1 / 16

Invasive Pneumococcal Disease

Invasive Pneumococcal Disease. Streptococcus pneumoniae. Clinical Syndromes. Meningitis: fever, headache, photophobia, nausea, vomiting, nuchal rigidity Bacteremia: fever, chills, (+/-)mental status or behavioral changes Pneumonia: fever, chills, productive cough, pleuritic chest pain

ecampbell
Download Presentation

Invasive Pneumococcal Disease

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Invasive Pneumococcal Disease Streptococcus pneumoniae

  2. Clinical Syndromes • Meningitis: fever, headache, photophobia, nausea, vomiting, nuchal rigidity • Bacteremia: fever, chills, (+/-)mental status or behavioral changes • Pneumonia: fever, chills, productive cough, pleuritic chest pain • Otitis media: fever, ear pain, lack of appetite, irritability

  3. Conjugate Vaccine (2000)MMWR, 2000; 49 (No RR-9) • 7 serotypes of capsular polysaccharide (4, 9V, 14, 19F, 23F, 18C, 6B) linked to a protein carrier • Recommended for: • Children < 23 months • Children 24-59 months with • Sickle cell* or trait, beta-thalassemia, functional or anatomic asplenia* • HIV* • Chronic disease*, including chronic heart or lung disease, diabetes, or CSF leak; cochlear implant • Immunocompromising conditions* *revaccinate (23-valent polysaccharide vaccine after age 2)

  4. Polysaccharide vaccine (1983) MMWR, 1997; 46(No RR-8) • 23 polysaccharide antigens • Recommended for: • Persons > 65 years • Persons age 2-64 with: • Chronic heart or lung disease or diabetes; cochlear implant • Alcoholism, chronic liver disease or CSF leaks • Functional or anatomic asplenia* • Living in special environments or social settings • Immunocompromising conditions* *revaccinate

  5. MMWR, 2000, 49(No.RR-9)

  6. ISP Antimicrobial Resistance TrendsNEJM, 2000; 343:1917

  7. Case Definition • Clinical descriptionStreptococcus pneumoniae causes many clinical syndromes, depending on the site of infection (e.g., acute otitis media, pneumonia, bacteremia, or meningitis).  • Laboratory criteria for diagnosis Isolation of S. pneumoniae from a normally sterile site (e.g., blood, cerebrospinal fluid, or, less commonly, joint, pleural, or pericardial fluid)  • Case classification • Confirmed: a clinically compatible case caused by laboratory-confirmed culture of S. pneumoniae  from a normally sterile site 

  8. Public Health Action • Confirm the case • Use the supplemental form to guide you in asking important questions: • What was the site of infection? • Did the case have underlying disease? • What is the immunization status of the case? • Attach laboratory results and antimicrobial susceptibility studies

  9. Surveillance Q. I. (preliminary) – Invasive S pneumoniae

  10. Surveillance Q. I. (preliminary) – Invasive S pneumoniae

  11. Outbreak example

  12. Outbreak Example (2) • Pneumonia in 11 (13%) of 84 nursing home residents • 3 deaths • S pneumoniae serotype 23 F, • intermediate resistance to penicillin, cefotaxime; resistant to trimethoprim sulfamethoxazole and erythromycin; and sensitive only to vancomycin, rifampin and ofloxacin • 3 (4%) of residents had been vaccinated • 20 (27%) of 74 residents and 12 (17%) of 69 staff were colonized with the outbreak strain

  13. ISP - Summary • Risk • Highest in the very young and the very old • Vaccine-preventable disease • Antimicrobial resistance increasing • Investigation: • Site of infection • Vaccination history • Underlying disease • Antimicrobial resistance profile

More Related