Colonização nasofaríngea pelo Streptococcus pneumoniae em crianças portadoras de doença falciforme imunizadas com a vacina pneumocócica conjugada 7-valente

Detalhes bibliográficos
Autor(a) principal: Fonseca, Patricia Belintani Blum [UNIFESP]
Data de Publicação: 2010
Tipo de documento: Tese
Idioma: por
Título da fonte: Repositório Institucional da UNIFESP
Texto Completo: http://repositorio.unifesp.br/handle/11600/9655
Resumo: Objectives: To assess the prevalence of nasopharyngeal colonization by Streptococcus pneumoniae in children with sickle cell disease using prophylactic penicillin and immunized with 7-valent pneumococcal conjugate vaccine; to identify risk factors for nasopharyngeal colonization; to assess the resistance profile to penicillin and other antimicrobials and to determine the most frequent serotypes in the nasopharyngeal isolates in children with sickle cell disease and in children from the control group. Methodology: Cross-sectional case-control study. A total of 424 swabs were collected from the nasopharynx in 216 children with sickle cell disease and 109 samples from the control group, both in the age range of 2 to 60 months, in the period between 11/06/2007 and 11/28/2008. Isolation and identification of pneumococcus followed standard procedures. Minimum inhibitory concentration (MIC) for penicillin and ceftriaxone were determined by the E-test method and interpreted according to CLSI 2008 criteria. Serotyping was performed by the Neufeld-Quellung reaction and by Imuno- blot. Results: Prevalence of nasopharyngeal colonization by pneumococcus in the 216 children with sickle cell disease was 17%, and 11% in the control group. The risk factors for increased colonization in children with sickle cell disease were the presence of more than five people in home (p=0.004), daycare/school attendance (p= 0.003) and low prophylaxis compliance (p=0,007). The prevalence of strains with penicillin resistance was 57.5% in patients with sickle cell disease and 25% in the control group, and in regard to ceftriaxone it was 15% and 16.7% respectively. There were no strains resistant to levofloxacin and vancomycin. The most frequently isolated serotype in both groups was NT (strains without polysaccharide capsule). Vaccine serotypes 6B, 14, 19F and 23F were isolated from five colonized children with sickle cell disease (13,5%), four of them with complete immunization for their age. Conclusions: Prevalence of nasopharyngeal colonization by pneumococcus was similar among the groups; although the penicillin prophylaxis decrease colonization, the high prevalence of strains resistant to penicillin among sickle cell disease patients may have been responsible for the similarity in the colonization rate. Prophylactic use of penicillin favored the increased prevalence of resistant strains. Since in the control group the most prevalent strain was also NT, it was not possible to verify the vaccine’s efficacy in decreasing the colonization by the vaccine serotypes.
id UFSP_81a249018ef0a6f5de3b194443f3ab3a
oai_identifier_str oai:repositorio.unifesp.br/:11600/9655
network_acronym_str UFSP
network_name_str Repositório Institucional da UNIFESP
repository_id_str 3465
spelling Colonização nasofaríngea pelo Streptococcus pneumoniae em crianças portadoras de doença falciforme imunizadas com a vacina pneumocócica conjugada 7-valenteNasopharyngeal colonization with Streptococcus pneumoniae in children with sickle cell disease vaccinated with7-valent pnemococcal conjugate vaccineColonizaçãoFarmacorresistência bacterianaStreptococcus pneumoniaeVacinasDoença da Hemoglobina SCVaccineStreptococcus pneumoniaeColonizationBacterial drug resistanceHemoglobin SC diseaseObjectives: To assess the prevalence of nasopharyngeal colonization by Streptococcus pneumoniae in children with sickle cell disease using prophylactic penicillin and immunized with 7-valent pneumococcal conjugate vaccine; to identify risk factors for nasopharyngeal colonization; to assess the resistance profile to penicillin and other antimicrobials and to determine the most frequent serotypes in the nasopharyngeal isolates in children with sickle cell disease and in children from the control group. Methodology: Cross-sectional case-control study. A total of 424 swabs were collected from the nasopharynx in 216 children with sickle cell disease and 109 samples from the control group, both in the age range of 2 to 60 months, in the period between 11/06/2007 and 11/28/2008. Isolation and identification of pneumococcus followed standard procedures. Minimum inhibitory concentration (MIC) for penicillin and ceftriaxone were determined by the E-test method and interpreted according to CLSI 2008 criteria. Serotyping was performed by the Neufeld-Quellung reaction and by Imuno- blot. Results: Prevalence of nasopharyngeal colonization by pneumococcus in the 216 children with sickle cell disease was 17%, and 11% in the control group. The risk factors for increased colonization in children with sickle cell disease were the presence of more than five people in home (p=0.004), daycare/school attendance (p= 0.003) and low prophylaxis compliance (p=0,007). The prevalence of strains with penicillin resistance was 57.5% in patients with sickle cell disease and 25% in the control group, and in regard to ceftriaxone it was 15% and 16.7% respectively. There were no strains resistant to levofloxacin and vancomycin. The most frequently isolated serotype in both groups was NT (strains without polysaccharide capsule). Vaccine serotypes 6B, 14, 19F and 23F were isolated from five colonized children with sickle cell disease (13,5%), four of them with complete immunization for their age. Conclusions: Prevalence of nasopharyngeal colonization by pneumococcus was similar among the groups; although the penicillin prophylaxis decrease colonization, the high prevalence of strains resistant to penicillin among sickle cell disease patients may have been responsible for the similarity in the colonization rate. Prophylactic use of penicillin favored the increased prevalence of resistant strains. Since in the control group the most prevalent strain was also NT, it was not possible to verify the vaccine’s efficacy in decreasing the colonization by the vaccine serotypes.Objetivos: Avaliar a prevalência da colonização nasofaríngea pelo Streptococcus pneumoniae em crianças portadoras de doença falciforme em uso de penicilina profilática e imunizadas com a vacina pneumocócica conjugada 7-valente; identificar fatores de risco para a colonização da nasofaringe; avaliar o perfil de resistência à penicilina e outros antimicrobianos e determinar os sorotipos mais freqüentes nos isolados de nasofaringe das crianças com doença falciforme e do grupo controle. Metodologia: Estudo seccional tipo caso/controle. Foram colhidos 424 “swabs” de nasofaringe de 216 crianças portadoras de doença falciforme e 109 amostras do grupo controle, ambos com faixa etária de 2 a 60 meses, no período de 06/11/2007 à 28/11/2008. O isolamento e identificação dos pneumococos seguiram procedimentos padronizados. As concentrações inibitórias mínima (CIM) para penicilina e ceftriaxona foram determinadas pelo método do E-teste e interpretadas segundo critérios do CLSI 2008. A sorotipagem foi realizada pela reação de Neufeld-Quellung e por Imuno- blot. Resultados: A prevalência da colonização nasofaríngea pelo pneumococo nos 216 pacientes portadores de doença falciforme foi de 17%, e no grupo controle de 11%. Os fatores de risco para maior colonização das crianças portadoras de doença falciforme foram a presença de mais de cinco habitantes no domicílio (p=0,004), a freqüência em creche/escola (p= 0,003) e o uso irregular da profilaxia (p=0,007). A prevalência de cepas com resistência à penicilina foi de 57,5% nos portadores de doença falciforme e no grupo controle de 25%, e em relação à ceftriaxona foi de 15% e 16,7%, respectivamente. Não houve cepas resistentes à levofloxacina e vancomicina. O sorotipo isolado mais freqüente em ambos os grupos foi o NT (cepas sem cápsula de polissacárides). Os sorotipos vacinais 6B, 14, 19F e 23F foram isolados de cinco crianças colonizadas com doença falciforme (13,5%), destas, quatro com a imunização completa para idade. Conclusões: A prevalência da colonização nasofaríngea pelo pneumococo foi semelhante entre os grupos, apesar da profilaxia com penicilina diminuir a colonização, a alta prevalência de cepas resistentes à penicilina entre os portadores de doença falciforme pode ter sido responsável pela semelhança na taxa de colonização. O uso profilático da penicilina favoreceu o aumento na prevalência de cepas resistentes. Como no grupo controle a cepa mais prevalente também foi a NT, não foi possível verificar a eficácia da vacina em diminuir a colonização pelos sorotipos vacinais.TEDEBV UNIFESP: Teses e dissertaçõesUniversidade Federal de São Paulo (UNIFESP)Farhat, Calil Kairalla [UNIFESP]Universidade Federal de São Paulo (UNIFESP)Fonseca, Patricia Belintani Blum [UNIFESP]2015-07-22T20:50:15Z2015-07-22T20:50:15Z2010-11-24info:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/publishedVersion112 p.application/pdfFONSECA, Patricia Belintani Blum. Fonseca, Patricia Belintani Blum Colonização nasofarígea pelo Streptococcus pneumoniae em crianças portadoras doença falciforme imunizadas com a vacina conjugada pneumocócica 7-valente. 2010. Tese (Doutorado) - Universidade Federal de São Paulo (UNIFESP), São Paulo, 2010.Tese-8626.pdfhttp://repositorio.unifesp.br/handle/11600/9655porinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-07-29T22:40:03Zoai:repositorio.unifesp.br/:11600/9655Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-07-29T22:40:03Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false
dc.title.none.fl_str_mv Colonização nasofaríngea pelo Streptococcus pneumoniae em crianças portadoras de doença falciforme imunizadas com a vacina pneumocócica conjugada 7-valente
Nasopharyngeal colonization with Streptococcus pneumoniae in children with sickle cell disease vaccinated with7-valent pnemococcal conjugate vaccine
title Colonização nasofaríngea pelo Streptococcus pneumoniae em crianças portadoras de doença falciforme imunizadas com a vacina pneumocócica conjugada 7-valente
spellingShingle Colonização nasofaríngea pelo Streptococcus pneumoniae em crianças portadoras de doença falciforme imunizadas com a vacina pneumocócica conjugada 7-valente
Fonseca, Patricia Belintani Blum [UNIFESP]
Colonização
Farmacorresistência bacteriana
Streptococcus pneumoniae
Vacinas
Doença da Hemoglobina SC
Vaccine
Streptococcus pneumoniae
Colonization
Bacterial drug resistance
Hemoglobin SC disease
title_short Colonização nasofaríngea pelo Streptococcus pneumoniae em crianças portadoras de doença falciforme imunizadas com a vacina pneumocócica conjugada 7-valente
title_full Colonização nasofaríngea pelo Streptococcus pneumoniae em crianças portadoras de doença falciforme imunizadas com a vacina pneumocócica conjugada 7-valente
title_fullStr Colonização nasofaríngea pelo Streptococcus pneumoniae em crianças portadoras de doença falciforme imunizadas com a vacina pneumocócica conjugada 7-valente
title_full_unstemmed Colonização nasofaríngea pelo Streptococcus pneumoniae em crianças portadoras de doença falciforme imunizadas com a vacina pneumocócica conjugada 7-valente
title_sort Colonização nasofaríngea pelo Streptococcus pneumoniae em crianças portadoras de doença falciforme imunizadas com a vacina pneumocócica conjugada 7-valente
author Fonseca, Patricia Belintani Blum [UNIFESP]
author_facet Fonseca, Patricia Belintani Blum [UNIFESP]
author_role author
dc.contributor.none.fl_str_mv Farhat, Calil Kairalla [UNIFESP]
Universidade Federal de São Paulo (UNIFESP)
dc.contributor.author.fl_str_mv Fonseca, Patricia Belintani Blum [UNIFESP]
dc.subject.por.fl_str_mv Colonização
Farmacorresistência bacteriana
Streptococcus pneumoniae
Vacinas
Doença da Hemoglobina SC
Vaccine
Streptococcus pneumoniae
Colonization
Bacterial drug resistance
Hemoglobin SC disease
topic Colonização
Farmacorresistência bacteriana
Streptococcus pneumoniae
Vacinas
Doença da Hemoglobina SC
Vaccine
Streptococcus pneumoniae
Colonization
Bacterial drug resistance
Hemoglobin SC disease
description Objectives: To assess the prevalence of nasopharyngeal colonization by Streptococcus pneumoniae in children with sickle cell disease using prophylactic penicillin and immunized with 7-valent pneumococcal conjugate vaccine; to identify risk factors for nasopharyngeal colonization; to assess the resistance profile to penicillin and other antimicrobials and to determine the most frequent serotypes in the nasopharyngeal isolates in children with sickle cell disease and in children from the control group. Methodology: Cross-sectional case-control study. A total of 424 swabs were collected from the nasopharynx in 216 children with sickle cell disease and 109 samples from the control group, both in the age range of 2 to 60 months, in the period between 11/06/2007 and 11/28/2008. Isolation and identification of pneumococcus followed standard procedures. Minimum inhibitory concentration (MIC) for penicillin and ceftriaxone were determined by the E-test method and interpreted according to CLSI 2008 criteria. Serotyping was performed by the Neufeld-Quellung reaction and by Imuno- blot. Results: Prevalence of nasopharyngeal colonization by pneumococcus in the 216 children with sickle cell disease was 17%, and 11% in the control group. The risk factors for increased colonization in children with sickle cell disease were the presence of more than five people in home (p=0.004), daycare/school attendance (p= 0.003) and low prophylaxis compliance (p=0,007). The prevalence of strains with penicillin resistance was 57.5% in patients with sickle cell disease and 25% in the control group, and in regard to ceftriaxone it was 15% and 16.7% respectively. There were no strains resistant to levofloxacin and vancomycin. The most frequently isolated serotype in both groups was NT (strains without polysaccharide capsule). Vaccine serotypes 6B, 14, 19F and 23F were isolated from five colonized children with sickle cell disease (13,5%), four of them with complete immunization for their age. Conclusions: Prevalence of nasopharyngeal colonization by pneumococcus was similar among the groups; although the penicillin prophylaxis decrease colonization, the high prevalence of strains resistant to penicillin among sickle cell disease patients may have been responsible for the similarity in the colonization rate. Prophylactic use of penicillin favored the increased prevalence of resistant strains. Since in the control group the most prevalent strain was also NT, it was not possible to verify the vaccine’s efficacy in decreasing the colonization by the vaccine serotypes.
publishDate 2010
dc.date.none.fl_str_mv 2010-11-24
2015-07-22T20:50:15Z
2015-07-22T20:50:15Z
dc.type.driver.fl_str_mv info:eu-repo/semantics/doctoralThesis
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format doctoralThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv FONSECA, Patricia Belintani Blum. Fonseca, Patricia Belintani Blum Colonização nasofarígea pelo Streptococcus pneumoniae em crianças portadoras doença falciforme imunizadas com a vacina conjugada pneumocócica 7-valente. 2010. Tese (Doutorado) - Universidade Federal de São Paulo (UNIFESP), São Paulo, 2010.
Tese-8626.pdf
http://repositorio.unifesp.br/handle/11600/9655
identifier_str_mv FONSECA, Patricia Belintani Blum. Fonseca, Patricia Belintani Blum Colonização nasofarígea pelo Streptococcus pneumoniae em crianças portadoras doença falciforme imunizadas com a vacina conjugada pneumocócica 7-valente. 2010. Tese (Doutorado) - Universidade Federal de São Paulo (UNIFESP), São Paulo, 2010.
Tese-8626.pdf
url http://repositorio.unifesp.br/handle/11600/9655
dc.language.iso.fl_str_mv por
language por
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 112 p.
application/pdf
dc.publisher.none.fl_str_mv Universidade Federal de São Paulo (UNIFESP)
publisher.none.fl_str_mv Universidade Federal de São Paulo (UNIFESP)
dc.source.none.fl_str_mv reponame:Repositório Institucional da UNIFESP
instname:Universidade Federal de São Paulo (UNIFESP)
instacron:UNIFESP
instname_str Universidade Federal de São Paulo (UNIFESP)
instacron_str UNIFESP
institution UNIFESP
reponame_str Repositório Institucional da UNIFESP
collection Repositório Institucional da UNIFESP
repository.name.fl_str_mv Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)
repository.mail.fl_str_mv biblioteca.csp@unifesp.br
_version_ 1814268452503814144