51 Epidemiology, Serotypes Distribution and Antibiotic Susceptibility of Streptococcus Pneumoniae Strains Associated with Invasive Pneumococcal Diseases in a Pediatric Tertiary Care Center in Montreal
Notice bibliographique
Résumé
Streptococcus pneumoniae (Sp) is a leading cause of invasive bacterial infections. Worldwide, a decreased susceptibility to antibiotics has been reported. The recently available heptavalent conjugated pneumococcal vaccine (PCV-7) includes serotypes responsible for the majority of Invasive Pneumococcal Diseases (IPD) and significant numbers of isolates being resistant to antibiotics. The aim of this study was to review the epidemiology, serotype distribution and antibiotic susceptibility pattern of Sp strains isolated from children seen at Sainte-Justine Hospital with IPD. We reviewed the microbiological characteristics of Sp strains isolated from children with IPD from September 2001 to September 2003. Serotyping was performed at the National Center for Streptococcus in Alberta and antimicrobial susceptibility testing was done in our microbiology laboratory. Most of the susceptibility results were confirmed at the Quebec Public Health Laboratory. Sp was recovered from 124 samples over the two-year study period but data were available for 104 of them: 92 blood cultures, 9 cere-brospinal fluids, 2 joint and 1 peritoneal fluids. The patient mean age was 35 months (median: 17 months, range: 4 months-17 years). Children less than 2 years of age represented 52.6% (62/104) of all cases. According to serotyping results, 80.6% (50/62) of the strains were included into the PCV-7. Of all strains isolated from children above 2 years, 78.6% (33/42) were included into the PCV-7 and 90.5 % into the polysaccharide vaccine. Decreased susceptibility to penicillin was found in 20.2% of all tested strains (7.7% highly resistant – MIC ≥2 mg/L) and 81.4 % of them were included into the PCV-7. Macrolide resistance was found in 37.5% of all tested strains. Combined resistance to both penicillin and macrolides was found in 16.35% of all tested strains. As already reported and shown is this retrospective study, Sp is responsible for invasive diseases in young children. However, almost half of the IPD diagnosed at Sainte-Justine hospital occurred in children above 2 years of age and are therefore largely preventable. Antimicrobial resistance of Sp concerns not only penicillin but also and more significantly the macrolides. Moreover, most of the penicillin resistant strains were included into the PCV-7. Prevention strategies based on both conjugated and polysaccharide vaccines would be useful to limit IPD and act on pneumococcal resistance.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».