Streptococcus pneumoniae: epidemiology and risk factors, evolution of antimicrobial resistance, and impact of vaccines

Lynch, Joseph P.; Zhanel, George G.

doi:10.1097/mcp.0b013e3283385653

Cited by 148 publications

(167 citation statements)

References 41 publications

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“…1 Vaccination against S. pneumoniae is now reducing the incidence of central nervous system infections caused by this bacterium. 2 As the burden of pneumococcal meningitis wanes, a relative increase in the proportion of cases caused by other streptococci emerges. An important example is Streptococcus salivarius, a viridans group streptococcus that is prone to causing nosocomial or iatrogenic central nervous system infections.…”

Section: Clinical and Laboratory Features Of Streptococcus Salivariusmentioning

confidence: 99%

Clinical and Laboratory Features of Streptococcus salivarius Meningitis: A Case Report and Literature Review

Wilson¹,

Ryan²,

Walk³

et al. 2011

Clinical Medicine & Research

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Streptococcus salivarius is a normal member of the human oral microbiome that is an uncommon cause of invasive infections. Meningitis is a rare but increasingly reported infection caused by S. salivarius. Despite the growing number of reported cases, a comprehensive review of the literature on S. salivarius meningitis is lacking. We sought to gain a better understanding of the clinical presentation, evaluation, management, and outcome of S. salivarius meningitis by analyzing previously reported cases. In addition to a single case reported here, 64 previously published cases of meningitis were identified for this review. The collected data confirm that most patients presented with classical signs and symptoms of bacterial meningitis with a predominance of neutrophils in the cerebrospinal fluid (CSF) and hypoglycorrhachia. The majority of cases followed iatrogenic or traumatic CSF contamination. Most cases were diagnosed by CSF culture within one day of symptom onset. There was no clear evidence of predisposing co-morbid conditions in patients with meningitis, although in most case reports, limited information was given on the medical history of each patient. Outcomes were generally favorable with antibiotic management. Clinicians should suspect S. salivarius meningitis in patients presenting acutely after medical or surgical procedures involving the meninges.

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Section: Clinical and Laboratory Features Of Streptococcus Salivariusmentioning

confidence: 99%

Clinical and Laboratory Features of Streptococcus salivarius Meningitis: A Case Report and Literature Review

Wilson¹,

Ryan²,

Walk³

et al. 2011

Clinical Medicine & Research

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“…71,72 Furthermore, multidrug-resistant S pneumoniae and β-lactamase-positive H influenzae and M catarrhalis are more commonly isolated after previous antibiotic exposure. [73][74][75][76][77][78] Unfortunately, there are no studies in children that have investigated the microbiology of treatment failure in acute bacterial sinusitis or cure rates using second-line antimicrobial agents. As a result, the likelihood of adequate antibiotic coverage for resistant organisms must be…”

Section: Key Action Statement 5bmentioning

confidence: 99%

Clinical Practice Guideline for the Diagnosis and Management of Acute Bacterial Sinusitis in Children Aged 1 to 18 Years

Wald,

Applegate,

Bordley

et al. 2013

Pediatrics

435

368

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OBJECTIVE: To update the American Academy of Pediatrics clinical practice guideline regarding the diagnosis and management of acute bacterial sinusitis in children and adolescents. METHODS: Analysis of the medical literature published since the last version of the guideline (2001). RESULTS: The diagnosis of acute bacterial sinusitis is made when a child with an acute upper respiratory tract infection (URI) presents with (1) persistent illness (nasal discharge [of any quality] or daytime cough or both lasting more than 10 days without improvement), (2) a worsening course (worsening or new onset of nasal discharge, daytime cough, or fever after initial improvement), or (3) severe onset (concurrent fever [temperature ≥39°C/102.2°F] and purulent nasal discharge for at least 3 consecutive days). Clinicians should not obtain imaging studies of any kind to distinguish acute bacterial sinusitis from viral URI, because they do not contribute to the diagnosis; however, a contrast-enhanced computed tomography scan of the paranasal sinuses should be obtained whenever a child is suspected of having orbital or central nervous system complications. The clinician should prescribe antibiotic therapy for acute bacterial sinusitis in children with severe onset or worsening course. The clinician should either prescribe antibiotic therapy or offer additional observation for 3 days to children with persistent illness. Amoxicillin with or without clavulanate is the first-line treatment of acute bacterial sinusitis. Clinicians should reassess initial management if there is either a caregiver report of worsening (progression of initial signs/symptoms or appearance of new signs/symptoms) or failure to improve within 72 hours of initial management. If the diagnosis of acute bacterial sinusitis is confirmed in a child with worsening symptoms or failure to improve, then clinicians may change the antibiotic therapy for the child initially managed with antibiotic or initiate antibiotic treatment of the child initially managed with observation. CONCLUSIONS: Changes in this revision include the addition of a clinical presentation designated as “worsening course,” an option to treat immediately or observe children with persistent symptoms for 3 days before treating, and a review of evidence indicating that imaging is not necessary in children with uncomplicated acute bacterial sinusitis.

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“…>5 yrs ago n (%) At any time n (%) PCV13 VACCINATED 1 n (%) 1 Vaccination at any time. distributed in each country, but these estimates show great disparities in PPSV23 uptakes (with higher levels of vaccine use in countries with age-based recommendations and public reimbursement).…”

Section: Ppsv23 Vaccinated Within Previous 5 Yrs N (%)mentioning

confidence: 99%

“…1 Since 2012, two pneumococcal vaccines are available for use in adults: the "classical" 23-valent pneumococcal polysaccharide vaccine (PPSV23) and the "new" 13-valent proteinpolysaccharide conjugate vaccine (PCV13). 2,3 The Healthy People 2020 goal is to achieve at least 90% coverage for pneumococcal vaccination among high-risk adults and elderly people (i.e, 65 y or older).…”

Section: Introductionmentioning

confidence: 99%

Pneumococcal vaccination coverages among low-, intermediate-, and high-risk adults in Catalonia

Vila-Córcoles

Ochoa-Gondar

Diego

et al. 2016

Human Vaccines & Immunotherapeutics

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There is scarce data about pneumococcal vaccination coverages among adults in recent years. We investigated current pneumococcal vaccination coverages in Catalonia, Spain, with a cross-sectional population-based study including 2,033,465 individuals aged 50 y or older assigned to the Catalonian Health Institute at 01/01/2015 (date of survey). A previously validated institutional research clinical Database was used to classify study subjects by their vaccination status for both 23-valent pneumococcal polysaccharide vaccine (PPSV23) and 13-valent pneumococcal conjugate vaccine (PCV13), to identify comorbidities and underlying conditions, and establish the risk stratum of each individual: High risk stratum: functional or anatomic asplenia, cochlear implants, CSF leaks, or immunocompromising conditions; medium risk stratum: immunocompetent persons with history of chronic cardiac or respiratory disease, liver disease, diabetes mellitus, alcoholism and/or smoking; low risk stratum: persons without high or medium risk conditions. Of the total 2,033,465 study population, an amount of 789,098 (38.8%) had received PPVS23, whereas 5031 (0.2%) had received PCV13. PPSV23 coverages increased largely with increasing age: 4.8% in 50-59 y vs 35.5% in 60-69 y vs 71.9% in 70-79 y vs 79.5% in 80 y or older; p < 0.001). PCV13 coverages also increased with age, although they were very low in all age groups. PPSV23 coverages were 59.2% in high risk stratum, 48.3% in medium risk stratum and 28.1% in low risk stratum (p < 0.001). For the PCV13, uptakes were 1.2%, 0.3% and 0.1% in high, medium and low stratum, respectively (p < 0.001). In conclusion, pneumococcal vaccination coverages in Catalonian adults are not optimal, being especially small for the PCV13 (even in high-risk subjects).

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Streptococcus pneumoniae: epidemiology and risk factors, evolution of antimicrobial resistance, and impact of vaccines

Cited by 148 publications

References 41 publications

Clinical and Laboratory Features of Streptococcus salivarius Meningitis: A Case Report and Literature Review

Clinical and Laboratory Features of Streptococcus salivarius Meningitis: A Case Report and Literature Review

Clinical Practice Guideline for the Diagnosis and Management of Acute Bacterial Sinusitis in Children Aged 1 to 18 Years

Pneumococcal vaccination coverages among low-, intermediate-, and high-risk adults in Catalonia

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