Carregant...
Fitxers
Tipus de document
ArticleVersió
Versió publicadaData de publicació
Llicència de publicació
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/98434
Invasive pneumococcal disease in healthy adults: increase of empyema associated with the clonal-type Sweden1-ST306
Títol de la revista
Director/Tutor
ISSN de la revista
Títol del volum
Recurs relacionat
Resum
Background: Adult invasive pneumococcal disease (IPD) occurs mainly in the elderly and patients with co-morbidities. Little is known about the clinical characteristics, serotypes and genotypes causing IPD in healthy adults. Methods: We studied 745 culture-proven cases of IPD in adult patients aged 18-64 years (1996-2010). Patients were included in two groups: 1.) adults with co-morbidities, and 2.) healthy adults, who had no prior or coincident diagnosis of a chronic or immunosuppressive underlying disease. Microbiological studies included pneumococcal serotyping and genotyping. Results: Of 745 IPD episodes, 525 (70%) occurred in patients with co-morbidities and 220 (30%) in healthy adults. The healthy adults with IPD were often smokers (56%) or alcohol abusers (18%). As compared to patients with co-morbidities, the healthy adults had (P,0.05): younger age (43.5+/213.1 vs. 48.7+/211.3 years); higher proportions of women (45% vs.24%), pneumonia with empyema (15% vs. 7%) and infection with non-PCV7 serotypes including serotypes 1 (25% vs. 5%), 7F (13% vs. 4%), and 5 (7% vs. 2%); and lower mortality (5% vs. 20%). Empyema was more frequently caused by serotype 1. No death occurred among 79 patients with serotype 1 IPD. There was an emergence of virulent clonal-types Sweden1-ST306 and Netherlands7F-ST191. The vaccine serotype coverage with the PCV13 was higher in healthy adults than in patients with co-morbidities: 82% and 56%, respectively, P,0.001. Conclusion: In this clinical study, one-third of adults with IPD had no underlying chronic or immunosuppressive diseases (healthy adults). They were often smokers and alcohol abusers, and frequently presents with pneumonia and empyema caused by virulent clones of non-PCV7 serotypes such as the Sweden1-ST306. Thus, implementing tobacco and alcohol abuse-cessation measures and a proper pneumococcal vaccination, such as PCV13 policy, in active smokers and alcohol abusers may diminish the burden of IPD in adults.
Matèries
Matèries (anglès)
Citació
Citació
GRAU, Immaculada, ARDANUY TISAIRE, María carmen, CALATAYUD, Laura, ROLO, Dora, DOMENECH PENA, Arnau, LIÑARES LOUZAO, Josefina, PALLARÉS GINER, Roman. Invasive pneumococcal disease in healthy adults: increase of empyema associated with the clonal-type Sweden1-ST306. _PLoS One_. 2012. Vol. 7, núm. 8, pàgs. e42595. [consulta: 8 de abril de 2026]. ISSN: 1932-6203. [Disponible a: https://hdl.handle.net/2445/98434]