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Azarsa M, Mosadegh M, Habibi Ghahfarokhi S, Pourmand MR. Serotype Distribution and Multi Locus Sequence Type (MLST) of Erythromycin-Resistant Streptococcus Pneumoniae Isolates in Tehran, Iran. Rep Biochem Mol Biol 2023; 12:259-268. [PMID: 38317819 PMCID: PMC10838590 DOI: 10.61186/rbmb.12.2.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 07/04/2023] [Indexed: 02/07/2024]
Abstract
Background The number of erythromycin-resistant Streptococcus pneumoniae has significantly increased around the world. The present study aimed to determine the serotype distribution and molecular epidemiology of the erythromycin-resistant Streptococcus pneumoniae (ERSP) isolated from patients with invasive disease. Methods A total of 44 Streptococcus pneumoniae isolates were tested for susceptibility to several antimicrobial agents. Additionally, the polymerase chain reaction (PCR) was applied to evaluate ERSP isolates in terms of the presence of erythromycin resistance genes (e.g., ermB and mefA). The isolates were serotyped using the sequential multiplex-PCR method, and molecular epidemiology was assessed through the multilocus sequence typing (MLST) analysis. Results The results represented multidrug resistance (MDR) in approximately half of the pneumococcal isolates. Among 22 ERSP isolates, 20 (90.9%) and 12 (56%) ones contained ermB and mefA, respectively. Further, 14 (31.8%), 3 (22.7%), and 19A (18.1%) were the common serotypes among the isolates. No significant correlation was observed between serotypes and erythromycin resistance genes. Furthermore, the MLST results revealed 18 different sequence types (STs), the top ones of which were ST3130 (3 isolates) and ST166 (3 isolates). Population genetic analysis disclosed that CC63 (32%), CC156 (18%), and CC320 (18%) were identified as the predominant clonal complexes. Conclusions The ERSP isolates exhibited high genetic diversity. The large frequency of MDR isolates suggests the emergence of high resistant strains, as well as the need to implement vaccination in the immunization schedule of Iran. These accumulating evidences indicate that 13-valent pneumococcal conjugate vaccines provided higher serotype coverage in the ERSP isolates.
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Affiliation(s)
- Mohammad Azarsa
- Department of Microbiology, Khoy University of Medical Sciences, Khoy, Iran.
| | - Mehrdad Mosadegh
- Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Soheila Habibi Ghahfarokhi
- Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mohammad Reza Pourmand
- Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
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Nisar MI, Shahid S, Muhammad S, Khalid F, Hussain A, Ahmed S, Shakoor S, Kabir F, Hotwani A, Ali A, Zaidi AK, Omer SB, Jehan F, Iqbal N. Impact of 10-valent Pneumococcal Conjugate Vaccine (PCV10) on nasopharyngeal carriage in children 2 years of age: Data from a four-year time series cross-sectional study from Pakistan. Data Brief 2021; 35:106828. [PMID: 33614873 PMCID: PMC7881212 DOI: 10.1016/j.dib.2021.106828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 11/10/2022] Open
Abstract
The dataset described in this paper was collected for a time-series cross-sectional study exploring the impact of 10-valent Pneumococcal Conjugate Vaccine (PCV10) on nasopharyngeal (NP) carriage in children under 2 years of age from a rural population in Sindh, Pakistan. The study was carried out in two union councils of Matiari - Khyber and Shah Alam Shah Jee Wasi (Latitude 25.680298 / Longitude 68.502711). Data was collected on socio-demographics, clinical characteristics and vaccination status using android phone-based application. NP samples were collected using standard World Health Organisation (WHO) techniques, culture and serotyping was done using sequential Multiplex PCR described by Centre for Disease Control, USA. We looked at the carriage rate of vaccine type (VT) and non-vaccine type (NVT) serotypes over time in vaccinated and unvaccinated children. We additionally looked at the predictors for pneumococcal carriage. The uploaded dataset, available on Mendeley data repository (Nisar, Muhammad Imran (2021), “Impact of PCV10 on nasopharyngeal carriage in children in Pakistan”, Mendeley Data, V1, doi:10.17632/t79h6g97gr.1), has 3140 observations in CSV format. Additional files uploaded include a data dictionary and the set of questionnaires. The dataset and accompanying files can be used by other interested researchers to replicate our analysis, carry similar analysis under varying set of assumptions or perform additional exploratory or metanalysis
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Affiliation(s)
- Muhammad Imran Nisar
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Shahira Shahid
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Sajid Muhammad
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Farah Khalid
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Amjad Hussain
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Sheraz Ahmed
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Sadia Shakoor
- Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Furqan Kabir
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Aneeta Hotwani
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Asad Ali
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Anita Km Zaidi
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.,Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - Saad B Omer
- Yale Institute for Global Health, New Haven, CT, USA
| | - Fyezah Jehan
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Najeeha Iqbal
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
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Cha J, Kim HW, Lee JH, Lee S, Kim KH. Validation of a Multiplexed Opsonophagocytic Assay for 11 Additional Pneumococcal Serotypes and Its Application to Functional Antibody Evaluation Induced by Pneumococcal Polysaccharide Vaccine. J Korean Med Sci 2018; 33:e340. [PMID: 30546285 PMCID: PMC6291409 DOI: 10.3346/jkms.2018.33.e340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 10/02/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Various pneumococcal vaccines have been evaluated for immunogenicity by opsonophagocytic assay (OPA). A multiplexed OPA (MOPA) for 13 pneumococcal serotypes was developed by Nahm and Burton, and expanded to 26 serotypes in 2012. The development of new conjugate vaccines with increased valence has necessitated expanded MOPAs to include these additional serotypes. In this study, we validated this expanded MOPA platform and applied to measure antibodies against 11 additional serotypes (2, 8, 9N, 10A, 11A, 12F, 15B, 17F, 20B, 22F, and 33F) in human sera. METHODS All materials, including serum, complement, bacterial master stocks, and HL-60 cells, were evaluated for assay optimization. Following optimization, the assay was validated for accuracy, specificity, and intra- and inter-assay precision with sera from adult donors following standard protocols. The assay was applied to evaluate functional antibodies of 42 sera immunized with 23-valent pneumococcal polysaccharide vaccine (PPV23). RESULTS The expanded MOPA platform was specific for all serotypes, with the exception of serotype 20. The assay results were highly correlated with those obtained from single-serotype OPA, indicating acceptable accuracy. The coefficients of variation were 7%-24% and 13%-39% in tests of intra- and inter-assay precision, respectively, using three quality-control samples. A MOPA that included 11 additional serotypes in the PPV23 was established and validated with respect to accuracy, specificity, and precision. The opsonic indices of immune sera were obtained using this validated assay. CONCLUSION The expanded MOPA will be useful for evaluation of the immunogenicity of PPV23 and future conjugate vaccine formulations.
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Affiliation(s)
- Jihei Cha
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Korea
- Center for Vaccine Evaluation and Study, Medical Research Institute, Ewha Womans University College of Medicine, Seoul, Korea
| | - Han Wool Kim
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Korea
- Center for Vaccine Evaluation and Study, Medical Research Institute, Ewha Womans University College of Medicine, Seoul, Korea
| | - Ji Hyen Lee
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Korea
- Center for Vaccine Evaluation and Study, Medical Research Institute, Ewha Womans University College of Medicine, Seoul, Korea
| | - Soyoung Lee
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Korea
- Center for Vaccine Evaluation and Study, Medical Research Institute, Ewha Womans University College of Medicine, Seoul, Korea
| | - Kyung-Hyo Kim
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Korea
- Center for Vaccine Evaluation and Study, Medical Research Institute, Ewha Womans University College of Medicine, Seoul, Korea
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Hurley LP, Allison MA, Pilishvili T, O'Leary ST, Crane LA, Brtnikova M, Beaty BL, Lindley MC, Bridges CB, Kempe A. Primary Care Physicians' Struggle with Current Adult Pneumococcal Vaccine Recommendations. J Am Board Fam Med 2018; 31:94-104. [PMID: 29330244 DOI: 10.3122/jabfm.2018.01.170216] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 08/17/2017] [Accepted: 08/31/2017] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION In 2012, the Advisory Committee on Immunization Practices recommended 13-valent pneumococcal conjugate vaccine (PCV13) in series with 23-valent pneumococcal polysaccharide vaccine (PPSV23) for at-risk adults ≥19; in 2014, it expanded this recommendation to adults ≥65. Primary care physicians' practice, knowledge, attitudes, and beliefs regarding these recommendations are unknown. METHODS Primary care physicians throughout the U.S. were surveyed by E-mail and post from December 2015 to January 2016. RESULTS Response rate was 66% (617 of 935). Over 95% of respondents reported routinely assessing adults' vaccination status and recommending both vaccines. A majority found the current recommendations to be clear (50% "very clear," 38% "somewhat clear"). Twenty percent found the upfront cost of purchasing PCV13, lack of insurance coverage, inadequate reimbursement, and difficulty determining vaccination history to be "major barriers" to giving these vaccines. Knowledge of recommendations varied, with 83% identifying the PCV13 recommendation for adults ≥65 and only 21% identifying the recommended interval between PCV13 and PPSV23 in an individual <65 at increased risk. CONCLUSIONS Almost all surveyed physicians reported recommending both pneumococcal vaccines, but a disconnect seems to exist between perceived clarity and knowledge of the recommendations. Optimal implementation of these recommendations will require addressing knowledge gaps and reported barriers.
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Ferreira M, Oliveira H, Silva NC, Januário L, Rodrigues F. [Paediatric Invasive Pneumococcal Disease Before Universal Vaccination: 1995 - 2015]. ACTA MEDICA PORT 2017; 30:457-462. [PMID: 28898612 DOI: 10.20344/amp.8493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 03/27/2017] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Pneumococcal conjugate vaccine was introduced in the private market in Portugal in 2001, reaching over the years a moderately high coverage. In July 2015, it was included in the National Immunisation Program. The aim of this study was to characterize invasive pneumococcal disease in a pediatric hospital before universal use of the vaccine. MATERIAL AND METHODS Retrospective analysis of medical records of all children with Streptococcus pneumoniae identified by culture and/or molecular biology (available since 2008), in products obtained from sterile sites, from January 1995 to June 2015. We evaluated demographic, clinical and microbiological data. Serotype results are available since 2004. RESULTS Over those 20 years, 112 invasive pneumococcal disease cases were identified, with a median age of 15 months (1 month - 15 years). The median number of cases /year was 4, the highest between 2001 - 2002 (8/year) and 2007 - 2012 (7 - 11/year). The identification occurred mostly in blood culture (72), cerebrospinal fluid (24), pleural fluid (11) an others (5). The most frequent diagnoses were pneumonia (38%), occult bacteraemia (34%) and meningitis (21%). Over the period under review, there was an increase of pneumonia and slight increase of OB, with meningitis cases remaining relatively unchanged. DISCUSSION In the last two decades, there was no reduction in the number of cases of invasive pneumococcal disease. There was an increase in isolates from pneumonia and occult bacteraemia that might be due to the introduction of molecular biological methods for Streptococcus pneumoniae detection. Vaccine serotypes were predominant. CONCLUSION This retrospective analysis before universal vaccination will contribute to evaluate the impact of vaccination in the Portuguese pediatric population.
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Affiliation(s)
- Muriel Ferreira
- Unidade de Infeciologia e Serviço de Urgência. Hospital Pediátrico. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - Henrique Oliveira
- Serviço de Patologia Clínica. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - Nuno Costa Silva
- Serviço de Patologia Clínica. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - Luís Januário
- Unidade de Infeciologia e Serviço de Urgência. Hospital Pediátrico. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - Fernanda Rodrigues
- Unidade de Infeciologia e Serviço de Urgência. Hospital Pediátrico. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal; Departamento de Pediatria. Faculdade de Medicina. Universidade de Coimbra. Coimbra. Portugal
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Vila-Córcoles A, Ochoa-Gondar O, Satué E, de Diego C, Vila-Rovira M, Jariod M. [Estimates of Target Population for Pneumococcal Vaccination in People over 50 years in Catalonia and Spain]. Rev Esp Salud Publica 2017; 91:e201703029. [PMID: 28300793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 03/15/2017] [Indexed: 06/06/2023] Open
Abstract
OBJECTIVE Published data about prevalence of distinct risk condictions for pneumococcal disease is scarce. This study investigated the prevalence of distinct risk conditions for pneumococal disease in Catalonian adults and stimated the potential size of target population for pneumococcal vaccination in Catalonia and Spain. METHODS Cross-sectional population-based study that included 2,033,465 individuals older than 49 years-old assigned to the Catalonian Health Institute (Catalonia, Spain) at 01/01/2015. The Catalonian Health Institute Information System for the Development of Research in Primary Care (SIDIAP) was used to identify comorbidities and/or underlying conditions in each subject and establish potential target population for pneumococcal vaccination on the basis of their risk for suffering pneumococcal infections: 1) immunocompromised subjects; 2) immunocompetents subjects with any risk condition; 3) immunocompetents subjects without risk conditions. RESULTS Of the 2,033,465 study subjects, 1,053,155 (51.8%) had no risk conditions, 649,014 (31.9%) had one risk condition and 331,296 (16.3%) had multiple risk conditions (11.4% in 50-64 years vs 21.2% in people older than 65 years, p smaller than 0.001; 21.8% in men vs 11.6% in women, p smaller than 0.001). Overall, 176,600 (8.7%) and 803,710 (39.5%) were classified in risk stratum 1 and 2, respectively. According to distinct risk strata considered, the target population for pneumococcal vaccination varied between 0.2-1.9 million in Catalonia and 1.5-2.3 million in Spain. CONCLUSIONS In our setting, almost fifty percent of people ≥50 years have at least one risk condition to suffert pneumococcal disease. Adult population susceptible for pneumococal vaccination largely varies depending on the risk stratum considered as targeted people for pneumococcal vaccination.
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Affiliation(s)
- Angel Vila-Córcoles
- Direcció d'Atenció Primària Camp de Tarragona. Institut Català de la Salut. Tarragona. España
| | - Olga Ochoa-Gondar
- Direcció d'Atenció Primària Camp de Tarragona. Institut Català de la Salut. Tarragona. España
| | - Eva Satué
- Direcció d'Atenció Primària Camp de Tarragona. Institut Català de la Salut. Tarragona. España
| | - Cinta de Diego
- Direcció d'Atenció Primària Camp de Tarragona. Institut Català de la Salut. Tarragona. España
| | | | - Manel Jariod
- Sistemas de Información. Hospital Universitario Joan XXIII. Institut Català de la Salut. Tarragona. España
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Cho EY, Choi EH, Kang JH, Kim KH, Kim DS, Kim YJ, Ahn YM, Eun BW, Oh SH, Cha SH, Cho HK, Hong YJ, Kim KN, Kim NH, Kim YK, Kim JH, Lee H, Lee T, Kim HM, Lee KS, Kim CS, Park SE, Kim YM, Oh CE, Ma SH, Jo DS, Choi YY, Lee J, Bae GR, Park O, Park YJ, Kim ES, Lee HJ. Early Changes in the Serotype Distribution of Invasive Pneumococcal Isolates from Children after the Introduction of Extended-valent Pneumococcal Conjugate Vaccines in Korea, 2011-2013. J Korean Med Sci 2016; 31:1082-8. [PMID: 27366006 PMCID: PMC4901000 DOI: 10.3346/jkms.2016.31.7.1082] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 04/07/2016] [Indexed: 11/20/2022] Open
Abstract
This study was performed to measure early changes in the serotype distribution of pneumococci isolated from children with invasive disease during the 3-year period following the introduction of 10- and 13-valent pneumococcal conjugate vaccines (PCVs) in Korea. From January 2011 to December 2013 at 25 hospitals located throughout Korea, pneumococci were isolated among children who had invasive pneumococcal disease (IPD). Serotypes were determined using the Quellung reaction, and the change in serotype distribution was analyzed. Seventy-five cases of IPD were included. Eighty percent of patients were aged 3-59 months, and 32% had a comorbidity that increased the risk of pneumococcal infection. The most common serotypes were 19A (32.0%), 10A (8.0%), and 15C (6.7%). The PCV7 serotypes (4, 6B, 9V, 14, 18C, 19F, 23F, and 6A) accounted for 14.7% of the total isolates and the PCV13 minus PCV7 types (1, 3, 5, 7F and 19A) accounted for 32.0% of the total isolates. Serotype 19A was the only serotype in the PCV13 minus PCV7 group. The proportion of serotype 19A showed decreasing tendency from 37.5% in 2011 to 22.2% in 2013 (P = 0.309), while the proportion of non-PCV13 types showed increasing tendency from 45.8% in 2011 to 72.2% in 2013 (P = 0.108). Shortly after the introduction of extended-valent PCVs in Korea, serotype 19A continued to be the most common serotype causing IPD in children. Subsequently, the proportion of 19A decreased, and non-vaccine serotypes emerged as an important cause of IPD. The impact of extended-valent vaccines must be continuously monitored.
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Affiliation(s)
- Eun Young Cho
- Seoul National University College of Medicine, Seoul, Korea
- Chungnam National University Hospital, Daejeon, Korea
| | - Eun Hwa Choi
- Seoul National University College of Medicine, Seoul, Korea
| | - Jin Han Kang
- College of Medicine, the Catholic University of Korea, Seoul, Korea
| | - Kyung-Hyo Kim
- School of Medicine, Ewha Womans University, Seoul, Korea
| | - Dong Soo Kim
- Yonsei University College of Medicine, Seoul, Korea
| | - Yae-Jean Kim
- Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | | | | | - Sung Hee Oh
- Hanyang University, College of Medicine, Seoul, Korea
| | - Sung-Ho Cha
- Kyung Hee University School of Medicine, Seoul, Korea
| | - Hye-Kyung Cho
- Graduate School of Medicine, Gachon University, Incheon, Korea
| | | | - Kwang Nam Kim
- Hallym University College of Medicine, Chuncheon, Korea
| | - Nam Hee Kim
- Inje University College of Medicine, Seoul, Korea
| | | | - Jong-Hyun Kim
- College of Medicine, the Catholic University of Korea, Seoul, Korea
| | - Hyunju Lee
- Seoul National University Bundang Hospital, Seoul, Korea
| | - Taekjin Lee
- CHA Bundang Medical Center, CHA University, Seoul, Korea
| | - Hwang Min Kim
- Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Kun Song Lee
- College of Medicine, Dankook University, Cheonan, Korea
| | - Chun Soo Kim
- Keimyung University School of Medicine, Daegu, Korea
| | - Su Eun Park
- Pusan National University School of Medicine, Busan, Korea
| | - Young Mi Kim
- Pusan National University School of Medicine, Busan, Korea
| | - Chi Eun Oh
- Kosin University College of Medicine, Busan, Korea
| | | | - Dae Sun Jo
- Chonbuk National University Medical School, Jeonju, Korea
| | | | - Jina Lee
- University of Ulsan College of Medicine, Seoul, Korea
| | - Geun-Ryang Bae
- Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Ok Park
- Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Young-Joon Park
- Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Eun Seong Kim
- Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Hoan Jong Lee
- Seoul National University College of Medicine, Seoul, Korea
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Wilson MW, Brown BJ, Miles MC. A Multicomponent Intervention to Improve Pneumococcal Vaccination Knowledge Among Internal Medicine Residents. MedEdPORTAL 2016; 12:10414. [PMID: 31008194 PMCID: PMC6464476 DOI: 10.15766/mep_2374-8265.10414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 05/12/2016] [Indexed: 06/09/2023]
Abstract
INTRODUCTION The Advisory Committee on Immunization Practices updated its pneumococcal vaccination guidelines in September 2014 and provided an additional recommendation in February 2016. We perceived a knowledge gap related to these guidelines among residents who serve as primary care physicians during postgraduate training. Our research team confirmed the presence of this knowledge gap and designed a curriculum focused on the current guidelines for pneumococcal vaccination. METHODS This curriculum consists of a preeducation quiz and survey, as well as an educational video, pocket card, and poster. The educational materials were then disseminated over a 7-week period and included a short video, handouts (laminated pocket cards), and summaries of guideline recommendations in electronic format. RESULTS The quiz, which includes eight clinical vignette selected-response items, revealed a knowledge deficiency. For example, only a minority of residents (31.2%) correctly chose the appropriate pneumococcal vaccination schedule for an elderly patient with multiple comorbid and chronic medical ailments. A postintervention survey showed that a majority of residents (87.5%) found the educational tools effective in improving understanding and implementation of vaccine guidelines. DISCUSSION This novel educational strategy is designed to increase resident knowledge of pneumococcal vaccination guidelines with eventual translation to actual clinical practice.
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Affiliation(s)
- Matthew W. Wilson
- Resident Physician, Wake Forest Baptist Medical Center
- Resident Physician, Wake Forest School of Medicine
- Resident Physician, United States Navy
| | - Blair J. Brown
- Resident Physician, Wake Forest Baptist Medical Center
- Resident Physician, Wake Forest School of Medicine
| | - Matthew C. Miles
- Assistant Professor of Pulmonary, Critical Care, Allergy and Immunologic Disease, Wake Forest School of Medicine
- Assistant Professor of Pulmonary, Critical Care, Allergy and Immunologic Disease, Wake Forest Baptist Medical Center
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Kim CJ, Song JS, Choi SJ, Song KH, Choe PG, Park WB, Bang JH, Kim ES, Park SW, Kim HB, Kim NJ, Kim EC, Oh MD. Serotype Distribution and Antimicrobial Susceptibilities of Invasive Streptococcus pneumoniae Isolates from Adults in Korea from 1997 to 2012. J Korean Med Sci 2016; 31:715-23. [PMID: 27134492 PMCID: PMC4835596 DOI: 10.3346/jkms.2016.31.5.715] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 02/17/2016] [Indexed: 11/20/2022] Open
Abstract
In Republic of Korea, a 7-valent pneumococcal conjugated vaccine (PCV7) was licensed for use in infants in 2003, and 13-valent PCV (PCV13) replaced it since 2010. We investigated trends in serotype distribution and antibiotic susceptibility of pneumococcal isolates from adult patients with invasive pneumococcal diseases (IPD). Invasive pneumococcal isolates from adult patients of ≥ 16 years of age were collected from 1997 to 2012. Serotypes of the isolates were determined by the Quellung reaction. Distribution of serotypes was analyzed according to the vaccine types. Antibiotic susceptibility was tested by using E-test strips. A total of 272 invasive pneumococcal isolates were included. The most common serotypes were serotype 19F (8.5%, 23/272), and serotype 3 (8.1%, 22/272), and 24.6% (67/272) of the isolates were of non-vaccine serotypes. Of the 272 isolates, 2.6% (7/272) were penicillin MICs of ≥ 4 µg/mL. The proportion of the PCV13 serotypes decreased from 63.3% (50/79) in 1997-2003 to 48.6% (17/35) in 2011-2012, whereas that of non-vaccine serotypes was 26.6% (21/79) and 25.7% (9/35), respectively, for the same periods. The proportion of the PCV13 serotypes showed a decreasing trend among adult patients with IPD over the study period.
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Affiliation(s)
- Chung Jong Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jin-Su Song
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Su-Jin Choi
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kyoung Ho Song
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Pyeong Gyun Choe
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Wan Beom Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Hwan Bang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Eu Suk Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Won Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hong Bin Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Nam-Joong Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Eui-Chong Kim
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Myoung-don Oh
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
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Falleiros-Arlant LH, Berezin EN, Avila-Aguero ML, Pirez MC, Gentile A, Richardson V, Brea J, Mariño C. Epidemiological burden of invasive pneumococcal disease in children and adolescents with predisposing risk factors. Int J Infect Dis 2015; 38:1-6. [PMID: 26135848 DOI: 10.1016/j.ijid.2015.06.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 06/12/2015] [Accepted: 06/23/2015] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE Some medical conditions constitute important risk factors for the development of invasive pneumococcal diseases in children and adolescents aged from 5 to 19 years. Conjugate vaccines have potential efficacy in this scenario, but are not available in many Latin American public healthcare systems for this age group. This study aimed to estimate the preventable fraction of invasive pneumococcal diseases among individuals aged from 5 to 19 years with associated risk factors for its development. METHODS Data regarding the Latin America population, risk factors prevalence and conjugate vaccines efficacy were obtained from the literature. RESULTS Total population at risk ranged from 17.3 to 64.6 million of individuals and asthma was the most impacting risk factor. According to SIREVA, PCV13 provided a 62.9% serotypes coverage in individuals from 5 to 29 years in 2012, potentially increasing the covered population from [8,338,457-31,057,620] with PCV10 to [10,906,356-40,622,078] with PCV13. To date, according to available efficacy data, the hypothetically immunized population ranged from 11.4 to 42.4 million, representing 7.0% to 26.0% of the total population in this age group. CONCLUSIONS Vaccination in risk groups should be encouraged, as it potentially contributes to the reduction in the number of cases of invasive pneumococcal disease.
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Affiliation(s)
| | | | | | | | - Angela Gentile
- Hospital de Niños Ricardo Gutierrez, Ciudad Autónoma de Buenos Aires, Argentina
| | | | - Jose Brea
- Centro Medico Universidad Central Del Este, Santo Domingo, Dominican Republic
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Cho EY, Kang HM, Lee J, Kang JH, Choi EH, Lee HJ. Changes in serotype distribution and antibiotic resistance of nasopharyngeal isolates of Streptococcus pneumoniae from children in Korea, after optional use of the 7-valent conjugate vaccine. J Korean Med Sci 2012; 27:716-22. [PMID: 22787364 PMCID: PMC3390717 DOI: 10.3346/jkms.2012.27.7.716] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Accepted: 03/16/2012] [Indexed: 11/20/2022] Open
Abstract
We investigated serotype distribution and antimicrobial resistance of pneumococcal carriage isolates from children after optional immunization with the 7-valent pneumococcal conjugate vaccine (PCV7) in Korea. From June 2009 to June 2010, 205 (16.5%) pneumococcal isolates were obtained from 1,243 nasopharyngeal aspirates of infants and children at Seoul National University Children's Hospital, Korea. Serotype was determined by Quellung reaction and antibiotic susceptibility was tested by E-test. The results were compared to previous studies done in the pre-PCV7 period. In this study, the most common serotypes were 6A (15.3%), 19A (14.7%), 19F (10.2%), 35B (7.3%), and 6D (5.6%). The proportion of PCV7 serotypes decreased from 61.9% to 23.8% (P < 0.001). The overall penicillin nonsusceptibility rate increased from 83.5% to 95.4% (P = 0.001). This study demonstrates the impact of optional PCV7 vaccination in Korea; the proportion of all PCV7 serotypes except 19F decreased while antimicrobial resistant serotypes 6A and 19A further increased.
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Affiliation(s)
- Eun Young Cho
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea.
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Shamsian BS, Arzanian MT, Kaviani R, Alavi S, Hedayat M, Rezaei N. Splenectomy for hematological disorders in Iranian pediatric patients: a single center study. Iran J Pediatr 2012; 22:275-6. [PMID: 23056902 PMCID: PMC3446078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Accepted: 11/15/2011] [Indexed: 11/05/2022]
Affiliation(s)
- Bibi Shahin Shamsian
- Department of Pediatric Hematology-Oncology, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Corresponding Author:Address: Department of Pediatric Hematology-Oncology, Mofid Children's Hospital, Shariati Avenue, Tehran, Iran. E-mail:
| | - Mohammad Thaghi Arzanian
- Department of Pediatric Hematology-Oncology, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Raheleh Kaviani
- Department of Pediatric Hematology-Oncology, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samin Alavi
- Department of Pediatric Hematology-Oncology, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mona Hedayat
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran, Iran,Molecular Immunology Research Center and Department of Immunology, Tehran University of Medical Sciences, Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran, Iran,Molecular Immunology Research Center and Department of Immunology, Tehran University of Medical Sciences, Tehran, Iran
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