马德里某三级医院的侵袭性肺炎球菌病：我们是否正确使用肺炎球菌疫苗？

IF 2.6 4区医学 Q3 INFECTIOUS DISEASES

Enfermedades infecciosas y microbiologia clinica Pub Date : 2025-04-01 DOI:10.1016/j.eimc.2024.08.006

María Isabel Serrano-Tomás , Margarita Cabello , Paloma Moreno-Nuñez , Juan Carlos Sanz , Rafael Cantón , Ana María Sánchez-Díaz

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引用次数: 0

摘要

侵袭性肺炎球菌病（IPD）值得关注。我们描述了马德里北部IPD流行病学并评估了IPD发作的疫苗接种计划充分性（2019-2021）。方法从临床/流行病学记录中收集临床、实验室和预防接种资料。根据EUCAST和肺炎测试-凝集/Quellung血清分型进行抗菌药物敏感性试验。结果103例患者(71例[IQR 23.5]岁；50.4%男性)，85.4%伴有菌血症和高死亡率（19.4%）。血清型8（29.9%）、3和22F（各占8%）占优势（45.9%），均对抗生素敏感。β-内酰胺类增加mic和大环内酯类耐药主要与血清型19A、23F、24F、6C和15A有关。只有10.5%有资格接种疫苗的成年人在IPD之前接种了足够的疫苗方案，而IPD的40%是由于非疫苗可预防的血清型（13,23b, 24F, 31）。结论ipd发作以抗生素敏感型ST8为主，多发生于高危成人。尽管有这些建议，但疫苗接种依从率非常低。

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Invasive pneumococcal disease in a tertiary hospital in Madrid: are we using pneumococcal vaccine correctly?

Introduction

Invasive pneumococcal disease (IPD) is of concern. We describe the epidemiology and assess the vaccination schedule adequacy of IPD episodes (2019–2021) in northern Madrid.

Methods

Clinical, laboratory and vaccination data were collected from clinical/epidemiological records. Antimicrobial susceptibility testing was performed according to EUCAST and serotyping by Pneumotest-agglutination/Quellung.

Results

IPD was identified in 103 patients (71 [IQR 23.5] year-old; 50.4% males), 85.4% associated with bacteremia and a high mortality rate (19.4%). Serotypes 8 (29.9%), 3 and 22F (8% each) were dominant (45.9%), all antibiotic-susceptible. β-Lactams increased MICs and macrolide resistance were mainly linked to serotypes 19A, 23F, 24F, 6C, and 15A. Only 10.5% of adults eligible for vaccination had an adequate vaccine regimen before IPD being 40% due to nonvaccine-preventable serotypes (13, 23B, 24F, 31).

Conclusion

IPD episodes were dominated by antibiotic-susceptible ST8 and frequently occurred in adults at risk. Despite recommendations, vaccination adherence rates were very low.

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来源期刊

Enfermedades infecciosas y microbiologia clinica 医学-传染病学

CiteScore

2.10

自引率

8.00%

发文量

194

审稿时长

29 days

期刊介绍： Hoy está universalmente reconocida la renovada y creciente importancia de la patología infecciosa: aparición de nuevos agentes patógenos, de cepas resistentes, de procesos con expresión clínica hasta ahora desconocida, de cuadros de una gran complejidad. Paralelamente, la Microbiología y la Infectología Clínicas han experimentado un gran desarrollo como respuesta al reto planteado por la actual patología infecciosa. Enfermedades Infecciosas y Microbiología Clínica es la Publicación Oficial de la Sociedad Española SEIMC. Cumple con la garantía científica de esta Sociedad, la doble función de difundir trabajos de investigación, tanto clínicos como microbiológicos, referidos a la patología infecciosa, y contribuye a la formación continuada de los interesados en aquella patología mediante artículos orientados a ese fin y elaborados por autores de la mayor calificación invitados por la revista.