Caracter?sticas microbiol?gicas do Streptococcus pneumoniae em pacientes internados por doen?a pneumoc?cica invasiva em hospital terci?rio

Submitted by Caroline Xavier ([email protected]) on 2017-06-30T17:23:45Z No. of bitstreams: 1 DIS_CYNTHIA_ROCHA_DULLIUS_PARCIAL.pdf: 1616329 bytes, checksum: b78ba61ceee893e19c9a37cda76e7f26 (MD5)Approved for entry into archive by Caroline Xavier ([email protected]) on 2017-06-30T17:23:52Z (GMT) No. of bitstreams: 1 DIS_CYNTHIA_ROCHA_DULLIUS_PARCIAL.pdf: 1616329 bytes, checksum: b78ba61ceee893e19c9a37cda76e7f26 (MD5)Made available in DSpace on 2017-06-30T17:23:59Z (GMT). No. of bitstreams: 1 DIS_CYNTHIA_ROCHA_DULLIUS_PARCIAL.pdf: 1616329 bytes, checksum: b78ba61ceee893e19c9a37cda76e7f26 (MD5) Previous issue date: 2017-03-31Introduction: Respiratory infections are responsible for high morbidity and mortality in most countries. Streptococcus pneumoniae (pneumococcus) remains the main agent responsible for these infections, whether they are invasive or not. Invasive pneumococcal disease (IPD) is one in which pneumococcus is found in noble liquids, that is, previously sterile material. This study aimed to evaluate the microbiological characteristics of pneumococcus in patients admitted to a terciary hospital. Methods: A cross-sectional study with descriptive and analytical analysis, consisted of patients hospitalized at the S?o Lucas Hospital of PUCRS (HSL /PUCRS, Porto Alegre, RS) who had laboratory identification of Streptococcus pneumoniae in noble liquid from January 2005 to July 2016. Results: The majority of the population was male (58.6%) and had a mean age of 55 years (P25-75 31-71). The most frequent diagnostic was pneumonia and pneumococcus was more frequently recovered from blood culture. More than 25% of the studied population had some degree of known immunosuppression (25.3%). There was no difference in mortality when subdividing the population into having comorbidities and / or need for ICU/MV. The overall mortality of the sample was 31.1%. The most common serotypes were 19A, 3, 12F e 8. The theoretical vaccine coverage in the sample was 34.4% for the PPV23 and 50.5% for PCV13 and PPV23 associated. Conclusions: In this IPD sample, the most common serotypes were 19A, 3, 12F and 8, although it was not possible to relate them to a higher mortality ou need to ICU/MV.Introdu??o: As infec??es respirat?rias s?o respons?veis por alta morbi-mortalidade na maioria dos pa?ses. O Streptococcus pneumoniae (pneumococo) segue sendo o principal agente destas infec??es, sendo elas invasivas ou n?o. Doen?a pneumoc?cica invasiva (DPI) ? aquela em que o pneumococo ? encontrado em l?quidos nobres, isto ?, material previamente est?ril. Este trabalho teve por objetivo avaliar as caracter?sticas microbiol?gicas do pneumococo em pacientes internados em hospital terci?rio. M?todos: Estudo transversal, com an?lise descritiva e anal?tica, realizado com pacientes internados no Hospital S?o Lucas da PUCRS (HSL/PUCRS, Porto Alegre, RS) que apresentaram identifica??o laboratorial de Streptococcus pneumoniae em l?quido nobre, de janeiro de 2005 at? julho de 2016. Resultados: Foram avaliadas 99 cepas de pneumococo. Os pacientes dos quais foram obtidas essas amostras eram em sua maioria do sexo masculino (58,6%) e com idade mediana de 55 anos (P25-75 31-71). O agravo mais frequente foi pneumonia e o pneumococo foi mais frequentemente recuperado em hemocultura. Mais de 25% da popula??o estudada tinha algum grau de imunossupress?o conhecida (25,3%). N?o houve diferen?a de mortalidade ao se subdividir a popula??o em comorbidades e/ ou necessidade de UTI/VM. A mortalidade global da amostra foi 31,1%. Os sorotipos mais comuns foram o 19A, 3, 12F e 8. A cobertura vacinal te?rica na amostra foi de 34,3% para PPV23 isoladamente e de 50,5% para a PCV13 e PPV23 associadas. Conclus?es: Nesta amostra de DPI, os sorotipos mais frequentes foram 19A, 3, 12F e 8, embora n?o tenha sido poss?vel relacionar com maior mortalidade ou necessidade de UTI/VM

Theoretical pneumococcal vaccine coverage: analysis of serotypes isolated from inpatients at a tertiary care hospital

ABSTRACT Objective: To evaluate Streptococcus pneumoniae serotypes isolated from an inpatient population at a tertiary care hospital, in order to determine the theoretical coverage of the 13-valent pneumococcal conjugate vaccine (PCV13) and the 23-valent pneumococcal polysaccharide vaccine (PPV23). Methods: This was a cross-sectional study involving 118 inpatients at the Hospital São Lucas, in the city of Porto Alegre, Brazil, whose cultures of blood, cerebrospinal fluid, or other sterile body fluid specimens, collected between January 2005 and December 2016, yielded pneumococcal isolates. The theoretical vaccine coverage was studied in relation to the serotypes identified in the sample and their relationship with those contained in the pneumococcal vaccines available in Brazil. Results: The majority of the population was male (n = 66; 55.9%), with a median age of 57 years (interquartile range: 33-72 years). The most common manifestation was pneumonia, and the pneumococcus was most commonly isolated from blood cultures. More than one fourth of the study population had some degree of immunosuppression (n = 34; 28.8%). Of the total sample, 39 patients (33.1%) died. There were no significant associations between mortality and comorbidity type, ICU admission, or need for mechanical ventilation. The theoretical vaccine coverage of PPV23 alone and PCV13 plus PPV23 was 31.4% and 50.8%, respectively. Conclusions: If the patients in this sample had been previously vaccinated with PCV13 plus PPV23, theoretically, 50.8% of the cases of invasive pneumococcal disease that required hospital admission could potentially have been prevented. Invasive pneumococcal disease should be prevented by vaccination not only of children and the elderly but also of adults in their economically productive years, so as to reduce the socioeconomic costs, morbidity, and mortality still associated with the disease, especially in underdeveloped countries