Clinical and microbiological characteristics of unusual manifestations of invasive pneumococcal disease

Sousa, Adrián; Pérez-Rodríguez, M. Teresa; Nodar, Andrés; Martínez-Lamas, Lucía; Vasallo, Francisco J.; Álvarez-Fernández, Maximiliano; Crespo, Manuel

doi:10.1016/j.eimc.2017.05.003

Cited by 9 publications

(16 citation statements)

References 24 publications

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“…The 300 S. pneumoniae isolates studied were isolated from 27 teaching hospitals in China, all from sterile body sites, including blood, cerebrospinal fluid, and pleural effusion, which can result in severe IPD. IPD is an aggressive disease with an annual incidence of 6.6–14 per 100,000 people, and a mortality rate of 10–30% ( Sousa et al, 2018 ). Given that S. pneumoniae has become a major challenge to public health systems worldwide, a comprehensive understanding of its clinical characteristics is of great importance.…”

Section: Discussionmentioning

confidence: 99%

Serotype Distribution, Antimicrobial Susceptibility, Multilocus Sequencing Type and Virulence of Invasive Streptococcus pneumoniae in China: A Six-Year Multicenter Study

et al. 2022

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Background:Streptococcus pneumoniae is an important human pathogen that can cause severe invasive pneumococcal diseases (IPDs). The aim of this multicenter study was to investigate the serotype and sequence type (ST) distribution, antimicrobial susceptibility, and virulence of S. pneumoniae strains causing IPD in China.Methods: A total of 300 invasive S. pneumoniae isolates were included in this study. The serotype, ST, and antimicrobial susceptibility of the strains, were determined by the Quellung reaction, multi-locus sequence typing (MLST) and broth microdilution method, respectively. The virulence level of the strains in the most prevalent serotypes was evaluated by a mouse sepsis model, and the expression level of well-known virulence genes was measured by RT-PCR.Results: The most common serotypes in this study were 23F, 19A, 19F, 3, and 14. The serotype coverages of PCV7, PCV10, PCV13, and PPV23 vaccines on the strain collection were 42.3, 45.3, 73.3 and 79.3%, respectively. The most common STs were ST320, ST81, ST271, ST876, and ST3173. All strains were susceptible to ertapenem, levofloxacin, moxifloxacin, linezolid, and vancomycin, but a very high proportion (>95%) was resistant to macrolides and clindamycin. Based on the oral, meningitis and non-meningitis breakpoints, penicillin non-susceptible Streptococcus pneumoniae (PNSP) accounted for 67.7, 67.7 and 4.3% of the isolates, respectively. Serotype 3 strains were characterized by high virulence levels and low antimicrobial-resistance rates, while strains of serotypes 23F, 19F, 19A, and 14, exhibited low virulence and high resistance rates to antibiotics. Capsular polysaccharide and non-capsular virulence factors were collectively responsible for the virulence diversity of S. pneumoniae strains.Conclusion: Our study provides a comprehensive insight into the epidemiology and virulence diversity of S. pneumoniae strains causing IPD in China.

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Section: Discussionmentioning

confidence: 99%

Serotype Distribution, Antimicrobial Susceptibility, Multilocus Sequencing Type and Virulence of Invasive Streptococcus pneumoniae in China: A Six-Year Multicenter Study

et al. 2022

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“…On an average, there are 4,100 cases of meningitis, 12,000 of bacteremia, 500,000 of pneumonia, and 7 million cases of otitis media due to S. pneumoniae annually in the United States alone [7]. Very rarely, unusual clinical manifestations of invasive pneumococcal diseases have been reported in literature consisting of pancreatic and liver abscess, aortitis, endocarditis, endophthalmitis, inguinal adenitis, arthritis and other osteoarticular infections, testicular and tubo-ovarian abscess, necrotizing fasciitis, pleural effusion, pyopneumothorax, mediastinitis with chest wall abscess, and multiple brain abscess [9,[17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Liver Abscess due to Streptococcus pneumoniae: A Clinical Rarity

Mohanty

Panigrahi

2020

Case Reports in Infectious Diseases

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We report a case of pyogenic liver abscess caused by a rare causative agent, Streptococcus pneumoniae. A 45-year-old man with underlying uncontrolled diabetes mellitus who had stopped taking his daily dose of insulin since the last 4 days, presented with pain in the abdominal area of one-day duration. Upon his admission to achieve diabetic control, a routine ultrasound examination of abdomen revealed incidentally, a large abscess in the left lobe of the liver with impending rupture. Culture of the ultrasound-guided liver aspirate pus yielded pure growth of a penicillin-susceptible S. pneumoniae isolate. After 4 weeks of parenteral ceftriaxone therapy along with intensive regimen for diabetic control, the liver abscess became resolved, and the patient improved and was discharged with no residual infection or recurrence at four months and at one-year follow-up. A review of relevant literature related to S. pneumoniae liver abscess revealed a mention of such entity only on 4 previous occasions. The present case highlights an important though rare manifestation of S. pneumoniae infection and emphasizes the need to establish an early diagnosis of S. pneumoniae infection for improved patient survival and favourable outcome.

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“…La enfermedad neumocócica invasiva (ENI) se define como el aislamiento de Streptococcus pneumoniae (Spn) en sangre u otro fluido orgánico estéril (1) . La neumonía es la forma de presentación más frecuente, seguida de bacteriemia sin foco, meningitis, otitis media y sinusitis (1)(2) . Sin embargo, Spn puede producir otro tipo de infecciones como endocarditis, artritis, peritonitis bacteriana espontánea (PBE) y enfermedad pélvica inflamatoria (EPI) entre otras, también conocida como ENI inusual (ENIi) (1)(2)(3) .…”

Section: Introductionunclassified

“…La neumonía es la forma de presentación más frecuente, seguida de bacteriemia sin foco, meningitis, otitis media y sinusitis (1)(2) . Sin embargo, Spn puede producir otro tipo de infecciones como endocarditis, artritis, peritonitis bacteriana espontánea (PBE) y enfermedad pélvica inflamatoria (EPI) entre otras, también conocida como ENI inusual (ENIi) (1)(2)(3) . Las infecciones intraabdominales incluyen un grupo heterogéneo de procesos infecciosos que se localizan anatómicamente entre el diafragma y la pelvis, pudiendo desarrollarse en el espacio retroperitoneal o dentro de la cavidad peritoneal (4) .…”

Section: Introductionunclassified

“…Las infecciones intraabdominales incluyen un grupo heterogéneo de procesos infecciosos que se localizan anatómicamente entre el diafragma y la pelvis, pudiendo desarrollarse en el espacio retroperitoneal o dentro de la cavidad peritoneal (4) . La peritonitis neumocócica (PN) es una infección reconocida en niños pero es rara en adultos en los cuales está usualmente asociada a cirrosis, síndrome nefrótico e infección por el virus de la inmunodeficiencia humana (VIH) (1,(5)(6)(7)(8) . Hay escasos reportes de PN en pacientes que reciben diálisis peritoneal ambulatoria (5) .…”

Section: Introductionunclassified

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Infecciones intraabdominales en adultos causadas por Streptococcus pneumoniae

Gasparotto

Gianecini

Kasparian

et al. 2022

Rev Fac Cien Med Univ Nac Cordoba

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Introducción: Streptococcus pneumoniae (Spn) ocasionalmente causa infección intraabdominal (IIASpn) que puede ser: 1) peritonitis bacteriana espontánea (PBE) en paciente añosos con enfermedad peritoneal previa, asociada con cirrosis, en la mayoría de los casos; 2) asociada o adyacente a un órgano intraabdominal o postquirúrgica (IIAbq); 3) peritonitis en mujeres jóvenes previamente sanas (MJPS). Nuestro objetivo es reportar 18 casos de IIASpn describiendo: presentación clínica, comorbilidades, necesidad de cirugía, microbiología y sensibilidad a los antimicrobianos, conducta terapéutica y evolución. Métodos: estudio de 18 pacientes adultos con IIASpn en un período de 23 años. Análisis de las características clínicas, microbiología y evolución de los pacientes. Resultados: las IIASpn ocurrieron en 9 MJPS, 6 varones y una mujer con PBE, y 2 varones con apendicitis. Las MJPS fueron intervenidas quirúrgicamente (4 pelviperitonitis, 3 salpingitis y 2 abscesos tubo ovárico) y evolucionaron favorablemente. En las muestras intraoperatorias se aisló Spn cultivo puro sensible a penicilina. Tres de cuatro pacientes tuvieron hemocultivo positivo. Cinco de siete pacientes con PBE fallecieron y en las muestras de líquido peritoneal desarrolló Spn cultivo puro. Gran porcentaje de cepas presentó sensibilidad disminuida a penicilina. Cuatro de cinco, tuvieron hemocultivo positivo. Los pacientes con apendicitis evolucionaron favorablemente. Conclusiones: La IIASpn en MJPS fue la presentación más frecuente, la cirugía jugó un rol significativo en el tratamiento y la respuesta clínica fue excelente. La segunda presentación ocurrió en pacientes añosos con cirrosis y en su mayoría, fallecieron. La apendicitis fue la tercera presentación en pacientes que evolucionaron favorablemente.

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Clinical and microbiological characteristics of unusual manifestations of invasive pneumococcal disease

Cited by 9 publications

References 24 publications

Serotype Distribution, Antimicrobial Susceptibility, Multilocus Sequencing Type and Virulence of Invasive Streptococcus pneumoniae in China: A Six-Year Multicenter Study

Serotype Distribution, Antimicrobial Susceptibility, Multilocus Sequencing Type and Virulence of Invasive Streptococcus pneumoniae in China: A Six-Year Multicenter Study

Liver Abscess due to Streptococcus pneumoniae: A Clinical Rarity

Infecciones intraabdominales en adultos causadas por Streptococcus pneumoniae

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