Treatment and prevention of invasive pneumococcal disease

Domínguez-Alegría, A.R.; Pintado, Vicente; Barbolla, I.

doi:10.1016/j.rceng.2018.01.004

Cited by 3 publications

(5 citation statements)

References 72 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The use of PCVs in routine immunization has resulted in a significant effect on the prevalence of antimicrobial resistance, as their formulations include serotypes mostly associated with penicillin and multidrug resistance [62][63][64]. Beta-lactams are widely used and generally effective for the treatment of pneumococcal infections.…”

Section: Discussionmentioning

confidence: 99%

Genomic surveillance of invasive Streptococcus pneumoniae isolates in the period pre-PCV10 and post-PCV10 introduction in Brazil

Almeida

Hawkins

et al. 2021

Microbial Genomics

View full text Add to dashboard Cite

In 2010, Brazil introduced the 10-valent pneumococcal conjugate vaccine (PCV10) into the national children’s immunization programme. This study describes the genetic characteristics of invasive Streptococcus pneumoniae isolates before and after PCV10 introduction. A subset of 466 [pre-PCV10 (2008–2009): n=232, post-PCV10 (2012–2013): n=234;<5 years old: n=310, ≥5 years old: n=156] pneumococcal isolates, collected through national laboratory surveillance, were whole-genome sequenced (WGS) to determine serotype, pilus locus, antimicrobial resistance and genetic lineages. Following PCV10 introduction, in the <5 years age group, non-vaccine serotypes (NVT) serotype 3 and serotype 19A were the most frequent, and serotypes 12F, 8 and 9 N in the ≥5 years old group. The study identified 65 Global Pneumococcal Sequence Clusters (GPSCs): 49 (88 %) were GPSCs previously described and 16 (12 %) were Brazilian clusters. In total, 36 GPSCs (55 %) were NVT lineages, 18 (28 %) vaccine serotypes (VT) and 11 (17 %) were both VT and NVT lineages. In both sampling periods, the most frequent lineage was GPSC6 (CC156, serotypes 14/9V). In the <5 years old group, a decrease in penicillin (P=0.0123) and cotrimoxazole (P<0.0001) resistance and an increase in tetracycline (P=0.019) were observed. Penicillin nonsusceptibility was predicted in 40 % of the isolates; 127 PBP combinations were identified (51 predicted MIC≥0.125 mg l−1); cotrimoxazole (folA and/or folP alterations), macrolide (mef and/or ermB) and tetracycline (tetM, tetO or tetS/M) resistance were predicted in 63, 13 and 21.6 % of pneumococci studied, respectively. The main lineages associated with multidrug resistance in the post-PCV10 period were composed of NVT, GPSC1 (CC320, serotype 19A), and GPSC47 (ST386, serotype 6C). The study provides a baseline for future comparisons and identified important NVT lineages in the post-PCV10 period in Brazil.

show abstract

Section: Discussionmentioning

confidence: 99%

Genomic surveillance of invasive Streptococcus pneumoniae isolates in the period pre-PCV10 and post-PCV10 introduction in Brazil

Almeida

Hawkins

et al. 2021

Microbial Genomics

View full text Add to dashboard Cite

show abstract

“…The lung is the most common portal of entry, where it migrates to the valves via direct extension and bacteremia [6]. It can also invade the pericardium, meninges, peritoneum, and joints [13,14]. Alcoholism is the biggest risk factor for pneumococcal IE [7,15].…”

Section: Discussionmentioning

confidence: 99%

“…The activity of beta-lactams is reduced against highly dense bacterial inoculums, where they require a greater minimum inhibitory concentration or display loss of bactericidal action [8,16]. This is further challenged by multiple vegetation layers of fibrin and platelets, which become a mechanical barrier to penetration [8,14]. Additionally, microbe laden biofilms induce a quiescent stationary phase that shortens the activity of beta-lactams [16,17].…”

Section: Discussionmentioning

confidence: 99%

“…Combination therapy has been suggested to overcome the limitations of beta-lactams via antimicrobial synergy that optimizes pharmacokinetics and pharmacodynamics, and improves rates of susceptibility [14,18,19]. Such regimens may be particularly useful in SPE, which are often polymicrobial due to seeding of both pneumococcal and atypical bacteria from the lungs [6].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Conquering the pneumococcal nemesis with oral antibiotics

Garris

Rushdy

Qaqa

et al. 2020

Journal of Community Hospital Internal Medicine Perspectives

View full text Add to dashboard Cite

Introduction: Streptococcus pneumoniae endocarditis (SPE) occurs in <3% of all EI cases due to the evolution of penicillin and vaccination. However, immunocompromised and unvaccinated patients are still at grave risk. Case: A 58-year-old African American male who used alcohol and intravenous (IV) drugs presented with confusion, fever, and hemoptysis. He had coarse rhonchi with a grade 2/5 holosystolic apical murmur. CT chest showed diffuse bilateral infiltrates. Blood cultures were positive for pansensitive Streptococcus pneumoniae. Echocardiogram demonstrated large vegetations on the anterior and posterior leaflets of the mitral valve with flail leaflet and severe eccentric mitral regurgitation. Patient was started on IV ceftriaxone, but after 3 weeks of therapy, he wished to leave against medical advice. He was discharged on combination oral therapy with successful resolution of SPE on follow-up. Discussion: Invasive pneumococcus is highly virulent causing irreversible valvular destruction or death.IV beta-lactams are first-line treatment, but there are currently no guideline-recommended alternatives for oral therapy. Recent data suggest partial oral therapy may be noninferior to IV only therapy. Conclusion: Switching to oral combination antibiotics after at least 2 weeks of IV therapy is an acceptable alternative to treat SPE.

show abstract

“…Beta-lactams, especially penicillin and amoxicillin, are the main, but not exclusive, choices to treat pneumococcal diseases. Other antimicrobial agents frequently used against pneumococcal diseases include macrolides, fluoroquinolones, and lincosamides [26][27][28]. The first choice for AOM is amoxicillin, which may be combined with clavulanate in cases of recurrence within 30 days or when associated with other symptoms.…”

Section: Introductionmentioning

confidence: 99%

Antimicrobial Resistance in Streptococcus pneumoniae before and after the Introduction of Pneumococcal Conjugate Vaccines in Brazil: A Systematic Review

Knupp-Pereira,

Cabral,

Dolores

et al. 2024

Antibiotics

View full text Add to dashboard Cite

Streptococcus pneumoniae causes serious illnesses, such as pneumonia, bacteremia, and meningitis, mainly in immunocompromised individuals and those of extreme ages. Currently, pneumococcal conjugate vaccines (PCVs) are the best allies against pneumococcal diseases. In Brazil, the 10-valent and 13-valent PCVs have been available since 2010, but the threat of antimicrobial resistance persists and has been changing over time. We conducted a systematic review of the literature with works published since 2000, generating a parallel between susceptibility data on isolates recovered from colonization and invasive diseases before and after the implementation of PCVs for routine childhood use in Brazil. This systematic review was based on the Cochrane Handbook for Systematic Reviews of Interventions and Preferred Reporting Items for Systematic Literature Reviews and Meta-Analyses (PRISMA) guidelines. Despite the inclusion of PCVs at a large scale in the national territory, high frequencies of non-susceptibility to important drugs used in pneumococcal diseases are still observed, especially penicillin, as well as increasing resistance to macrolides. However, there are still drugs for which pneumococci have a comprehensive sensitivity profile.

show abstract

Treatment and prevention of invasive pneumococcal disease

Cited by 3 publications

References 72 publications

Genomic surveillance of invasive Streptococcus pneumoniae isolates in the period pre-PCV10 and post-PCV10 introduction in Brazil

Genomic surveillance of invasive Streptococcus pneumoniae isolates in the period pre-PCV10 and post-PCV10 introduction in Brazil

Conquering the pneumococcal nemesis with oral antibiotics

Antimicrobial Resistance in Streptococcus pneumoniae before and after the Introduction of Pneumococcal Conjugate Vaccines in Brazil: A Systematic Review

Contact Info

Product

Resources

About