CC4909 (P = 0.015). There was a decrease of CC4909 (P < 0.001) following PCV13 introduction (2012 to 2017). The CC4909 isolates were represented mostly by ST1119 (n = 40), seemingly having a restricted geographic origin, with isolates in the PubMLST database having been recovered only in Mexico, the United States, and Germany. A genomic analysis of publicly available genomes showed that ST1119 isolates have less than 32% similarity with ST180 isolates, indicating that these lineages are more separated than revealed by traditional multilocus sequence typing. Considering the suggestions of a lower efficacy of the 13-valent pneumococcal conjugate vaccine against serotype 3, the different dynamics of the two major serotype 3 lineages in Mexico following the introduction of PCV13 should be closely monitored.
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Farhat K, Bodart G, Charlet-Renard C, Desmet CJ, Moutschen M, Beguin Y, Baron F, Melin P, Quatresooz P, Parent AS, Desmecht D, Sirard JC, Salvatori R, Martens H, Geenen VG. Growth Hormone (GH) Deficient Mice With GHRH Gene Ablation Are Severely Deficient in Vaccine and Immune Responses Against Streptococcus pneumoniae. Front Immunol 2018; 9:2175. [PMID: 30333823 PMCID: PMC6176084 DOI: 10.3389/fimmu.2018.02175] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 09/03/2018] [Indexed: 01/01/2023] Open
Abstract
The precise impact of the somatotrope axis upon the immune system is still highly debated. We have previously shown that mice with generalized ablation of growth hormone (GH) releasing hormone (GHRH) gene (Ghrh−/−) have normal thymus and T-cell development, but present a marked spleen atrophy and B-cell lymphopenia. Therefore, in this paper we have investigated vaccinal and anti-infectious responses of Ghrh−/− mice against S. pneumoniae, a pathogen carrying T-independent antigens. Ghrh−/− mice were unable to trigger production of specific IgM after vaccination with either native pneumococcal polysaccharides (PPS, PPV23) or protein-PPS conjugate (PCV13). GH supplementation of Ghrh−/− mice restored IgM response to PPV23 vaccine but not to PCV13 suggesting that GH could exert a specific impact on the spleen marginal zone that is strongly implicated in T-independent response against pneumococcal polysaccharides. As expected, after administration of low dose of S. pneumoniae, wild type (WT) completely cleared bacteria after 24 h. In marked contrast, Ghrh−/− mice exhibited a dramatic susceptibility to S. pneumoniae infection with a time-dependent increase in lung bacterial load and a lethal bacteraemia already after 24 h. Lungs of infected Ghrh−/− mice were massively infiltrated by inflammatory macrophages and neutrophils, while lung B cells were markedly decreased. The inflammatory transcripts signature was significantly elevated in Ghrh−/− mice. In this animal model, the somatotrope GHRH/GH/IGF1 axis plays a vital and unsuspected role in vaccine and immunological defense against S. pneumoniae.
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Affiliation(s)
- Khalil Farhat
- GIGA-I3 Center of Immunoendocrinology, University of Liège, Liège, Belgium
| | - Gwennaëlle Bodart
- GIGA-I3 Center of Immunoendocrinology, University of Liège, Liège, Belgium
| | | | - Christophe J Desmet
- GIGA-I3 Cellular and Molecular Immunology, University of Liège, Liège, Belgium
| | - Michel Moutschen
- GIGA-I3 Infectious diseases, University of Liège, Liège, Belgium
| | - Yves Beguin
- GIGA-I3 Hematology, University of Liège, Liège, Belgium
| | | | - Pierrette Melin
- Department of Clinical Microbiology, University Hospital of Liège, University of Liège, Liège, Belgium
| | | | - Anne-Simone Parent
- Division of Pediatric Endocrinology, University Hospital of Liège, Liège, Belgium
| | - Daniel Desmecht
- Department of Veterinary Pathology, University of Liège, Liège, Belgium
| | - Jean-Claude Sirard
- CNRS, INSERM, CHU Lille, Institut Pasteur de Lille, U1019-UMR8204-Center for Infection and Immunity of Lille, University of Lille, Lille, France
| | - Roberto Salvatori
- Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Henri Martens
- GIGA-I3 Center of Immunoendocrinology, University of Liège, Liège, Belgium
| | - Vincent G Geenen
- GIGA-I3 Center of Immunoendocrinology, University of Liège, Liège, Belgium
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Molecular characterisation of multidrug-resistant pneumococcal clones colonising healthy children in Mérida, Venezuela. J Glob Antimicrob Resist 2018; 14:45-50. [DOI: 10.1016/j.jgar.2018.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 01/25/2018] [Accepted: 02/05/2018] [Indexed: 11/18/2022] Open
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Nurse-Lucas M, McGee L, Hawkins PA, Swanston WH, Akpaka PE. Serotypes and genotypes of Streptococcus pneumoniae isolates from Trinidad and Tobago. Int J Infect Dis 2016; 46:100-6. [PMID: 27062986 PMCID: PMC5739879 DOI: 10.1016/j.ijid.2016.04.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 03/22/2016] [Accepted: 04/03/2016] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES There are currently 94 known pneumococcal capsular polysaccharide serotypes and their prevalence differs by geographic region and the period studied. Streptococcus pneumoniae infections have been diagnosed clinically in Trinidad and Tobago and other Caribbean countries, however data on the serotype and sequence type distributions in this country are limited. The objective of this study was to determine serotypes and multilocus sequence types (MLSTs) of invasive and non-invasive pneumococcal isolates from Trinidad and Tobago. METHODS Ninety-eight pneumococcal isolates from several regional hospitals in the country were analyzed using both standard microbiological methods and molecular analysis. These isolates included invasive (n=83) and selected non-invasive (n=15) strains recovered before (n=25) and after (n=73) the introduction of the pneumococcal conjugate vaccine. RESULTS More than half of the isolates (54.1%) were recovered from children under 15 years of age, with the largest proportion being from children under 2 years of age (24.5%). The most prevalent serotypes were 19F (18.4%), 6B (15.3%), 23F (14.3%), 3 (11.2%), 19A (6.1%), 6A (5.1%), 14 (5.1%), and 9V (4.1%). The most common serotype/MLST combinations were 6B/ST138 (n=10, 10.2%), 3/ST180 (n=5, 5.1%), 23F/ST629 (n=5, 5.1%), 19F/ST8398 (n=4, 4.1%), and three each of 6B/ST145, 14/9V/ST156, 9V/ST162, 19A/320, and 3/ST10440. CONCLUSIONS This report provides the first glimpse of the prevailing pneumococcal sequence types in the country. Most of the isolates represented serotypes in the 10-valent (61.2% of isolates) and 13-valent (83.7%) pneumococcal conjugate vaccines. A detailed population study is warranted to fully determine the circulating pneumococcal sequence types. Furthermore, the implementation of an effective and continuous surveillance system in Trinidad and Tobago is paramount to monitor vaccine impact.
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Affiliation(s)
- Michele Nurse-Lucas
- Department of Paraclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St Augustine, Trinidad and Tobago
| | - Lesley McGee
- Respiratory Disease Branch, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Paulina A Hawkins
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - William H Swanston
- Department of Paraclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St Augustine, Trinidad and Tobago
| | - Patrick Eberechi Akpaka
- Department of Paraclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St Augustine, Trinidad and Tobago.
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Caierão J, Hawkins P, Sant’anna FH, da Cunha GR, d’Azevedo PA, McGee L, Dias C. Serotypes and genotypes of invasive Streptococcus pneumoniae before and after PCV10 implementation in southern Brazil. PLoS One 2014; 9:e111129. [PMID: 25356595 PMCID: PMC4214725 DOI: 10.1371/journal.pone.0111129] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 09/19/2014] [Indexed: 11/26/2022] Open
Abstract
To reduce the burden of pneumococcal diseases, different formulations of pneumococcal conjugate vaccines (PCV) have been introduced in many countries. In Brazil, PCV10 has been available since 2010. We aimed to analyze the serotype and genetic composition of invasive pneumococci from Brazil in pre- and post- vaccination periods (2007–2012). Antibiotic susceptibility was determined and genotypes of macrolide and fluoroquinolone resistance were characterized. The genotypes of isolates of the most frequent serotypes were determined by multilocus sequence typing. The study included 325 isolates, which were primarily recovered from blood. The most common serotypes recovered were 14, 3, 4, 23F, 7F, 9V, 12F, 20, 19F, 8, 19A, and 5. Thirty-eight pneumococci (11.7%) were from children ≤5 years old. Considering the overall population, PCV10 and PCV13 serotype coverage was 50.1% and 64.9%, respectively. During the pre-vaccine period, isolates with serotypes belonging to the PVC10 represented 51.5% (100/194), whereas in the post vaccine they represented 48.0% (63/131). PCV13 serotypes represented 67.5% (131/194) and 59.2% (77/131) of total for pre- and post-vaccination periods, respectively. Seventy different sequence types [STs] were found, accounting for 9 clonal complexes [CCs] and 45 singletons. Eight STs (156, 180, 218, 8889, 53, 191, 770, and 4967) represented the majority (51.5%) of isolates. Fifty STs were associated with the pre-vaccination period (27 exclusive) and 43 (20 exclusive) with the post-vaccination period; 23 STs were identified in both periods. Some serotypes were particularly clonal (7F, 8, 12F, 20). Non-susceptibility to penicillin was associated with serotype 19A, CC320. Erythromycin resistance was heterogeneous when considering serotype and ST. A single serotype 23F (ST4967) isolate was resistant to levofloxacin. Continued surveillance is required to determine vaccine impact and to monitor changes in pneumococcal population biology post-PCV10 introduction in Brazil.
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Affiliation(s)
- Juliana Caierão
- Federal University of Health Science of Porto Alegre, Rio Grande do Sul, Brazil
| | - Paulina Hawkins
- Emory University, Atlanta, Georgia, United States of America
| | | | | | | | - Lesley McGee
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Cícero Dias
- Federal University of Health Science of Porto Alegre, Rio Grande do Sul, Brazil
- * E-mail:
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Fica A, Bunster N, Aliaga F, Olivares F, Porte L, Braun S, Dabanch J, Hormázabal JC, Hernández A, Benavides MG. Bacteremic pneumococcal pneumonia: serotype distribution, antimicrobial susceptibility, severity scores, risk factors, and mortality in a single center in Chile. Braz J Infect Dis 2013; 18:115-23. [PMID: 24120831 PMCID: PMC9427511 DOI: 10.1016/j.bjid.2013.06.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 05/01/2013] [Accepted: 06/03/2013] [Indexed: 11/18/2022] Open
Abstract
Aims Bacteremic pneumococcal pneumonia (BPP) is a severe condition. To evaluate seasonal distribution, mortality, serotype frequencies, antimicrobial susceptibility, and different severity scores among patients with BPP. Patients and methods Patients were identified by laboratory data and restricted to adulthood. Standard methods were used for serotyping and antimicrobial susceptibility. Risk factors were analyzed by univariate and multivariate methods. Severity scores (APACHE II, CURB-65 and CAP PIRO) were compared using ROC curves. Results Sixty events of community-acquired BPP occurred between 2005 and 2010. A seasonal pattern was detected. Mean age was 72.1 years old (81.4% ≥60 years). All had a predisposing factor. Previous influenza (3.3%) or pneumococcal immunization (1.7%) was infrequent. Admission to critical units was required by 51.7%. Twenty-two serotypes were identified among 59 strains. Only one strain had intermediate resistance to penicillin (1.7%). In-hospital mortality reached 33.3%. Multivariate analysis identified a CAP PIRO score > 3 (OR 29.7; IC95 4.7–187), age ≥65 years (OR 42.1; IC95 2.2–796), and a platelet count < 100,000/μL (OR 10.9; IC95 1.2–96) as significant independent factors associated with death. ROC curve analysis did not reveal statistical differences between the three severity scores to predict death (AUC 0.77–0.90). The prognostic yield for all of them was limited (Positive Likelihood Ratio: 1.5–3.8). Conclusions BPP had a high case-fatality rate in this group of adult patients with no association to resistant isolates, and a low immunization record. Three independent factors were related to death and the prognostic yield of different severity scores was low.
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Affiliation(s)
- Alberto Fica
- Servicio de Infectología, Hospital Militar de Santiago, Chile.
| | | | - Felipe Aliaga
- Unidad de Pacientes Críticos, Hospital Militar de Santiago, Chile
| | - Felipe Olivares
- Residente Medicina Interna, Hospital Militar de Santiago, Chile
| | - Lorena Porte
- Laboratorio de Microbiología, Hospital Militar de Santiago, Chile
| | - Stephanie Braun
- Laboratorio de Microbiología, Hospital Militar de Santiago, Chile
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Ivanov S, Renneson J, Fontaine J, Barthelemy A, Paget C, Fernandez EM, Blanc F, De Trez C, Van Maele L, Dumoutier L, Huerre MR, Eberl G, Si-Tahar M, Gosset P, Renauld JC, Sirard JC, Faveeuw C, Trottein F. Interleukin-22 reduces lung inflammation during influenza A virus infection and protects against secondary bacterial infection. J Virol 2013; 87:6911-24. [PMID: 23596287 PMCID: PMC3676141 DOI: 10.1128/jvi.02943-12] [Citation(s) in RCA: 131] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Accepted: 04/04/2013] [Indexed: 12/30/2022] Open
Abstract
Interleukin-22 (IL-22) has redundant, protective, or pathogenic functions during autoimmune, inflammatory, and infectious diseases. Here, we addressed the potential role of IL-22 in host defense and pathogenesis during lethal and sublethal respiratory H3N2 influenza A virus (IAV) infection. We show that IL-22, as well as factors associated with its production, are expressed in the lung tissue during the early phases of IAV infection. Our data indicate that retinoic acid receptor-related orphan receptor-γt (RORγt)-positive αβ and γδ T cells, as well as innate lymphoid cells, expressed enhanced Il22 transcripts as early as 2 days postinfection. During lethal or sublethal IAV infections, endogenous IL-22 played no role in the control of IAV replication and in the development of the IAV-specific CD8(+) T cell response. During lethal infection, where wild-type (WT) mice succumbed to severe pneumonia, the lack of IL-22 did not accelerate or delay IAV-associated pathogenesis and animal death. In stark contrast, during sublethal IAV infection, IL-22-deficient animals had enhanced lung injuries and showed a lower airway epithelial integrity relative to WT littermates. Of importance, the protective effect of endogenous IL-22 in pulmonary damages was associated with a more controlled secondary bacterial infection. Indeed, after challenge with Streptococcus pneumoniae, IAV-experienced Il22(-/-) animals were more susceptible than WT controls in terms of survival rate and bacterial burden in the lungs. Together, IL-22 plays no major role during lethal influenza but is beneficial during sublethal H3N2 IAV infection, where it limits lung inflammation and subsequent bacterial superinfections.
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Affiliation(s)
- Stoyan Ivanov
- Institut Pasteur de Lille, Centre d'Infection et d'Immunité de Lille, Lille, France
- Université Lille Nord de France, Lille, France
- Centre National de la Recherche Scientifique, UMR 8204, Lille, France
- Institut National de la Santé et de la Recherche Médicale, U1019, Lille, France
- Institut Fédératif de Recherche 142, Lille, France
| | - Joelle Renneson
- Institut Pasteur de Lille, Centre d'Infection et d'Immunité de Lille, Lille, France
- Université Lille Nord de France, Lille, France
- Centre National de la Recherche Scientifique, UMR 8204, Lille, France
- Institut National de la Santé et de la Recherche Médicale, U1019, Lille, France
- Institut Fédératif de Recherche 142, Lille, France
| | - Josette Fontaine
- Institut Pasteur de Lille, Centre d'Infection et d'Immunité de Lille, Lille, France
- Université Lille Nord de France, Lille, France
- Centre National de la Recherche Scientifique, UMR 8204, Lille, France
- Institut National de la Santé et de la Recherche Médicale, U1019, Lille, France
- Institut Fédératif de Recherche 142, Lille, France
| | - Adeline Barthelemy
- Institut Pasteur de Lille, Centre d'Infection et d'Immunité de Lille, Lille, France
- Université Lille Nord de France, Lille, France
- Centre National de la Recherche Scientifique, UMR 8204, Lille, France
- Institut National de la Santé et de la Recherche Médicale, U1019, Lille, France
- Institut Fédératif de Recherche 142, Lille, France
| | - Christophe Paget
- Institut Pasteur de Lille, Centre d'Infection et d'Immunité de Lille, Lille, France
- Université Lille Nord de France, Lille, France
- Centre National de la Recherche Scientifique, UMR 8204, Lille, France
- Institut National de la Santé et de la Recherche Médicale, U1019, Lille, France
- Institut Fédératif de Recherche 142, Lille, France
| | - Elodie Macho Fernandez
- Institut Pasteur de Lille, Centre d'Infection et d'Immunité de Lille, Lille, France
- Université Lille Nord de France, Lille, France
- Centre National de la Recherche Scientifique, UMR 8204, Lille, France
- Institut National de la Santé et de la Recherche Médicale, U1019, Lille, France
- Institut Fédératif de Recherche 142, Lille, France
| | - Fany Blanc
- Institut Pasteur, Paris, France
- Institut National de la Santé et de la Recherche Médicale, U874, Paris, France
| | - Carl De Trez
- Vlaams Interuniversitair Instituut voor Biotechnologie, Vrije Universiteit Brussel, Brussels, Belgium
| | - Laurye Van Maele
- Institut Pasteur de Lille, Centre d'Infection et d'Immunité de Lille, Lille, France
- Université Lille Nord de France, Lille, France
- Centre National de la Recherche Scientifique, UMR 8204, Lille, France
- Institut National de la Santé et de la Recherche Médicale, U1019, Lille, France
- Institut Fédératif de Recherche 142, Lille, France
| | - Laure Dumoutier
- Ludwig Institute for Cancer Research, Université Catholique de Louvain, Brussels
| | - Michel-René Huerre
- Institut Pasteur, Paris, France
- Unite de Recherche et d'Expertise Histotechnologie et Pathologie, Paris, France
| | - Gérard Eberl
- Institut Pasteur, Paris, France
- Centre National de la Recherche Scientifique, URA 1961, Paris, France
| | - Mustapha Si-Tahar
- Institut Pasteur, Paris, France
- Institut National de la Santé et de la Recherche Médicale, U874, Paris, France
| | - Pierre Gosset
- Hopital Saint Vincent, Groupe Hospitalier de l'Institut Catholique de Lille, Université Catholique de Lille, Lille, France
| | | | - Jean Claude Sirard
- Institut Pasteur de Lille, Centre d'Infection et d'Immunité de Lille, Lille, France
- Université Lille Nord de France, Lille, France
- Centre National de la Recherche Scientifique, UMR 8204, Lille, France
- Institut National de la Santé et de la Recherche Médicale, U1019, Lille, France
- Institut Fédératif de Recherche 142, Lille, France
| | - Christelle Faveeuw
- Institut Pasteur de Lille, Centre d'Infection et d'Immunité de Lille, Lille, France
- Université Lille Nord de France, Lille, France
- Centre National de la Recherche Scientifique, UMR 8204, Lille, France
- Institut National de la Santé et de la Recherche Médicale, U1019, Lille, France
- Institut Fédératif de Recherche 142, Lille, France
| | - François Trottein
- Institut Pasteur de Lille, Centre d'Infection et d'Immunité de Lille, Lille, France
- Université Lille Nord de France, Lille, France
- Centre National de la Recherche Scientifique, UMR 8204, Lille, France
- Institut National de la Santé et de la Recherche Médicale, U1019, Lille, France
- Institut Fédératif de Recherche 142, Lille, France
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Ivanov S, Fontaine J, Paget C, Macho Fernandez E, Van Maele L, Renneson J, Maillet I, Wolf NM, Rial A, Léger H, Ryffel B, Frisch B, Chabalgoity JA, Sirard JC, Benecke A, Faveeuw C, Trottein F. Key role for respiratory CD103(+) dendritic cells, IFN-γ, and IL-17 in protection against Streptococcus pneumoniae infection in response to α-galactosylceramide. J Infect Dis 2012; 206:723-34. [PMID: 22723642 DOI: 10.1093/infdis/jis413] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Exogenous activation of pulmonary invariant natural killer T (iNKT) cells, a population of lipid-reactive αβ T lymphocytes, with use of mucosal α-galactosylceramide (α-GalCer) administration, is a promising approach to control respiratory bacterial infections. We undertook the present study to characterize mechanisms leading to α-GalCer-mediated protection against lethal infection with Streptococcus pneumoniae serotype 1, a major respiratory pathogen in humans. METHODS AND RESULTS α-GalCer was administered by the intranasal route before infection with S. pneumoniae. We showed that respiratory dendritic cells (DCs), most likely the CD103(+) subset, play a major role in the activation (IFN-γ and IL-17 release) of pulmonary iNKT cells, whereas alveolar and interstitial macrophages are minor players. After challenge, S. pneumoniae was rapidly (4 hours) eliminated in the alveolar spaces, a phenomenon that depended on respiratory DCs and neutrophils, but not macrophages, and on the early production of both IFN-γ and IL-17. Protection was also associated with the synthesis of various interferon-dependent and IL-17-associated genes as revealed by transcriptomic analysis. CONCLUSIONS These data imply a new function for pulmonary CD103(+) DCs in mucosal activation of iNKT cells and establish a critical role for both IFN-γ and IL-17 signalling pathways in mediating the innate immune response to S. pneumoniae.
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Affiliation(s)
- Stoyan Ivanov
- Institut Pasteur de Lille, Centre d'Infection et d'Immunité de Lille, France
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Castañeda E, Agudelo CI, De Antonio R, Rosselli D, Calderón C, Ortega-Barria E, Colindres RE. Streptococcus pneumoniae serotype 19A in Latin America and the Caribbean: a systematic review and meta-analysis, 1990-2010. BMC Infect Dis 2012; 12:124. [PMID: 22639955 PMCID: PMC3475047 DOI: 10.1186/1471-2334-12-124] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Accepted: 03/27/2012] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Pneumococcal conjugate vaccines (PCVs) are in the process of implementation in Latin America. Experience in developed countries has shown that they reduce the incidence of invasive and non-invasive disease. However, there is evidence that the introduction of PCVs in universal mass vaccination programs, combined with inappropriate and extensive use of antibiotics, could be associated to changes in non-PCV serotypes, including serotype 19A. We conducted a systematic review to determine the distribution of serotype 19A, burden of pneumococcal disease and antibiotic resistance in the region. METHODS We performed a systematic review of serotype 19A data from observational and randomized clinical studies in the region, conducted between 1990 and 2010, for children under 6 years. Pooled prevalence estimates from surveillance activities with confidence intervals were calculated. RESULTS We included 100 studies in 22 countries and extracted data from 63. These data reported 19733 serotyped invasive pneumococcal isolates, 3.8% of which were serotype 19A. Serotype 19A isolates were responsible for 2.4% acute otitis media episodes, and accounted for 4.1% and 4.4% of 4,380 nasopharyngeal isolates from healthy children and in hospital-based/sick children, respectively. This serotype was stable over the twenty years of surveillance in the region. A total of 53.7% Spn19A isolates from meningitis cases and only 14% from non meningitis were resistant to penicillin. CONCLUSIONS Before widespread PCV implementation in this region, serotype 19A was responsible for a relatively small number of pneumococcal disease cases. With increased use of PCVs and a greater number of serotypes included, monitoring S. pneumoniae serotype distribution will be essential for understanding the epidemiology of pneumococcal disease.
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Affiliation(s)
| | | | | | - Diego Rosselli
- Department of Clinical Epidemiology and Biostatistics, Universidad Javeriana Medical School, Bogotá, Colombia
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β-Lactam resistance, serotype distribution, and genotypes of meningitis-causing Streptococcus pneumoniae, Rio de Janeiro, Brazil. Pediatr Infect Dis J 2012; 31:30-6. [PMID: 21860337 PMCID: PMC4745886 DOI: 10.1097/inf.0b013e31822f8a92] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Here, we report a laboratory-based study of Streptococcus pneumoniae recovered from patients with meningitis in Rio de Janeiro State, Brazil. METHODS The aim of this study was to determine the evolution of β-lactam resistance, antimicrobial susceptibility pattern, serotypes, and genetic diversity of S. pneumoniae, isolated from meningitis patients between 2000 and 2008. RESULTS A total of 264 S. pneumoniae recovered from patients between 2000 and 2008 were included. Susceptibility testing (E-test) of S. pneumoniae showed resistance to penicillin, ceftriaxone, oxacillin, cotrimoxazole, tetracycline, ofloxacin, erythromycin, chloramphenicol, and rifampicin. Penicillin resistance (PEN-R, minimal inhibitory concentration [MIC] ≥ 0.12 μg/mL) increased from 8% of isolates in 2000-2002, to 12% in 2003-2005, and to 20% in 2006-2008. Ceftriaxone resistance (MIC ≥ 1.0 μg/mL) was detected among some PEN-R isolates (13%) from 2004 onward. Within the PEN-R isolates, serotypes that are included in 10-valent pneumococcal conjugate vaccine predominated (90%), and resistance was detected mostly in isolates of serotypes 14 (61%), 23F (16%), 6B (10%), and 19F (3%). Multilocus sequence typing showed that 52% of the PEN-R isolates, and 89% of those with MICs ≥ 0.5 μg/mL, were sequence type (ST)-156 or single-locus variants of this ST (ST-557 or ST-4388); all of these isolates were serotype 14 and were assigned to the Spain-3 clone. CONCLUSIONS β-lactam resistance increased recently among cerebrospinal fluid isolates and was mainly due to the surge of the ST-4388, a previously undescribed gki single-locus variants of ST-156. Regional surveillance is shown to be essential to provide optimal antimicrobial therapy, monitor highly successful clones, and formulate adequate vaccination strategy.
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Protection against Streptococcus pneumoniae serotype 1 acute infection shows a signature of Th17- and IFN-γ-mediated immunity. Immunobiology 2011; 217:420-9. [PMID: 22204818 DOI: 10.1016/j.imbio.2011.10.012] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Revised: 10/18/2011] [Accepted: 10/21/2011] [Indexed: 12/22/2022]
Abstract
Acute pneumonia caused by Streptococcus pneumoniae is a major cause of child mortality. Antibodies are considered the main effectors of protection in this clinical presentation of pneumococcal invasive disease. To get new insights into the mechanisms involved in the protective immunity, we established a murine experimental model of protection against acute pneumococcal pneumonia and then evaluated the transcriptional, humoral and cellular responses in protected and non-protected animals. We found that intranasal inoculation of a sublethal dose of S. pneumoniae serotype 1 conferred complete protection against a subsequent challenge with a lethal dose of the same strain. Sublethal infection elicited a strong IgM and IgG antibody response against the capsular polysaccharide, as assessed one week later, and an exacerbated influx of neutrophils into the lungs immediately after the lethal challenge. Genome-wide microarray-based transcriptional analysis of whole lungs showed 149 differentially expressed genes among which we found upregulation of Il17a, Ifng and several IL-17A- and IFN-γ-related genes in protected versus non-protected mice. Kinetics analysis showed higher expression levels of Il17a in protected animals at all time points whereas Ifng was upregulated early in the protected mice and later in the non-protected animals. Intracelluar cytokine staining demonstrated that CD4(+) T cells account for a great proportion of the IL-17A produced in the lungs of protected animals. Overall, these results showed that an upregulation of IL-17A- and a timely regulation of IFN-γ-related gene expression, together with development of a Th17 response, are relevant characteristics of the protective immunity against S. pneumoniae acute pneumonia.
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de Lencastre H, Tomasz A. The CEM-NET initiative: molecular biology and epidemiology in alliance--tracking antibiotic-resistant staphylococci and pneumococci in hospitals and in the community. Int J Med Microbiol 2011; 301:623-9. [PMID: 22000742 DOI: 10.1016/j.ijmm.2011.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Abstract
In this brief report, we provide a portrait of the CEM-NET initiative and review studies that highlight contributions of this molecular epidemiological network to the understanding of the molecular mechanisms of drug resistance in Staphylococcus aureus and Streptococcus pneumoniae clones as well as their routes and modes of geographic expansion.
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Affiliation(s)
- Herminia de Lencastre
- Laboratory of Molecular Genetics, Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa, Oeiras, Portugal
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Inverarity D, Diggle M, Ure R, Johnson P, Altstadt P, Mitchell T, Edwards G, Santana-Hernandez D. Molecular epidemiology and genetic diversity of pneumococcal carriage among children in Beni State, Bolivia. Trans R Soc Trop Med Hyg 2011; 105:445-51. [DOI: 10.1016/j.trstmh.2011.04.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Revised: 04/15/2011] [Accepted: 04/15/2011] [Indexed: 10/18/2022] Open
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Bonofiglio L, Regueira M, Pace J, Corso A, García E, Mollerach M. Dissemination of an Erythromycin-Resistant Penicillin-NonsusceptibleStreptococcus pneumoniaePoland6B-20 Clone in Argentina. Microb Drug Resist 2011; 17:75-81. [DOI: 10.1089/mdr.2010.0027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Laura Bonofiglio
- Cátedra de Microbiología, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
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Poolman J, Kriz P, Feron C, Di-Paolo E, Henckaerts I, Miseur A, Wauters D, Prymula R, Schuerman L. Pneumococcal serotype 3 otitis media, limited effect of polysaccharide conjugate immunisation and strain characteristics. Vaccine 2009; 27:3213-22. [DOI: 10.1016/j.vaccine.2009.03.017] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2008] [Revised: 03/03/2009] [Accepted: 03/05/2009] [Indexed: 10/21/2022]
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Serotype coverage of invasive and mucosal pneumococcal disease in Israeli children younger than 3 years by various pneumococcal conjugate vaccines. Pediatr Infect Dis J 2009; 28:277-82. [PMID: 19258924 DOI: 10.1097/inf.0b013e31818e0e2e] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND : Since the introduction of the 7-valent pneumococcal conjugate vaccine (PCV7) in the United States, the need for additional serotype coverage has become clear. Our objective was to assess the potential serotype coverage of PCV7 and of the 2 experimental conjugate vaccines, 10-valent (PCV10) and 13-valent (PCV13), against invasive pneumococcal disease (IPD), acute otitis media (AOM), acute conjunctivitis (AC), and pneumococcal carriage in southern Israel, where PCV7 had not yet been introduced at the time of the study. METHODS : Data on isolates were obtained prospectively from children <36 months during 2000-2004. The potential coverage of the PCVs was calculated and analyzed separately for antibiotic-resistant strains. RESULTS : A total of 5497 isolates were collected: 189 from blood or cerebrospinal fluid, 3197 from middle ear fluid, 348 from the conjunctiva, and 1763 from the nasopharynx of healthy children. The serotype coverage of PCV7 for IPD, AOM, AC, and carriage was 44%, 54%, 37%, and 46%, respectively. Serotypes included in PCV7 caused 47 IPD cases per 100,000 children <3 years (54 per 100,000 if serotype 6A is included). PCV10 extended mainly the coverage of IPD, while addition of serotypes 6A and 19A to PCV13 increased the coverage substantially in all entities (84%, 79%, 54%, and 67% in IPD, AOM, AC, and carriage, respectively). PCV13 could prevent >90% of penicillin-, macrolide-, and multidrug-resistant strains associated with IPD and AOM. CONCLUSIONS : PCV7 can substantially decrease pneumococcal disease and carriage in Israel, but PCV10 and PCV13 have a significant added benefit. Moreover, PCV13 has an important potential added benefit over PCV7 and PCV10 in reducing disease by drug-resistant Streptococcus pneumoniae.
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Chiou AC, Andrade SS, Almeida SCG, Zanella RC, Andrade AL, Brandileone MCDC. Molecular assessment of invasive Streptococcus pneumoniae serotype 1 in Brazil: evidence of clonal replacement. J Med Microbiol 2008; 57:839-844. [DOI: 10.1099/jmm.0.47612-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
| | | | | | | | - Ana-Lúcia Andrade
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Brazil
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Increasing penicillin and trimethoprim-sulfamethoxazole resistance in nasopharyngeal Streptococcus pneumoniae isolates from Guatemalan children, 2001--2006. Int J Infect Dis 2007; 12:289-97. [PMID: 18035570 DOI: 10.1016/j.ijid.2007.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2007] [Revised: 07/17/2007] [Accepted: 09/04/2007] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES We aimed to determine nasopharyngeal colonization rates and antibiotic resistance patterns of Streptococcus pneumoniae isolated from Guatemalan children, and to determine risk factors for colonization and antibiotic nonsusceptibility. METHODS Isolates were obtained from children aged 5 to 60 months attending public and private outpatient clinics and daycare centers during August 2001--June 2002 and outpatient clinics during November 2005--February 2006 in Guatemala City. Minimal inhibitory concentrations of penicillin, trimethoprim-sulfamethoxazole (TMS), cefotaxime, and erythromycin were determined using the E-test. RESULTS The overall nasopharyngeal colonization rate for S. pneumoniae was 59.1%. From 2001/2 to 2005/6 TMS nonsusceptibility increased from 42.4% to 60.8% (p<0.05) in public clinics and from 51.4% to 84.0% (p=0.009) in private clinics, and penicillin nonsusceptibility increased from 1.5% to 33.3% in public clinics (p<0.001). Reported antibiotic use was not strictly associated with nonsusceptibility to that same antibiotic. Resistance to three or four antibiotics increased in public clinics from 2001/2 (0%) to 2005/6 (10.7%; p<0.001). Risk factors for nasopharyngeal colonization with penicillin- or TMS-nonsusceptible S. pneumoniae were low family income, daycare center attendance, and recent penicillin use. CONCLUSIONS Increasing antibiotic nonsusceptibility rates in nasopharyngeal S. pneumoniae isolates from Guatemalan children reflect worldwide trends. Policies encouraging more judicious use of TMS should be considered.
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Harrington SM, Stock F, Kominski AL, Campbell JD, Hormazabal JC, Livio S, Rao L, Kotloff KL, Sow SO, Murray PR. Genotypic analysis of invasive Streptococcus pneumoniae from Mali, Africa, by semiautomated repetitive-element PCR and pulsed-field gel electrophoresis. J Clin Microbiol 2007; 45:707-14. [PMID: 17192418 PMCID: PMC1829114 DOI: 10.1128/jcm.01871-06] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2006] [Revised: 10/26/2006] [Accepted: 12/13/2006] [Indexed: 12/30/2022] Open
Abstract
As part of a large, ongoing study of invasive infections in pediatric patients in Bamako, Mali, 106 cases of invasive pneumococcal disease were identified from June 2002 to July 2003 (J. D. Campbell et al., Pediatr. Infect. Dis. J. 23:642-649, 2004). Of the 12 serotypes present, the majority of isolates were not contained in PCV7 (the 7-valent pneumococcal conjugate vaccine), including 1 isolate that was serotype 1, 12 isolates that were serotype 2, 58 isolates that were serotype 5, 7 isolates that were serotype 7F, and 1 isolate that was serotype 12F. To determine whether clonal dissemination of the predominant serotypes had taken place, genotyping was performed on 100 S. pneumoniae isolates by using two methods: pulsed-field gel electrophoresis (PFGE) of SmaI-digested genomic DNA, and the Bacterial Barcodes repetitive-element PCR (rep-PCR) method. Criteria for delineating rep-PCR genotypes were established such that isolates of different serotypes were generally not grouped together. The two methods were equally discriminatory within a given pneumococcal serotype. PFGE separated the isolates into 15 genotypes and 7 subtypes; rep-PCR separated isolates into 15 genotypes and 6 subtypes. Using either method, isolates within serotypes 2, 5, and 7 formed three large, separate clusters containing 1 genotype each. Both methods further distinguished related subtypes within serotypes 2 and 5. Interestingly, one of the PFGE subtypes of serotype 5 is indistinguishable from the Columbia(5)-19 clone circulating in Latin America since 1994. The data support that serotypes 2 and 5 were likely to be the result of dissemination of particular clones, some of which are responsible for invasive disease over a broad population range.
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Affiliation(s)
- S M Harrington
- Department of Laboratory Medicine, National Institutes of Health, Bethesda, Maryland, USA.
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