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Yoshioka, Cristina Ryoka Miyao. "Estudo das pneumonias causadas por Streptococcus pneumoniae em crianças internadas na enfermaria de pediatria do Hospital Universitário da Universidade de São Paulo." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/5/5141/tde-07122009-185246/.
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Introdução: Atualmente a incidência anual de pneumonia adquirida na comunidade nos países em desenvolvimento é de 150,7 milhões de casos entre crianças menores de 5 anos de idade , dos quais 11 a 20 milhões (7-13%) necessitam de internação hospitalar devido à gravidade. O tratamento geralmente é empírico mas o Streptococcus pneumoniae é o principal agente etiológico bacteriano.É necessário manter monitoramento dos sorotipos e padrão de resistência para melhor orientação terapêutica. Metodologia: Estudo de coorte retrospectivo com inclusão de 107 crianças com diagnóstico clínico e radiológico de pneumonia e com isolamento de Streptococcus pneumoniae em sangue e ou líquido pleural no período de janeiro de 2003 a outubro de 2008. Realizado determinação de concentração inibitória mínima (MIC) para penicilina e antibiograma para outros antimicrobianos. A sensibilidade para penicilina utilizada foi conforme Clinical and Laboratory Standards Institute (CLSI ) de 2008. Realizado sorotipagem de 96 cepas de pneumococos (89,7%) e analisados os dados da população em estudo e da evolução clínica. Resultados:Cerca de 47,5% das internações na enfermaria foram por pneumonia ou broncopneumonia e a média de positividade em cultura para pneumococo (sangue e ou líquido pleural) foi de 2,5%. Houve uma sazonalidade bem definida da pneumonia pneumocócica. Cerca de 70% ocorreram nos meses de junho a outubro. A mediana de idade foi de 23 meses (82,2%<5anos); predomínio do sexo masculino (58,9%);utilização de antibioticoterapia nos dois meses prévios à internação de 23,4%; freqüência em creche no menores de 2 anos de 36,4%; apenas um caso com vacinação heptavalente completa; doença associada em 44,9% sendo a mais freqüente a sibilância( 77,1%); tempo de febre e de sintomas respiratórios antes da admissão foi de 4 dias;necessidade de oxigenoterapia não invasiva em 70,1% com tempo médio de utilização de 4 dias;necessidade de ventilação mecânica em 19,6%, mediana do tempo de internação de 9 dias.Em 62% houve complicações sendo as mais freqüentes: empiema (53%) e efusão pleural não complicada (42%). As crianças com empiema tiveram mais pneumonia necrotizante, abscesso pulmonar, sepse, pneumotórax, necessidade de decorticação e ainda maior mortalidade (todas com p<0,05). As crianças com complicações tiveram mais dias de sintomas respiratórios antes da admissão (3x5dias), mais tempo de febre após o início de antibiótico (1x4,5dias), necessitaram de oxigenoterapia não invasiva(58,5x77,3%) e ventilação mecânica (7,3x27,3%) por tempo maior e permaneceram por mais tempo internados (5x12 dias). Das 107 cepas de pneumococo, 100 (93,5%) foram sensíveis à penicilina e 7 (6,5%) de sensibilidade intermediária. Todas as cepas testadas foram sensíveis para rifampicina e vancomicina e ainda mantiveram boa sensibilidade para clindamicina, cloranfenicol, ceftriaxone, eritromicina e levofloxacina. Cinco cepas foram multiresistentes. Notou-se que a média geométrica das concentrações inibitórias mínimas (GMC) para penicilina foram maiores nas crianças com complicações. Os sorotipos mais freqüentes foram: 14(36,5%), 1(16,7%) , 5(14,6%) e 6B(6,3%). O sorotipo 14 apresentou a maior GMC para penicilina e houve um aumento progressivo no decorrer dos anos de estudo. A cobertura dos sorotipos pela vacina heptavalente seria de 53,1% e esta cobertura menor se deve principalmente ao sorotipo 1 e 5, que corresponde a 31,3% dos casos. A cobertura dos sorotipos associados à resistência seria de 94,2%. A cobertura pela vacina 10-valente seria de 86,5% e com a 13-valente seria de 96,9%. Três casos que evoluíram para óbito (2,8%) tinha mediana de idade de 18 meses, todos do sexo masculino, todos com concentração inibitória mínima para penicilina menor ou igual 1g/mL, todos evoluíram com empiema e sepse. Dois foram do sorotipo 5 e um do sorotipo 14. Conclusões: Aproximadamente 2,5% das crianças internadas com diagnóstico de pneumonia foram diagnosticadas como pneumonia pneumocócica.Verificamos uma sazonalidade bem definida.Houve complicações em 62% dos casos. As mais freqüentes foram : empiema e a efusão pleural não complicada. Evidenciou-se uma GMC para penicilina maior nas crianças com complicações comparadas às crianças com ausência de complicações. Os sorotipos mais freqüentes foram 14,1 ,5 e 6B sendo que os sorotipos 1 e 5 totalizam 31,3%. A cobertura pela vacina heptavalente dos sorotipos isolados seria de 53,1%. A sensibilidade para penicilina dos pneumococos isolados de pneumonia foi de 93,5%. Assim, a opção terapêutica continua sendo a penicilina.Introduction: Currently, the annual incidence of the acquired pneumonia in the developing country communities are around 150.7 million cases, among childrens under 5 years of age, and 11 to 20 million (7-13%) of those require hospitalization due to their gravity. In general, the treatments used to be empirical, however, it is important to be noted that Streptococcus pneumoniae is far the major bacterial etiologic agent. It is necessary to keep monitoring the serotypes and the pattern of resistance in order to improve the therapy guidance. Methodology: Retrospective cohort study with inclusion of the 107 childrens with clinical and radiological diagnosis of the pneumonia, and the isolation of Streptococcus pneumoniae in the blood and/or pleural fluid during the period of January 2003 to October 2008. It was performed determination of the minimum inhibitory concentration (MIC) related to the penicillin and other antibiotics. The sensitivity analysis to the penicillin was based on Clinical and Laboratory Standards Institute (CLSI), 2008, recommendations. They were performed serotyping in 96 pneumococcal strains (89.7%) and they were analyzed datas referred to the considered population and their clinical course. Results: About 47.5% of admissions in the ward were caused by pneumonia or bronchopneumonia, and the average positive occurrences in the pneumococcal (blood and / or pleural) culture were 2.5%. It was noted a clear seasonality phenomena of the pneumococcal pneumonia. About 70% of the cases occurred during months of June to October. The median age was 23 months (82.2%<5 years); with predominance of males (58.9%); in the 23,4% of the cases the antibiotic therapy was used during two months prior to the admission; the daycare frequency of the childs less than 2 years were 36.4%; only one case with complete vaccination heptavalent; associated disease was detected in the 44.9% of the cases and the most frequent was wheezing (77.1%); time of fever and respiratory symptoms before admission were 4 days; the need for noninvasive oxygen therapy occurred in 70.1% being 4 days of the average time of the use; the need for mechanical ventilation occurred in 19.6%; the median period of stay were 9 days. In 62% of the cases there were the most frequent complications: empyema (53%) and non-complicated pleural effusion (42%). The childrens with empyema had more necrotizing pneumonia, lung abscess, sepsis, pneumothorax, need for decortication, and even higher mortality (all with p<0.05). The childrens with complications had more days of respiratory symptoms before admission (3x5days), more time of the fever after initiation with antibiotic (1x4, 5days), they need noninvasive oxygen therapy (58,5 x77, 3%) and mechanical ventilation (7 , 3x27, 3%) for more time and remained hospitalized during longer period(5x12 days). Among 107 pneumococcal strains, 100 (93.5%) were susceptible to penicillin and 7 (6.5%) presented intermediate sensitivity. All strains tested were sensitive to rifampicin and vancomycin, and they maintained good sensitivity to clindamycin, chloramphenicol, ceftriaxone, erythromycin and levofloxacin. Five strains were multi-resistant. It was noted that the geometric mean of minimum inhibitory concentrations (GMC) to penicillin were higher in children with complications. The most frequent serotypes were: 14 (36.5%), 1 (16.7%), 5 (14.6%) and 6B (6.3%). The serotype 14 presented the highest GMC for penicillin and it was verified a progressive increase during the years of the study. The coverage of serotypes by the heptavalent vaccine would be cover 53.1% and this less coverage is represented by serotype 1 and 5, which corresponds to 31.3% of the cases. The coverage of serotypes associated with resistance would be 94.2%. The coverage of the 10-valent vaccine would be 86.5% and for 13-valent would be 96.9%. Three cases that carried to died (2.8%) had median age of 18 months, all they male, all they with minimum inhibitory concentration for penicillin <= 1g/mL, all they progressed to empyema and sepsis. Two of them were serotype 5 and one of them was serotype 14. Conclusions: Approximately 2.5% of children were admitted with diagnosis of pneumonia were diagnosed as pneumococcal pneumonia. It was verified a clear seasonality phenomena. They were observed complications in 62% of the cases. The most frequent were: empyema and non-complicated pleural effusion cases. It was confirmed a higher GMC for penicillin in children with complications compared to the children without complications. The most frequent serotypes were 14, 1, 5 and 6B and the serotypes 1 and 5 accounted 31.3%. The coverage of heptavalent vaccine for the isolated serotypes would be 53.1%. The sensitivity to the penicillin of the isolated pneumococcal was 93.5%. Therefore, the therapy option remains being the penicillin.
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Bazaz, Rohit. "The effect of Streptococcus pneumoniae pneumonia on atherosclerosis." Thesis, University of Sheffield, 2016. http://etheses.whiterose.ac.uk/16897/.
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Koppe, Uwe Moritz Eberhard. "Role of type I interferons in Streptococcus pneumoniae pneumonia." Doctoral thesis, Humboldt-Universität zu Berlin, Mathematisch-Naturwissenschaftliche Fakultät I, 2012. http://dx.doi.org/10.18452/16532.
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Streptococcus pneumoniae ist die häufigste Ursache für ambulant erworbene Pneumonien weltweit. Daher müssen die Wirts-Pathogen-Interaktionen erforscht werden, um neue Therapiestrategien zu entwickeln. In dieser Studie habe ich 1. den Typ I Interferon (IFN)-stimulierenden Signalweg des angeborenen Immunsystems in Pneumokokken-infizierten Wirtszellen sowie 2. dessen Bedeutung in der Pneumokokkenpneumonie untersucht. Humane und murine Makrophagen, aber nicht alveolare Epithelzellen, produzierten Typ I IFNs nach Infektion mit S. pneumoniae. Dieses war abhängig vom Virulenzfaktor Pneumolysin und erforderte sowohl die Phagozytose der Bakterien als auch die Ansäuerung der Endosomen. Die Induktion der Typ I IFNs wird durch einen zytosolischen Signalweg vermittelt, welcher wahrscheinlich DNA erkennt und sowohl das Adapterprotein STING als auch den Transkriptionsfaktor IRF3 aktiviert. Typ I IFNs, welche von infizierten Makrophagen gebildet wurden, regulierten die Expression von IFN-stimulierten Genen (ISGs) und Chemokinen in Makrophagen und co-kultivierten alveolaren Epithelzellen in vitro und in Mauslungen in vivo. In einem murinen Pneumoniemodell hatten die Typ I IFNs jedoch einen negativen Effekt für den Wirt. Mäuse mit einem Defekt im Typ I IFN-Rezeptor oder mit einem Knockout im Typ I und Typ II IFN-Rezeptor hatten eine signifikant geringere Bakterienlast in der Lunge und eine verminderte Reduktion der Körpertemperatur und des Körpergewichtes als wild-typ Mäuse. Diese Effekte waren nicht durch Änderungen in der Zellrekrutierung oder durch Änderungen der Zytokin-/Chemokinexpression erklärbar. Zusammenfassend lässt sich feststellen, dass Typ I IFNs durch Pneumokokken induziert werden, aber dass sie trotz einiger positiver Effekte auf die Expression von ISGs einen negativen Gesamteffekt in einem murinen Pneumoniemodell aufweisen. Ein detailliertes Verständnis der Typ I IFN-Antwort während der Pneumokokkeninfektion kann die Entwicklung neuer Therapiestrategien unterstützen.Streptococcus pneumoniae is the leading cause of community-acquired pneumonia world-wide. A detailed understanding of the host-pathogen interactions is required in order to foster the development of new therapeutic strategies. Here, I (I) characterized an innate immune recognition pathway that senses pneumococcal infection and triggers the production of type I interferons (IFNs), and (II) examined the role of type I IFNs in pneumococcal pneumonia in mice. Human and murine macrophages, but not alveolar epithelial cells, produced type I IFNs after infection with S. pneumoniae. This induction was dependent on the virulence factor pneumolysin, the phagocytosis of the bacteria, and the acidification of the endosome. Moreover, it appeared to be mediated by a cytosolic DNA-sensing pathway involving the adaptor molecule STING and the transcription factor IRF3. Type I IFNs produced by S. pneumoniae-infected macrophages positively regulated the expression of IFN-stimulated genes (ISGs) and chemokines in macrophages and co-cultured alveolar epithelial cells in vitro and in mouse lungs in vivo. However, in a murine model of pneumococcal pneumonia, type I IFN signaling was detrimental to the host defense. Mice deficient in the type I IFN signaling or double deficient in type I and type II IFN signaling had a significantly reduced bacterial load in the lung and a diminished reduction of body temperature and body weight compared to wild-type mice. The decreased susceptibility of the knockout mice was unlikely to be attributable to alterations in cell recruitment or cytokine/chemokine production. In conclusion, type I IFNs are induced during pneumococcal infection. However, despite their positive effects on the expression of some ISGs and chemokines, they negatively affect the outcome of pneumococcal pneumonia in an in vivo mouse model. Targeting the type I IFN system could potentially be an effective way in enhancing the immune response in patients with S. pneumoniae pneumonia.
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McNamee, Lynnelle Ann. "Effects of a primary influenza infection on susceptibility to a secondary Streptococcus pneumoniae infection." Diss., Montana State University, 2006. http://etd.lib.montana.edu/etd/2006/mcnamee/McNameeL1206.pdf.
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Silva, Júnior Jailton de Azevedo. "Estudo da colonização nasofaringeana por Streptococcus pneumoniae em crianças com suspeita clínica de pneumonia." reponame:Repositório Institucional da FIOCRUZ, 2011. https://www.arca.fiocruz.br/handle/icict/4220.
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Submitted by Ana Maria Fiscina Sampaio (fiscina@bahia.fiocruz.br) on 2012-07-19T21:35:50Z
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Jailton de Azevedo Silva Junior Estudo da colonização....pdf: 1101716 bytes, checksum: 049972199c76bb97406fc006c2ba9c27 (MD5)Made available in DSpace on 2012-07-19T21:35:50Z (GMT). No. of bitstreams: 1 Jailton de Azevedo Silva Junior Estudo da colonização....pdf: 1101716 bytes, checksum: 049972199c76bb97406fc006c2ba9c27 (MD5) Previous issue date: 2011
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, Bahia, Brasil
Streptococcus pneumoniae constitui um dos mais importantes patógenos bacterianos do trato respiratório, podendo causar infecções invasivas e não invasivas, levando a altas taxas de morbi-mortalidade, particularmente em crianças menores de cinco anos de idade. A bactéria ganha acesso ao hospedeiro através da colonização da nasofaringe, que representa um importante reservatório para a transmissão deste patógeno na comunidade, contribuindo para a disseminação horizontal de S. pneumoniae entre os indivíduos de uma população. No presente estudo, procuramos caracterizar o perfil de colonização nasofaringeana por S. pneumoniae em pacientes menores de cinco anos de idade com suspeita clínica de pneumonia, atendidos na Unidade de Saúde de São Marcos, Bairro de Pau da Lima, Salvador, no ano de 2009. Um total de 205 swabs foram coletados entre as crianças consideradas elegíveis para o estudo. Os isolados de S. pneumoniae foram identificados através de métodos microbiológicos clássicos e a determinação do sorogrupo/sorotipo foi realizada empregando-se a técnica de Multiplex-PCR. A sensibilidade a sete antimicrobianos foi testada através da técnica de microdiluição em caldo, sendo que os isolados com CIM para penicilina ≥ 0,125 μg/mL foram considerados não-susceptíveis. A técnica de PFGE foi realizada para 26 isolados correspondentes aos sorotipos mais frequentes e associados a não-sensibilidade à penicilina (sorotipos 14, 19F e 23F). Um total de 72 (35,1%) crianças foram diagnosticadas com pneumonia, sendo 39 (54,2%) menores de dois anos de idade. A taxa de colonização geral foi de 50,2%, não havendo diferença entre essas taxas quando se considerou o grupo de crianças confirmadas e suspeitas para pneumonia. Crianças na faixa etária de 36 a 47 meses formaram o grupo com maior risco de ter pneumonia bacteriana (OR: 3.17 [1.29-7.88]). Entre os sorotipos encontrados, o sorogrupo 6 (6A/6B) (17,3%) foi predominante, seguido dos sorotipos 14 (15,4%), 19F (10,6%), sorogrupo 15 (15B/15C) (9,6%), 23F (6,7%) e o sorotipo 19A (6,7%). Os demais sorotipos e sorogrupos compreenderam 33,7%. O padrão de sorotipos foi semelhante aqueles encontrados nos casos de meningite pneumocócica na cidade de Salvador. Um total de 41 isolados (39,8%) apresentaram CIM ≥ 0,125 μg/mL para penicilina e a resistência a SMX-TMP foi identificada em 69,2% dois isolados. A tipagem por PFGE identificou 11 padrões eletroforéticos, sendo que a maioria dos isolados do sorotipo 14 estavam relacionados a clones amplamente disseminados entre os casos de doença pneumocócica (“A” e “GK”). Um total de 50,5% dos isolados foram de sorotipos inclusos na vacina decavalente (PCV10) e considerando os isolados não-susceptíveis à penicilina, esta representatividade foi de 90,2%. O estudo ressalta a importância de um contínuo monitoramento do perfil de sorotipos na colonização nasofaringeana por S. pneumoniae, no período pós-vacina e da necessidade de busca de novos métodos de diagnóstico que otimizem a definição da pneumonia.
Streptococcus pneumoniae is one of the most important bacterial pathogens of the respiratory tract, causing invasive and noninvasive infections, leading to high rates of morbidity and mortality, particularly among children under five years old. The bacterium gains access to the host by colonizing the nasopharynx, which represents an important reservoir for transmission of this pathogen in the community, contributing to the horizontal spread of S. pneumoniae among individuals in a population. In this study, we sought to characterize the profile of nasopharyngeal colonization by S. pneumoniae in patients under five years of age with clinical suspicion of pneumonia seeking medical care at the Unidade de Saúde de São Marcos, District of Pau da Lima, Salvador, in 2009. A total of 205 swabs were collected from children eligible for the study. The isolates of S. pneumoniae were identified by classical methods and the determination of the serogroup / serotype was performed using the technique of multiplex-PCR. The sensitivity to seven antibiotics was tested by the microdilution broth method, and strains with MIC for penici≥lli n 0.125 mg/mL were considered non-susceptible. The PFGE technique was performed for 26 strains corresponding to serotypes more frequent and associated with nonsusceptibility to penicillin (serotypes 14, 19F and 23F). A total of 72 (35.1%) children were diagnosed with pneumonia, 39 (54.2%) less than two years old. The overall colonization rate was 50.2%, with no difference between those rates when considering the children's group confirmed and suspected to pneumonia. Children aged 36 to 47 months formed the group with higher risk for bacterial pneumonia (OR: 3.17 [1.29-7.88]). Among the serotypes, serogroup 6 (6A/6B) (17.3%) predominated, followed by serotypes 14 (15.4%), 19F (10.6%), serogroup 15 (15B/15C) (9.6%), 23F (6.7%) and serotype 19A (6.7%). The other serotypes and serogroups comprised 33.7%. The pattern of serotypes was similar to those found in cases of pneumococcal meningitis in Salvador. A total of 41 isolates (39.8%) had MIC ≥ 0.125 mg / mL and resistance to TMP-SMX was identified in 69.2% of isolates. Molecular typing identified 11 electrophoretic patterns, whereas most isolates of serotype 14 was associated with widespread clones among cases of pneumococcal disease ("A" and "GK"). The 10-valent conjugate vaccine (PCV10) implemented in Brazil shows a coverage of 50.5% from serotypes in the population and 90.2% for isolates not susceptible to penicillin. The study underscores the importance of continued monitoring of the prevalence of serotypes in nasopharyngeal colonization by S. pneumoniae, in the post-vaccine era, and the need to search for new methods for diagnosing pneumonia.
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Scholtz, Janet. "The serotypes and antimicrobial susceptibility patterns of streptococcus pneumoniae in the Cape Peninsula." Thesis, Cape Technikon, 2000. http://hdl.handle.net/20.500.11838/1464.
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Thesis (Masters Diploma(Technology))--Cape Technikon, Cape Town, 2000Streptococcus pneumoniae (S.pneumoniae) infections are an important cause of morbidity and mortality in adults and children worldwide. Mortality rates are highest amongst the very young and the elderly. Streptococcus pneumoniae is the most common form of community acquired bacterial pneumonia. Other diseases commonly caused by Streptococcus pneumoniae include meningitis, pericarditis, bacteraemia and septicaemia. Penicillin is today still consid3red the drug of choice when treating pneumococcal infections. The emergence of resistant pneumococcal strains has made it necessary to adapt antimicrobial regimens when treating pneumococcal infections. Hansman (1967) reported the first penicillin resistant strain, which was isolated from a woman in Australia in 1967. Since then penicillin and multi-resistant Streptococcus pneumoniae strains have been observed worldwide, including South Africa. Streptococcus pneumoniae infections may be caused by anyone of the 84 serotypes recognized to date. The distribution of serotypes varies, depending on geographical area, age and site of infection. High-level penicillin resistance and multiple resistant Streptococcus pneumoniae strains have been recognised worldwide in a few pneumococcal serotypes. Pneumococcal vaccines have been used since the seventies. These capsular polysaccharide vaccines are generally recommended for at risk population such as the elderly and immunocompromised patients. This vaccine is not effective in children under 2 years old. The current vaccine in South Africa (Pneumovax, MSD) consists of purified capsular polysaccharides of 23 pneumococcal serotypes. Conjugated polysaccharide vaccines have been developed to overcome the problems of efficacy in children < 2 years old. These vaccines consist of a capsular polysaccharide linked to a protein carrier, which makes them immunogenic in infants. Clinical trials of these vaccines are currently under way to demonstrate safety, efficacy and immunogenicity. Knowledge of serotype distribution and antimicrobial susceptibility patterns are important in relation to the treatment of pneumococcal diseases and vaccination programmes.
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Abdeldaim, Guma M. K. "PCR detection of Streptococcus pneumoniae and Haemophilus influenzae in pneumonia patients." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl.[distributör], 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-107931.
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Ekdahl, Karl. "Immunological aspects on pneumococcal infections with special reference to bacteremic pneumococcal infections and recurrent pneumonia /." Lund : Dept. of Infectious Diseases, University of Lund, 1995. http://catalog.hathitrust.org/api/volumes/oclc/39177549.html.
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Machado, Lais Del Prá Netto. "Pneumonia bacteriana adquirida na comunidade: avaliação clínico-epidemiológica e padronização de métodos moleculares para detecção de Mycoplasma pneumoniae, Haemophilus influenzae e Streptococcus pneumoniae." reponame:Repositório Institucional da UFSC, 2015. https://repositorio.ufsc.br/xmlui/handle/123456789/158899.
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Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Farmácia, Florianópolis, 2015.Made available in DSpace on 2016-02-09T03:17:04Z (GMT). No. of bitstreams: 1 336847.pdf: 2261623 bytes, checksum: 5220583fc8a657b02f17b72e42ab63bc (MD5) Previous issue date: 2015
A pneumonia pode ser causada por diversos microrganismos e classificada de forma abrangente, havendo poucos e frágeis estudos clínicos e epidemiológicos sobre pneumonias adquiridas na comunidade (PACs). Os patógenos mais frequentes nas PACs são Streptococcus pneumoniae e Haemophilus influenzae (em pneumonias típicas) e Mycoplasma pneumoniae (em pneumonias atípicas). Assim, o objetivo deste trabalho foi padronizar uma metodologia para detecção molecular dessas bactérias em amostras de orofaringe, avaliar sua prevalência e o perfil clínico-epidemiológico de pacientes com PAC em um hospital na cidade de Blumenau/SC. Para tanto, além da técnica de PCR padronizada in house, foram realizadas culturas de raspado de orofaringe e pesquisa de anticorpos específicos para detecção de M. pneumoniae. A reação de PCR realizada com os iniciadores desenhados neste estudo para M. pneumoniae apresentou sensibilidade 10x maior que a reação mais citada na literatura, e a sensibilidade das reações para S. pneumoniae e H. influenzae foi 0,1ng de DNA/reação. Dos 58 pacientes incluídos no estudo, H. influenzae e S. pneumoniae foram detectados respectivamente em 41,38% e 15,52% das amostras. M. pneumoniae não foi detectado em nenhuma amostra analisada por métodos de cultura, PCR e sorologia com anticorpos específicos IgM. Todavia não se exclui a circulação dessa bactéria na região devido à presença de anticorpos IgG específicos. A maioria dos pacientes com PAC avaliados apresentou idade =65 anos e pelo menos uma comorbidade. A maioria dos pacientes apresentou quatro ou mais sinais e sintomas, destes os mais prevalentes foram dispneia, tosse, secreção purulenta e crepitações. Evidenciou-se, neste estudo, a baixa aderência dos clínicos às Diretrizes Brasileiras para diagnóstico, estratificação e tratamento dos pacientes com suspeita de PAC, pois os exames complementares para diagnóstico e avaliação de risco dos casos e o antibiótico escolhido para grande parte dos pacientes não estava de acordo com a determinação das diretrizes. Sugere-se a replicação desta pesquisa, pois os resultados foram de encontro àqueles apresentados na literatura relacionada ao entendimento de PAC, acompanhamento dos ciclos epidêmicos de M. pneumoniae na região e conhecimento da real prevalência dos patógenos típicos, uma vez que o H. influenzae foi o patógeno mais detectado.
Abstract : Pneumonia can be caused by different microorganisms and classified through comprehensive forms, but there are few and fragile clinical and epidemiological studies of community-acquired pneumonia (CAPs). The most common pathogens in CAPs are Streptococcus pneumoniae and Haemophilus influenzae (in typical pneumonia) and Mycoplasma pneumoniae (in atypical pneumonia). Therefore, the aim of this study was to standardize a methodology for molecular detection of these bacteria in the oropharynx samples, and to evaluate their prevalence and the clinical and epidemiological profile of patients with CAP in a hospital in Blumenau/SC. Thus, besides the standard technique PCR in-house, oropharyngeal swab cultures and search for specific antibodies for detection of M. pneumoniae were performed. The PCR reaction performed with primers designed in this study for M. pneumoniae showed sensitivity greater than 10-fold the most cited in the literature reaction and the sensitivity of the reactions to S. pneumoniae and H. influenzae was 0.1 ng DNA / reaction. Out of the 58 patients included in the study, H. influenzae and S. pneumoniae were detected respectively in 41.38% and 15.52% of the samples. M. pneumoniae was not detected in any sample analyzed by culture methods, PCR and serology with IgM specific antibodies. Nevertheless it is not possible to exclude the circulation of this bacterium in the region due to the presence of specific IgG antibodies. Most CAP patients evaluated were 65 years or older and had at least one comorbidity. Most of the patients had four or more signs and symptoms, the most prevalent ones were dyspnea, cough, purulent secretion and crackles. It is evident in this study the low adherence of the practitioners to Brazilian Guidelines for the diagnosis, stratification and treatment of patients with suspected CAP, as the laboratory tests for diagnosis and case risk assessment and also the antibiotic selected for most patients were not determined according to the guidelines. Replication of this research is indicated for a better understanding of the CAP, support of epidemic cycles of M. pneumoniae in the region and knowledge of the real prevalence of the typical pathogens.
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Piroth, Lionel. "Apports d'un modèle de pneumonie expérimentale bactériémique à streptococcus pneumoniae de sensibilité diminuée à la pénicilline dans la prise en charge des pneumonies humaines." Dijon, 2001. http://www.theses.fr/2001DIJOMU02.
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Strpetococcus pneumoniae est l'un des pathogenes les plus frequemment responsables de pneumonies bacteriemiques, avec une morbidite et une mortalite consequentes. L'incidence des souches de s. Pneumoniae de sensibilite diminuee a la penicilline et a d'autres antibiotiques est en constante augmentation. Ces donnees et les problemes therapeutiques inherents soulignent l'importance d'une meilleure connaissance des relations hote-pathogene-antibiotique, que seuls les modeles experimentaux permettent d'approfondir significativement. Nous avons pu developper un modele reproductible et simple de pneumonie chez le lapin immuno-competent, par instillation endo-bronchique d'un inoculum de s. Pneumoniae resistant a la penicilline, sans utilisation d'adjuvants pro-inflammatoires. La pneumonie bacteriemique ainsi obtenue reproduit fidelement les caracteristiques observees chez l'homme, tant sur les plans clinique, radiologique, histologique que microbiologique. Nous avons pu egalement reproduire la cinetique humaine plasmatique des antibiotiques par administration continue controlee par ordinateur. Ce modele, qui permet donc d'obtenir avec des souches d'origine humaine une pneumonie bacteriemique proche de celle observee chez l'homme et de realiser un traitement antibiotique humanise, a ete utilise sur plus de 200 animaux.
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Leite, Ilaiáli Souza. "Inativação de Streptococcus pneumoniae por terapia fotodinâmica infravermelha com indocianina verde e sua interação com macrófagos RAW 264.7." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/76/76132/tde-17092015-110348/.
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As infecções do trato respiratório inferior lideram entre as principais causas de morbidade e mortalidade no mundo. Um dos grandes problemas associados ao tratamento das infecções do sistema respiratório, como as pneumonias, advém da crescente resistência aos mais modernos antibióticos adquirida pelos microrganismos. A terapia fotodinâmica, uma técnica baseada na interação da luz com uma substância fotoativa para causar dano oxidativo a células, tem se destacado como uma interessante alternativa para diversas doenças como diferentes tipos de câncer e infecções. Neste trabalho foi realizada, com experimentos in vitro, uma prova de princípio da possibilidade de inativar, com um protocolo eficiente e seguro, uma das bactérias mais comumente encontradas em quadros de pneumonia, a Streptococcus pneumoniae, com terapia fotodinâmica infravermelha mediada pela indocianina verde. Duas fontes de luz, uma a base de lasers emitindo 780 nm e outra construída com LEDs emitindo 850 nm, foram comparadas para avaliar sua eficiência. Experimentos com a bactéria foram realizados para determinação dos melhores parâmetros de inativação microbiana. Em seguida, ensaios de citotoxicidade foram feitos com macrófagos RAW 264.7 com o intuito de averiguar se as condições microbicidas não apresentavam atividade tóxica para células fagocitárias do sistema imune. Foi possível delinear os parâmetros de concentração de indocianina, tempo de incubação e dose de luz que apresentassem atividade microbicida e que não fossem tóxicas para as células. A interação da terapia fotodinâmica com a ação fagocitária dos macrófagos sobre as bactérias foi avaliada pelo estabelecimento de co-cultura dessas espécies. Concluiu-se que, utilizando-se LEDs de 850 nm fornecendo uma dose de luz de 10 J/cm2 as amostras contendo indocianina verde 5μM, é possível inativar S. pneumoniae de modo eficiente e auxiliar a ação fagocitária de macrófagos.The lower respiratory tract infections lead among the main causes of morbidity and mortality worldwide. A major problem associated with respiratory tract infections, e.g. pneumonia, stems from from the increasingly resistance to most modern antibiotics developed by microorganisms. Photodynamic therapy, a technique based on the interaction of light and a photoactive substance to cause oxidative damage to cells, has emerged as an attractive alternative for several diseases such as different kinds of cancer and infections. In this work, with in vitro experiments, we accomplished a proof of concept for the possibility of inactivating, with an efficient and secure protocol, one of the most commonly found bacteria in pneumonia cases, Streptococcus pneumoniae, with infrared photodynamic therapy mediated by indocyanine green. Two light sources, one based on 780 nm lasers and the other built with 850 nm LEDs, were compared to evaluate their efficiency. Experiments with bacteria determined the best parameters microbial inactivation. Then, cytotoxicity assays with RAW 264.7 macrophages analyzed if the microbicidal parameters had toxic effects on immune cells. It was possible to delineate the indocyanine concentration parameters, incubation time and dose of light to obtain microbicidal results that weren´t toxic to the cells. Interaction of photodynamic therapy with the phagocytic action of macrophages on the bacteria was assessed by establishing a co-culture with these species. We concluded that, using 850 nm LEDs providing a light dose of 10 J/cm2 to samples containing 5μM indocyanine green, it is possible to inactivate S. pneumoniae and efficiently assist the phagocytic action of macrophages.
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Domingues, Carla Magda Allan Santos. "Avaliação da efetividade da vacina antipneumocócica 10 valente na redução da doença pneumocócica invasiva em crianças brasileiras : estudo caso controle multicêntrico." reponame:Repositório Institucional da UnB, 2014. http://repositorio.unb.br/handle/10482/18910.
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Tese (doutorado)—Universidade de Brasília, Faculdade de Medicina, Programa de Pós-graduação em Medicina Tropical, 2014.Submitted by Fernanda Percia França (fernandafranca@bce.unb.br) on 2015-12-04T11:40:13Z No. of bitstreams: 1 2014_CarlaMagdaAllanSantosDomingues.pdf: 9749751 bytes, checksum: 674ee7ccb659f8eb05072d9d7824b080 (MD5)
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Introdução: A infecção por Streptococcus pneumoniae (pneumococo) é uma importante causa de morbi-mortalidade em todo o mundo e se constitui em uma das prioridades em saúde pública mundial. A Organização Mundial da Saúde (OMS) estima que em 2005, 1,6 milhões de mortes foram causadas por este agente; sendo que 0,7 a 1 milhão ocorrem em crianças menores de 5 anos. Neste contexto, a utilização de vacinas anti-pneumocócicas conjugadas nos programas nacionais de imunização tem um papel fundamental na prevenção das doenças causadas pelo pneumococo. O objetivo principal da tese foi avaliar a efetividade da vacina anti-pneumocócica 10 valente conjugada (PCV-10) contra doença pneumocócica invasiva no Brasil. Metodologia: estudo realizado no período de 2010 a 2012, a partir da realização de um estudo caso-controle pareado, por idade e local de residência, na proporção 1:4. A doença pneumocócica invasiva, definida como isolamento de Streptococcus pneumoniae na coleta de sangue, líquido cefalorraquidiano ou outro local normalmente estéril, foi identificada em crianças em idade elegível para receber pelo menos uma dose vacina PCV-10, por meio da vigilância laboratorial e de base hospitalar em dez Unidades Federadas, no período de 1 de Março de 2010 até 31 de Dezembro de 2012. Foi utilizada a regressão logística condicional para cálculo da efetividade da PCV-10 (1 - odds ratio ajustado) × 100%, para os sorotipos incluídos na vacina e os sorotipos relacionados à vacina, ou seja, não incluídos na vacina, porém pertencentes ao mesmo sorogrupo dos sorotipos incluídos na vacina. Resultados: Esse estudo forneceu evidências da efetividade da PCV-10, quando usada para a imunização de rotina em crianças, em um programa nacional de vacinação pública, em um país de renda média. Entre 316 casos (mediana de idade 13,2 meses, intervalo 2,6 – 53,1) e 1219 controles casos (mediana de idade 13,3 meses, intervalo 2,6 – 53,1) a efetividade ajustada para a PCV-10, em crianças com esquema vacinal atualizado para a idade da criança, de acordo com o esquema vacinal adotado pelo PNI foi 83,3% (IC 95%: 65,9 – 92,3%) contra os sorotipos incluídos na vacina e de 77•9% (IC95%: 41,0 – 91,7%) contra os sorotipos relacionados à vacina. Em relação aos sorotipos específicos, a efetividade foi demonstrada para dois sorotipos vacinais mais comuns: para o sorotipo 14 foi 87,7% (IC95%: 60,8 – 96,1%); para o 6B foi 82,8% (IC95%: 23,8 – 96,1%) e para o sorotipo 19A foi 82,2% (IC95%: 10,7 – 96,4%), sorotipo esse relacionado ao sorotipo 19F, que está incluído na vacina. Uma única dose utilizada no catch up para crianças de 12 a 23 meses foi efetiva para os sorotipos incluídos na vacina [68•0%: IC95%: 17,6 – 87,6%)]. Efetividade para os sorotipos não vacinais para a idade apropriada para receber a vacina ou para o catch up não foi estatisticamente significativa. Conclusões: a principal conclusão deste trabalho é que as PCV apresentam uma alta proteção contra os sorotipos vacinais para doença pneumocócica invasiva e que a PCV-10 também poderá contribuir na diminuição da morbimortalidade por essa enfermidade, na medida em que estas vacinas forem introduzidas de forma rotineira nos programas nacionais de imunizações, principalmente em países de média e baixa renda. Os resultados encontrados neste trabalho, juntamente com os das avaliações contínuas das duas vacinas hoje disponíveis no mercado (PCV- 10 e PCV-13), poderão apoiar a tomada de decisões das políticas de introdução de novas vacinas em países que ainda não introduziram a PCV. ___________________________________________________________________________ ABSTRACT
Introduction: Streptococcus pneumoniae (pneumococcus)’s infection is a major cause of morbidity and mortality worldwide and constitutes one of the priorities in global health. The World Health Organization (WHO) estimates that in 2005, 1.6 million deaths were caused by this agent and from this 0.7 to 1 million occur in children under 5 years. In this context, the use of pneumococcal conjugate vaccine in national immunization programs has a key role in the prevention of diseases caused by pneumococcus. The purpose of this study was to evaluate the effectiveness of pneumococcal conjugate 10 valent vaccine (PCV-10) against invasive pneumococcal disease in Brazil. Methodology: it’s a case-control study, matched by age and place of residence, in the proportion of 1:4. Invasive pneumococcal disease was defined as the isolation of Streptococcus pneumoniae in collecting blood, cerebrospinal fluid or other normally sterile site identified in children in the eligible age to receive at least one dose PCV10 vaccine, through laboratory surveillance and hospital based (1 - adjusted odds ratio) × 100% of the vaccine serotypes from ten states of Brazil from March 1, 2010 to December 31, 2012. To calculate the effectiveness of PCV-10 conditional logistic regression was used for serotypes vaccine-related and also non- vaccine related, but belonging to the same serogroup of the vaccine’s serotypes. Results: This study provided evidence of PCV10 effectiveness when used in a national public immunization program, in a middle-income country. Among 316 cases (median age 13.2 months, range 2.6 to 53.1) and 1219 controls (median age 13.3 months, range 2.6 to 53.1). The effectiveness adjusted for PCV 10 by age, in children with updated vaccine schedule according to the National Immunization Program’s immunization schedule was 83.3% (95% CI: 65.9 to 92.3%) against the vaccine’s serotypes and 77. 9% (95% CI: 41.0 to 91.7%) against the vaccine’s related serotypes. In relation to the specific serotypes, the effectiveness was demonstrated for the two most common vaccine serotypes: 87.7% (95% CI: 60.8 to 96.1%) for serotype 14; 82.8% (95% CI: 23.8 to 96.1%) for serotype 6B and 82.2% (95% CI: 10.7 to 96.4%) for serotype 19A, this last serotype related to serotype 19F, which is included in the vaccine. A single dose used in the catch up for children from 12 to 23 months of age was effective for the serotypes included in the vaccine [68 .0%: 95% CI: 17.6 to 87.6%)]. Effectiveness for non-vaccine serotypes in the appropriate age to vaccination or catch up was not statistically significant. Conclusions: The main conclusion of this work is that pneumococcal conjugate vaccines have a high protection against vaccine serotypes for invasive pneumococcal disease and may also contribute to decrease the morbidity and mortality from this disease, when introduced routinely in the national immunization programs, particularly in low and middle income countries. This finding, together with the permanent assessment of the two vaccines on the market today (PCV-10 and PCV-13), may support the policies and decision making of introducing new vaccines in countries that have not yet introduced them.
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Camargo, Dhian Renato Almeida. "Método, software e banco de dados para sorotipagem molecular de Streptococcus pneumoniae visando o monitoramento da eficácia do programa de vacinação no Brasil." s.n, 2014. https://www.arca.fiocruz.br/handle/icict/9937.
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Fundação Oswaldo Cruz. Centro de Pesquisa René Rachou. Belo Horizonte, MG, Brasil
Noventa e dois sorotipos de Streptococcus pneumoniae já foram descritos, mas a vacina pneumocócica conjugada (PCV10) introduzida no calendário básico de vacinação do Brasil, em 2010, cobre somente os mais prevalentes no país. A substituição dos sorotipos vacinais após imunização em massa é uma grande preocupação e monitorar esse fenômeno requer métodos de sorotipagem eficientes e acessíveis. A Sorotipagem clássica de pneumococos baseada em antissoros produzidos em animais é trabalhosa, restrita a poucos laboratórios de referência, e não pode tipar isolados não capsulados. Alternativamente, os métodos de sorotipagem molecular avaliam os polimorfismos dos genes do cluster cps, que codificam enzimas chave para a síntese do CPS em Streptococcus pneumoniae. Em uma abordagem apropriada, cps-RFLP, os loci cps amplificados por PCR são digeridos com uma endonuclease gerando perfis únicos à eletroforese em gel de agarose, permitindo assim a identificação do sorotipo. Neste trabalho, nós combinamos abordagens in silico e in vitro para demonstrar que XhoII é a endonuclease mais discriminante para o método cps-RFLP, e para construir um banco de dados de perfis sorotipo-específico que acomodou a diversidade genética do lócus cps de 91 conhecidos sorotipos de pneumococos. O banco de dados de perfis cps-RFLP foi integrado ao Molecular Serotyping Tool (MST), software anteriormente publicado baseado em web-based para sorotipagem molecular. Usando XhoII, o método cps-RFLP obteve especificidade de 84,6% para sorotipagem e 100 % para sorogrupagem de pneumococos. Esta nova ferramenta pode representar uma colaboração relevante para vigilância epidemiológica em tempo real da diversidade de pneumococos em resposta a programas de imunização em massa.
Ninety-two Streptococcus pneumoniae serotypes have been described, but the pneumococcal conjugate vaccine (PCV10) introduced in the Brazilian basic vaccination schedule, in 2010, covers only the most prevalent in the country. Pneumococcal serotype-shifting after massive immunization is a major concern and monitoring this phenomenon requires efficient and accessible serotyping methods. Classical pneumococcal serotyping based on antisera produced in animals is laborious, restricted to a few reference laboratories, and cannot type non-capsulated isolates. Alternatively, molecular serotyping methods assess the polymorphisms in the cps gene cluster, which encodes key enzymes for CPS synthesis in Streptococcus pneumoniae. In one such approach, cps-RFLP, the PCR amplified cps loci are digested with an endonuclease, generating unique fingerprints on agarose gel electrophoresis, therefore allowing serotype identification. In this work, we combined in silico and in vitro approaches to demonstrate that XhoII is the most discriminating endonuclease for cps-RFLP, and to build a database of serotype-specific fingerprints that accommodates the genetic diversity within the cps locus of 91 known pneumococci serotypes. The database of cps-RFLP fingerprints was integrated to Molecular Serotyping Tool (MST), our previously published web-based software for molecular serotyping. Using XhoII, the cps-RFLP method achieved 84.6% specificity for serotyping and 100% for serogrouping of pneumococci. This new tool may represent a relevant aid to real time epidemiological surveillance of pneumococci diversity in response to mass immunization programs.
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Oliveira, Nayara Santos de. "Streptococcus pneumoniae: sensibilidade a antimicrobianos e detecção de genes de resistência em isolados de crianças com pneumonia adquirida na comunidade em Fortaleza, Ceará." reponame:Repositório Institucional da UFC, 2013. http://www.repositorio.ufc.br/handle/riufc/17898.
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OLIVEIRA, N. S. Streptococcus pneumoniae: sensibilidade a antimicrobianos e detecção de genes de resistência em isolados de crianças com pneumonia adquirida na comunidade em Fortaleza, Ceará. 2013. 83 f. Dissertação (Mestrado em Microbiologia Médica) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2013.Submitted by Erika Fernandes (erikaleitefernandes@gmail.com) on 2016-06-23T12:51:16Z No. of bitstreams: 1 2013_dis_nsoliveira.pdf: 1681873 bytes, checksum: c62b8c7f03d7d8081b4975a923cd4dae (MD5)
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Acute respiratory infection (ARI) is a clinical syndrome, in which about 80% of deaths attributed to pneumonia, a serious disease that affects the lower respiratory tract. The common etiologic agent in community-acquired pneumonia (CAP) is Streptococcus pneumoniae (S. pneumoniae). Pneumococcal diseases begin with colonization of S. pneumoniae in the nasopharynx and may progress to invasive disease. In recent decades, the increasing number of strains of S. pneumoniae resistant to β-lactam antibiotics and macrolides has hindered the treatment of pneumococcal infections. The objectives of this study were to determine the prevalence of carriers of S. pneumoniae in children with CAP, the sensitivity profile to antibiotics and serotype distribution in Fortaleza, Brazil. The strains of S. pneumoniae were isolated from nasopharyngeal aspirates of children with CAP treated at Children's Hospital Albert Sabin (HIAS). For the determination of minimum inhibitory concentration (MIC) was used the E-test method for the following antibiotics: penicillin, ceftriaxone, sulfamethoxazole / trimethoprim, amoxicillin, clindamycin and erythromycin. Genotyping of strains of S. pneumoniae was performed by multiplex PCR technique. 527 samples of children with CAP were isolated S. pneumoniae in 30.17%. 126 isolates from patients found a resistance rate of 25.8% for penicillin, 81.2% to sulfamethoxazole / trimethoprim, from 21.4% to erythromycin, 19% to clindamycin and 0.8% for ceftriaxone and amoxicillin. Of the 102 genotyped strains, the most commonly found serotypes were 6A / 6B, followed by 14, 19A and 19F. They selected 29 strains resistant to penicillin for detection of protein modifications penicillin binding (PBP). Found change in PBP 1a in 69%, while for the PBP 2b and PBP 2x all tested strains showed change. As for clindamycin and erythromycin were selected 24 strains for the detection of gene ermB. Of the 24 strains tested, 79.2% had ermB gene. This study generated data on the prevalence of children with CAP S. pneumoniae revealed phenotypic and genotypic data on the resistance of the isolated front to antimicrobials used in clinical and distribution of serotypes of pneumococcus in children with CAP treated at HIAS.
A infecção respiratória aguda (IRA) é uma síndrome clínica, em que cerca de 80% das mortes são atribuídas à pneumonia, uma doença grave que atinge o trato respiratório inferior. O agente etiológico comumente isolado na pneumonia adquirida na comunidade (PAC) é o Streptococcus pneumoniae (S. pneumoniae). As doenças pneumocócicas começam com a colonização do S. pneumoniae na nasofaringe, podendo progredir para doença invasiva. Nas últimas décadas, o aumento do número de cepas de S. pneumoniae resistentes a antibióticos β-lactâmicos e a macrolídeos tem dificultado o tratamento das infecções pneumocócicas. Os objetivos desse estudo foram determinar à prevalência de portadores de S. pneumoniae em crianças com PAC, o perfil de sensibilidade a antimicrobianos e distribuição dos sorotipos, em Fortaleza, Brasil. As cepas de S. pneumoniae foram isoladas de aspirados de nasofaringe de crianças com PAC atendidas no Hospital Infantil Albert Sabin (HIAS). Para a determinação das Concentrações Inibitórias Mínimas (CIM) foi utilizado o método de E-test para os seguintes antimicrobianos: penicilina, ceftriaxona, sulfametoxazol/trimetoprim, amoxicilina, clindamicina e eritromicina. A genotipagem das cepas de S. pneumoniae foi realizada pela técnica de multiplex PCR. De 527 amostras de crianças com PAC, foram isolados S. pneumoniae em 30,17%. De 126 isolados de portadores foi encontrada uma taxa resistência de 25,8% para penicilina, de 81,2% para sulfametoxazol/trimetoprim, de 21,4% para eritromicina, de 19% para clindamicina e de 0,8% para ceftriaxona e amoxicilina. Das 102 cepas genotipadas, os sorotipos mais comumente encontrados foram 6A/6B, seguido do 14, 19A e 19F. Foram selecionadas 29 cepas resistentes à penicilina para detecção das alterações proteínas de ligação a penicilina (PBP). Foi encontrada alteração na PBP 1a em 69%, já para as PBP 2b e PBP 2x todas as cepas testadas apresentaram alteração. Já para clindamicina e eritromicina, foram selecionados 24 cepas para detecção do gene ermB. Das 24 cepas testadas, 79,2% possuíam o gene ermB. O presente trabalho gerou dados sobre a prevalência de crianças portadoras com PAC de S. pneumoniae, revelou dados fenotípicos e genotípicos acerca da resistência dos isolados frente aos antimicrobianos utilizados na clínica e a distribuição dos sorotipos do pneumococo de crianças com PAC atendidas no HIAS.
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Parameswar, Archana R. "Towards development of a fully synthetic conjugate vaccine investigation of structural analogs of Streptococcus pneumoniae serogroup 6 /." Diss., St. Louis, Mo. : University of Missouri--St. Louis, 2008. http://etd.umsl.edu/r3161.
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Bracht, Dagmar. "Proteomanalyse von Streptococcus pneumoniae." [S.l.] : [s.n.], 2005. http://deposit.ddb.de/cgi-bin/dokserv?idn=977729931.
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Bedos, Jean-Pierre. "Evaluation pharmacodynamique de l'activite des fluoroquinolones dans des modeles murins de pneumonies experimentales a streptococcus pneumoniae." Paris 7, 1997. http://www.theses.fr/1997PA077175.
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Streptococcus pneumoniae est la bacterie principale des pneumonies communautaires. L'apparition de souches resistantes en particulier aux betalactamines souleve le probleme d'alternatives therapeutiques. Notre but a ete de fournir des donnees experimentales rationnelles, comparatives et explicatives de l'activite des nouvelles fluoroquinolones dans le traitement d'infection pulmonaire a s. Pneumoniae sensibles ou de moindre sensibilite a la penicilline. Le choix de modeles de pneumonies murines reproductibles a permis en jouant sur la virulence des souches de pneumocoques, la nature genetique et les defenses de l'hote d'aboutir a differentes maladies experimentales. Cette approche nous a amenes aux conclusions suivantes : 1) les nouvelles fluoroquinolones (temafloxacine, sparfloxacine, trovafloxacine) demontrent in vivo une activite anti-pneumococcique tres nettement superieure a celle de leurs predecesseurs (ofloxacine, ciprofloxacine) ; 2) l'infection modifie de facon plus ou moins importante la cinetique de distribution et d'elimination des fluoroquinolones ; 3) l'activite des fluoroquinolones s'exerce sur les pneumocoques penicillino-resistants et multiresistants ; 4) les donnees microbiologiques in vitro ne sont pas toujours suffisantes pour predire les resultats observes in vivo ; 6) en revanche, les donnees pharmacodynamiques sont largement predictives de l'activite observee in vivo. Ces resultats peuvent aider au choix de la fluoroquinolone et de son meilleur mode d'administration dans le cadre d'une pneumonie a s. Pneumoniae.
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Magdelaine, François. "Etude de l'activité bactéricide de cinq associations d'antibiotiques sur cinq souches de "S. Pneumoniae" en vue d'une application thérapeutique dans le traitement des méningites à pneumocoque résistant à la péniciline G." Paris 5, 1993. http://www.theses.fr/1993PA05P061.
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Burman, Lars Å. "Streptococcus pneumoniae : epidemiological, clinical and serological studies." Doctoral thesis, Umeå universitet, Infektionssjukdomar, 1993. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-102563.
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A retrospective study of invasive pneumococcal disease in patients from Greater Göteborg in 1964- 1980 identified 125 cases of meningitis, 305 of pneumonia, 61 of septicemia with unknown focus, and 17 with other manifestations, all verified by cultures from normally sterile body fluids. The incidence was several times higher in infants and in the elderly than in any other age-group. A wide variety of underlying conditions were present in 23% of the infants, 34% of the children, and 81% of the adults. In adults alcoholism was known in one third of the cases. The case fatality rate was 24% among patients with underlying conditions and 9% among previously healthy individuals. The case fatality rate was 50% in patients with hospital-acquired infection. Twohundred-fifteen pneumococcal strains, isolated from blood or CSF from 1971 to 1983 at the laboratories of clinical bacteriology of Göteborg, Malmö, and Umeå were serotyped by coagglutination (COA). Of all isolates, 89% belonged to serotypes represented in the 23-valent vaccine. In a separate study COA was compared with counterimmunoelectrophoresis (CIE). COA was found to have several advantages; rapidity, lower cost, and ability to disclose serotypes with neutral charge, which constituted 19% of all strains. In a prospective study the etiology was determined in 196 hospitalized patients with pneumonia, most of them community-acquired. Culture of specimens from blood, transtracheal aspirate (TTA), sputum, and nasopharynx, assays of antigen in sputum, urine, and TTA, and assays of pneumococcal antibodies to capsular polysaccharide, C-polysaccharide, and pneumolysin in paired sera were performed. The etiology was established in 64% of the patients. Streptococcus pneumoniae was the most common agent (32%). In a serological study of patients with pneumococcal infection, diagnosed by culture of CSF, TTA, or blood, IgG antibodies against C-polysaccharide and pneumolysin were determined by ELISA. The diagnostic sensitivity was only 51% and 60%, respectively. In conclusion, invasive pneumococcal disease is strongly overrepresented at tender and high age and in patients with concomitant conditions, notably alcoholism. S. pneumoniae remains a predominant causative agent of community-acquired pneumonia in adults needing hospitalization. Due to the low sensitivity and/or specificity of individual microbiological techniques, a combined use of several techniques is necessary when trying to assess the relative importance of pneumococci and other agents in pneumonia. Extended use of the currently available pneumococcal vaccine and development of improved pneumococcal vaccines seem highly warranted.Diss. (sammanfattning) Umeå : Umeå universitet, 1993, härtill 5 uppsatser.
digitalisering@umu.se
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Champagne, Marie-Eve. "Ré-infections avec Streptococcus pneumoniae : effet sur les réponses immunes innée et acquise lors d'une pneumonie à pneumocoque." Master's thesis, Université Laval, 2007. http://hdl.handle.net/20.500.11794/19368.
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Webb, Silky Fanyelle. "Hospitalizations associated with pneumococcal infection within the Medicare population among vaccinated and non-vaccinated patients." [Tampa, Fla.] : University of South Florida, 2007. http://purl.fcla.edu/usf/dc/et/SFE0002032.
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Fillion, Isabelle. "La cinétique des chimiokines et rôle de MCP-1 lors d'une pneumonie à Streptococcus pneumoniae." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0020/MQ55852.pdf.
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Vallée, Éric. "Streptococcus pneumoniae et fluoroquinolones : évaluation de l'activité antipneumococcique dans la pneumonie expérimentle de la souris." Université de Paris-Sud. Faculté de pharmacie (Châtenay-Malabry, Hauts-de-Seine), 1992. http://www.theses.fr/1992PA114821.
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Koo, Kun, and 古軍. "Vancomycin tolerance in streptococcus pneumoniae." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B31970588.
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Wyres, Kelly L. "Genome evolution in Streptococcus pneumoniae." Thesis, University of Oxford, 2012. http://ora.ox.ac.uk/objects/uuid:985b1fc6-c1a9-41b3-a20a-1735329d962b.
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Streptococcus pneumoniae (the pneumococcus) is a bacterial pathogen responsible for >1.6 million annual deaths globally. Pneumococcal penicillin-resistance is conferred by acquisition of ‘altered’ penicillin-binding protein (pbp) genes. The first penicillin-nonsusceptible pneumococci were identified in the late 1960s. Global pneumococcal penicillin-nonsusceptibility rates rapidly increased in the 1980s/90s. Since 2000, protein-conjugate vaccines, targeting 7, 10 or 13 of the ≥94 different pneumococcal capsule types (serotypes), have been introduced in many countries. Following vaccine implementation there has been a decline in vaccine-type pneumococcal disease and an increase in non-vaccine-type disease. These epidemiological changes result from “serotype replacement” and/or “serotype switching”. The former describes the expansion of non-vaccine-type clones in the absence of vaccine-type pneumococci. The latter describes serotype change following recombination at the capsule polysaccharide synthesis (cps) locus. To fully understand how pneumococci respond to vaccine- and antibiotic-induced selective pressures, we must better understand the evolutionary history of this pathogen. This thesis describes the study of a global collection of 426 pneumococci, dated 1937 - 2007. Serotype, genotype and penicillin-susceptibility data were collected. Nucleotide sequences of three pbp genes (for 389 isolates) and whole-genome sequences (for 96 isolates) were also generated. The data demonstrated the long-term persistence of certain clones within pneumococcal populations, and that pbp and large-fragment (>30 kb) cps ± pbp recombination was occurring prior to both widespread antibiotic use and vaccine implementation. The data highlighted the promiscuous nature of the globally-distributed PMEN1 clone and its contribution to the spread of pneumococcal penicillin-resistance. PMEN1 also donated multiple, large regions (1.7 - 32.3 kb) of its genome to at least two un-related clones. Finally, six “Tn916-like” genetic elements, conferring resistance to non-penicillin antibiotics, were newly identified. These included two of the oldest ever described. These results provided a unique insight into the history of pneumococcal evolution and the importance of genetic recombination.
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Rudmann, Emily. "Parsing the Streptococcus pneumoniae virulome." Thesis, Boston College, 2020. http://hdl.handle.net/2345/bc-ir:108795.
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Thesis advisor: Tim van OpijnenStreptococcus pneumoniae is a prominent gram-positive commensal and opportunistic pathogen which possesses a large pan-genome. Significant strain-to-strain variability in genomic content drives the use of varied pathways to perform similar processes between strains. Considering this variation, we employ a set of 36 strains, representative of 78% of total pan-genome diversity, with which to perform functional studies. We previously determined the set of genes required by 22 of the 36 strains to maintain successful infection in a host, or the virulome. In this work, we sought to parse from the virulome the genes required specifically for nasopharyngeal adhesion, a crucial step in S. pneumoniae colonization and transmission, and often a precursor to invasive disease, as well as gene requirements for subversion of the macrophage. We performed in vitro attachment Tn-seq in the 22 strains to D562 human nasopharyngeal epithelial cells, identifying thirteen factors that exhibit requirements for adhesion, and preliminarily validated a proposed universal requirement for survival of the macrophage by a killing assay using J774A.1 murine migratory macrophages
Thesis (BS) — Boston College, 2020
Submitted to: Boston College. College of Arts and Sciences
Discipline: A&S Honors
Discipline: Biology
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Koo, Kun. "Vancomycin tolerance in streptococcus pneumoniae." Hong Kong : University of Hong Kong, 2002. http://sunzi.lib.hku.hk/hkuto/record.jsp?B25139216.
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Alghofaili, Fayez Abdullah. "Streptococcus pneumoniae-stress hormone interactions." Thesis, University of Leicester, 2018. http://hdl.handle.net/2381/41267.
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Streptococcus pneumoniae is one of the most important bacterial pathogens of humans causing a wide range of mild to life-threating diseases. It is also a commensal microorganism in the nasopharynx of up to 60% of people. Fundamental aspects of its ability for transition from colonisation to an infectious state as well as how bacterial-host interactions influence this process are largely unknown. In the field of microbial endocrinology, it has been well established in mainly Gram-negative bacteria that stress hormones such as norepinephrine epinephrine and dopamine play an essential role in determining the outcome of bacterial infections. This study successfully established the conditions to investigate S. pneumoniae-stress hormone interactions using modified serum-SAPI media. 13 mutants lacking two-component regulatory system and 4 two-component system fusion reporter strains were created, and examined for their role in S. pneumoniae-stress hormone interactions. This study demonstrated that S. pneumoniae is stress hormone responsive and has mechanisms to recognise and process host stress hormones by a transferrin-iron delivery mechanism, which evidence suggests might be mediated via the TCS09 system since hormone-induced growth and radiolabelled norepinephrine and Fe uptake were reduced in a ΔTCS09 mutant. In addition, the pneumococcal response to stress hormone exposure resulted in a change in cell-cell association from chains into diplococci and cell morphology by reducing cell size and the capsule. Furthermore, the pneumococcal exposure to norepinephrine also increased biofilm formation and significantly altered metabolism. The analysis of in vivo experiments indicated that a stress hormone encounter might trigger translocation from the nasopharynx into the lungs, which may enhance S. pneumoniae in its transition from commensal to pathogen. Therefore, the pneumococcal ability to respond to host stress signals may be key to its capacity to cause life-threatening pneumonia, septicaemia and meningitis.
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Silva, Sandra Rodrigues da. "Análise do impacto na redução de pneumonia adquirida na comunidade em crianças após a introdução da vacina antipneumocócica 10-valente no Programa Nacional de Imunização." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/17/17139/tde-30062015-155505/.
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O Streptococcus pneumoniae (pneumococo) constitui um dos mais importantes patógenos bacterianos do trato respiratório, podendo causar infecções invasivas e não invasivas, levando a altas taxas de morbimortalidade, particularmente em crianças menores de cinco anos de idade. A bactéria ganha acesso ao hospedeiro através da colonização da nasofaringe, que representa um importante reservatório para a transmissão deste patógeno na comunidade, contribuindo para a disseminação horizontal de pneumococo entre os indivíduos de uma população. As doenças respiratórias causadas por pneumococo constituem em uma das prioridades atuais em Saúde Pública, recebendo atenção destacada das organizações internacionais da área da saúde, como a Organização Mundial da Saúde. No presente trabalho procura-se conhecer e avaliar a ocorrência da pneumonia adquirida na comunidade (PAC) antes e após a implantação no Calendário Vacinal da Vacina Pneumocócica-10 Valente Conjugada em 2010, na área de abrangência da Superintendência Regional de Saúde (SRS) de Alfenas/MG. Foi realizado um estudo ecológico com componente temporal que incluiu registros de crianças menores que um ano de idade, vacinadas e não vacinadas com a vacina antipneumocócica 10-valente conjugada, no período pré e pós inclusão da vacina no PNI nos municípios da Superintendência Regional de Saúde (SRS) de Alfenas/MG, sendo a vacinação o fator de exposição e a ocorrência de PAC o desfecho, utilizando dados anuais secundários por município para cálculo da cobertura vacinal e das taxas de morbidade por pneumonia em menores de um ano no período de 2007 a 2013. Considerando se os 26 municípios da SRS de Alfenas, houve redução significativa do número de casos de PAC em crianças abaixo de um ano de idade, cuja Razão de Prevalência foi de 0,81 (IC95%: 0,74 0,89; p<0,05). Mesmo com um tempo reduzido de uso, a vacina pneumocócica conjugada 10 valente apresentou um impacto relevante na redução de PAC em crianças, ajustada por cobertura vacinal no período pós vacinação (2011-2013), sendo estatisticamente significativa na maioria dos municípios, o que sugere a efetividade da vacina PCV-10 na prevenção de casos da doença em crianças menores de um ano de idade.The Streptococcus pneumoniae (pneumococcus) is one of the most important bacterial pathogens of the respiratory tract, may cause invasive and non-invasive infections, leading to high morbidity and mortality rates, particularly in children under five years of age. The bacteria gain access to the host through the nasopharyngeal colonization, which is an important reservoir for the transmission of this pathogen in the community, contributing to the horizontal spread among individuals in a population. Respiratory diseases caused by pneumococcus are in one of the current priorities in Public Health, receiving outstanding attention of international organizations in the health field, such as the World Health Organization. In the present study we aimed to understand and evaluate the occurrence of community acquired pneumonia (CAP) before and after implantation in 10- valent pneumococcal conjugate vaccine in 2010, on the coverage area of the Regional Health Service (SRS) of Alfenas / MG. An ecological study with temporal component was conducted which included records of children under one year old, vaccinated and not vaccinated with 10-valent pneumococcal conjugate vaccine, before and after period inclusion of the vaccine in PNI, in the municipalities of SRS of Alfenas / MG, with vaccination the exposure factor and the occurrence of CAP the outcome, using annual data side by municipality to calculate vaccination coverage and pneumonia morbidity in children under one year old, in the period 2007 to 2013. Considering the 26 municipalities of SRS Alfenas, there was a significant reduction in the number of CAP cases in children under one year old. The prevalence ratio was 0.81 (95%CI: 0.74 - 0.89; p<0.05). Even with a short period of use, the 10-valent pneumococcal conjugate vaccine had a significant impact on the reduction of CAP in children, adjusted for immunization coverage in the post vaccination period (2011-2013) and was statistically significant in most municipalities, which suggests the effectiveness of PCV-10 vaccine in preventing cases of the disease in children under one year of age.
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Shriner, Anne K. "Analysis of the Human Variable Gene Repertoire in Response to Pneumococcal Polysaccharides." University of Toledo Health Science Campus / OhioLINK, 2006. http://rave.ohiolink.edu/etdc/view?acc_num=mco1174573682.
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Martins, João Paulo. "Estratégias para otimizar o acesso à vacina pneumocócica polissacarídica 23-valente junto à população de adultos com indicação clínica no SUS." Botucatu, 2019. http://hdl.handle.net/11449/183280.
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Orientador: Edison Iglesias de Oliveira VidalResumo: Introdução: O Streptococcus Pneumoniae é o agente infeccioso mais frequentemente associado à ocorrência de pneumonia bacteriana e a vacinação é considerada a principal estratégia para a prevenção dessa doença. De acordo com o Programa Nacional de Imunização (PNI) a vacina pneumocócica polissacarídica 23-valente (Pn23) não faz parte do calendário básico de vacinação e deve ser dispensada a indivíduos a partir de 2 anos de idade desde que portadores de um conjunto de doenças e condições de alto risco para infecções pneumocócicas. A forma de operacionalização atual do PNI em relação à Pn23 se dá de modo que essa vacina não se encontra disponível nas Unidades Básicas de Saúde (UBS) e sua liberação se dá mediante solicitação aos Centros de Referência em Imunobiológicos Especiais (CRIEs), através de uma ficha de Solicitação de Imunobiológicos Especiais (SIBE). Acredita-se que tal formatação da logística de dispensação da vacina constitui um elemento limitador do acesso da população adulta à mesma. O objetivo da presente pesquisa foi avaliar a efetividade de uma intervenção piloto no município de Jahu de caráter multifatorial sobre a frequência de dispensação da Pn23 para a população adulta com indicação clínica conforme definida pelo PNI. Métodos: A intervenção foi composta por um componente caracterizado pela descentralização do fluxo de dispensação da vacina, de modo que esta passasse a estar disponível diretamente nas UBS, como é feito com as demais vacinas do calendário básico ... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Introduction: Streptococcus Pneumoniae is the infectious agent most commonly associated with bacterial pneumonia and vaccination against it is considered the main strategy to prevent its occurrence. According to the Brazilian National Immunization Program (NIP) the 23-valent pneumococcal polysaccharide vaccine (Pn23) is not part of the country’s basic vaccination program and is recommended only for individuals aged 2 years and older who suffer from a variety of high-risk diseases and conditions for pneumococcal infections. The current operationalization of the NIP regarding the Pn23 vaccine determines that that vaccine is not available at Primary Healthcare Units (PHU) and that its distribution to those units is conditional to the receipt of a special vaccine request form by the regional Reference Centers for Special Immunobiologic Products (RCSIP). We believed that such centralized system of distribution of the Pn23 vaccine constituted a barrier for the eligible adult population to have access the vaccine. The aim of the present study was to assess the effectiveness of a multifactorial intervention on the frequency of use of the Pn23 vaccine among adults of the municipality of Jahu with a clinical indication for the vaccine according to the NIP. Methods: The intervention consisted of the decentralization of the Pn23 vaccine distribution so that doses of that vaccine were made available at each PHU as if it were part of the country’s basic vaccination program. Additionally, t... (Complete abstract click electronic access below)
Mestre
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Owugha, J. T. "New vaccines against pneumonia : investigating protein-specific immune responses to Streptococcus pneumoniae using Experimental Human Pneumococcal Carriage." Thesis, University of Liverpool, 2017. http://livrepository.liverpool.ac.uk/3012998/.
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Infections caused by Streptococcus pneumoniae are a major cause of morbidity and mortality globally: S. pneumoniae is the primary bacterial agent of pneumonia, the leading cause of death in children under 5 years of age and a major cause of invasive disease in the elderly. Currently licensed vaccination strategies target pneumococcal capsular polysaccharides of which there are 94 known types (serotypes). Antibodies against vaccine serotypes effectively protect against invasive pneumococcal disease, but less so against mucosal infections including pneumonia. New vaccine development efforts aim to overcome these hurdles by targeting conserved and immunogenic pneumococcal proteins. The Pneumococcal Surface Protein A (PspA) is a leading candidate due to its expression across all known clinically relevant pneumococcal strains, and ability to protect against infection across serotypes. However, PspA sequence heterogeneity necessitates identification of cross-protective protein constructs. In this doctoral research project, I investigated pneumococcal protein-specific humoral and CD4+ T-lymphocyte immune responses to S. pneumoniae utilising the platform of Experimental Human Pneumococcal Carriage (EHPC). With an emphasis on PspA, immune responses to nasopharyngeal carriage - the prerequisite to pneumococcal disease and proxy for infection - were evaluated. I present the first evidence of CD4+ T-cell responses specific to an individual pneumococcal purified protein in the blood of healthy adults both before and after carriage. PspA-specific CD4+ T-cell responses to S. pneumoniae in bronchoalveolar lavage of healthy adults after EHPC were detected at lower levels than in blood, indicating non-immunodominance of PspA as a T-cell antigen in the lung, and compartmentalisation of immune response. I also describe from preliminary data, a potential role of PspA in protection from pneumococcal carriage re- acquisition, and optimise an assay for the identification of linear pneumococcal protein epitopes with potential for inclusion in a multiple epitope protein. Unveiling protein-specific immune responses to S.pneumoniae using controlled and reproducible EHPC, may aid in our understanding of immunity towards selection of protein vaccine candidates for protection against human pneumococcal infection and disease.
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Skull, Susan. "Effectiveness of influenza and pneumococcal vaccination against hospitalisation for community-acquired pneumonia among persons >65 years /." Connect to thesis, 2007. http://repository.unimelb.edu.au/10187/1998.
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Although there are well-documented benefits from influenza vaccine and 23-valent pneumococcal polysaccharide vaccine (23vPPV) against invasive pneumococcal disease and laboratory confirmed influenza, their effectiveness against pneumonia remains controversial for community-based persons aged >=65years. At the time of this research, within Australia, only the government of Victoria publicly funded these vaccines for elderly persons. With continued growth of the elderly population, the subsequent adoption of an Australia-wide program, and increasing uptake of similar programs in other countries, there is a need for data clarifying the impact of vaccination on pneumonia. This research estimates incremental vaccine effectiveness of 23vPPV over and above influenza vaccine against hospitalisation with community-acquired pneumonia (CAP) in the elderly.
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Le, Thomas Isabelle. "Histoire naturelle de la colonisation nasopharyngée par Streptococcus pneumoniae chez l'enfant vivant en crèche fermée." Paris 5, 1998. http://www.theses.fr/1998PA05P205.
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Floc'h, Erwan. "Contribution à l'étude de l'épidémiologie de Streptococcus pneumoniae résistant aux bêta-lactamines." Paris 5, 1998. http://www.theses.fr/1998PA05P010.
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Pratt, Stephanie Ann. "Immunoglobulin A1 protease of Streptococcus pneumoniae." Thesis, University of Leicester, 1988. http://hdl.handle.net/2381/35410.
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The aim of this project was to examine the Streptococcal IgA1 proteases, with particular interest on the Streptococcus pneumoniae enzyme. IgA1 protease of S. pneumoniae was identified and characterised. A non-reducing polyacrylamide gel system was employed to screen clinical isolates for IgA1 protease activity. Of 187 isolates tested 18% were found to be IgA1 protease negative, there was no correlation with the site of isolation of the organism and its ability to produce the enzyme. Attempts were made to clone the pneumococcal IgA1 protease gene using the cosmid pEMBLcos4, the plasmid vector pLG339 and the ? replacement vector ?EMB4. Libraries were screened for pneumolysin and IgA1 protease activity. Clones that expressed pneumolysin were identified by overlaying with sheep red blood cells. One haemolytic clone was not inhibited in the presence of cholesterol. Screening for IgA1 protease activity identified clones with IgA1 protease-ike activity but this activity was not stably expressed. Closer analysis of the libraries suggested that pneumococcal DNA was highly unstable when cloned into E. coil plasmid and cosmid vectors.
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Ho, Pak-leung, and 何柏良. "Emerging antimicrobial resistance in Streptococcus pneumoniae." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B41290999.
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Ibrahim, Yasser Musa. "Stress response proteins in Streptococcus pneumoniae." Thesis, University of Glasgow, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.412962.
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Ouennane, Siham. "Interactions phage-hôte chez Streptococcus pneumoniae." Doctoral thesis, Université Laval, 2017. http://hdl.handle.net/20.500.11794/27790.
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Streptococcus pneumoniae est une bactérie à la fois commensale et pathogène opportuniste chez l’humain. Elle est responsable de nombreuses infections telles que la pneumonie, la méningite, l’otite moyenne et la sinusite. En maladie infectieuse, S. pneumoniae occupe une place importante en tant que l’une des principales causes de morbidité et de mortalité dans le monde. Elle est dotée de plusieurs capacités fascinantes, comme la compétence naturelle pour l’aider à résister aux antibiotiques et la grande diversité des sérotypes capsulaires pour contourner la vaccination. Puisque la résistance aux antibiotiques ne cesse de menacer l’efficacité des thérapies standards, la thérapie par phage est maintenant reconsidérée comme une des alternatives thérapeutiques. La réévaluation des phages fait renaitre l’espoir thérapeutique, mais sans élucider leur mécanisme d’interaction et décortiquer leur mystère cet espoir restera modeste. Ce projet de doctorat consiste à mieux comprendre les phages infectant S. pneumoniae et les interactions phage-hôte. Dans un premier temps, le potentiel des pneumophages à infecter Streptococcus mitis, une espèce phylogénétiquement proche de S. pneumoniae, a été mis en évidence. Deux pneumophages se sont avérés les premiers phages virulents capables d’infecter S. mitis, bactérie pathogène responsable d’endocardite. Les deux phages pouvaient non seulement se répliquer dans S. mitis mais également produisent des plages de lyses plus visibles. Ensuite, la comparaison du génome des phages a confirmé que le changement de l’hôte n’induit aucune variation aux génomes des phages testés. Cependant, plusieurs mutations ont été observées dans la séquence génomique du podophage sauvage et il a fait ensuite l’objet d’une nouvelle annotation. Dans un deuxième temps, l’étude des interactions phage-hôte chez S. pneumoniae a été approfondie. Pour ce faire, l’implication de plusieurs facteurs de l’hôte dans la réplication des pneumophages a été étudiée. Plusieurs gènes pneumococciques se sont avérés nécessaires ou impliqués pour assurer l'efficacité de la réplication des phages seuls ou en cocktail. D’un autre côté, en étudiant ces facteurs de l’hôte, des gènes/ protéines potentiellement essentiels à la viabilité de S. pneumoniae ont été identifiés. Cette étude a aussi permis d’identifier de nouvelles cibles thérapeutiques et donne un nouvel aperçu du réseau complexe des interactions phage-hôte.Streptococcus pneumoniae is a commensal and opportunistic pathogen bacterium, exclusively found in humans. It is the main agent of many infections such as pneumonia, meningitis, otitis media and sinusitis. S. pneumoniae infections are a major cause of morbidity and mortality worldwide. S. pneumoniae has several fascinating abilities, such as natural competence to facilitate the acquisition of antibiotic resistance genes and diversity of capsular serotypes to circumvent the vaccination. The rise of antibiotic resistant bacteria continues to threaten the effectiveness of standard therapies and as such phage therapy is now reconsidered as a therapeutic alternative. The reevaluation of phages as therapeutic agents must go through a better understanding of phage-bacterium interactions. This PhD thesis aims to better understand S. pneumoniae virulent phages and phage-host interactions. First, the ability of pneumophages to infect Streptococcus mitis, a species phylogenetically related to S. pneumoniae, was demonstrated. The pneumophages are the first two virulent phages able to infect this pathogenic bacterium, the common cause of bacterial endocarditis. Both pneumophages could not only replicate in S. mitis but also produced more visible plaques on this host. The comparison of the genomes of each phage grown on both hosts produced identical nucleotide sequences, confirming that S. mitis as a host does not induce any nucleotide variation. However, the genomic sequence of wild-type podophage was different than the previously reported sequence and it was the subject of a new annotation. In addition, S. pneumoniae phage-host interactions were investigated. The involvement of several host factors in replication of both pneumophages was observed. Indeed, several pneumococcal genes were found to be necessary or involved to ensure efficient phage replication. Moreover, the study of these host factors has led to the identification of new genes that appear to be essential for viability and normal growth of S. pneumoniae. This project led to identify new potential therapeutic targets and provided new insight into the complex network of phage-host interactions.
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Carvalho, Ricardo Jorge da Silva. "Revisiting molecular diagnostics of Streptococcus pneumoniae." Master's thesis, Universidade de Aveiro, 2016. http://hdl.handle.net/10773/16115.
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Mestrado em Biologia Molecular e CelularStreptococcus pneumoniae is a human pathobiont that colonizes the nasopharynx. S. pneumoniae is responsible for causing non-invasive and invasive disease such as otitis, pneumonia, meningitis, and sepsis, being a leading cause of infectious diseases worldwide. Due to similarities with closely related species sharing the same niche, it may be a challenge to correctly distinguish S. pneumoniae from its relatives when using only non-culture based methods such as real time PCR (qPCR). In 2007, a molecular method targeting the major autolysin (lytA) of S. pneumoniae by a qPCR assay was proposed by Carvalho and collaborators to identify pneumococcus. Since then, this method has been widely used worldwide. In 2013, the gene encoding for the ABC iron transporter lipoprotein PiaA, was proposed by Trzcinzki and collaborators to be used in parallel with the lytA qPCR assay. However, the presence of lytA gene homologues has been described in closely related species such as S. pseudopneumoniae and S. mitis and the presence of piaA gene is not ubiquitous between S. pneumoniae. The hyaluronate lyase gene (hylA) has been described to be ubiquitous in S. pneumoniae. This gene has not been used so far as a target for the identification of S. pneumoniae. The aims of our study were to evaluate the specificity, sensitivity, positive predicted value (PPV) and negative predicted value (NPV) of the lytA and piaA qPCR methods; design and implement a new assay targeting the hylA gene and evaluate the same parameters above described; analyze the assays independently and the possible combinations to access what is the best approach using qPCR to identify S. pneumoniae. A total of 278 previously characterized strains were tested: 61 S. pseudopneumoniae, 37 Viridans group strains, 30 type strains from other streptococcal species and 150 S. pneumoniae strains. The collection included both carriage and disease isolates. By Mulilocus Sequence Analysis (MLSA) we confirmed that strains of S. pseudopneumoniae could be misidentified as S. pneumoniae when lytA qPCR assay is used. The results showed that as a single target, lytA had the best combination of specificity, sensitivity, PPV and NPV being, 98.5%, 100.0%, 98.7% and 100.0% respectively. The combination of targets with the best values of specificity, sensibility, PPV and NPV were lytA and piaA, with 100.0%, 93.3%, 97.9% and 92.6%, respectively. Nonetheless by MLSA we confirmed that strains of S. pseudopneumoniae could be misidentified as S. pneumoniae and some capsulated (23F, 6B and 11A) and non-capsulated S. pneumoniae were not Identified using this assay. The hylA gene as a single target had the lowest PPV. Nonetheless it was capable to correctly identify all S. pneumoniae.
Streptococcus pneumoniae é uma bactéria patogénica que coloniza a nasofaringe humana. S. pneumoniae é responsável por causar doenças, tanto invasivas como não invasivas como: otite, pneumonia, meningite e sepsis, continuando a ser uma das principais causas de doenças infecciosas a nível mundial. Devido a semelhanças com espécies que lhe são estreitamente relacionadas, e que compartilham o mesmo nicho ecológico, pode ser um desafio identificar corretamente S. pneumoniae aplicando apenas técnicas não dependentes do passo de cultura bacteriana como a técnica de PCR em tempo real (qPCR). Em 2007, um método molecular para identificação de S. pneumoniae baseado num qPCR e tendo como alvo o gene da autolisina principal (lytA) de S. pneumoniae foi proposto por Carvalho e seus colaboradores. Desde então, este tem sido usado de uma forma sistemática por vários grupos. Em 2013, foi proposto por Trzcinszki e seus colaboradores o uso da lipoproteína ABC transportadora de ferro PiaA como alvo num qPCR. O piaA qPCR foi usado em paralelo com o lytA qPCR. Contudo, a presença de genes homólogos de lytA foi descrita em espécies filogeneticamente próximas, como S. pseudopneumoniae e S. mitis, e a presença do gene piaA não é ubíquo entre S. pneumoniae. O gene da proteína hyaluronato lyase (hylA) é descrito como sendo ubíquo a todas as estirpes de S. Pneumoniae. Este gene ainda não foi usado até ao momento como alvo para a identificação de S. pneumoniae. Assim o objectivo do nosso estudo foi a avaliação da especificidade, sensibilidade, valor positivo preditivo (VPP) e valor negativo preditivo (VNP) do método lytA e piaA qPCR; construção de hylA qPCR avaliando os mesmos parâmetros acima referidos; analise dos ensaios de uma forma independente e em conjunto, para poder retirar conclusões sobre qual o melhor gene alvo, ou alvos, a usar na identificação de S. pneumoniae. Foram testadas um total de 278 estirpes anteriormente caracterizadas: 61 S. pseudopneumoniae, 37 estirpes do grupo Viridans, 30 estirpes referência de outras espécies de Streptococcus e 150 estirpes de S. pneumoniae. A coleção usada incluía tanto estirpes obtidas em colonização como estirpes obtidas em doença. Através do método Multilocus sequence analysis (MLSA) verificámos que estirpes de S. pseudopneumoniae podem ser incorretamente identificadas como S. pneumoniae quando é utilizado o lytA qPCR. Ainda assim, os resultados mostraram que como alvo único, o gene lytA apresenta a melhor combinação de valores de especificidade, a sensibilidade, VPP e VNP sendo, respetivamente, 98.5%, 100.0%, 98.7% e 100.0%. A combinação de genes com a melhor combinação de valores de especificidade, sensibilidade, VPP e VNP foi lytA e piaA, com 100.0%, 93.3%, 97.9% e 92.6%, respetivamente. De realçar que pelo método MLSA verificámos que estirpes de S. pseudopneumoniae podem ser incorretamente identificadas como S. pneumoniae e algumas estirpes capsuladas (23F, 6B e 11A) e não-capsuladas de S. pneumoniae não são identificadas quando usada esta combinação de genes. O gene hylA como alvo único apresentou o valor de PPV mais baixo, todavia identificou corretamente todos os S. pneumoniae.
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Chewapreecha, Kamolchanok. "Evolution of Streptococcus pneumoniae during carriage." Thesis, University of Cambridge, 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.708595.
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Ho, Pak-leung. "Emerging antimicrobial resistance in Streptococcus pneumoniae." Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B41290999.
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McNamara, Tracy Renee. "Chlamydia pneumoniae and airways inflammation : an investigation of the host cell-pathogen relationship /." Title page, table of contents and abstract only, 2004. http://web4.library.adelaide.edu.au/theses/09PH/09phm4791.pdf.
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Morona, Judy Kay. "Characterisation of the capsular polysaccharide biosynthesis loci of streptococcus pneumoniae serogroup 19 /." Title page, contents and abstract only, 1998. http://web4.library.adelaide.edu.au/theses/09PH/09phm8678.pdf.
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Fernebro, Jenny. "Genetic approaches towards understanding pneumococcal virulence and biology /." Stockholm : Karolinska institutet, 2007. http://diss.kib.ki.se/2007/978-91-7357-403-7/.
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Miotto, Fabiane. "Estudo da resistência do streptococcus pneumoniae à penicilina em pneumopatias infecciosas nas cidades de Porto Alegre e Caxias do Sul (RS - Brasil)." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2001. http://hdl.handle.net/10183/5465.
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A resistência aos antibióticos dos patógenos mais comuns do trato respiratório está aumentando mundialmente. Recentemente, Streptococcus pneumoniae resistente à penicilina tem sido isolado em diversos países, e a freqüência dessas cepas tem elevado de modo alarmante. O aumento da resistência, com conseqüentes implicações terapêuticas, tem levado a uma reavaliação do uso dos antibióticos ß-lactâmicos para o tratamento de infecções pneumocócicas. No presente trabalho, um total de 107 amostras de Streptococcus pneumoniae, obtidas de materiais provenientes de pacientes adultos ambulatoriais e hospitalizados, em dois centros médicos de duas cidades do Rio Grande do Sul (Porto Alegre e Caxias do Sul), os quais apresentavam quadro clínico-radiológico de infecção pulmonar, foram analisadas com o objetivo de estudar-se a resistência do germe à penicilina. As amostras constituídas de escarro (80,4%), lavado brônquico (13,5%) e aspirado traqueal (6,6%) foram coletadas no período compreendido entre Julho de 1998 e Julho de 1999. O material foi semeado em meio de Agar sangue e as colônias suspeitas de Streptococcus pneumoniae foram transferidas para meio de Mueller-Hinton para teste de optoquina e de sensibilidade à penicilina com discos de oxacilina. Um halo de inibição da oxacilina menor do que 20 mm indicava a realização de teste para determinação da concentração inibitória mínima (MIC) com E-test. Um total de nove cepas foi identificado como tendo resistência intermediária à penicilina (MIC 0,1-1,0μg/ml) e nenhuma cepa resistente (resistência elevada: MIC > 2,0 μg/ml) foi identificada. Uma monitorização local das cepas quanto à resistência antimicrobiana é de grande importância para os clínicos no manejo de infecções pneumocócicas.Antibiotic resistance to the common respiratory tract pathogens is increasing worldwide. Recently, penicillin-resistant pneumococci have been isolated in several countries, and the incidence of these strains has risen alarmingly. The increased of resistance with consequence therapeutic implications has led to a re-evaluation of ß-lactam antibiotics for the treatment of streptococcal infections. In present study a total of 107 isolates of Streptococcus pneumoniae from samples of adult hospitalizated patients ando outpatients were prospectively collected in 2 different medical centers of Rio Grande do Sul - Brazil (Caxias do Sul and Porto Alegre) with clinical and radiologyc signs of respiratory infections, were analyzed with objective to study the penicillin-resistant pneumococci. The samples consisting of sputum (80,4%), bronchial lavage (13,5%) and inhaled traqueal (6,6%) had been colected in the period understood between 98 July and 99 July. The material was sown in agar-blood and the colonies suspicion of Streptococcus pneumoniae had been transferred to Mueller-Hinton for test of optochin and for sensitivity to penicillin test with oxacilin disks. One inhibition of the lesser that 20 mmm for oxacilin indicates the test accomplishment to determine minimum inhibitory concentration (MIC) with E-test. A total of 9 strains were intermediate-resistant to penicillin (MIC 0,1-1,0μg/ml) and neither was resistant to penicillin (MIC > 2,0 μg/ml). Monitoring local of antimicrobial resistant strains is of great importance to clinicians for the management of pneumococcal infections.
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Vasconcellos, Ângela Gomes de. "Perfil de citocinas em crianças com pneumonia adquirida na comunidade." de Medicina, 2015. http://repositorio.ufba.br/ri/handle/ri/18654.
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PERFIL DE CITOCINAS E QUIMIOCINAS EM CRIANÇAS HOSPITALIZADAS COM PNEUMONIA ADQUIRIDA NA COMUNIDADE. Introdução: Pneumonia adquirida na comunidade (PAC) é a principal causa de óbito em crianças abaixo de 5 anos em todo o mundo. No entanto, o diagnóstico etiológico da PAC permanece um desafio em pediatria, além de existir uma escassez de estudos sobre a resposta inflamatória nesta doença. Objetivo: Descrever o perfil de citocinas e quimiocinas detectadas na admissão de crianças com PAC e avaliar se existe associação entre os níveis de citocinas e pneumonia pneumocócica em crianças. Metodologia: Estudo prospectivo realizado no pronto atendimento do Hospital da Universidade Federal da Bahia, em Salvador, Brasil. Crianças hospitalizadas com PAC com idade <5 anos foram avaliadas. Na admissão, dados clínicos e radiológicos foram coletados, assim como amostras biológicas para investigar 19 agentes etiológicos e dosar 14 citocinas/quimiocinas séricas (IL-8, IL-6, IL-10, IL-1β, IL-12, TNF-α, IL-2, IL-4, IL-5, IFN-γ, CCL2, CCL5, CXCL9 e CXCL10). Resultados: Foram incluídas 166 crianças. As citocinas que apresentaram níveis detectáveis foram IL-8, IL-10 e IL-6; com as respectivas medianas (IQR): 78,0 (30,7-244,3) pg/ml, 10;6 (4,6-30,6) pg/ml e 3,6 (3,1-4,4) pg/ml. As quimiocinas detectadas foram CXCL10 e CCL2; as medianas (IQR) calculadas foram: 74,2 pg/ml (36,1-164,8) e 19,1 (10,8-22,8) pg/ml, respectivamente. Infecção pneumocócica foi detectada em 38 (22,9%) casos dentre os quais a mediana de IL-6 (pg/ml) foi 32.2 pg/ml (IIQ: 12,4-54,1 pg/ml). Outros agentes etiológicos (Haemophilus influenzae, Moraxella catarrhalis, bactérias atípicas e vírus) foram detectados em 128 (77,1%) casos com a mediana de concentração de IL-6 igual a 9,0 pg/ml (IIQ: 4,1–22,0 pg/ml). Na análise multivariada, com pneumonia pneumocócica 7 como variável dependente, IL-6 foi preditor independente para infecção pneumocócica (OR=5,6; IC95% = 2,4–12,7; ponto de corte 12,5 pg/ml). O valor preditivo negativo de IL-6 na concentração sérica abaixo de 12,5pg/ml para infecção pneumocócica foi de 90% (IC95% = 82%-95%). Conclusões: Citocinas e quimiocinas inflamatórias séricas são detectáveis na admissão de criança com PAC; a concentração sérica de IL-6 na admissão esta independentemente associada com infecção pneumocócica em crianças abaixo de 5 anos de idade e com PAC.
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Croisier, Delphine. "Pharmacodynamie des fluoroquinolones dans la pneumonie expérimentale à streptococcus pneumoniae : étude de la fenêtre de selection des mutations." Dijon, 2005. http://www.theses.fr/2005DIJOMU02.
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L'efficacité de 3 nouvelles fluoroquinolones (lévofloxacine, gatifloxacine, moxifloxacine) a été évaluée dans un modèle expérimental de pneumonie à pneumocoque avec traitement humanisé. In vivo, ces 3 FQ sont très actives sur la souche sauvage. Toutefois, lorsque la souche porte une mutation parC, un traitement standard par FQ s'associe à un échec microbiologique du fait de l'émergence de mutants résistants (MR). Si les critères pharmacodynamiques incluant la CMI (AUC/CMI, Cmax/CMI) ne constituent pas de bons marqueurs de survenue de ces MR, les paramètres intégrant la fenêtre de sélection des mutations, comprise entre la CMI et la MPC (Concentration de Prévention des Mutations), sont pertinents car lorsque cet intervalle diminue, le risque d'émergence de MR diminue (exemple : simulation d'une surdose de moxifloxacine). Ce nouveau concept, spécifique d'un couple antibiotique-bactérie donné, doit faire l'objet d'autres travaux dans une perspective de lutte contre l'antibiorésistance.
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Silva, Francisco Eliclécio Rodrigues da. "Detecções de vírus respiratórios e Streptococcus pneumoniae em crianças com pneumonia após a inclusão da vacina pneumocócica 10-valente conjugada no cartão vacinal infantil." reponame:Repositório Institucional da UFC, 2014. http://www.repositorio.ufc.br/handle/riufc/23083.
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SILVA, F. E. R. Detecções de vírus respiratórios e Streptococcus pneumoniae em crianças com pneumonia após a inclusão da vacina pneumocócica 10-valente conjugada no cartão vacinal infantil. 2014. 77 f. Dissertação (Mestrado em Microbiologia Médica) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2014.Submitted by Carolinda Oliveira (ppgmm@ufc.br) on 2017-06-07T12:21:05Z No. of bitstreams: 1 Dissertação Francisco Eliclécio Rodrigues da Silva.pdf: 1306976 bytes, checksum: de135ab336986077f41f11fe48c12d5c (MD5)
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Pneumonia is responsible for approximately 1.6 million annual deaths in children of age five and below worldwide. A group of virus and bacteria is associated with the etiology of this infection being commonly reported the association between them. As strategy of reducing child mortality from this condition, in 2010 it was incorporated the 10-valent pneumococcal vaccine to the child immunization calendar. The objective of this study is to determine the rate of detection of several respiratory viruses and Streptococcus pneumoniae, including its serotypes, in children with pneumonia after the introduction of the 10-valent pneumococcal vaccine in the child immunization calendar. For this, samples of nasopharyngeal aspirates were analyzed in rapid antigen detection by indirect immunofluorescence for Respiratory Syncytial Virus, adenovirus, Influenza A and B and Parainfluenza 1, 2 and 3. After the isolation of S. pneumoniae, it was used the multiplex PCR for its serotyping. 781 samples were analyzed. The detection of the respiratory viruses and S. pneumoniae ranged during the years 2011, 2012 and 2013, in which, at the end, 441 (56,47%) of the samples were negative for both microorganisms, 199 (25,48%) were positive for at least one virus, being the RSV the most detected, 184 (23,56%) were positive for S. pneumoniae and 43 (5,51%) were positive for coinfection (the simultaneous detection of the pneumococcus and the RSV, 60,47%, was the most frequent). There was a percentage reduction of the detection of pneumococcus over the years studied, with the predominance of vaccinal serotypes (69/54,33%). However, despite the decrease of detection of S. pneumoniae, whether they are present or not in the vaccine, there seems to be a growing number of circulating strains of pneumococcus not included in the vaccine, this fact is more evident in the year 2013. As the profile of prevalent serotypes of S. pneumoniae differs from one region to another and the immunity is serotype-specific, it is necessary a continuous surveillance for the knowledgement of the circulation of serotypes that are not included in the vaccine and to ensure that the future vaccines target the appropriate serotypes.
A pneumonia é responsável por aproximadamente 1,6 milhões de óbitos anuais em crianças com idade inferior a cinco anos no mundo. Um grupo de vírus e bactérias está associado à etiologia dessa infecção sendo comumente relatadas associações entre eles. Como estratégia de redução da mortalidade infantil por essa afecção foi incorporada, em 2010 no Brasil, a vacina pnemocócica conjugada 10 valente no calendário vacinal infantil. Este estudo teve como objetivo determinar a taxa de detecção de diversos vírus respiratórios e Streptococcus pneumoniae, inclusive seus sorotipos, em crianças com pneumonia após a introdução da vacina pneumocócica 10 valente conjugada no calendário vacinal infantil. Para isso foram analisadas amostras de aspirados de nasofaringe na detecção rápida de antígenos através de imunofluorescência indireta para o Vírus Sincicial Respiratório, Adenovírus, Influenza A e B e Parainfluenza 1, 2 e 3. Após o isolamento de S. pneumoniae foi utilizado PCR multiplex para sua sorotipagem. Foram analisadas 781 amostras. A detecção dos vírus respiratórios e S. pneumoniae variou durante os anos de 2011, 2012 e 2013, tendo no final 441 (56,47%) amostras negativas para ambos os microorganismos, 199 (25,48%) positivas para pelo menos um vírus, sendo o VSR o mais detectado, 184 (23,56%) positivas para S. pneumoniae e 43 (5,51%) tiverem detecção mista (sendo a detecção concomitante do pneumococo com o VSR , 60,47%, a mais frequente). Houve uma redução no percentual de detecção do pneumococo ao longo dos anos estudados, com predominância dos sorotipos vacinais (69/54,33%). No entanto, apesar da queda no número de S.pneumoniae detectados, estejam eles presentes ou não na vacina, parece haver um número crescente de cepas circulantes do pneumococo não incluída na vacina, fato este mais evidente no ano de 2013. Sendo o perfil dos sorotipos de S. pneumoniae diferente de uma região para outra e a imunidade sorotipo-específica é necessária uma vigilância contínua para o conhecimento dos sorotipos circulantes para assegurar que futuras vacinas sejam voltadas para os sorotipos adequados.
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Agarwal, Vaibhav. "Role of PspC interaction with human polymeric immunoglobulin receptor and Factor H in Streptococcus pneumoniae infections and host cell induced signalling." kostenfrei, 2008. http://www.opus-bayern.de/uni-wuerzburg/volltexte/2009/3652/.
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