Prospective, population-based surveillance of the burden of Streptococcus pneumoniae in community-acquired pneumonia in older adults, Chrzanów County, Poland, 2010 to 2012

INTRODUCTION: Community-acquired pneumonia (CAP) caused by Streptococcus pneumoniae is a substantial cause of morbidity and mortality among older adults. This study estimated incidences of CAP, chest x-ray−confirmed CAP (CXR+CAP), S pneumonia- positive CAP, S pneumonia-positive CXR+CAP, and S. pneumoniae serotype distribution among 46,000 at-risk adults aged ≥ 50 years residing in Chrzanów County, Poland. MATERIAL AND METHODS: From January 2010 to January 2012, all facilities providing ambulatory and inpatient care enrolled all consenting resident patients with suspicion of CAP. Chest x-rays, urine, blood, and sputum samples were analyzed. Annualized incidence rates were determined. Presence of S pneumonia-positive CAP and/or S. pneumoniae serotype distribution was determined using the urine antigen detection assay (capable of detecting the serotypes in the 13-valent pneumococcal conjugate vaccine [PCV13]), BinaxNOW®, and/or microbiology cultures. RESULTS: Among 5055 enrolled patients, 1195 (23.7%) were diagnosed with CAP and 1166 (23.4%) had CXR+CAP. S. pneumoniae was detected in 144 (12.1%) and 131 (11.2%) patients from the CAP and CXR+CAP cohorts, respectively. Annualized incidence rates of CAP, CXR+CAP, S pneumonia-positive CAP, and S. pneumonia-positive CXR+CAP were 12.8, 12.5, 1.6, and 1.4 per 1000 residents, respectively. Among CXR+CAP patients, 39.7% were aged 50 to 64 years and 60.3% were aged ≥ 65 years. Incidence rates generally increased with age. The most common serotypes in S. pneumoniae-positive CXR+CAP patients were 3 (n = 15), 23F (n = 10), 18C (n = 9), and 9V (n = 6). CONCLUSIONS: CAP due to PCV13 serotypes is a source of morbidity among adults >50 years and may be reduced by greater access to pneumococcal vaccines.INTRODUCTION: Community-acquired pneumonia (CAP) caused by Streptococcus pneumoniae is a substantial cause of morbidity and mortality among older adults. This study estimated incidences of CAP, chest x-ray−confirmed CAP (CXR+CAP), S pneumonia- positive CAP, S pneumonia-positive CXR+CAP, and S. pneumoniae serotype distribution among 46,000 at-risk adults aged ≥ 50 years residing in Chrzanów County, Poland. MATERIAL AND METHODS: From January 2010 to January 2012, all facilities providing ambulatory and inpatient care enrolled all consenting resident patients with suspicion of CAP. Chest x-rays, urine, blood, and sputum samples were analyzed. Annualized incidence rates were determined. Presence of S pneumonia-positive CAP and/or S. pneumoniae serotype distribution was determined using the urine antigen detection assay (capable of detecting the serotypes in the 13-valent pneumococcal conjugate vaccine [PCV13]), BinaxNOW®, and/or microbiology cultures. RESULTS: Among 5055 enrolled patients, 1195 (23.7%) were diagnosed with CAP and 1166 (23.4%) had CXR+CAP. S. pneumoniae was detected in 144 (12.1%) and 131 (11.2%) patients from the CAP and CXR+CAP cohorts, respectively. Annualized incidence rates of CAP, CXR+CAP, S pneumonia-positive CAP, and S. pneumonia-positive CXR+CAP were 12.8, 12.5, 1.6, and 1.4 per 1000 residents, respectively. Among CXR+CAP patients, 39.7% were aged 50 to 64 years and 60.3% were aged ≥ 65 years. Incidence rates generally increased with age. The most common serotypes in S. pneumoniae-positive CXR+CAP patients were 3 (n = 15), 23F (n = 10), 18C (n = 9), and 9V (n = 6). CONCLUSIONS: CAP due to PCV13 serotypes is a source of morbidity among adults >50 years and may be reduced by greater access to pneumococcal vaccines

Immunological disturbances in Good’s syndrome

Background: Immunodeficiency with a thymoma (Good’s syndrome) is a rare condition occurring in patients with adult-onset hypogammaglobulinaemia. Clinical report: We describe the case of a 38-yr-old woman with an upper mediastinal mass and inflammatory infiltrations in the lungs. After thymectomy, the patient’s condition did not improve. The HRCT scan showed bronchiectasies with parenchymal opacities. As pulmonary infection persisted despite wide spectrum antibiotic therapy, additional tests were performed to diagnose an immunodeficiency. Serum immunoglobulin levels were very low. T cell response to mitogens was normal, but to Staphylococcus aureus Cowan I was impaired. Immunophenotyping of peripheral blood and bone marrow aspirate showed a very low number of B-cell at all the stages of development (CD10+CD19+, CD5+CD20). In peripheral blood 2.5% of CD19+ lymphocytes were found. On the basis of clinical history and immunological analysis, Good’s syndrome was recognized. Treatment with intravenous gammaglobulin and antibiotics improved the patient’s performance. Conclusion: Measurement of serum immunoglobulin concentration is recommended for all patients suspected of thymoma

Chest Pain of Atypical Cause in a Young Man

Granulomatosis with polyangiitis (GPA) is a rare systemic vasculitis that classically affects the upper respiratory tract, lungs, and kidneys. The involvement of other organs occurs but is less frequent. Clinically overt cardiac involvement is rare. We present a rare case of thoracic pain caused by cardiac involvement in GPA, without any other symptoms. The diagnosis was made using an integral approach, with several complementary imaging modalities, including cardiac histology

Prospective, Population-Based Surveillance of the Burden of Streptococcus pneumoniae in Community-Acquired Pneumonia in Older Adults, Chrzanów County, Poland, 2010 to 2012

Introduction: Community-acquired pneumonia (CAP) caused by Streptococcus pneumoniae is a substantial cause of morbidity and mortality among older adults. This study estimated incidences of CAP, chest X-ray−confirmed CAP (CXR+CAP), S pneumoniae-positive CAP, S pneumoniae-positive CXR+CAP, and S. pneumoniae serotype distribution among 46,000 at-risk adults aged ≥ 50 years residing in Chrzanów County, Poland. Material and methods: From January 2010 to January 2012, all facilities providing ambulatory and inpatient care enrolled all consenting resident patients with suspicion of CAP. Chest X-rays, urine, blood, and sputum samples were analyzed. Annualized incidence rates were determined. Presence of S pneumoniae-positive CAP and/or S. pneumoniae serotype distribution was determined using the urine antigen detection assay (capable of detecting the serotypes in the 13-valent pneumococcal conjugate vaccine [PCV13]), BinaxNOW®, and/or microbiology cultures. Results: Among 5055 enrolled patients, 1195 (23.7%) were diagnosed with CAP and 1166 (23.4%) had CXR+CAP. S. pneumoniae was detected in 144 (12.1%) and 131 (11.2%) patients from the CAP and CXR+CAP cohorts, respectively. Annualized incidence rates of CAP, CXR+CAP, S pneumoniae-positive CAP, and S. pneumoniae-positive CXR+CAP were 12.8, 12.5, 1.6, and 1.4 per 1000 residents, respectively. Among CXR+CAP patients, 39.7% were aged 50 to 64 years and 60.3% were aged ≥ 65 years. Incidence rates generally increased with age. The most common serotypes in S. pneumoniae-positive CXR+CAP patients were 3 (n = 15), 23F (n = 10), 18C (n = 9), and 9V (n = 6). Conclusions: CAP due to PCV13 serotypes is a source of morbidity among adults >50 years and may be reduced by greater access to pneumococcal vaccines

Prospektywna, populacyjna obserwacja występowania Streptococcus pneumoniae w przebiegu pozaszpitalnego zapalenia płuc wśród osób starszych, Chrzanów, Polska, 2010−2012

WSTĘP: Pozaszpitalne zapalenie płuc wywołane przez S. pneumoniae jest istotną przyczyną chorobowości i śmiertelności wśród osób starszych. Badanie to ocenia występowanie pozaszpitalnego zapalenia płuc (CAP, community acquired pneumonia), CAP potwierdzonego radiologicznie (CXR+CAP), S. pneumoniae dodatniego CAP, S. pneumoniae dodatniego CAP potwierdzonego radiologicznie oraz dystrybucję serotypów S. pneumoniae u ponad 46 000 dorosłych powyżej 50. roku życia mieszkających w powiecie chrzanowskim w Polsce. MATERIAŁ I METODY: Od stycznia 2010 do stycznia 2012 roku wszystkie placówki zapewniające amulatoryjną i szpitalną opiekę medyczną włączały wszystkich wyrażających zgodę pacjentów z podejrzeniem CAP. Wykonywano zdjęcie RTG klatki piersiowej, badanie moczu, krwi i plwociny. Uzyskano roczne wskażniki zapadalności. Potwierdzenie S. pneumoniae-dodatniego CAP i/lub rozkład serotypów S. pneumoniae uzyskiwano w analizie antygenowej moczu (BINAX NOW®) (wykrywający serotypy obecne w 13-walentnej szczepionce PCV 13) i posiewach mikrobiologicznych. WYNIKI: Wśród 5055 pacjentów włączonych do badania u 1195 (23,7%) zdiagnozowano pozaszpitalne zapalenie płuc, w tym 1166 (23,4%) miało zmiany radiologiczne (CAP+CXR). S. pneumoniae stwierdzono u 144 pacjentów z CAP (12,1%) i u 133 w grupie z CAP+CXR (11,2%). Roczne wskaźniki zapadalności na CAP, CAP+CXR, S. pneumonia-dodatniego CAP oraz S. pneumonia-dodatniego CAP+CXR wynosiły odpowiednio 12,8, 12,5, 1,6 i 1,4 na 1000 mieszkańców. Wśród pacjentów z CAP+CXR 39,7% było w grupie wiekowej 50−64, a 60,3% miało ≥ 65 lat. Częstość występowania rosła z wiekiem. Najczęstsze serotypy S. pneumoniae u pacjentów z CAP+CXR to 3 (n = 15), 23F (n = 10), 18C (n = 9), 9V (n = 6). WNIOSKI: CAP spowodowane serotypami PCV13 jest przyczyną chorobowości u dorosłych powyżej 50. roku życia, która może być zredukowana większym dostępem do szczepionki.WSTĘP: Pozaszpitalne zapalenie płuc wywołane przez S. pneumoniae jest istotną przyczyną chorobowości i śmiertelności wśród osób starszych. Badanie to ocenia występowanie pozaszpitalnego zapalenia płuc (CAP, community acquired pneumonia), CAP potwierdzonego radiologicznie (CXR+CAP), S. pneumoniae dodatniego CAP, S. pneumoniae dodatniego CAP potwierdzonego radiologicznie oraz dystrybucję serotypów S. pneumoniae u ponad 46 000 dorosłych powyżej 50. roku życia mieszkających w powiecie chrzanowskim w Polsce. MATERIAŁ I METODY: Od stycznia 2010 do stycznia 2012 roku wszystkie placówki zapewniające amulatoryjną i szpitalną opiekę medyczną włączały wszystkich wyrażających zgodę pacjentów z podejrzeniem CAP. Wykonywano zdjęcie RTG klatki piersiowej, badanie moczu, krwi i plwociny. Uzyskano roczne wskażniki zapadalności. Potwierdzenie S. pneumoniae-dodatniego CAP i/lub rozkład serotypów S. pneumoniae uzyskiwano w analizie antygenowej moczu (BINAX NOW®) (wykrywający serotypy obecne w 13-walentnej szczepionce PCV 13) i posiewach mikrobiologicznych. WYNIKI: Wśród 5055 pacjentów włączonych do badania u 1195 (23,7%) zdiagnozowano pozaszpitalne zapalenie płuc, w tym 1166 (23,4%) miało zmiany radiologiczne (CAP+CXR). S. pneumoniae stwierdzono u 144 pacjentów z CAP (12,1%) i u 133 w grupie z CAP+CXR (11,2%). Roczne wskaźniki zapadalności na CAP, CAP+CXR, S. pneumonia-dodatniego CAP oraz S. pneumonia-dodatniego CAP+CXR wynosiły odpowiednio 12,8, 12,5, 1,6 i 1,4 na 1000 mieszkańców. Wśród pacjentów z CAP+CXR 39,7% było w grupie wiekowej 50−64, a 60,3% miało ≥ 65 lat. Częstość występowania rosła z wiekiem. Najczęstsze serotypy S. pneumoniae u pacjentów z CAP+CXR to 3 (n = 15), 23F (n = 10), 18C (n = 9), 9V (n = 6). WNIOSKI: CAP spowodowane serotypami PCV13 jest przyczyną chorobowości u dorosłych powyżej 50. roku życia, która może być zredukowana większym dostępem do szczepionki

COVID-19 in patients with pulmonary alveolar proteinosis: a European multicentre study

Adult PAP patients experience similar #COVID19 rates to the general population, and high rates of hospitalisation and deaths, underscoring their vulnerability and the need for measures to prevent infection. The impact of iGM-CSF must be considered. https://bit.ly/3M0wKnZ