BACKGROUND Vaccination against influenza and pneumococcus is effective in reducing morbidity and mortality in patients with diabetes.AIM To investigate the prevalence of influenza and pneumococcal vaccinations and to ...BACKGROUND Vaccination against influenza and pneumococcus is effective in reducing morbidity and mortality in patients with diabetes.AIM To investigate the prevalence of influenza and pneumococcal vaccinations and to search for the independent associates of vaccination in Turkish patients with diabetes.METHODS In this cross-sectional,nationwide,multicenter study,adult patients with type 1 diabetes(T1DM)(n=454)and type 2 diabetes(T2DM)(n=4721),who were under follow-up for at least a year in the outpatient clinics,were consecutively enrolled.Sociodemographic,clinical,and laboratory parameters of patients were recorded.Vaccination histories were documented according to the self-statements of the patients.RESULTS Patients with T1DM and T2DM had similar vaccination rates for influenza(23.6%vs 21.2%;P=0.240)and pneumococcus(8%vs 7%;P=0.451)vaccinations.Longer diabetes duration and older age were the common independent associates of having vaccination for both types of diabetes patients.Higher education level,using statin treatment,and having optimal hemoglobin A1c levels were the common independent associates of influenza and pneumococcal vaccination in patients with T2DM.CONCLUSION TEMD Vaccination Study shows that patients with T1DM and T2DM had very low influenza and pneumococcal vaccination rates in Turkey.The lower rates of vaccination in certain populations urges the necessity of nationwide vaccination strategies targeting these populations.展开更多
Since its discovery in 1891, the pneumococcus has been one of the most extensively studied microbes, and was involved in several historical findings such as the discovery of genetic material that was later shown to be...Since its discovery in 1891, the pneumococcus has been one of the most extensively studied microbes, and was involved in several historical findings such as the discovery of genetic material that was later shown to be DNA. The pneumococcus is part of the normal bacterial flora of the nasopharynx, but can on occasions progress to sterile sites of the body and cause invasive diseases. There are about one million new invasive pneumococcal infections every year, majority of which occur in the developing world where children <5 years are most affected. The burden of pneumococcal disease is further heightened by the increasing prevalence of multidrug resistance of the organism. The pneumococcus remains a pathogen of immense public health significance and understanding its biology, particularly the pathogenesis and antibiotic resistance is crucial to controlling pneumococcal disease.展开更多
Streptococcus pneumoniae is a medically important pathogen capable of causing human infections of pneumonia, bacteremia, otitis media, and meningitis. Although there are vaccinations available, infections with S. pneu...Streptococcus pneumoniae is a medically important pathogen capable of causing human infections of pneumonia, bacteremia, otitis media, and meningitis. Although there are vaccinations available, infections with S. pneumoniae still remains a global problem. S. pneumoniae is a highly adaptable bacterial species with numerous serotypes based on capsular polysaccharides. The different serotypes vary in their ability to colonize and causing pathology. Here we compared the regulation of five different virulence factors from four common serotypes of S. pneumoniae that vary in their carriage, morbidity, and mortality rates in the human population using two different in vitro methods, broth and cell culture. We determine that there is variation of virulence factor gene regulation within a serotype using two different culture methods, and variation between the serotypes in the same culture condition. The regulation of genes appeared to have a correlation with the ability of the various serotypes to grow in broth culture, adhere to cultured lung cells, and invade the cultured lung cells, as serotypes that shared similar regulation of virulence factors tended to behave similarly in culture. Many studies with S. pneumoniae rely on the use of one selected serotype, but since there is a wide variation in the growth and regulatory mechanisms of these bacteria. As demonstrated here, future studies should utilize more strains in models before concluding mechanisms of pathobiology.展开更多
Aim: To investigate the effects of exposure of a macrolide-resistant [erm (B)-expressing] strain of Streptococcus pneumoniae (strain 2507) to clarithromycin (0.5 and 5 mg/L) added at the outset and 6 hours after initi...Aim: To investigate the effects of exposure of a macrolide-resistant [erm (B)-expressing] strain of Streptococcus pneumoniae (strain 2507) to clarithromycin (0.5 and 5 mg/L) added at the outset and 6 hours after initiation of culture on early gene expression, energy metabolism, and growth. Methods: Bacterial growth was determined by turbidometric and colony counting procedures, energy metabolism by measurement of ATP, while analysis of gene expression was performed using reverse transcription-PCR and sequencing. Results: Addition of clarithromycin, at either concentration, at the outset of culture, caused transient suppression of growth of 10 - 12 hours duration, while delayed addition of antibiotic (during the logarithmic phase) resulted in an abrupt halt in growth followed by recovery. These inhibitory effects of clarithromycin on bacterial growth were associated with up-regulation of expression of erm(B), decreased ATP and protein synthesis, and were unaffected by inclusion of either catalase (500 and 1000 kunits/L), or competence-stimulating peptide (CSP-1, 0.5 mg/L). The inhibitory effects could, however, be overcome by pre-exposure of the bacteria to the antibiotic. Moreover, clarithromycin appeared to potentiate the antimicrobial actions of ceftriaxone, at sub-MIC concentrations, for strain 2507. Conclusions: Unlike several other common bacterial pathogens, the full expression of erm(B)-mediated macrolide resistance by the pneumococcus has a slow onset, which is associated with transient susceptibility to macrolides and inhibition of growth.展开更多
Background The thirteen-valent pneumococcal conjugate vaccine(PCV13)is not included in the national immu-nization program and is administered voluntarily with informed consent in China.In preparation for assessing the...Background The thirteen-valent pneumococcal conjugate vaccine(PCV13)is not included in the national immu-nization program and is administered voluntarily with informed consent in China.In preparation for assessing the impact of pilot introduction in Hainan Province,we conducted a carriage study among children under 5 years of age from four locations in Hainan Province,China.Methods From March to June 2022,nasopharyngeal(NP)swabs,collected from healthy children aged younger than 59 months who lived in the 4 different locations(Haikou,Wanning,Baisha and Qiongzhong)in Hainan Province,were tested for pneumococcus using conventional culture.Pneumococcal isolates were serotyped using the Quel-lung reaction.Risk factors associated with pneumococcal colonization were assessed using univariate analysis and multivariable logistic regression adjusting for age,daycare attendance and other factors.Results Pneumococcus was isolated in 710(30.4%)of the 2333 children enrolled.Of 737 pneumococci,29 serotypes were identifed;60.9%were PCV13 serotypes;the most common vaccine serotypes were 6B(20.4%),19F(13.0%),6A(11.9%)and 23F(6.1%);and the most common nonvaccine serotypes were 23A(12.9%),34(6.1%)and nontypeable(NT)pneumococci(5.6%).Children vaccinated with PCV13 had lower carriage(17.7%vs 32.5%;P=0.0001)and fewer PCV13 serotypes(41.9%vs 62.7%;P=0.0017)compared to unimmunized children.After adjustment,NP carriage Was higher among children attending daycare(aOR=2.3,95%CI:1.7-3.2),living in rural areas(aOR=1.4,95%CI:1.1-1.8),living with siblings(aOR=1.3,95%CI:1.0-1.6)and whose mothers had completed senior high/technical sec-ondary school(aOR=1.5,95%CI:1.1-2.0).In contrast,completion of 3-4 doses of PCV13 were associated with a lower carriage rate(aOR=0.6,95%CI:0.4-0.9).Conclusions We established the baseline of pneumococcal carriage,serotype distribution and PCV13 immuni-zation rates among healthy children under 5 years of age in Hainan Province,prior to the introduction of PCV13 into the national immunization program.The high proportion of PCV13 serotypes suggests that PCV13 introduction will likely have a substantial impact on pneumococcal carriage in Hainan Province.展开更多
文摘BACKGROUND Vaccination against influenza and pneumococcus is effective in reducing morbidity and mortality in patients with diabetes.AIM To investigate the prevalence of influenza and pneumococcal vaccinations and to search for the independent associates of vaccination in Turkish patients with diabetes.METHODS In this cross-sectional,nationwide,multicenter study,adult patients with type 1 diabetes(T1DM)(n=454)and type 2 diabetes(T2DM)(n=4721),who were under follow-up for at least a year in the outpatient clinics,were consecutively enrolled.Sociodemographic,clinical,and laboratory parameters of patients were recorded.Vaccination histories were documented according to the self-statements of the patients.RESULTS Patients with T1DM and T2DM had similar vaccination rates for influenza(23.6%vs 21.2%;P=0.240)and pneumococcus(8%vs 7%;P=0.451)vaccinations.Longer diabetes duration and older age were the common independent associates of having vaccination for both types of diabetes patients.Higher education level,using statin treatment,and having optimal hemoglobin A1c levels were the common independent associates of influenza and pneumococcal vaccination in patients with T2DM.CONCLUSION TEMD Vaccination Study shows that patients with T1DM and T2DM had very low influenza and pneumococcal vaccination rates in Turkey.The lower rates of vaccination in certain populations urges the necessity of nationwide vaccination strategies targeting these populations.
文摘Since its discovery in 1891, the pneumococcus has been one of the most extensively studied microbes, and was involved in several historical findings such as the discovery of genetic material that was later shown to be DNA. The pneumococcus is part of the normal bacterial flora of the nasopharynx, but can on occasions progress to sterile sites of the body and cause invasive diseases. There are about one million new invasive pneumococcal infections every year, majority of which occur in the developing world where children <5 years are most affected. The burden of pneumococcal disease is further heightened by the increasing prevalence of multidrug resistance of the organism. The pneumococcus remains a pathogen of immense public health significance and understanding its biology, particularly the pathogenesis and antibiotic resistance is crucial to controlling pneumococcal disease.
文摘Streptococcus pneumoniae is a medically important pathogen capable of causing human infections of pneumonia, bacteremia, otitis media, and meningitis. Although there are vaccinations available, infections with S. pneumoniae still remains a global problem. S. pneumoniae is a highly adaptable bacterial species with numerous serotypes based on capsular polysaccharides. The different serotypes vary in their ability to colonize and causing pathology. Here we compared the regulation of five different virulence factors from four common serotypes of S. pneumoniae that vary in their carriage, morbidity, and mortality rates in the human population using two different in vitro methods, broth and cell culture. We determine that there is variation of virulence factor gene regulation within a serotype using two different culture methods, and variation between the serotypes in the same culture condition. The regulation of genes appeared to have a correlation with the ability of the various serotypes to grow in broth culture, adhere to cultured lung cells, and invade the cultured lung cells, as serotypes that shared similar regulation of virulence factors tended to behave similarly in culture. Many studies with S. pneumoniae rely on the use of one selected serotype, but since there is a wide variation in the growth and regulatory mechanisms of these bacteria. As demonstrated here, future studies should utilize more strains in models before concluding mechanisms of pathobiology.
文摘Aim: To investigate the effects of exposure of a macrolide-resistant [erm (B)-expressing] strain of Streptococcus pneumoniae (strain 2507) to clarithromycin (0.5 and 5 mg/L) added at the outset and 6 hours after initiation of culture on early gene expression, energy metabolism, and growth. Methods: Bacterial growth was determined by turbidometric and colony counting procedures, energy metabolism by measurement of ATP, while analysis of gene expression was performed using reverse transcription-PCR and sequencing. Results: Addition of clarithromycin, at either concentration, at the outset of culture, caused transient suppression of growth of 10 - 12 hours duration, while delayed addition of antibiotic (during the logarithmic phase) resulted in an abrupt halt in growth followed by recovery. These inhibitory effects of clarithromycin on bacterial growth were associated with up-regulation of expression of erm(B), decreased ATP and protein synthesis, and were unaffected by inclusion of either catalase (500 and 1000 kunits/L), or competence-stimulating peptide (CSP-1, 0.5 mg/L). The inhibitory effects could, however, be overcome by pre-exposure of the bacteria to the antibiotic. Moreover, clarithromycin appeared to potentiate the antimicrobial actions of ceftriaxone, at sub-MIC concentrations, for strain 2507. Conclusions: Unlike several other common bacterial pathogens, the full expression of erm(B)-mediated macrolide resistance by the pneumococcus has a slow onset, which is associated with transient susceptibility to macrolides and inhibition of growth.
基金This research was funded by Bill&Melinda Gates Foundation(No.INV-034554)Beijing Municipal Natural Science Foundation(No.L202007)Special funds for the construction of high-level public health technical personnel from Beijing Municipal Health Commission(No.2022-3-01-021).
文摘Background The thirteen-valent pneumococcal conjugate vaccine(PCV13)is not included in the national immu-nization program and is administered voluntarily with informed consent in China.In preparation for assessing the impact of pilot introduction in Hainan Province,we conducted a carriage study among children under 5 years of age from four locations in Hainan Province,China.Methods From March to June 2022,nasopharyngeal(NP)swabs,collected from healthy children aged younger than 59 months who lived in the 4 different locations(Haikou,Wanning,Baisha and Qiongzhong)in Hainan Province,were tested for pneumococcus using conventional culture.Pneumococcal isolates were serotyped using the Quel-lung reaction.Risk factors associated with pneumococcal colonization were assessed using univariate analysis and multivariable logistic regression adjusting for age,daycare attendance and other factors.Results Pneumococcus was isolated in 710(30.4%)of the 2333 children enrolled.Of 737 pneumococci,29 serotypes were identifed;60.9%were PCV13 serotypes;the most common vaccine serotypes were 6B(20.4%),19F(13.0%),6A(11.9%)and 23F(6.1%);and the most common nonvaccine serotypes were 23A(12.9%),34(6.1%)and nontypeable(NT)pneumococci(5.6%).Children vaccinated with PCV13 had lower carriage(17.7%vs 32.5%;P=0.0001)and fewer PCV13 serotypes(41.9%vs 62.7%;P=0.0017)compared to unimmunized children.After adjustment,NP carriage Was higher among children attending daycare(aOR=2.3,95%CI:1.7-3.2),living in rural areas(aOR=1.4,95%CI:1.1-1.8),living with siblings(aOR=1.3,95%CI:1.0-1.6)and whose mothers had completed senior high/technical sec-ondary school(aOR=1.5,95%CI:1.1-2.0).In contrast,completion of 3-4 doses of PCV13 were associated with a lower carriage rate(aOR=0.6,95%CI:0.4-0.9).Conclusions We established the baseline of pneumococcal carriage,serotype distribution and PCV13 immuni-zation rates among healthy children under 5 years of age in Hainan Province,prior to the introduction of PCV13 into the national immunization program.The high proportion of PCV13 serotypes suggests that PCV13 introduction will likely have a substantial impact on pneumococcal carriage in Hainan Province.
