Outbreaks of serious pneumococcal disease in closed settings in the post-antibiotic era: A systematic review

Ihekweazu, Chikwe; Basarab, Marina; Wilson, Deborah; Oliver, Isabel; Dance, David A. B.; George, Robert C.; Pebody, Richard

doi:10.1016/j.jinf.2010.03.032

Cited by 27 publications

(22 citation statements)

References 52 publications

(103 reference statements)

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“…However, since outbreaks are usually relatively brief in duration, there are insufficient data to conclude that vaccination is effective [24]. A systematic review of pneumococcal outbreaks reported before 2006, identified serotype 14 as the most commonly implicated serotype [70]. However, the majority of outbreaks included in this report involved patients with underlying…”

Section: Outbreaksmentioning

confidence: 99%

What is Different About Serotype 1 Pneumococci?

Ritchie

Mitchell

Evans³

2011

Future Microbiol.

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Serotype 1 Streptococcus pneumoniae is among the most commonly isolated serotype in invasive pneumococcal disease but is rarely found causing asymptomatic nasopharyngeal colonization. Compared to infection by other serotypes, infection caused by serotype 1 is more likely to be identified in young patients without comorbidities but is generally associated with a lower mortality. Empyema and extrapulmonary manifestations are common. Outbreaks of serotype 1 disease have been reported in closed communities and epidemics are particularly common in sub-Saharan Africa. The serotype 1 capsular polysaccharide is a zwitterionic structure that enables it to function as a T-cell dependent antigen under some circumstances, in contrast to other pneumococcal capsular polysaccharides that are T-cell independent antigens. There are also differences in the key virulence factor pneumolysin in some serotype 1 isolates. The clinical significance of these differences remains to be determined.

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Section: Outbreaksmentioning

confidence: 99%

What is Different About Serotype 1 Pneumococci?

Ritchie

Mitchell

Evans³

2011

Future Microbiol.

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“…Carriage rates of S. pneumoniae are highest among young children (37%) and may rise to up to 58% in crowded situations such as day care centers (50). In adults, crowding may also lead to increased carriage rates, specifically in hospitals, long-term care facilities, shelters, and prisons, where carriage rates of up to 40% have been reported (199,208), compared to 4% in the general adult population (410). The bacterium is transferred between people mainly by coughing and sneezing.…”

Section: Mucosal Colonizationmentioning

confidence: 99%

Pathogenesis and Pathophysiology of Pneumococcal Meningitis

et al. 2011

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SUMMARY Pneumococcal meningitis continues to be associated with high rates of mortality and long-term neurological sequelae. The most common route of infection starts by nasopharyngeal colonization by Streptococcus pneumoniae , which must avoid mucosal entrapment and evade the host immune system after local activation. During invasive disease, pneumococcal epithelial adhesion is followed by bloodstream invasion and activation of the complement and coagulation systems. The release of inflammatory mediators facilitates pneumococcal crossing of the blood-brain barrier into the brain, where the bacteria multiply freely and trigger activation of circulating antigen-presenting cells and resident microglial cells. The resulting massive inflammation leads to further neutrophil recruitment and inflammation, resulting in the well-known features of bacterial meningitis, including cerebrospinal fluid pleocytosis, cochlear damage, cerebral edema, hydrocephalus, and cerebrovascular complications. Experimental animal models continue to further our understanding of the pathophysiology of pneumococcal meningitis and provide the platform for the development of new adjuvant treatments and antimicrobial therapy. This review discusses the most recent views on the pathophysiology of pneumococcal meningitis, as well as potential targets for (adjunctive) therapy.

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“…The ability of S. pneumoniae to cause outbreaks in long-term care facilities has been reported ( 2 , 12 , 13 ). Most reports have described invasive infections over a few weeks that involved on average 10–20 patients ( 2 , 12 ).…”

Section: Discussionmentioning

confidence: 99%

“…Most reports have described invasive infections over a few weeks that involved on average 10–20 patients ( 2 , 12 ). Also well documented is the ability of multiresistance serotypes to spread internationally and to become predominant clones in multiple geographic areas ( 14 – 16 ).…”

Section: Discussionmentioning

confidence: 99%

“…Most health care–associated S. pneumoniae infections are reported from long-term care facilities, and residence in a long-term care facility is an independent risk factor ( 2 , 3 , 17 , 18 ). In the study reported here, despite the persistence of FQRSP in the facility, we did not notice spread of FQRSP to other settings or health care facilities.…”

Section: Discussionmentioning

confidence: 99%

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