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Safari D, Daningrat WOD, Milucky JL, Khoeri MM, Paramaiswari WT, Tafroji W, Salsabila K, Winarti Y, Soebandrio A, Hadinegoro SR, Prayitno A, Childs L, Pimenta FC, Carvalho MDG, Pilishvili T. Nasopharyngeal carriage of Streptococcus pneumoniae among children <5 years of age in Indonesia prior to pneumococcal conjugate vaccine introduction. PLoS One 2024; 19:e0297041. [PMID: 38206916 PMCID: PMC10783721 DOI: 10.1371/journal.pone.0297041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 12/27/2023] [Indexed: 01/13/2024] Open
Abstract
Pneumococcal conjugate vaccines (PCVs) prevent nasopharyngeal colonization with vaccine serotypes of Streptococcus pneumoniae, leading to reduced transmission of pneumococci and stronger population-level impact of PCVs. In 2017 we conducted a cross-sectional pneumococcal carriage study in Indonesia among children aged <5 years before 13-valent PCV (PCV13) introduction. Nasopharyngeal swabs were collected during visits to community integrated health service posts at one peri-urban and one rural study site. Specimens were analyzed by culture, and isolates were serotyped using sequential multiplex polymerase chain and Quellung reaction. Antibiotic susceptibility was performed by broth microdilution method. We enrolled 1,007 children in Gunungkidul District, Yogyakarta (peri-urban) and 815 in Southwest Sumba, East Nusa Tenggara (rural). Pneumococcal carriage prevalence was 30.9% in Gunungkidul and 87.6% in Southwest Sumba (combined: 56.3%). PCV13 serotypes (VT) carriage was 15.0% in Gunungkidul and 52.6% in Southwest Sumba (combined: 31.8%). Among pneumococcal isolates identified, the most common VT were 6B (16.4%), 19F (15.8%), and 3 (4.6%) in Gunungkidul (N = 323) and 6B (17.6%), 19F (11.0%), and 23F (9.3%) in Southwest Sumba (N = 784). Factors associated with pneumococcal carriage were age (1-2 years adjusted odds ratio (aOR) 1.9, 95% CI 1.4-2.5; 3-4 years aOR 1.5, 95% CI 1.1-2.1; reference <1 year), other children <5 years old in the household (aOR 1.5, 95% CI 1.1-2.0), and presence of ≥1 respiratory illness symptom (aOR 1.8, 95% CI 1.4-2.2). Overall, 61.5% of the pneumococcal isolates were non-susceptible to ≥1 antibiotic class and 13.2% were multi-drug non-susceptible (MDNS) (non-susceptible to ≥3 classes of antibiotics). Among 602 VT isolates, 73.9% were non-susceptible and 19.9% were MDNS. These findings are critical to establish a pre-PCV13 carriage prevalence and demonstrate the complexity in evaluating the impact of PCV13 introduction in Indonesia given the wide variability in the carriage prevalence as shown by the two study sites.
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Affiliation(s)
- Dodi Safari
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency, Cibinong, West Java, Indonesia
| | - Wa Ode Dwi Daningrat
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency, Cibinong, West Java, Indonesia
- Centre for Genomic Pathogen Surveillance, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Jennifer L. Milucky
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Miftahuddin Majid Khoeri
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency, Cibinong, West Java, Indonesia
| | - Wisiva Tofriska Paramaiswari
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency, Cibinong, West Java, Indonesia
| | - Wisnu Tafroji
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency, Cibinong, West Java, Indonesia
| | - Korrie Salsabila
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency, Cibinong, West Java, Indonesia
| | - Yayah Winarti
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency, Cibinong, West Java, Indonesia
| | - Amin Soebandrio
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency, Cibinong, West Java, Indonesia
| | | | - Ari Prayitno
- Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
| | - Lana Childs
- CDC Foundation, Atlanta, GA, United States of America
| | - Fabiana C. Pimenta
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Maria da Gloria Carvalho
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Tamara Pilishvili
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
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Ritter JM, Seixas JN, Walong E, Dawa J, Onyango C, Pimenta FC, da Gloria Carvalho M, Silva-Flannery L, Jenkinson T, Howard K, Bhatnagar J, Diaz M, Winchell JM, Zaki SR, Chaves SS, Martines RB. Histopathology Is Key to Interpreting Multiplex Molecular Test Results From Postmortem Minimally Invasive Tissue Samples. Clin Infect Dis 2021; 73:S351-S359. [PMID: 34910182 PMCID: PMC8672755 DOI: 10.1093/cid/ciab772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Minimally invasive tissue sampling (MITS) is an alternative to complete autopsy for determining causes of death. Multiplex molecular testing performed on MITS specimens poses challenges of interpretation, due to high sensitivity and indiscriminate detection of pathogenic, commensal, or contaminating microorganisms. METHODS MITS was performed on 20 deceased children with respiratory illness, at 10 timepoints up to 88 hours postmortem. Samples were evaluated by multiplex molecular testing on fresh tissues by TaqMan® Array Card (TAC) and by histopathology, special stains, immunohistochemistry (IHC), and molecular testing (PCR) on formalin-fixed, paraffin-embedded (FFPE) tissues. Results were correlated to determine overall pathologic and etiologic diagnoses and to guide interpretation of TAC results. RESULTS MITS specimens collected up to 3 days postmortem were adequate for histopathologic evaluation and testing. Seven different etiologic agents were detected by TAC in 10 cases. Three cases had etiologic agents detected by FFPE or other methods and not TAC; 2 were agents not present on TAC, and 2 were streptococci that may have been species other than those present on TAC. Result agreement was 43% for TAC and IHC or PCR, and 69% for IHC and PCR. Extraneous TAC results were common, especially when aspiration was present. CONCLUSIONS TAC can be performed on MITS up to 3 days after death with refrigeration and provides a sensitive method for detection of pathogens but requires careful interpretation in the context of clinicoepidemiologic and histopathologic findings. Interpretation of all diagnostic tests in aggregate to establish overall case diagnoses maximizes the utility of TAC in MITS.
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Affiliation(s)
- Jana M Ritter
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Josilene N Seixas
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Edwin Walong
- College of Health Sciences, University of Nairobi, Nairobi, Kenya
| | - Jeanette Dawa
- College of Health Sciences, University of Nairobi, Nairobi, Kenya
- Washington State University, Global Health Programs (Kenya office), Nairobi, Kenya
| | - Clayton Onyango
- Division of Global Health Protection, Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Fabiana C Pimenta
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Maria da Gloria Carvalho
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Luciana Silva-Flannery
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Tiffany Jenkinson
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Katie Howard
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Julu Bhatnagar
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Maureen Diaz
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jonas M Winchell
- Division of Bacterial Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sherif R Zaki
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sandra S Chaves
- Influenza Program, Centers for Disease Control and Prevention, Nairobi, Kenya and Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Roosecelis B Martines
- Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Safari D, Gultom SM, Tafroji W, Azzahidah A, Soesanti F, Khoeri MM, Prayitno A, Pimenta FC, da Gloria Carvalho M, Uiterwaal CSPM, Putri ND. Prevalence, serotype and antibiotic susceptibility of Group B Streptococcus isolated from pregnant women in Jakarta, Indonesia. PLoS One 2021; 16:e0252328. [PMID: 34043711 PMCID: PMC8158947 DOI: 10.1371/journal.pone.0252328] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 05/13/2021] [Indexed: 01/31/2023] Open
Abstract
Group B Streptococcus (GBS) is a bacterial pathogen which is a leading cause of neonatal infection. Currently, there are limited GBS data available from the Indonesian population. In this study, GBS colonization, serotype distribution and antimicrobial susceptibility profile of isolates were investigated among pregnant women in Jakarta, Indonesia. Demographics data, clinical characteristics and vaginal swabs were collected from 177 pregnant women (mean aged: 28.7 years old) at 29–40 weeks of gestation. Bacterial culture identification tests and latex agglutination were performed for GBS. Serotyping was done by conventional multiplex PCR and antibiotic susceptibility testing by broth microdilution. GBS colonization was found in 53 (30%) pregnant women. Serotype II was the most common serotype (30%) followed by serotype III (23%), Ia and IV (13% each), VI (8%), Ib and V (6% each), and one non-typeable strain. All isolates were susceptible to vancomycin, penicillin, ampicillin, cefotaxime, daptomycin and linezolid. The majority of GBS were resistant to tetracycline (89%) followed by clindamycin (21%), erythromycin (19%), and levofloxacin (6%). The serotype III was more resistant to erythromycin, clindamycin, and levofloxacin and these isolates were more likely to be multidrug resistant (6 out of 10) compared to other serotypes. This report provides demographics of GBS colonization and isolate characterization in pregnant women in Indonesia. The results may facilitate preventive strategies to reduce neonatal GBS infection and improve its treatment.
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Affiliation(s)
- Dodi Safari
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia
| | - Septiani Madonna Gultom
- Faculty of Medicine, Department of Child Health, Universitas Indonesia/Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Wisnu Tafroji
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia
| | | | - Frida Soesanti
- Faculty of Medicine, Department of Child Health, Universitas Indonesia/Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | | | - Ari Prayitno
- Faculty of Medicine, Department of Child Health, Universitas Indonesia/Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Fabiana C. Pimenta
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Maria da Gloria Carvalho
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Cuno S. P. M. Uiterwaal
- Julius Center for Health Sciences and Primary Care, Julius Global Health, University Medical Center, Utrecht, the Netherlands
| | - Nina Dwi Putri
- Faculty of Medicine, Department of Child Health, Universitas Indonesia/Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- * E-mail:
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Valenciano SJ, Moiane B, Lessa FC, Chaúque A, Massora S, Pimenta FC, Mucavele H, Verani JR, da Gloria Carvalho M, Whitney CG, Tembe N, Sigaúque B. Effect of 10-Valent Pneumococcal Conjugate Vaccine on Streptococcus pneumoniae Nasopharyngeal Carriage Among Children Less Than 5 Years Old: 3 Years Post-10-Valent Pneumococcal Conjugate Vaccine Introduction in Mozambique. J Pediatric Infect Dis Soc 2021; 10:448-456. [PMID: 33245124 DOI: 10.1093/jpids/piaa132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 10/30/2020] [Indexed: 11/14/2022]
Abstract
BACKGROUND Mozambique introduced 10-valent pneumococcal conjugate vaccine (PCV10) in 2013 with doses at ages 2, 3, and 4 months and no catch-up or booster dose. We evaluated PCV10 impact on the carriage of vaccine-type (VT), non-VT, and antimicrobial non-susceptible pneumococci 3 years after introduction. METHODS We conducted cross-sectional carriage surveys among HIV-infected and HIV-uninfected children aged 6 weeks to 59 months: 1 pre-PCV10 (2012-2013 [Baseline]) and 2 post-PCV10 introductions (2014-2015 [Post1] and 2015-2016 [Post2]). Pneumococci isolated from nasopharyngeal swabs underwent Quellung serotyping and antimicrobial susceptibility testing. Non-susceptible isolates (intermediate or resistant) were defined using Clinical and Laboratory Standards Institute 2018 breakpoints. We used log-binomial regression to estimate changes in the pneumococcal carriage between survey periods. We compared proportions of non-susceptible pneumococci between Baseline and Post2. RESULTS We enrolled 720 children at Baseline, 911 at Post1, and 1208 at Post2. Baseline VT carriage was similar for HIV-uninfected (36.0%, 110/306) and HIV-infected children (34.8%, 144/414). VT carriage was 36% (95% confidence interval [CI]: 19%-49%) and 27% (95% CI: 11%-41%) lower in Post1 vs baseline among HIV-uninfected and HIV-infected children, respectively. VT carriage prevalence declined in Post2 vs Post1 for HIV-uninfected but remained stable for HIV-infected children. VT carriage prevalence 3 years after PCV10 introduction was 14.5% in HIV-uninfected and 21.0% in HIV-infected children. Pneumococcal isolates non-susceptible to penicillin declined from 66.0% to 56.2% (P= .0281) among HIV-infected children. CONCLUSIONS VT and antimicrobial non-susceptible pneumococci carriage dropped after PCV10 introduction, especially in HIV-uninfected children. However, VT carriage remained common, indicating ongoing VT pneumococci transmission.
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Affiliation(s)
- Sandra J Valenciano
- Epidemic Intelligence Service assigned to National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases, Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Benild Moiane
- Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Moçambique
| | - Fernanda C Lessa
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases, Respiratory Diseases Branch, Atlanta, Georgia, USA
| | - Alberto Chaúque
- Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Moçambique
| | - Sergio Massora
- Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Moçambique
| | - Fabiana C Pimenta
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases, Respiratory Diseases Branch, Atlanta, Georgia, USA
| | - Helio Mucavele
- Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Moçambique
| | - Jennifer R Verani
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases, Respiratory Diseases Branch, Atlanta, Georgia, USA
| | - Maria da Gloria Carvalho
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases, Respiratory Diseases Branch, Atlanta, Georgia, USA
| | - Cynthia G Whitney
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases, Respiratory Diseases Branch, Atlanta, Georgia, USA
| | - Nelson Tembe
- Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Moçambique.,Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique
| | - Betuel Sigaúque
- Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Moçambique.,Instituto Nacional de Saúde, Ministério de Saúde, Maputo, Mozambique.,John Snow Inc. (JSI) on the Maternal and Child Survival Program-MCSP (USAID Grantee), Maputo, Mozambique
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Farrar JL, Odiembo H, Odoyo A, Bigogo G, Kim L, Lessa FC, Feikin DR, Breiman RF, Whitney CG, Carvalho MG, Pimenta FC. Limited Added Value of Oropharyngeal Swabs for Detecting Pneumococcal Carriage in Adults. Open Forum Infect Dis 2020; 7:ofaa368. [PMID: 32995349 PMCID: PMC7505525 DOI: 10.1093/ofid/ofaa368] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 08/13/2020] [Indexed: 11/14/2022] Open
Abstract
We compared pneumococcal isolation rates and evaluated the benefit of using oropharyngeal (OP) specimens in addition to nasopharyngeal (NP) specimens collected from adults in rural Kenya. Of 846 adults, 52.1% were colonized; pneumococci were detected from both NP and OP specimens in 23.5%, NP only in 22.9%, and OP only in 5.7%. Ten-valent pneumococcal conjugate vaccine strains were detected from both NP and OP in 3.4%, NP only in 4.1%, and OP only in 0.7%. Inclusion of OP swabs increased carriage detection by 5.7%; however, the added cost of collecting and processing OP specimens may justify exclusion from future carriage studies among adults.
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Affiliation(s)
- Jennifer L Farrar
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Herine Odiembo
- Global Disease Detection Division (GDD) and International Emerging Infections Program (IEIP), Kenya Medical Research Institute (KEMRI)/CDC Public Health and Research Collaboration, Kisumu, Kenya
| | - Arthur Odoyo
- Global Disease Detection Division (GDD) and International Emerging Infections Program (IEIP), Kenya Medical Research Institute (KEMRI)/CDC Public Health and Research Collaboration, Kisumu, Kenya
| | - Godfrey Bigogo
- Global Disease Detection Division (GDD) and International Emerging Infections Program (IEIP), Kenya Medical Research Institute (KEMRI)/CDC Public Health and Research Collaboration, Kisumu, Kenya
| | - Lindsay Kim
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Fernanda C Lessa
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Daniel R Feikin
- Global Disease Detection Division (GDD) and International Emerging Infections Program (IEIP), Kenya Medical Research Institute (KEMRI)/CDC Public Health and Research Collaboration, Kisumu, Kenya
| | - Robert F Breiman
- Emory Global Health Institute, Emory University, Atlanta, Georgia, USA
| | - Cynthia G Whitney
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Maria G Carvalho
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Fabiana C Pimenta
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Pimenta FC, Moiane B, Lessa FC, Venero AKL, Moura I, Larson S, Massora S, Chaúque A, Tembe N, Mucavele H, Verani JR, Whitney CG, Sigaúque B, Carvalho MGS. Dried blood spots for Streptococcus pneumoniae and Haemophilus influenzae detection and serotyping among children < 5 years old in rural Mozambique. BMC Pediatr 2020; 20:326. [PMID: 32615947 PMCID: PMC7331148 DOI: 10.1186/s12887-020-02209-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 06/16/2020] [Indexed: 11/26/2022] Open
Abstract
Background Dried blood spots (DBS) have been proposed as potentially tool for detecting invasive bacterial diseases. Methods We evaluated the use of DBS for S. pneumoniae and H. influenzae detection among children in Mozambique. Blood for DBS and nasopharyngeal (NP) swabs were collected from children with pneumonia and healthy aged < 5 years. Bacterial detection and serotyping were performed by quantitative PCR (qPCR) (NP and DBS; lytA gene for pneumococcus and hpd for H. influenzae) and culture (NP). Combined detection rates were compared between children with pneumonia and healthy. Results Of 325 children enrolled, 205 had pneumonia and 120 were healthy. Pneumococci were detected in DBS from 20.5 and 64.2% of children with pneumonia and healthy, respectively; NP specimens were positive for pneumococcus in 80.0 and 80.8%, respectively. H. influenzae was detected in DBS from 22.9% of children with pneumonia and 59.2% of healthy; 81.4 and 81.5% of NP specimens were positive for H. influenzae, respectively. Conclusion DBS detected pneumococcal and H. influenzae DNA in children with pneumonia and healthy. Healthy children were often DBS positive for both bacteria, suggesting that qPCR of DBS specimens does not differentiate disease from colonization and is therefore not a useful diagnostic tool for children.
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Affiliation(s)
- Fabiana C Pimenta
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, 30329, USA.
| | - Benild Moiane
- Centro de Investigação em Saúde de Manhiça, 1929, Maputo, Mozambique
| | - Fernanda C Lessa
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, 30329, USA
| | | | - Iaci Moura
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, 30329, USA
| | | | - Sergio Massora
- Centro de Investigação em Saúde de Manhiça, 1929, Maputo, Mozambique
| | - Alberto Chaúque
- Centro de Investigação em Saúde de Manhiça, 1929, Maputo, Mozambique
| | - Nelson Tembe
- Centro de Investigação em Saúde de Manhiça, 1929, Maputo, Mozambique
| | - Helio Mucavele
- Centro de Investigação em Saúde de Manhiça, 1929, Maputo, Mozambique
| | - Jennifer R Verani
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, 30329, USA
| | - Cynthia G Whitney
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, 30329, USA
| | - Betuel Sigaúque
- Centro de Investigação em Saúde de Manhiça, 1929, Maputo, Mozambique
| | - Maria G S Carvalho
- Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, 30329, USA
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Massora S, Lessa FC, Moiane B, Pimenta FC, Mucavele H, Chaúque A, Cossa A, Verani JR, Tembe N, da Gloria Carvalho M, Muñoz-Almagro C, Sigaúque B. Invasive disease potential of Streptococcus pneumoniae serotypes before and after 10-valent pneumococcal conjugate vaccine introduction in a rural area, southern Mozambique. Vaccine 2019; 37:7470-7477. [PMID: 31575493 PMCID: PMC10962395 DOI: 10.1016/j.vaccine.2019.09.079] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 09/02/2019] [Accepted: 09/24/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND Invasive pneumococcal disease (IPD) is a significant cause of morbidity and mortality among children worldwide. In April 2013, Mozambique introduced 10-valent PCV (PCV10) into the National Expanded Program on immunization using a three-dose schedule at 2, 3, and 4 months of age. We aimed to evaluate the invasive disease potential of pneumococcal serotypes among children in our region before and after PCV10 introduction. METHODS We used data from ongoing population-based surveillance for IPD and cross-sectional pneumococcal carriage surveys among children aged <5 years in Manhiҫa, Mozambique. To determine the invasive disease potential for each serotype pre- and post-PCV10 introduction, odds ratios (OR) and 95% confidence intervals (95% CI) were calculated comparing serotype-specific prevalence in IPD and in carriage. For each serotype, OR and 95% CI > 1 indicated high invasive disease potential and OR and 95% CI < 1 indicated low invasive disease potential. RESULTS In the pre-PCV10 period, 524 pneumococcal isolates were obtained from 411 colonized children and IPD cases were detected in 40 children. In the post-PCV10 period, 540 pneumococcal isolates were obtained from 507 colonized children and IPD cases were detected in 30 children. The most prevalent serotypes causing IPD pre-PCV10 were 6A (17.5%), 6B (15.0%), 14 (12.5%), 23F (10.0%) and 19F (7.5%), and post-PCV10 were 6A (36.7%), 13 (10%), 1 (10.0%), 6B (6.7%) and 19A (6.7%). Serotypes associated with high invasive disease potential pre-PCV10 included 1 (OR:22.3 [95% CI 2.0; 251.2]), 6B (OR:3.1 [95% CI 1.2; 8.1]), 14 (OR: 3.4 [95% CI 1.2; 9.8]) and post-PCV10 included serotype 6A (OR:6.1[95% CI 2.7; 13.5]). CONCLUSION The number of serotypes with high invasive disease potential decreased after PCV10 introduction. Serotype 6A, which is not included in PCV10, was the most common cause of IPD throughout the study and showed a high invasive potential in the post-PCV10 period.
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Affiliation(s)
- Sérgio Massora
- Fundação Manhiça, Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique.
| | - Fernanda C Lessa
- Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
| | - Benild Moiane
- Fundação Manhiça, Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique.
| | - Fabiana C Pimenta
- Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
| | - Hélio Mucavele
- Fundação Manhiça, Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique.
| | - Alberto Chaúque
- Fundação Manhiça, Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique.
| | - Anélsio Cossa
- Fundação Manhiça, Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique.
| | - Jennifer R Verani
- Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
| | - Nelson Tembe
- Fundação Manhiça, Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique.
| | - Maria da Gloria Carvalho
- Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
| | - Carmen Muñoz-Almagro
- Molecular Microbiology Department, Instituto de Recerca Pediatrica, University Hospital Sant Joan de Deu, Barcelona, Spain; Ciber of Epidemiology and Public Health, CIBERESP, Instituto de Salud Carlos III, Madrid, Spain; Medicine Department, Universitat Internacional de Catalunya, Barcelona, Spain.
| | - Betuel Sigaúque
- Fundação Manhiça, Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique.
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Andrade AL, Ternes YM, Vieira MA, Moreira WG, Lamaro-Cardoso J, Kipnis A, Cardoso MR, Brandileone MC, Moura I, Pimenta FC, da Gloria Carvalho M, Saraiva FO, Toscano CM, Minamisava R. Direct effect of 10-valent conjugate pneumococcal vaccination on pneumococcal carriage in children Brazil. PLoS One 2014; 9:e98128. [PMID: 24892409 PMCID: PMC4043727 DOI: 10.1371/journal.pone.0098128] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 04/29/2014] [Indexed: 01/15/2023] Open
Abstract
Background 10-valent conjugate pneumococcal vaccine/PCV10 was introduced in the Brazilian National Immunization Program along the year of 2010. We assessed the direct effectiveness of PCV10 vaccination in preventing nasopharyngeal/NP pneumococcal carriage in infants. Methods A cross-sectional population-based household survey was conducted in Goiania Brazil, from December/2010-February/2011 targeting children aged 7–11 m and 15–18 m. Participants were selected using a systematic sampling. NP swabs, demographic data, and vaccination status were collected from 1,287 children during home visits. Main outcome and exposure of interest were PCV10 vaccine-type carriage and dosing schedules (3p+0, 2p+0, and one catch-up dose), respectively. Pneumococcal carriage was defined by a positive culture and serotyping was performed by Quellung reaction. Rate ratio/RR was calculated as the ratio between the prevalence of vaccine-types carriage in children exposed to different schedules and unvaccinated for PCV10. Adjusted RR was estimated using Poisson regression. PCV10 effectiveness/VE on vaccine-type carriage was calculated as 1-RR*100. Results The prevalence of pneumococcal carriage was 41.0% (95%CI: 38.4–43.7). Serotypes covered by PCV10 and PCV13 were 35.2% and 53.0%, respectively. Vaccine serotypes 6B (11.6%), 23F (7.8%), 14 (6.8%), and 19F (6.6%) were the most frequently observed. After adjusted for confounders, children who had received 2p+0 or 3p+0 dosing schedule presented a significant reduction in pneumococcal vaccine-type carriage, with PCV10 VE equal to 35.9% (95%CI: 4.2–57.1; p = 0.030) and 44.0% (95%CI: 14.–63.5; p = 0.008), respectively, when compared with unvaccinated children. For children who received one catch-up dose, no significant VE was detected (p = 0.905). Conclusion PCV10 was associated with high protection against vaccine-type carriage with 2p+0 and 3p+0 doses for children vaccinated before the second semester of life. The continuous evaluation of carriage serotypes distribution is likely to be useful for evaluating the long-term effectiveness and impact of pneumococcal vaccination on serotypes reduction.
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Affiliation(s)
- Ana Lucia Andrade
- Institute of Tropical Pathology and Public Health, Federal University of Goias, Goiania, Brazil
- * E-mail:
| | - Yves Mauro Ternes
- Institute of Tropical Pathology and Public Health, Federal University of Goias, Goiania, Brazil
- Epidemiology Branch, Secretariat of Health of Municipality of Goiania, Goias, Brazil
| | | | - Weslley Garcia Moreira
- Institute of Tropical Pathology and Public Health, Federal University of Goias, Goiania, Brazil
- Laboratory of Bacteriology, Federal University of Goias, Goiania, Brazil
| | | | - André Kipnis
- Laboratory of Bacteriology, Federal University of Goias, Goiania, Brazil
| | - Maria Regina Cardoso
- Department of Epidemiology, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | | | - Iaci Moura
- Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Fabiana C. Pimenta
- Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Maria da Gloria Carvalho
- Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | | | - Cristiana Maria Toscano
- Institute of Tropical Pathology and Public Health, Federal University of Goias, Goiania, Brazil
| | - Ruth Minamisava
- Faculty of Nursing, Federal University of Goias, Goiania, Brazil
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Carvalho MDG, Pimenta FC, Moura I, Roundtree A, Gertz RE, Li Z, Jagero G, Bigogo G, Junghae M, Conklin L, Feikin DR, Breiman RF, Whitney CG, Beall BW. Non-pneumococcal mitis-group streptococci confound detection of pneumococcal capsular serotype-specific loci in upper respiratory tract. PeerJ 2013; 1:e97. [PMID: 23825797 PMCID: PMC3698467 DOI: 10.7717/peerj.97] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 06/10/2013] [Indexed: 11/20/2022] Open
Abstract
We performed culture-based and PCR-based tests for pneumococcal identification and serotyping from carriage specimens collected in rural and urban Kenya. Nasopharyngeal specimens from 237 healthy children <5 years old (C-NPs) and combined nasopharyngeal/oropharyngeal specimens from 158 adults (A-NP/OPs, 118 HIV-positive) were assessed using pneumococcal isolation (following broth culture enrichment) with Quellung-based serotyping, real-time lytA-PCR, and conventional multiplexed PCR-serotyping (cmPCR). Culture-based testing from C-NPs, HIV-positive A-NP/OPs, and HIV-negative A-NP/OPs revealed 85.2%, 40.7%, and 12.5% pneumococcal carriage, respectively. In contrast, cmPCR serotypes were found in 93.2%, 98.3%, and 95.0% of these sets, respectively. Two of 16 lytA-negative C-NPs and 26 of 28 lytA-negative A-NP/OPs were cmPCR-positive for 1–10 serotypes (sts) or serogroups (sgs). A-NP/OPs averaged 5.5 cmPCR serotypes/serogroups (5.2 in HIV-positive, 7.1 in HIV-negative) and C-NPs averaged 1.5 cmPCR serotypes/serogroups. cmPCR serotypes/serogroups from lytA-negative A-NP/OPs included st2, st4, sg7F/7A, sg9N/9L, st10A, sg10F/10C/33C, st13, st17F, sg18C/18A/18B/18F, sg22F/22A, and st39. Nine strains of three non-pneumococcal species (S. oralis, S. mitis, and S. parasanguinis) (7 from A-OP, 1 from both A-NP and A-OP, and 1 from C-NP) were each cmPCR-positive for one of 7 serotypes/serogroups (st5, st13, sg15A/15F, sg10F/10C/33C, sg33F/33A/37, sg18C/18A/18B/18F, sg12F/12A/12B/ 44/46) with amplicons revealing 83.6–99.7% sequence identity to pneumococcal references. In total, 150 cmPCR amplicons from carriage specimens were sequenced, including 25 from lytA-negative specimens. Amplicon sequences derived from specimens yielding a pneumococcal isolate with the corresponding serotype were identical or highly conserved (>98.7%) with the reference cmPCR amplicon for the st, while cmPCR amplicons from lytA-negative specimens were generally more divergent. Separate testing of 56 A-OPs and 56 A-NPs revealed that ∼94% of the positive cmPCR results from A-NP/OPs were from OP microbiota. In contrast, A-NPs yielded >2-fold more pneumococcal isolates than A-OPs. Verified and suspected non-pneumococcal cmPCR serotypes/serogroups appeared to be relatively rare in C-NPs and A-NPs compared to A-OPs. Our findings indicate that non-pneumococcal species can confound serotype-specific PCR and other sequence-based assays due to evolutionarily conserved genes most likely involved in biosynthesis of surface polysaccharide structures.
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Affiliation(s)
- Maria da Gloria Carvalho
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta , USA
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10
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Pimenta FC, Carvalho MDGS, Gertz RE, Bastos-Rocha CGB, Oliveira LSC, Lacerda Pigosso L, Lima JA, Marquez Franco C, Andrade AL, Beall BW. Serotype and genotype distributions of pneumococcal carriage isolates recovered from Brazilian children attending day-care centres. J Med Microbiol 2011; 60:1455-1459. [PMID: 21636673 DOI: 10.1099/jmm.0.031450-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Pneumococcal nasopharyngeal carriage isolates recovered from Brazilian children attending day-care centres in 2005 were assessed for serotype, genotype and penicillin susceptibility phenotype. As 124 of the 253 isolates (49 %) were characterized previously with respect to serotype and penicillin susceptibility, the primary objectives were to examine clonal associations and penicillin susceptibility within major serotypes and to assess the suitability of conventional multiplex PCR for deducing carriage serotypes within this population. Using a combination of PCR-based serotyping and the Quellung reaction, serotypes were identified for 81 % (205/253) of the isolates, with serogroups or types 14, 6, 23F, 19F and 18 being predominant. Included within the 205 isolates successfully serotyped by PCR were 28 isolates that had become non-viable. Forty-eight isolates were non-typable using both the PCR method and the Quellung reaction. Penicillin non-susceptibility was observed within 16 of the 18 multilocus sequence types detected. Thus, this study provides further evidence from a diverse collection of pneumococcal clones that PCR-based serotype deduction is useful for providing supportive evidence for pneumococcal conjugate vaccine implementation.
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Affiliation(s)
- Fabiana C Pimenta
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás State, Brazil.,Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Robert E Gertz
- Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Cristyane G B Bastos-Rocha
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás State, Brazil
| | - Luciana S C Oliveira
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás State, Brazil
| | - Laurine Lacerda Pigosso
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás State, Brazil
| | - Juliane A Lima
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás State, Brazil
| | | | - Ana Lucia Andrade
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás State, Brazil
| | - Bernard W Beall
- Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
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11
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Goulart C, Darrieux M, Rodriguez D, Pimenta FC, Brandileone MCC, de Andrade ALS, Leite LC. Selection of family 1 PspA molecules capable of inducing broad-ranging cross-reactivity by complement deposition and opsonophagocytosis by murine peritoneal cells. Vaccine 2011; 29:1634-42. [DOI: 10.1016/j.vaccine.2010.12.074] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Revised: 11/30/2010] [Accepted: 12/16/2010] [Indexed: 11/27/2022]
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12
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Millar EV, Pimenta FC, Roundtree A, Jackson D, Carvalho MDG, Perilla MJ, Reid R, Santosham M, Whitney CG, Beall BW, O'Brien KL. Pre- and post-conjugate vaccine epidemiology of pneumococcal serotype 6C invasive disease and carriage within Navajo and White Mountain Apache communities. Clin Infect Dis 2010; 51:1258-65. [PMID: 21034194 DOI: 10.1086/657070] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND A second-generation 13-valent pneumococcal conjugate vaccine, PCV13, was recently licensed. Although PCV13 includes serotype 6A, the usefulness of that antigen may be limited by the emergence of a new serotype, 6C, which was identified among isolates initially characterized (Quellung reaction) as serotype 6A. The epidemiology of serotype 6C prior to and after 7-valent PCV (PCV7) introduction is incompletely understood. METHODS We analyzed conventionally serotyped 6A (CS6A) pneumococci from invasive disease case patients of all ages and carriage isolates from children and adults obtained in population-based studies among Navajo and White Mountain Apache communities during 1994-2009. Samples were tested by triplex polymerase chain reaction to resolve serotypes 6C and 6A. RESULTS A total of 74 invasive CS6A episodes occurred. All were retyped by polymerase chain reaction; 40 (54.1%) were serotype 6C. The mean annual incidence of serotype 6C invasive disease was 0.3 (95% confidence interval, 0.03-0.9), 0.7 (95% confidence interval, 0.2-1.3), and 1.5 (95% confidence interval, 1.0-2.1) cases per 100,000 population in the years prior to the PCV7 efficacy trial, during the time the PCV7 trial was conducted, and following PCV7 introduction and routine use, respectively (P = .01). In the routine vaccination era, 76% of invasive CS6As were serotype 6C; nearly all cases occurred in adults. The proportion of serotype 6C among CS6A carriage isolates increased from 42% to 61% to 94% in the prevaccine, early vaccine, and routine vaccination eras, respectively. CONCLUSION In the PCV7 routine use era, virtually all serogroup 6 invasive pneumococcal disease and carriage strains among Navajo and White Mountain Apache communities are 6C. Monitoring and evaluation of this and other emerging serotypes among invasive disease and carriage isolates is warranted.
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Affiliation(s)
- Eugene V Millar
- Johns Hopkins Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
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13
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Gertz RE, Li Z, Pimenta FC, Jackson D, Juni BA, Lynfield R, Jorgensen JH, Carvalho MDG, Beall BW. Increased penicillin nonsusceptibility of nonvaccine-serotype invasive pneumococci other than serotypes 19A and 6A in post-7-valent conjugate vaccine era. J Infect Dis 2010; 201:770-5. [PMID: 20178139 DOI: 10.1086/650496] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
According to population-based invasive pneumococcal surveillance in the United States during 2007, 898 (26%) of 3,511 isolates were penicillin nonsusceptible. Non-7-valent pneumococcal conjugate vaccine (PCV7) serotypes other than 19A accounted for 40% of these penicillin-nonsusceptible isolates; of these, serotypes 15A (11%), 23A (8%), 35B (8%), and 6C (5%) were most common (cumulatively 32% of penicillin-nonsusceptible isolates). Each except 6C represented a single serotype and clonal complex combination that predated the introduction of PCV7. We evaluated the genetic characteristics and nonsusceptibility to penicillin of non- PCV7 serotypes, and we found increased proportions of specific penicillin-nonsusceptible clones in serotypes 15A, 23A, 35B, and 6C, which potentially indicates a basic change of population structure within these individual serotypes.
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Affiliation(s)
- Robert E Gertz
- Respiratory Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA
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14
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Fernandes LF, Pimenta FC, Fernandes FF. First report of human myiasis in GoiáS state, Brazil: frequency of different types of myiasis, their various etiological agents, and associated factors. J Parasitol 2009; 95:32-8. [PMID: 18576696 DOI: 10.1645/ge-1103.1] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2006] [Accepted: 05/28/2008] [Indexed: 11/10/2022] Open
Abstract
The objective of this study was to show which species of flies are responsible for human myiasis in the Brazilian state of Goiás and to determine the frequency of cases. Patients at the Clinical Hospital of the Federal University of Goiás (UFG) were examined, and any fly larvae found in their wounds were collected for taxonomic identification. First instar larvae were observed using light microscopy; second and third instars were examined using stereoscopy. The following screwworm flies were observed, in decreasing order of prevalence: Cochliomyia hominivorax, Sarcodexia lambens, Dermatobia hominis, Chrysomya albiceps, Chrysomya megacephala, Lucilia cuprina, and Eristalis tenax. Myiasis was most frequent in the legs in adults, male patients, elderly people, and people of reproductive age. It was lowest in children, females, and patients with neurologic or psychiatric disorders. Frequency was high in patients living in low socioeconomic conditions with poor personal hygiene. Education and sanitation measures are needed to counteract this situation.
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Affiliation(s)
- Ly F Fernandes
- Universidade Federal de Goiás, Departamento de Clínica Cirúrgica do Hospital das Clínicas da UFG, Goiânia-Goiás, Brazil.
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15
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Darrieux M, Moreno AT, Ferreira DM, Pimenta FC, de Andrade ALSS, Lopes APY, Leite LCC, Miyaji EN. Recognition of pneumococcal isolates by antisera raised against PspA fragments from different clades. J Med Microbiol 2008; 57:273-278. [DOI: 10.1099/jmm.0.47661-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Pneumococcal surface protein A (PspA) is an important vaccine candidate against pneumococcal infections, capable of inducing protection in different animal models. Based on its structural diversity, it has been suggested that a PspA-based vaccine should contain at least one fragment from each of the two major families (family 1, comprising clades 1 and 2, and family 2, comprising clades 3, 4 and 5) in order to elicit broad protection. This study analysed the recognition of a panel of 35 pneumococcal isolates bearing different PspAs by antisera raised against the N-terminal regions of PspA clades 1 to 5. The antiserum to PspA clade 4 was found to show the broadest cross-reactivity, being able to recognize pneumococcal strains containing PspAs of all clades in both families. The cross-reactivity of antibodies elicited against a PspA hybrid including the N-terminal region of clade 1 fused to a shorter and more divergent fragment (clade-defining region, or CDR) of clade 4 (PspA1–4) was also tested, and revealed a strong recognition of isolates containing clades 1, 4 and 5, and weaker reactions with clades 2 and 3. The analysis of serum reactivity against different PspA regions further revealed that the complete N-terminal region rather than just the CDR should be included in an anti-pneumococcal vaccine. A PspA-based vaccine is thus proposed to be composed of the whole N-terminal region of clades 1 and 4, which could also be expressed as a hybrid protein.
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Affiliation(s)
- Michelle Darrieux
- Centro de Biotecnologia, Instituto Butantan, Av. Vital Brasil, 1500, 05509-900, São Paulo, SP, Brazil
| | - Adriana T. Moreno
- Centro de Biotecnologia, Instituto Butantan, Av. Vital Brasil, 1500, 05509-900, São Paulo, SP, Brazil
| | - Daniela M. Ferreira
- Centro de Biotecnologia, Instituto Butantan, Av. Vital Brasil, 1500, 05509-900, São Paulo, SP, Brazil
| | - Fabiana C. Pimenta
- Instituto de Patologia Tropical e Saude Publica, Universidade Federal de Goias, Goiania, Brazil
| | | | - Alexandre P. Y. Lopes
- Centro de Biotecnologia, Instituto Butantan, Av. Vital Brasil, 1500, 05509-900, São Paulo, SP, Brazil
| | - Luciana C. C. Leite
- Centro de Biotecnologia, Instituto Butantan, Av. Vital Brasil, 1500, 05509-900, São Paulo, SP, Brazil
| | - Eliane N. Miyaji
- Centro de Biotecnologia, Instituto Butantan, Av. Vital Brasil, 1500, 05509-900, São Paulo, SP, Brazil
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16
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Pimenta FC, Miyaji EN, Arêas APM, Oliveira MLS, de Andrade ALSS, Ho PL, Hollingshead SK, Leite LCC. Intranasal immunization with the cholera toxin B subunit-pneumococcal surface antigen A fusion protein induces protection against colonization with Streptococcus pneumoniae and has negligible impact on the nasopharyngeal and oral microbiota of mice. Infect Immun 2006; 74:4939-44. [PMID: 16861686 PMCID: PMC1539618 DOI: 10.1128/iai.00134-06] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
One of the candidate proteins for a mucosal vaccine antigen against Streptococcus pneumoniae is PsaA (pneumococcal surface antigen A). Vaccines targeting mucosal immunity may raise concerns as to possible alterations in the normal microbiota, especially in the case of PsaA, which was shown to have homologs with elevated sequence identity in other viridans group streptococci. In this work, we demonstrate that intranasal immunization with a cholera toxin B subunit-PsaA fusion protein is able to protect mice against colonization with S. pneumoniae but does not significantly alter the natural oral or nasopharyngeal microbiota of mice.
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Affiliation(s)
- F C Pimenta
- Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, Brazil
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17
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Ribeiro EL, Scroferneker ML, Cavalhaes MS, Campos CC, Nagato GM, Souza NA, Ferreira WM, Cardoso CG, Dias SMS, Pimenta FC, Toledo OA. Phenotypic aspects of oral strains of Candida albicans in children with down's syndrome. BRAZ J BIOL 2006; 66:939-44. [PMID: 17119842 DOI: 10.1590/s1519-69842006000500020] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2005] [Accepted: 04/11/2005] [Indexed: 11/22/2022] Open
Abstract
The aim of this article is to characterize the biological aspects of oral strains of C. albicans in children with Down's syndrome. These yeasts were analyzed as to their macromorphological and enzymatic aspects and were tested as to their in vitro susceptibility to antifungal drugs using broth microdilution to determine the minimum inhibitory concentration (MIC). The morphotyping revealed that all oral C. albicans isolates from children with Down's syndrome promoted the formation of fringes regardless of size, while the control group presented smaller fringes. All oral C. albicans strains produced proteinase, but those with phospholipolytic activity showed greater enzyme capacity in the test group. In vitro susceptibility showed that all oral C. albicans isolates were sensitive to the drugs used.
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Affiliation(s)
- E L Ribeiro
- Institute of Tropical Pathology and Public Health, Universidade Federal de Goiás, Goiânia, GO, Brazil.
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18
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Laval CB, de Andrade ALSS, Pimenta FC, de Andrade JG, de Oliveira RM, Silva SA, de Lima EC, Fabio JL, Casagrande ST, Brandileone MCC. Serotypes of carriage and invasive isolates of Streptococcus pneumoniae in Brazilian children in the era of pneumococcal vaccines. Clin Microbiol Infect 2006; 12:50-5. [PMID: 16460546 DOI: 10.1111/j.1469-0691.2005.01304.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Nasopharyngeal carriage of Streptococcus pneumoniae is a key factor in the development of invasive disease and the spread of resistant strains within the community. A single nasopharyngeal swab was obtained from 648 unvaccinated children aged <5 years, either healthy or with acute respiratory tract infection or meningitis, during the winters of 2000 and 2001. The overall pneumococcal carriage rate was 35.8% (95% CI 32.1-39.6). The pneumococcal serotypes found most frequently in the nasopharynx were 14, 6B, 6A, 19F, 10A, 23F and 18C, which included five of the seven serotypes in the currently licensed seven-valent conjugate vaccine (PCV7); serotypes 4 and 9V were less common. Serotypes 1 and 5 were isolated rarely from the nasopharynx. A comparison of 222 nasopharyngeal isolates with 125 invasive isolates, matched for age and time to the carrier isolates, showed a similar prevalence of penicillin non-susceptible pneumococci (PNSp) (19.8% and 19.2%, respectively). PNSp serotypes were similar (6B, 14, 19F, 19 A, 23B and 23F) for carriage and invasive disease isolates. The coverage of PCV7 for carriage isolates (52.2%) and invasive isolates (62.4%) did not differ significantly (p 0.06); similarly, there was no significant difference in PCV7 coverage for carriage isolates (34.5%) and invasive isolates (28.2%) of PNSp. These data suggest that PCV7 has the potential to reduce pneumococcal carriage and the number of carriers of PNSp belonging to vaccine serotypes.
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Affiliation(s)
- C B Laval
- Communicable Disease Surveillance, Secretariat of Health of the Municipality of Goiânia, Brazil
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Abstract
The fungal pathogenic flora of the external surface of 103 cockroaches (Periplaneta americana) collected from the intensive care unit of a hospital were investigated. In this study, a high percentage of test cockroaches (93.2%) were found to carry fungi of medical importance. The main fungi isolated were species of Candida, Aspergillus and Penicillium. Information about the carriage of pathogenic fungi by cockroaches in hospital environment is scanty. The results suggest that cockroaches can play a role in dissemination of fungi, which they can carry on their external surface.
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Affiliation(s)
- A A Lemos
- Instituto de Patologia Tropical e Saúde Pública da UFG, Goiania, Goias, Brazil
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Abstract
The aim of this study was to identify the aerobic and the anaerobic microorganisms which can be related to duct ectasia. The patients were divided into two groups. Group 1 comprised 100 patients with coloured nipple discharge (duct ectasia group), and Group 2 (the control group) was composed of 50 patients without nipple discharge. The culture media used were BHI-PRAS, blood agar, mannitol agar and MacConkey agar. There was a high frequency of bacterial growth in the two groups: 85% in Group 1 and 88% in Group 2. The most prevalent bacteria were Staphylococcus aureus and Staphylococcus epidermidis. There was a statistically significant higher rate of smokers in the duct ectasia group compared with the control group, 25 (25%) patients vs. 5 (10%), respectively (p = 0.03). These findings allow us to put forth the hypothesis that the genesis of duct ectasia may be a non-infectious inflammatory process.
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Affiliation(s)
- R M S Rahal
- Medical School, Institute of Tropical Pathology and Public Health, Goiania, Brazil
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21
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Barnabé W, de Mendonça Neto T, Pimenta FC, Pegoraro LF, Scolaro JM. Efficacy of sodium hypochlorite and coconut soap used as disinfecting agents in the reduction of denture stomatitis, Streptococcus mutans and Candida albicans. J Oral Rehabil 2004; 31:453-9. [PMID: 15140171 DOI: 10.1111/j.1365-2842.2004.01254.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study evaluated the reduction of denture stomatitis and the antimicrobial activity of 0.05% sodium hypochlorite opposed to Candida albicans and Streptococcus mutans (SGM) when associated with brushing complete dentures with coconut soap. The mucosal characteristics were evaluated according to Newton's classification at baseline, after cleansing the dentures with coconut soap for 15 days in group 1 (nine patients). In the other group (19 patients) the analysis were made before and after cleansing the dentures with coconut soap and with disinfection in a soak solution of 0.05% sodium hypochlorite for 10 min during 15 days. Microbiological tests were used to isolate C. albicans and SGM. Mann-Whitney and Wilcoxon tests were used to compare the mucosal characteristics and Fisher test and McNemar test to compare C. albicans and SGM levels. Statistical analysis at the 95% confidence level (P < 0.05) showed that: (i) the association of coconut soap and 0.05% sodium hypochlorite significantly reduced clinical signs of denture stomatitis, (ii) C. albicans did not reduce in counts, (iii) SGM were reduced but not significantly and (iv) the association of coconut soap and 0.5% sodium hypochlorite was effective in controlling denture biofilm.
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Affiliation(s)
- W Barnabé
- Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil.
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Ribeiro EL, Campos CDC, Crespo AMC, Castro JS, Rocha FP, Alves M, Goulart MS, Cardoso C, Ferreira W, Naves PL, Soares AJ, Miranda SR, Pimenta FC. [Detection of phospholipidolytic Candida albicans isolated from saliva of children with Down's syndrome]. ACTA MEDICA PORT 2002; 15:171-4. [PMID: 12379993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
The childhood is one of the most propitious period of the life to the occurrence of infection by yeasts of the genus Candida. In children with Down's syndrome, besides the predispose factors to bucal candidiasis; macroglossia, bucal muscular incompetence, frequent respiratory diseases, motor difficulty and immunologic deficit are mentioned as additional elements for this fungus disease. It was verified that the children attacked by this syndrome have much more strains of Candida than other children. The aim of this study was to detect the prevalence of phospholipase producer, Candida on the saliva of children with Down's syndrome. Candida albicans was the only identified specie of Candida. The phospholipase production was found in isolated strains from both of study and control. However, the isolated strains of the group of children with Down's syndrome have strongly present phospholipidolitic.
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Affiliation(s)
- Evandro L Ribeiro
- Departamento em Medicina Tropical e Microbiologia/Imunologia, Universidade Federal de Goiás, Brasil
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Prado MA, Pimenta FC, Hayashid M, Souza PR, Pereira MS, Gir E. [Enterobacteria isolated from cockroaches (Periplaneta americana) captured in a Brazilian hospital]. Rev Panam Salud Publica 2002; 11:93-8. [PMID: 11939120 DOI: 10.1590/s1020-49892002000200005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To isolate and identify microorganisms from cockroaches that were captured in a public hospital and to test the antimicrobial susceptibility of these microorganisms. METHODS Cockroaches were captured in the morning and at night. They were placed in flasks rinsed with 70% alcohol, transferred to sterilized flasks, and then taken to the laboratory. Only cockroaches captured whole and live were utilized for the study. After being immobilized at 0 degree C, each cockroach was placed in a test tube with sterile saline solution (0.8%) and then homogenized. The resulting solution was then placed in the following five culture media: MacConkey agar, nutrient broth, brain-heart infusion agar, Sabouraud agar, and mannitol. The cultures were examined using a stereomicroscope, and colony-forming units were counted. The disk diffusion test was used to determine antimicrobial susceptibility. RESULTS We found a 56% prevalence of enterobacteria and an 18% prevalence of coagulase-negative staphylococci. Fifteen species of enterobacteria were identified. The most frequent were Klebsiella pneumoniae (17%), Enterobacter aerogenes (14%), Serratia marcescens (13%), Hafnia alvei (12%), Enterobacter gergoviae and Enterobacter cloacae (each 9%), and Serratia spp. (6%). Both the enterobacteria and the coagulase-negative staphylococci showed significant resistance to antimicrobials, including oxacillin. CONCLUSIONS The prevalence of enteropathogenic bacteria and coagulase-negative staphylococci isolated from Periplaneta americana cockroaches in the studied hospital reflects the weakness of the measures adopted both for vector control and for antimicrobial use. The results show the need to implement effective health-institution programs focusing on hygiene and the rational use of antimicrobials.
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Affiliation(s)
- Marinésia A Prado
- Universidade Federal de Goiás, Faculdade de Enfermagem, Goiânia, Brasil.
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Pimenta FC, Marin JM, de Uzeda M, Ito IY. Prevalence of mutans streptococci in 93 members from six Brazilian families. Pesqui Odontol Bras 2001; 15:181-6. [PMID: 11705264 DOI: 10.1590/s1517-74912001000300002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/17/2023]
Abstract
Several studies report that mutans streptococci (MS) are closely associated with caries in humans and that there is a correlation between the number of carious lesions and the levels of MS in the saliva of children and adults. The presence of MS in the saliva of 93 members of six Brazilian families with at least 3 generations was investigated. Samples of whole unstimulated saliva were collected and diluted. Aliquots of 50 microliters of each suspension were dropped onto SB20 agar and incubated in a candle jar at 37 degrees C for 72 h. Colonies resembling MS were counted, collected, seeded in thioglycoilate medium and subjected to biochemical typing. Mutans streptococci were isolated from 80 subjects (86.0%) and the counts ranged from 3.0 x 10(2) (log 2.477) to 1.6 x 10(8) (log 8.204) CFU/ml of saliva. All of the 73 adults were colonized by MS, but the bacteria were detected in only 7 (35.0%) of the 20 children evaluated. Streptococcus mutans occurred in 78 subjects (97.5%), and 51 (63.7%) were monocolonized. S. sobrinus occurred in 29 individuals (36.3%) and 2 (2.5%) were monocolonized. Twenty-seven (33.8%) subjects were multicolonized with S. mutans and S. sobrinus. This study showed a high prevalence (86.0%) of mutans streptococci in the saliva of members of the studied families, which suggests the risk of intrafamilial transmission.
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Abstract
AIM The aim of this study was to determine the influence of vehicles on the antimicrobial efficiency of calcium hydroxide. METHODOLOGY A total of 588 size 50 sterile absorbent paper points, were immersed in various microbial suspensions for 3 min. The points were then placed on Petri dishes and covered with intracanal dressings containing calcium hydroxide: Ca(OH)2 + saline; Ca(OH)2 + camphorated paramonochlorophenol; Ca(OH)2 + 1% chlorhexidine solution: Ca(OH)2 + 3% sodium lauryl sulphate; Ca(OH)2 + Otosporin. After 1 min, 48 and 72 h and 7 days, 147 absorbent paper cones were removed from contact with the intracanal dressings and individually transported and immersed in 5 mL of Letheen Broth, followed by incubation at 37 degrees C for 48 h. Microbial growth was evaluated by turbidity of the culture medium. A 0.1-mL inoculum obtained from the Letheen Broth was transferred to 5 mL of BHI, and incubated at 37 degrees C for 48 h. Bacterial growth was again evaluated by turbidity of the culture medium. Positive BHI tubes were selected and inocula were spread on the surface of BHI agar and incubated at 37 degrees C for 48 h. Gram staining of the BHI growth and from colonies growing on BHI agar was carried out. RESULTS An antimicrobial effect occurred after 48 h on the cultures of S. mutans, E. faecalis, S. aureus, P aeruginosa, B. subtilis, C. albicans and a mixed culture, irrespective of the intracanal dressing. CONCLUSIONS Under the conditions of this study, the various vehicles associated with calcium hydroxide pastes did not influence the time required for microbial inactivation.
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Affiliation(s)
- C Estrela
- Department of Endodontics, Federal University of Goiás, Goiânia
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Abstract
The objective of this study was to evaluate the antimicrobial activity of calcium hydroxide in infected dentinal tubules. Four microorganisms, strains of ATCC (Streptococcus faecalis (ATCC-29212), Staphylococcus aureus (ATCC-6538), Bacillus subtilis (ATCC-6633), and Pseudomonas aeruginosa (ATCC-27853)) and one mixture of these were used. These strains were inoculated in brain heart infusion (BHI) and incubated at 37 degrees C for 24 h. Sixty-three human maxillary central incisors were prepared and sterilized by autoclaving. Five groups of 12 teeth each were contaminated for 28 days using new 24-h cultures every 72 h, prepared and adjusted to tube 2 of the MacFarland scale (6 x 10(8) cells/ml). Root canals were then irrigated with 5 ml of saline, dried, and completely filled with calcium hydroxide paste. At intervals of 0, 48, and 72 h, and 7 days, dressings were removed and teeth were immersed in 5 ml of BHI and incubated at 37 degrees C for 48 h to observe the growth and multiplication of the microorganisms. Three uninoculated teeth were maintained in a humid environment as an aseptic control. These teeth were immersed in BHI and maintained at 37 degrees C for 7 days to determine microbial growth. Bacterial growth was shown by turbidity of the culture medium and confirmed by seeding these broths on BHI agar at 37 degrees C for 24 h. The positive BHI tubes were selected, and inoculum was spread on the surface of BHI agar, followed by the same incubation conditions. Gram stain was conducted from BHI growth and from colonies growing on solid medium. Calcium hydroxide in infected dentinal tubules showed no antimicrobial effect on S. faecalis, S. aureus, B. subtilis, P. aeruginosa, or on the bacterial mixture used throughout the experiment.
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Affiliation(s)
- C Estrela
- Federal University of Goiás, Goiânia, Brazil
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Abstract
The objective of this study was to determine in vitro the time required for calcium hydroxide in direct contact with microorganisms to express its antimicrobial effect. The microorganisms used were: Micrococcus luteus (ATCC-9341), Staphylococcus aureus (ATCC-6538), Fusobacterium nucleatum (ATCC-25586), Pseudomonas aeruginosa (ATCC-27853), Escherichia coli, and Streptococcus sp. The strains were cultivated in Brain Heart Infusion (BHI), with the exception of F. nucleatum (BHI-PRAS). Pure and mixed suspensions of the microorganisms were prepared. Paper cones immersed in these substances were covered with calcium hydroxide paste, and after 0, 1, 2, 6, 12, 24, 48, and 72 h and 7 days they were transferred to an appropriate medium to observe the growth and multiplication of the microorganisms. Incubation was conducted at 37 degrees C for 48 h, according to the requirements of oxygen of each microorganism. The antimicrobial effect of calcium hydroxide was shown to occur after 12 h on M. luteus and F. nucleatum, 24 h on Streptococcus sp, 48 h on E. coli, and 72 h on S. aureus and P. aeruginosa. Mixture II (M. luteus + Streptococcus sp + S. aureus) was sensitive to calcium hydroxide antimicrobial potential after 48 h, whereas mixture I (M. luteus + E. coli + P. aeruginosa), mixture III (E. coli + P. aeruginosa), and mixture IV (S. aureus + P. aeruginosa) were inactivated after 72 h of exposure.
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Affiliation(s)
- C Estrela
- Federal University of Goiás, Goiânia, Brazil
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