Información del artículo
La introducción de la vacuna neumocócica conjugada heptavalente en algunos países ha dado lugar a cambios substanciales en la epidemiología de las infecciones producidas por esta bacteria. La mayor repercusión ha sido una disminución global de la enfermedad invasora, sobre todo por un descenso de las infecciones producidas por los serotipos vacunales. La vacuna ha generado una inmunidad de grupo muy efectiva, extendiendo su efecto protector a las personas no vacunadas de todas las edades, entre ellas los mayores de 65 años, una población en la que la infección conlleva una morbimortalidad elevada. La inmunidad de grupo se debe, en parte, a la inducción de respuestas inmunitarias en las mucosas respiratorias. El resultado es una disminución de la colonización nasofaríngea por los serotipos vacunales, que, sin embargo, son reemplazados por otros serotipos no contenidos en la vacuna. Como quiera que la colonización nasofaríngea es un hecho crucial en la epidemiología de las infecciones neumocócicas, no es de extrañar que los cambios en la misma den lugar a algunas consecuencias conocidas y otras que se empiezan a conocer. Más del 80% de las resistencias de neumococo van ligadas a 5 de los serotipos vacunales, cuya desaparición de la nasofaringe se ha acompañado de una disminución marcada de infecciones causadas por cepas resistentes. Un hecho preocupante ha sido la emergencia de serotipos no contenidos en la vacuna, como 19A, 3, 15, 33 y 6A, que podría, en un futuro, dar lugar a una disminución de la efectividad de la vacuna o a cambios en la epidemiología de la enfermedad.
Palabras clave:
Streptococcus pneumoniae
Vacunas neumocócicas conjugadas
Vacuna neumocócica conjugada heptavalente
Enfermedad invasiva neumocócica
Neumonía
Colonización nasofaríngea
Serotipos neumocócicos
The introduction of the heptavalent pneumococcal conjugate vaccine in some countries has substantially changed the epidemiology of pneumococcal infections. The greatest effect has been an overall reduction of invasive disease, especially due to a decrease in infections produced by vaccine serotypes. This vaccine has generated highly effective group immunity, extending its protective effect to non-vaccinated individuals of all ages, including those older than 65 years, a population in which infection carries high morbidity and mortality. Group immunity is partly due to induction of immune responses in the respiratory mucosa. The result is a decrease in nasopharyngeal colonization by vaccine serotypes which, however, can be replaced by other serotypes not contained in the vaccine. Since nasopharyngeal colonization is a crucial factor in the epidemiology of pneumococcal infections, changes in colonization lead to some known consequences and others that are beginning to be known. More than 80% of pneumococcal-resistant strains are linked to five vaccine serotypes; the disappearance of these vaccine serotypes from the nasopharynx has been accompanied by a marked decrease in infections caused by resistant strains. A worrying recent finding has been the emergence of serotypes not contained in the vaccine such as 19A, 3, 15, 33 and 6A, which could in future decrease the effectiveness of the vaccine or lead to changes in the epidemiology of pneumococcal disease.
Key words:
Streptococcus pneumoniae
Pneumococcal conjugate vaccines
Heptavalent pneumococcal conjugate vaccine
Pneumococcal invasive disease
Pneumonia
Nasopharyngeal colonization
Pneumococcal serotypes
El Texto completo está disponible en PDF
Bibliografía
[1.]
World Health Organization.
Pneumococcal conjugate vaccine for childhood immunization-WHO position paper.
Weekly Epidemiological Record, 82 (2007), pp. 93-104
[2.]
Centers for Disease Control and Prevention.
Prevention of pneumococcal disease: recommendations of the Advisory Committee on Inmunization Practices (ACIP).
MMWR, 46 (1997), pp. 1-24
[3.]
C.G. Grijalva, J.P. Nuorti, P.G. Arbogast, S.W. Martin, K.M. Edwards, M.R. Griffin.
Decline in pneumonia admissions after routine childhood immunisation with pneumococcal conjugate vaccine in the USA: a time series analysis.
Lancet, 369 (2007), pp. 1179-1186
[4.]
M. Vives, M.E. García, P. Saenz, M.A. Mora, L. Mata, H. Sabharwal, et al.
Nasopharyngeal colonization in Costa Rican children during the first year of life.
Pediatr Infect Dis J, 16 (1997), pp. 852-858
[5.]
T. Leino, K. Auranen, J. Jokinen, M. Leinonen, P. Tervonen, A.K. Tacala.
Pneumococcal carriage in children during their first two years: importance role of family exposure.
Pediatr Infect Dis J, 20 (2001), pp. 1022-1027
[6.]
F. Ghaffar, T. Barton, J. Lozano, L.S. Muniz, P. Hicks, V. Gan, et al.
Effect of the 7-Valent pneumococcal conjugate vaccine on nasopharyngeal colonization by Streptococcus pneumoniae in the first 2 years of life.
Clin Infect Dis, 39 (2004), pp. 930-938
[7.]
R. Lakshman, C. Murdoch, G. Race, R. Burkinshaw, L. Shaw, A. Finn.
Pneumococcal nasopharyngeal carriage in children following heptavalent pneumococcal conjugate vaccination in infancy.
Arch Dis Child, 88 (2003), pp. 211-214
[8.]
R. Dagan, N. Givon-Lavi, O. Zamir, D. Fraser.
Effect of a nonavalent conjugate vaccine on carriage of antibiotic-resistant Streptococcus pneumoniae in day-care centers.
Pediatr Infect Dis J, 22 (2003), pp. 532-539
[9.]
R.H. Veenhoven, D. Bogaert, A.G.M. Schilder, G.T. Rijkers, C.S.P.M. Uitervaal, H.H. Kiezibrink, et al.
Nasopharyngeal pneumococcal carriage after combined pneumococcal conjugate and polysaccharide.
Clin Infect Dis, 39 (2004), pp. 911-919
[10.]
C.B. Laval, A.L.S.S. De Andrade, F.C. Pimenta, J.G. De Andrade, R.M. De Oliveira, S.A. Silva, et al.
Serotypes of carriage and invasive isolates of Streptococcus pneumoniae in Brazilian children in the era of pneumococcal vaccines.
Clin Microbiol Infect, 12 (2006), pp. 50-55
[11.]
D. Guillemot, C. Carbon, B. Balkau, P. Geslin, H. Lecoeur, F. Vauzelle-Kervoëdan, et al.
Low dosage and long treatment duration of beta-lactam: risk factors for carriage of penicillin-resistant Streptococcocus pneumoniae.
JAMA, 279 (1998), pp. 365-370
[12.]
A.C. Nyquist, R. Gonzales, J.F. Steiner, M.A. Sande.
Antibiotic prescribing for children with colds, upper respiratory tract infections and bronchitis.
JAMA, 279 (1998), pp. 875-877
[13.]
A.G. Mainous III, W.J. Hueston, M.M. Love.
Antibiotics for colds in children: who are the high prescribers?.
Arch Pediatr Adolesc Med, 152 (1998), pp. 349-352
[14.]
C.G. Whitney.
Can vaccines control resistance? The example of pneumococcal conjugate vaccine.
Infect Dis Clin Pract, 14 (2006), pp. 24S-30S
[15.]
W.J. Lin, W.T. Lo, C.Y. Chou, Y.Y. Chen, S.Y. Tsai, M.L. Chu, et al.
Antimicrobial resistance patterns and serotype distribution of invasive Streptococcus pneumoniae isolates from children in Taiwan from 1999 to 2004.
Diagnost Microbiol Infect Dis, 56 (2006), pp. 189-196
[16.]
C.G. Whitney, M.M. Farley, J. Hadler, L.H. Harrison, C. Lexau, A. Reingold, et al.
Increasing prevalence of multidrug-resistant Streptococcus pneumoniae in the United States.
N Engl J Med, 343 (2000), pp. 1917-1924
[17.]
W.P. Hausdorff, D.R. Feikin, K.P. Klugman.
Epidemiological differences among pneumococcal serotypes.
Lancet Infect Dis, 5 (2005), pp. 83-93
[18.]
L.L. Hammit, D.L. Bruden, J.C. Butler, H.C. Baggett, D.A. Hurlburt, A. Reasonover, et al.
Indirect effect of conjugate vaccine on adult carriage of Streptococcus pneumoniae: and explanation of trends in invasive pneumococcal disease.
J Infect Dis, 193 (2006), pp. 1487-1494
[19.]
D.R. Feikin, K.P. Klugman, R.R. Facklan, E.R. Zell, A. Schuchat.
Increased prevalence of pediatric pneumococcal serotypes in elderly adults.
Clin Infect Dis, 41 (2005), pp. 481-487
[20.]
J.P. Nuorti, J.C. Butler, M.M. Farley, L.H. Harrison, A. McGeer, M.S. Kolczak, et al.
Cigarette smoking and invasive pneumococcal disease.
N Engl J Med, 342 (2000), pp. 681-689
[21.]
M. Koskela, M. Leinonen, V.M. Häivä, M. Timonen, P.H. Mäkelä.
First and second dose antibody responses to pneumococcal polysaccharide vaccine in infants.
Pediatr Infect Dis J, 5 (1986), pp. 45-50
[22.]
M. Leinonen, A. Säkkinen, R. Kalliokoski, J. Luotonen, M. Timonen, P.H. Mäkela.
Antibody response to 14-valent pneumococcal capsular polysaccharide vaccine in preschool age children.
Pediatr Infect Dis, 5 (1986), pp. 39-44
[23.]
K.E. Stein.
Thymus-independent and thymus-dependent responses to polysaccharide antigens.
J Infect Dis, 165 (1992), pp. 49S-52S
[24.]
T.V. Murphy, P. Pastor, F. Medley, M.T. Osterholm, D.M. Granoff.
Decreased Haemophilus colonization in children vaccinated with Haemophilus influenzae type b conjugate vaccine.
J Pediatr, 122 (1993), pp. 517-523
[25.]
J.C. Mohle-Boetani, G. Ajello, E. Breneman, et al.
Carriage of Haemophilus influenzae type b in children after widespread vaccination with conjugate Haemophilus influenzae type b vaccines.
Pediatr Infect Dis J, 12 (1993), pp. 589-593
[26.]
M.L. Barbour, R.T. Maynon-White, C. Coles, W.M. Crook, R. Moxon.
The impact of conjugate vaccine on carriage of Haemophilus influenzae type b.
J Infect Dis, 171 (1995), pp. 93-98
[27.]
K.L. O’Brien, R. Dagan.
The potential indirect effect of conjugate pneumococcal vaccines.
Vaccine, 21 (2003), pp. 1815-1825
[28.]
Q. Zhang, A. Finn.
Mucosal immunology of vaccines against pathogenic nasopharyngeal bacteria.
J Clin Pathol, 57 (2004), pp. 1015-1021
[29.]
D.F. Kelly, E.R. Moxon, A.J. Pollard.
Haemophilus influenzae type b conjugate vaccines.
Immunology, 113 (2004), pp. 163-174
[30.]
J. Eskola, M. Anttila.
Pneumococcal conjugate vaccines.
Pediatr Infect Dis J, 18 (1999), pp. 543-551
[31.]
S.K. Obaro, Z. Huo, W.A.S. Banya, D.C. Henderson, M.A. Monteil, M. Leach, et al.
A glycoprotein pneumococcal conjugate vaccine primes for antibody responses to a pneumococcal polysaccharide vaccine in Gambian children.
Pediatr Infect Dis J, 16 (1997), pp. 1135-1140
[32.]
S.K. Obaro, R.A. Adegbola, W.A.S. Banya, et al.
Carriage of pneumococci after pneumococcal vaccination.
Lancet, 348 (1996), pp. 271-272
[33.]
K.P. Klugman.
Efficacy of pneumoccal conjugate vaccines and their effect on carriage and antimicrobial resistance.
Lancet Infect Dis, 1 (2001), pp. 85-91
[34.]
R. Dagan, R. Melamed, M. Muallem, L. Piglansky, D. Greenberg, Abramson, et al.
Reduction of nasopharyngeal carriage of pneumococci during the second year of life by a heptavalent conjugate pneumococcal vaccine.
J Infect Dis, 174 (1996), pp. 1271-1278
[35.]
R. Dagan, M. Muallem, R. Melamed, O. Leroy, P. Yagupsky.
Reduction of nasopharyngeal carriage in early infancy after immunization with tetravalent pneumococcal vaccines conjugated to either tetanus toxoid or diphteria toxoid.
Pediatr Infect Dis J, 16 (1997), pp. 1060-1064
[36.]
S.I. Pelton, A.M. Loughlin, C.D. Marchant.
Seven valent pneumococcal conjugate vaccine immunization in two Boston communities. Changes in serotypes and antimicrobial susceptibility among Streptococcus pneumoniae isolates.
Pediatr Infect Dis J, 23 (2004), pp. 1015-1022
[37.]
Huang SS, Platt R, Rifas-Shiman SL, Pelton SI, Goldmann D, Filkestein JA. Post-PCV7 changes in colonizing pneumococcal serotypes in 16 Massachusetts Communities, 2001 and 2004. Pediatrics 2005;116:408e-13e. Disponible en: www.pediatrics.org/cgi/doi/10.1542/peds.2004-338
[38.]
E.V. Millar, K.L. O’Brien, J.P. Watt, M.A. Bronsdon, J. Dallas, C.G. Whitney, et al.
Effect of Community-wide conjugate pneumococcal vaccine use in infancy on nasopharyngeal carriage through 3 years of age: a cross-sectional study in a high-risk population.
Clin Infect Dis, 43 (2006), pp. 8-15
[39.]
R. Cohen, C. Levy, F. De La Rocque, N. Gelbert, A. Wollner, B. Fritzell, et al.
Impact of pneumococcal conjugate vaccine and of reduction of antibiotic use on nasopharyngeal carriage of nonsusceptible pneumococci in children with acute otitis media.
Pediatr Infect Dis J, 25 (2006), pp. 1001-1007
[40.]
N. Givon-Lavi, D. Fraser, R. Dagan.
Vaccination of day-care center attendees reduces carriage of Streptococcus pneumoniae among their younger siblings.
Pediatr Infect Dis J, 22 (2003), pp. 524-531
[41.]
W.P. Hausdorff, J. Bryant, P.R. Paradiso, G.R. Siber.
Which pneumococcal serogroups cause the most invasive disease: implications for conjugate vaccine formulation and use (I).
Clin Infect Dis, 30 (2000), pp. 100-121
[42.]
W.P. Hausdorff.
The roles of pneumococcal serotypes 1 and 5 in pediatric invasive disease.
Vaccine, 25 (2007), pp. 2406-2412
[43.]
S. Black, H. Shinefield, B. Fireman, E. Lewis, P. Ray, J.R. Hansen, et al.
Efficacy, safety and immunogenicity of heptavalent pneumococcal conjugate vaccine in children.
Pediatr Infect Dis J, 19 (2000), pp. 187-195
[44.]
C.G. Whitney, T. Pilishvili, M.M. Farley, W. Schaffner, A.S. Craig, R. Lynfield, et al.
Effectiveness of seven-valent pneumococcal conjugate vaccine against invasive pneumococcal disease: a matchet case-control study.
Lancet, 368 (2006), pp. 1495-1502
[45.]
S. Black, H. Shinefield, R. Baxter, R. Austrian, L. Bracken, J. Hansen, et al.
Postlicensure surveillance for pneumococcal invasive disease after use of heptavalent pneumococcal conjugate vaccine in northern California Kaiser Permanente.
Pediatr Infect Dis J, 23 (2004), pp. 485-489
[46.]
C.G. Whitney, M.M. Farley, J. Hadler, L.H. Harrison, N.M. Bennet, R. Lynfield, et al.
Decline in invasive pneumococcal disease after the introduction of protein-polysaccharide conjugate vaccine.
N Engl J Med, 348 (2003), pp. 1737-1746
[47.]
D.S. Stephens, S.M. Zughaier, C.G. Whitney, W.S. Baughman, L. Barker, K. Gay, et al.
Incidence of macrolido resistance in Streptococcus pneumoniae after introduction of the pneumococcal conjugate vaccine: population-based assessment.
Lancet, 365 (2005), pp. 855-863
[48.]
S.L. Kaplan, E.Q.J. Mason, E.R. Wald, et al.
Decrease of invasive pneumococcal infections in children among 8 children's hospitals in the United States after the introduction of the 7-valent pneumococcal conjugate vaccine.
Pediatrics, 113 (2004), pp. 443-449
[49.]
Centers for Disease Control and Prevention.
Direct and indirect effects of routine vaccination of children wit 7-valent pneumococccal conjugate vaccine on incidence of invasive pneumococcal disease. United States, 1998-2003.
MMWR, 54 (2005), pp. 893-897
[50.]
M.H. Kyaw, R. Lynfield, W. Schaffner, A.S. Craig, J. Hadler, A. Reingold, et al.
Active Bacterial Core Surveillance of the Emerging Infections Program Network. Effect of the introduction of the pneumococcal conjugate vaccine on drug-resistant Streptococcus pneumoniae.
N Engl J Med, 354 (2006), pp. 1455-1463
[51.]
W.C. Albrich, W. Baugman, B. Schmotzer, M.M. Farley.
Changing characteristics of invasive pneumococcal disease in a metropolitan Atlanta, Georgia, after introduction of a 7-valent pneumococcal conjugate vaccine.
Clin Infect Dis, 44 (2007), pp. 1569-1576
[52.]
J.D. Kellner, D.L. Church, J. MacDonald, G.J. Tirrell, D. Scheifele.
Progress in prevention of pneumococcal infection.
Can Med Assoc J, 173 (2005), pp. 1149-1151
[53.]
G. Bjornson, D.W. Scheifele, J. Bettinger, D.M. Patrick, L. Gustafson, P. Daly, et al.
Effectiveness of pneumococcal conjugate vaccines in Greater Vancouver, Canada: 2004-2005.
Pediatr Infect Dis J, 26 (2007), pp. 540-542
[54.]
C. Giele, H. Moore, K. Bayley, C. Harrison, D. Murphy, K. Rooney, et al.
Has the seven-valent pneumococcal conjugate vaccine had an impact on invasive pneumococcal disease in Western Australia?.
Vaccine, 25 (2007), pp. 2379-2384
[55.]
C.A. Lexau, R. Lynfield, L. Danila, T. Pilishvili, R. Facklam, M. Farley, et al.
Changing epidemiology of invasive pneumococcal disease among older adults in the era of pediatric pneumococcal conjugate vaccine.
JAMA, 294 (2005), pp. 2043-2051
[56.]
A.M. McBean, Y.T. Park, D. Caldwell, X. Yu.
Declining invasive pneumococcal disease in the US elderly.
Vaccine, 23 (2005), pp. 5641-5645
[57.]
J.P. Metlay, N.O. Fishman, M. Joffe, P.H. Edelstein.
Impact of pediatric vaccination with pneumococcal conjugate vaccine on the risk of bacteremic pneumococcal pneumonia in adults.
Vaccine, 24 (2006), pp. 468-475
[58.]
K.A. Poehling, T.R. Talbot, M.R. Griffin, A.S. Craig, C.G. Whitney, E. Zell.
Invasive pneumococcal disease among infants before and after introduction of pneumococcal conjugate vaccine.
JAMA, 295 (2006), pp. 1668-1674
[59.]
J.D. Kellner, D.L. Church, J. MacDonald, G.J. Tyrrell, D. Scheifele.
Progress in the prevention of pneumococcal infection.
CMAJ, 173 (2005), pp. 1149-1151
[60.]
Haber M, Barskey A, Baughman W, Barker L, Whitney CG, Shaw KM, et al. Herd immunity and pneumococcal conjugate vaccine: a quantitative model. Vaccine. En prensa 2007.
[61.]
J. Eskola, T. Kilpi, A. Palmu, J. Jokinen, J. Haapakoski, E. Herva, et al.
Efficacy of pneumococcal conjugate vaccine against acute otitis media.
N Engl J Med, 344 (2001), pp. 403-409
[62.]
S. Black, H. Shinefield, B. Fireman, E. Lewis, P. Ray, J.R. Hansen, The Northern California Kaiser Permanente Vaccine Study Center Group, et al.
Efficacy, safety and immunogenicity of heptavalent pneumococcal conjugate vaccine in children.
Pediatr Infect Dis J, 19 (2000), pp. 187-195
[63.]
Straetemans M, Sanders EAM, Veenhoven RH, Schilder AGM, Damoiseaux RAMJ, Zielhuis GA. Vacunas antineumocócicas para la prevención de la otitis media (Revisión Cochrane traducida). En: La BibliotecaCochrane Plus, 2007 Número 2. Oxford: Update Software Ltd. Disponible en: http://www.update-software.com (traducida de The Cochrane Library, Issue 2. Chichester: John Wiley & Sons, Ltd.; 2007).
[64.]
M.C. McEllistrem, J.M. Adams, K. Patel, A.B. Mendelsohn, S.L. Kaplan, J.S. Bradley, et al.
Acute otitis media due to penicillin-nonsusceptible Streptococcus pneumoniae before and after the introduction of the pneumococcal conjugate vaccine.
Clin Infect Dis, 40 (2005), pp. 1738-1744
[65.]
S.B. Black, H.R. Shinefield, S. LinG, J. Hansen, B. Fireman, D. Spring.
Effectiveness of heptavalent pneumococcal conjugate vaccine in children younger than five years of age for prevention of pneumonia.
Pediatr Infect Dis J, 21 (2002), pp. 810-815
[66.]
J. Hansen, S. Black, H. Shinefield, T. Cherian, J. Benson, B. Fireman, et al.
Effectiveness of heptavalent pneumococcal conjugate vaccine in children younger than 5 years of age for prevention pneumonia. Updated analysis using World Health Organization Standarized Interpretation of Chest Radiographs.
Pediatr Infect Dis J, 25 (2006), pp. 779-781
[67.]
S.A. Madhi, K.P. Klugman, The vaccine Trialist Group.
A role for Streptococcus pneumoniae in virus-associated pneumonia.
Nature Med, 10 (2004), pp. 811-813
[68.]
F.T. Cutts, S.M.A. Zaman, G. Enwere, S. Jaffar, O.S. Levine, J.B. Okoko, et al.
Efficacy of nine-valent pneumococcal conjugate vaccine against pneumonia and invasive pneumococcal disease in The Gambia: randomized, doubleblind, placebo-controlled trial.
Lancet, 365 (2005), pp. 1139-1146
[69.]
K.A. Poehling, B.J. Lafleur, P.G. Szilagyi, K.M. Edwards, Ed Mitchel, R. Barth, et al.
Population-based impact of pneumococcal conjugate vaccine in young children.
Pediatrics, 114 (2004), pp. 755-761
[70.]
N. Mbelle, R.E. Huebner, A.D. Wasas, A. Kimura, I. Chang, K.P. Klugman.
Immunogenicity and impact on nasopharyngeal carriage of a nonavalent pneumococcal conjugate vaccine.
J Infect Dis, 180 (1999), pp. 1171-1176
[71.]
A. Fenoll, I. Jado, D. Vicioso, S. Berrón, J.E. Yuste, J. Casal.
Streptococcus pneumoniae in children in Spain.
Acta Paediatr, 89 (2000), pp. 44S-50S
[72.]
T. Jefferson, E. Ferroni, F. Curtale, P.G. Rossi, P. Borgia.
Streptococcus pneumoniae in western Europe: serotype distribution and incidence in children less than 2 years old.
Lancet Infect Dis, 6 (2006), pp. 405-410
[73.]
J. Arístegui, E. Bernaola, I. Pocheville, C. García, L. Arranz, G. Durán, et al.
Reduction in pediatric invasive pneumococcal disease in the Basque Country and Navarre, Spain, after introduction of the heptavalent pneumococcal conjugate vaccine.
Eur J Clin Microbiol Infect Dis, 26 (2007), pp. 303-310
[74.]
A. Barricarte, A. Gil-Setas, L. Torroba, J. Castilla, A. Petit, I. Polo, et al.
Enfermedad neumocócica invasiva en la población menor de 5 años de edad de Navarra (2000-2005): impacto de la vacuna conjugada.
Med Clin (Barc), 129 (2007), pp. 41-45
[75.]
A. Barricarte, J. Castilla, A. Gil-Setas, L. Torroba, A. Navarro-Alonso, F. Irisarri, et al.
Effectiveness of the 7-valent pneumococcal conjugate vaccine: a population-based case-control study.
Clin Infect Dis, 44 (2007), pp. 1436-1441
[76.]
E. Calbo, A. Díaz, E. Cañadel, J. Fábrega, S. Uriz, M. Xercavins, et al.
Invasive pneumococcal disease among children in a health district of Barcelona: early impact of pneumococcal conjugate vaccine.
Clin Microbiol Infect, 12 (2006), pp. 867-872
[77.]
C.L. Byington, M.H. Samore, G.J. Stoddard, S. Barlow, J. Daly, K. Korgenski, et al.
Temporal trends of invasive disease due to Streptococcus pneumoniae among children in the Intermountain West: emergence of nonvaccine serogroups.
Clin Infect Dis, 41 (2005), pp. 21-29
[78.]
K. Hsu, S. Pelton, S. Karumuri, D. Hesey-Grove, J. Klein, Massachusetts Department of Public Health Epidemiologists.
Population-Based surveillance for childhood invasive pneumococcal disease in the era of conjugate vaccine.
Pediatr Infect Dis J, 24 (2005), pp. 17-23
[79.]
C.L. Byington, K. Korgenski, J. Daly, K. Ampofo, A. Pavia, E.O. Mason.
Impact of the pneumococcal conjugate vaccine on pneumococcal parapneumonic empyema.
Pediatr Infect Dis J, 25 (2006), pp. 250-254
[80.]
A.P. Steenhoff, S.S. Shah, A.J. Ratner, S.M. Patil, K.L. McGowan.
Emergence of vaccine-related pneumococcal serotypes as a cause of bacteremia.
Clin Infect Dis, 42 (2006), pp. 907-914
[81.]
R. Pai, M.R. Moore, T. Pilishvili, R.E. Gertz, C.G. Whitney, B. Beall, et al.
Postvaccine genetic structure of Streptococcus pneumoniae serotype 19A from children in the United States.
J Infect Dis, 192 (2005), pp. 1988-1995
[82.]
A.F. Messina, K. Katz-Gaynor, T. Barton, N. Ahmad, F. Ghaffar, D. Rasko, et al.
Impact of the pneumococcal conjugate vaccine on serotype distribution and antimicrobial resistance of invasive Streptococcus pneumoniae isolates in Dallas, TX, children from 1999 through 2005.
Pediatr Infect Dis J, 26 (2007), pp. 461-467
[83.]
S.I. Pelton, H. Huot, J.A. Finkelstein, C.J. Bishop, K.K. Hsu, J. Kellenberg, et al.
Emergence of 19A as virulent and multidrug resistant pneumococcus in Massachusetts following universal immunization of infants with pneumococcal conjugate vaccine.
Pediatr Infect Dis J, 26 (2007), pp. 468-472
[84.]
R.J. Singleton, T.W. Hennessy, L.R. Bulkow, L.L. Hammit, T. Zulz, D.A. Hurlburt, et al.
Invasive pneumococcal disease caused by nonvaccine serotypes among Alaska native children with high levels of 7-valent pneumococcal conjugate vaccine coverage.
JAMA, 297 (2007), pp. 1784-1792
[85.]
K.P. Klugman, L. McGee.
Resurgence of the multiresistant pneumococcus in the United States: a commentary.
Pediatr Infect Dis J, 26 (2007), pp. 473-474
[86.]
B.E. González, K.G. Hulten, L. Lamberth, S.L. Kaplan, E.O. Mason.
Pediatric Multicenter Pneumococcal 7-valent conjugate vaccine. Streptococcus pneumoniae serogroups 15 and 33: an increasing cause of pneumococcal infections in children in the United States after the introduction of the pneumococcal 7-valent conjugate vaccine.
Pediatr Infect Dis J, 25 (2006), pp. 301-305
[87.]
D.J. Farrell, K.P. Klugman, M. Pichichero.
Increased antimicrobial resistance among nonvaccine serotypes of Streptococcus pneumoniae in the pediatric population after the introduction of 7-valent pneumococcal vaccine in the United States.
Pediatr Infect Dis J, 26 (2007), pp. 123-128
[88.]
G. Eltringham, A. Kearns, R. Freeman, J. Clark, D. Spencer, K. Eatstham, et al.
Culture-negative childhood empyema is usually due to penicillin-sensitive Streptococcus pneumoniae capsular serotype 1.
J Clin Microbiol, 41 (2003), pp. 521-522
[89.]
I. Obando, L.A. Arroyo, D. Sánchez-Tatay, D. Tarragó, D. Moreno, W.P. Hausdorff, et al.
Molecular epidemiology of paediatric invasive pneumococcal disease in southern Spain after the introduction of heptavalent pneumococcal conjugate vaccine.
Clin Microbiol Infect, 13 (2006), pp. 347-349
[90.]
K.M. Eastham, R. Freeman, A.M. Kearns, G. Eltringham, J. Clark, J. Leeming, et al.
Clinical features, aetiology and outcome of empyema in children in the north east of England.
Thorax, 59 (2004), pp. 522-525
[91.]
M. Fletcher, J. Leeming, K. Cartwright, A. Finn, On behalf of the South West of England Invasive Community Acquired Infection Study Group.
Childhood empyema: limited potential impact of 7-valent pneumococcal conjugate vaccine.
Pediatr Infect Dis J, 25 (2006), pp. 559-560
[92.]
H. Bekri, R. Cohen, E. Varon, F. Madhi, R. Gire, F. Guillot, et al.
Streptococcus pneumoniae serotypes involved in children with pleural empyemas in France.
Arch Pediatr, 14 (2007), pp. 239-243
[93.]
S.C. Buckingham, M.D. King, M.L. Miller.
Incidence and etiologies of complicated parapneumonic effusions in children, 1966 to 2001.
Pediatr Infect Dis J, 22 (2003), pp. 499-504
[94.]
D.A. Spencer, S.M. Iqbal, A. Hasan, L. Hamilton.
Empyema thoracis is still increasing in UK children.
BMJ, 332 (2006), pp. 1333
[95.]
C.L. Byington, L.Y. Spencer, T.A. Johnson, A.T. Pavia, D. Allen, E.O. Mason, et al.
An epidemiological investigation of a sustained high rate of pediatric parapneumonic empyema: risk factors and microbiological considerations.
Clin Infect Dis, 34 (2002), pp. 434-435
[96.]
A.B. Brueggemann, T.E.A. Peto, D.W. Crook, J.C. Butler, K.G. Kristinsson, B.G. Spratt.
Temporal and geographic stability of the serogroup-specific invasive disease potential of Streptococcus pneumoniae in children.
J Infect Dis, 190 (2004), pp. 1203-1211
[97.]
S.S. Long.
Cpasules, clones, and curious events: pneumococcus under fire from polysaccharide conjugate vaccine.
Clin Infect Dis, 41 (2005), pp. 30-34
[98.]
E. Miller, P. Waight, A. Efstraiou, M. Brisson, A. Johnson, R. George.
Epidemiology of invasive and other pneumococcal disease in children in England and Wales 1996-1998.
Acta Paediatr, 89 (2000), pp. 11S-16S
[99.]
R. Von Kries, M. Hermann, A. Hachmeister, A. Siedler, H. Schmitt, A. Al-Lahhan, et al.
Prediction of the potential benefit of different pneumococcal conjugate vaccines on invasive pneumococcal disease in German children.
Pediatr Infect Dis J, 21 (2002), pp. 1017-1023
[100.]
R.D. Feikin, K.P. Klugman.
Historical changes in pneumococcal serogroup distribution: implications for the era of pneumococcal conjugate vaccines.
Clin Infect Dis, 35 (2002), pp. 547-555
[101.]
O.S. Levine, K.L. O’Brien, M. Knoll, R.A. Adegbola, S. Black, T. Cherian, et al.
Pneumococcal vaccination in developing countries.
Lancet, 367 (2006), pp. 1880-1882
[102.]
I. Rudan, S. El Arifeen, R.E. Black, H. Campbell.
Childhood pneumonia and diarrhoea: setting our priorities right.
Lancet Infect Dis, 7 (2007), pp. 56-61
[103.]
T. Wardlaw, P. Salama, E.W. Johansson, E. Mason.
Pneumonia the leader killer in children.
Lancet, 368 (2006), pp. 1048-1050
[104.]
J.A. Berkley, B.S. Lowe, I. Mwangi, T. Williams, E. Bauni, S. Mwarumba, et al.
Bacteremia among children admitted to a rural hospital in Kenya.
N Engl J Med, 352 (2005), pp. 39-47
Copyright © 2008. Elsevier España S.L.. Todos los derechos reservados
