Analysis of invasive infections caused by capsular strains in the years 2000-2013 – own observations
Journal Title: Postępy Nauk Medycznych - Year 2014, Vol 27, Issue 9
Abstract
Introduction. Invasive infections caused by capsular bacteria Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae are a major public health problem, and still, despite the availability of vaccines, are causing serious infections in both children and adults.Aim. The aim of the study was to analyze the clinical cases of invasive infections, diagnosed in the period 2000-2013, confirmed by molecular biology techniques at National Reference Centre for Bacterial Meningitis (KOROUN).Materials and methods. The study included 72 cases (55.6%, 40/72 male and 44.4%, 32/72 female) of invasive infections (Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae), diagnosed in the period 2000-2013 at the Bielański Hospital in Warsaw. The average age of patients was 39.6 years (2 days-89 years). We examined the number and etiology of infections in each year, the demographic characteristics of the cases, the clinical form of the infection, the course of the infection, as well as the diagnostic methods used.Results. Invasive infections occurred with equal frequency in all age groups. 22.2% (16/72) of infections were diagnosed in children under five years of age, while 23.6% (17/72) in patients above 65 years of age. Bacteremia, sepsis and meningitis are the most common clinical symptoms of invasive infections, diagnosed in 91.7% (66/72) of patients. In 61.1% (44/72) the cases were followed also after the treatment. Deaths were reported in 25% (11/44) of patients, while 75% (33/44) of patients recovered. The etiology of invasive infections in 66.7% (48/72) consisted of the Streptococcus pneumoniae, 25% (18/72) of the Neisseria meningitidis and 8.3% (6/72) of the Haemophilus influenzae. 60.4% (29/48) of patients with infections caused by the Streptococcus pneumoniae were above 50 years of age. The serotypes present in the PCV10 vaccine were the cause of infection in 46.5% (20/43) of cases, in the PCV13 in 67.4% (29/43) while the PPV23 in 83.3% (36/43) of cases. Deaths were caused by the Streptococcus pneumoniae in 5 patients and concerned only adults (50-86 years old). They were caused by the strains present in the conjugated PCV13 vaccine and the polysaccharide vaccine. In 5/18 (27.8%) cases, the infection was caused by the Neisseria meningitidis of the serogroup C, while in 13/18 (72.2%) of the serogroup B. Eight (44.4%) patients with an infection caused by the Neisseria meningitidis were over 18 years old. The mean age of the patients with infections caused by the Haemophilus influenzae was 27.1 years (ranging from 2 days to 74 years). In all patients, the Haemophilus influenzae infection was confirmed by the KOROUN and it was caused by the ”non-typeable Haemophilus influenzae”. The etiology of the invasive infections was found in 90.2% (65/72) of the patients based routine diagnostics, and in 7 (9.8%) cases using molecular biology techniques at the KOROUN.Conclusions. Invasive infections caused by capsular bacteria occur at any age. Vaccinations to prevent the onset of a disease induced by the Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae may be highly effective in both children and adults. 67.4-83.3% of the pneumococcal serotypes and 100% of the meningococcal ones identified in the reported cases are present in the available vaccines. No case was caused by the Haemophilus influenzae type b, against which children have been commonly vaccinated for a number of years.
Authors and Affiliations
Teresa Jackowska, Katarzyna Pawlik
Keywords
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