Pneumococcal bacteraemia during a recent decade

Kuikka, Arja; Syrjänen, Jaana; Renkonen, Olli-Veikko; Valtonen, Ville

doi:10.1016/0163-4453(92)92850-i

Cited by 49 publications

(27 citation statements)

References 20 publications

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“…Cirrhosis has been documented as an important predisposing factor for pneumococcal bacteremia, setting the stage for a more rapid disease course and increased mortality (18,19). Hypocomplementemic cirrhotic patients with depressed C3 levels were shown to have a particularly high incidence of infection (10).…”

Section: Discussionmentioning

confidence: 99%

“…S. pneumoniae is the most common gram-positive organism isolated from the bloodstream of cirrhotic patients (31), and cirrhosis is one of the most common underlying diseases associated with a high risk of mortality from pneumococcal bacteremia (19). Using a rat model of carbon tetrachloride-induced cirrhosis that is histologically indistinguishable from alcoholic cirrhosis in humans (20), workers in our laboratory have shown that the complement-activating activity of pneumolysin uniquely reduces pneumococcal bloodstream clearance and increases mortality from pneumococcal bacteremia in the cirrhotic host (2).…”

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confidence: 99%

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Pneumolysin-Induced Complement Depletion during Experimental Pneumococcal Bacteremia

2001

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To quantify complement depletion by pneumolysin during Streptococcus pneumoniae bacteremia, cirrhotic and control rats were infected intravenously with one of three isogenic mutant strains of S. pneumoniae expressing different forms of pneumolysin. Outcome measures included clearance of the organisms from the bloodstream, alterations in 50% serum hemolytic complement (CH 50 ) activity and complement C3 levels during infection, and serum opsonic capacity at 18 h postinfection. Cirrhotic rats had significantly lower CH 50 and C3 levels than control rats, both before and after infection. However, initial complement levels did not predict bacterial load after 18 h of infection. Changes in CH 50 and C3 levels over the 18-h period correlated with numbers of H؉C؉ but not H؉C؊ or PLY؊ organisms in the bloodstream at 18 h postinfection. The sera of cirrhotic rats infected with the H؉C؉ strain had significantly decreased levels of C3 and showed significantly lower opsonizing activity for S. pneumoniae than sera from H؉C؉-infected control rats. These studies suggest that under limiting concentrations of complement, the expression of pneumolysin by pneumococci has a significant, negative effect on serum complement levels and reduces serum opsonic activity.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Pneumolysin-Induced Complement Depletion during Experimental Pneumococcal Bacteremia

2001

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“…There are an estimated 3,000 cases of meningitis and 50,000 cases of bacteremia per year in the United States (5,24,146,163). In adults, 60 to 87% of pneumococcal bacteremia is associated with pneumonia (1,20,83).…”

Section: Introductionmentioning

confidence: 99%

Pneumococcal Virulence Factors: Structure and Function

Jedrzejas

2001

Microbiol Mol Biol Rev

407

354

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The overall goal for this review is to summarize the current body of knowledge about the structure and function of major known antigens of Streptococcus pneumoniae, a major gram-positive bacterial pathogen of humans. This information is then related to the role of these proteins in pneumococcal pathogenesis and in the development of new vaccines and/or other antimicrobial agents. S. pneumoniae is the most common cause of fatal community-acquired pneumonia in the elderly and is also one of the most common causes of middle ear infections and meningitis in children. The present vaccine for the pneumococcus consists of a mixture of 23 different capsular polysaccharides. While this vaccine is very effective in young adults, who are normally at low risk of serious disease, it is only about 60% effective in the elderly. In children younger than 2 years the vaccine is ineffective and is not recommended due to the inability of this age group to mount an antibody response to the pneumococcal polysaccharides. Antimicrobial drugs such as penicillin have diminished the risk from pneumococcal disease. Several pneumococcal proteins including pneumococcal surface proteins A and C, hyaluronate lyase, pneumolysin, autolysin, pneumococcal surface antigen A, choline binding protein A, and two neuraminidase enzymes are being investigated as potential vaccine or drug targets. Essentially all of these antigens have been or are being investigated on a structural level in addition to being characterized biochemically. Recently, three-dimensional structures for hyaluronate lyase and pneumococcal surface antigen A became available from X-ray crystallography determinations. Also, modeling studies based on biophysical measurements provided more information about the structures of pneumolysin and pneumococcal surface protein A. Structural and biochemical studies of these pneumococcal virulence factors have facilitated the development of novel antibiotics or protein antigen-based vaccines as an alternative to polysaccharide-based vaccines for the treatment of pneumococcal disease

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“…Steven and Wright reported that 64 % of patients with pneumococcal infection over the age of 65 had no underlying risk factor (18). In contrast, in a study of pneumococcal bacteraemia from Finland during 1979-89, only 11 % of patients were previously healthy [19].…”

Section: Ribotypingmentioning

confidence: 98%

“…1). The number of different serotypes causing disease in children under 5 was relatively restricted; 11 serotypes of 7 serogroups were identified among the 28 isolates collected from children (1,6,9,14,15,18,19). Twenty serotypes caused disease in those of 5 years and older (Fig.…”

Section: Ribotypingmentioning

confidence: 99%

Pneumococcal meningitis in the North East Thames Region UK: epidemiology and molecular analysis of isolates

et al. 1996

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SUMMARYOne hundred and fourteen cases of pneumococcal meningitis were identified by prospective laboratory based surveillance during 1990-3 in the North East Thames Region. Higher rates of disease were seen in Asians (2' 1 / 100000) than Caucasians (0 8/ 100000) (P = 0 002). The incidence of meningitis was higher in children than adults, while mortality rates were highest in adults over the age of 60 (48 %). In 72 cases, both blood and CSF were culture positive. Serotyping of 65 isolates collected identified 22 serotypes (and one non-typable) causing disease, the most common being serotype 6 (13 cases) and serotype 14 (11 cases). Overall, 90% of serotype antigens identified were represented in the 23 valent vaccine. Ribotyping of 62 isolates identified 35 different patterns, of which 26 were single types. Different ribotypes were found among isolates of the same serotypes, with the exception of serotype 14, where 9 of 11 isolates had the same ribotype pattern. Four percent of isolates had reduced susceptibility to penicillin, but no high level penicillin resistance was found.

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Pneumococcal bacteraemia during a recent decade

Cited by 49 publications

References 20 publications

Pneumolysin-Induced Complement Depletion during Experimental Pneumococcal Bacteremia

Pneumolysin-Induced Complement Depletion during Experimental Pneumococcal Bacteremia

Pneumococcal Virulence Factors: Structure and Function

Pneumococcal meningitis in the North East Thames Region UK: epidemiology and molecular analysis of isolates

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