Unknown 14 Bacterial single 14 Bacterial multiple 5
Αιτιολογία της πνευμονίας Unknown 14% Bacterial (single) 14% Bacterial (multiple) 5% Viral (single) 21% Mixed 33% Viral (multiple) 12% Ø Severity of the disease may be linked to aetiology Ø Bacterial pneumonia usually causes children to become severely ill 1. Cevey-Macherel M. , et al. 2009. Eur J.
Αίτια βακτηριακής πνευμονίας στα παιδιά ‡Bacterial isolates in lung aspirate samples from children N=255 (66%)‡ N=240 (34%) N=885 (44%) N=949 (66%) N=674 (51%) N=101 (58%) Vuori-Holopainene E Clin Infect Dis 2001; 32: 715– 26
Cochrane review: Impact of PCVs on clinical pneumonia in HIV negative children <24 months old Risk Ratio N, Random, 95% CI Madhi et al 2005 (PCV 9) “The impact is considerably lower for clinical pneumonia relative to X-ray defined pneumonia but still significant” Black et al 2000 (PCV 7) Cutts et al 2005 (PCV 9) Lucero et al 2009 (PCV 11) Pooled RR = 0. 94 (95% CI 0. 91 to 0. 98, p = 0. 0006) Pooled VE = 6% (95% CI 2% to 9%). 0. 5 0. 7 1 Favours PCV 1. 5 Favours Control SYN-2010 -052 Intent to treat (ITT) analysis (random effects model) RR= Risk ratio; VE = vaccine efficacy Cochrane database System Rev 2009; Oct 7(4): 8 2
Antibiotic resistance in IPD in Greece 60 1 50 1 1 10 6 10 40 8 1 30 52 20 42 54 51 45 37 10 0 Penicillin Sensitive. Fluoroquinolones Intermediate. TMP-SMXResistant Cephalosporin Erythromycin Vancomycin Syriopoulou V et al. ESPID, 2010, Nice. 20
Το αποικισμένο παιδί αποτελεί « πηγή μετάδοσης» για τον ενήλικα. 60% 60 Carriage rate (%) 50 35% 40 30 25% 29% 20 10 6% 0 Preschool Grammar school 1 Presentation by Mark A. Fletcher, M. D. , on Epidemiology Jr. High School Households with children Households without children of Streptococcus pneumoniae: “Pneumococcus”
Επίπτωση και θνησιμότητα της πνευμονιοκοκκικής νόσου Centers for Disease Control and Prevention, 2010. Active Bacterial Core Surveillance (ABCs) Report, Emerging Infections Program Network, Streptococcus pneumoniae, 2009. Available at: http: //www. cdc. gov/abcs/reports-findings/survreports/spneu 09. pdf
2 nd Generation Cephalosporins vs. amoxicilline for S. pneumoniae In vitro • Optimal bactericidal activity vs. S. pneumoniae achieved at lower concentrations (relative to MIC) for amoxicillin than cefuroxime In vivo (animal models) • Mice infected with penicillin-resistant S. pneumoniae – Time above MIC • >40% for amoxicillin • 6% for cefuroxime – Time above optimal bactericidalconcentration • >40% for amoxicillin • 3% for cefuroxime Perez-Trallero E, et al. J Antimicro Chemother 1998; 41: 629 -634; Perez-Trallero E, et al. J Chemother 2001; 13: 118 -125
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