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Search Results: 1 - 10 of 8211 matches for " Carolina Soley "
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Streptococcus pneumoniae Upper Respiratory Carriage in Costa Rican Children with Otitis Media before the Introduction of the Heptavalent Conjugated Vaccine in the National Immunization Program  [PDF]
Catalina Ulloa, Alfonso Pereira, Carolina Soley, Nurith Porat, Arturo Abdelnour, Ron Dagan, Adriano Arguedas
World Journal of Vaccines (WJV) , 2013, DOI: 10.4236/wjv.2013.32007
Abstract:

Objective: The aim of this study was to analyze the NP/OP S. pneumoniae serotype distribution and potential vaccine coverage in Costa Rican children with Otitis Media (OM) before the introduction of PCV-7 in the National Immunization Program (NIP). Methods: Between 2002 and 2006, NP and OP samples were obtained from 641 children from 6 to 79 months of age, at the time of OM diagnosis. S. pneumoniae serotyping and antimicrobial susceptibility were performed. Results: 386 S. pneumoniae isolates were recovered. The most common S. pneumoniae serotypes (ST) were: ST 6B, ST 14, ST 19F. Penicillin non-susceptibility was observed among 57% of the isolates obtained from children < 24 months of age. 15% strains were multidrug resistant. Potential vaccine coverage was: PCV-7: 60%; PCV-10: 62%; and PCV-13: 76% and against penicillin non-susceptible and multidrug resistant isolates was: PCV-7; 59% and 83%, respectively; PCV-10: 60% and 85%, respectively and PCV-13: 74% and 96%, respectively. Conclusions: S. pneumoniae was isolated from the NP and/or OP in the majority (59%) of studied children with OM. At a statistical significant level, only serotype 3 was more frequently isolated among children >24 months of age. Antibiotic non-susceptibility and MDR were significantly higher in children <24 months of age. This study demonstrates that PCV-13 offers the highest potential vaccine coverage and serves to assess the impact of introduction of one of the conjugated vaccines in the NIP in Costa Rica.

Vigilancia epidemiológica prospectiva de la enfermedad neumocócica invasora y de la neumonía en ni os de San José, Costa Rica Prospective epidemiologic surveillance of invasive pneumococcal disease and pneumonia in children in San José, Costa Rica
Adriano Arguedas,Arturo Abdelnour,Carolina Soley,Elias Jimenez
Acta Médica Costarricense , 2012,
Abstract: Justificación y objetivo: Streptococcus pneumoniae es globalmente la primera causa de muertes inmunoprevenibles en ni os menores de 5 a os. Métodos: entre 2007 y 2009 se realizó una vigilancia prospectiva con base poblacional en ni os de 28 días a 36 meses en San José, Costa Rica. Se determinaron la incidencia de la enfermedad neumocócica invasora y de neumonía confirmada clínicamente y por radiografía, la distribución de serotipos y la sensibilidad a los antibióticos. Resultados: participaron 8801 sujetos (mediana de edad: 13,0 meses). En 25 ni os se detectó enfermedad neumocócica invasora mediante aislamiento en cultivos (22) o mediante reacción de polimerasa en cadena y un cuadro clínico compatible con enfermedad neumocócica invasora (3) En los casos diagnosticados únicamente por cultivo, la tasa de incidencia de enfermedad neumocócica invasora en ni os de 28 días a 36 meses de edad fue de 33,7/100 000 por a o para los a os 1 y 2 combinados. Al considerar los casos adicionales diagnosticados por reacción de polimerasa en cadena, la incidencia aumentó a 46,0/100 000. El serotipo más frecuente fue el 14 (28,6%), seguido por los serotipos 3, 4, 6A, 19A y 22F. 42,9% de los aislamientos eran insensibles a la penicilina y al cotrimoxazol. La incidencia de neumonía confirmada clínicamente y de neumonía confirmada por radiografía fue de 1968/100 000 y 551/100 000, respectivamente. Conclusión: la incidencia de enfermedad neumocócica invasora y neumonía en ni os de San José es considerable. Estos datos epidemiológicos sirven como línea de base para evaluar la efectividad de nuevas vacunas antineumocócicas conjugadas. Background and aim: Streptococcus pneumoniae is globally the leading cause of vaccine-preventable death in children below 5 years of age. Methods: Between 2007 and 2009, a prospective, population-based surveillance was conducted in children aged 28 days to 36 months in San José, Costa Rica. Incidence of invasive pneumococcal disease as well as clinically- and chest X ray-confirmed pneumonia were determined, as well as serotype distribution and antibiotic susceptibility. Results: 8801 subjects were enrolled (median age: 14.5 months). Invasive pneumococcal disease was detected in 25 children by isolation from cultures (22)or by PCR and a clinical picture consistent with invasive pneumococcal disease (3). For culture-positive only cases in children aged 28 days to <36 months, the invasive pneumococcal disease incidence rate was 33.7/100,000 per year for years 1 and 2 combined. Consideration of additional PCR-positive cases increased the incidence of
Streptococcus pneumoniae Serotype 3 among Costa Rican Children with Otitis Media: clinical, epidemiological characteristics and antimicrobial resistance patterns
Arturo Abdelnour, Carolina Soley, Silvia Guevara, Nurith Porat, Ron Dagan, Adriano Arguedas
BMC Pediatrics , 2009, DOI: 10.1186/1471-2431-9-52
Abstract: To describe the clinical, epidemiological and antimicrobial resistance patterns of Costa Rican children with otitis media caused by Streptococcus pneumoniae serotype 3.Middle ear fluid samples were obtained from Costa Rican children with otitis media who participated in various antimicrobial clinical trials between 1992 and 2007. Streptococcus pneumoniae was identified according to laboratory standard procedures. Strains were serotyped and antimicrobial susceptibility to penicillin, amoxicillin, cefuroxime, ceftriaxone, azithromycin and levofloxacin was determined by E-test.Throughout 1992–2007 a total of 1919 tympanocentesis were performed in children with otitis media (median age: 19 months) and yielded a total of 1208 middle ear isolates. The most common pathogens were: Streptococcus pneumoniae, 511 isolates (49%); Non-Typable Haemophilus influenzae, 386 isolates (37%); Moraxella catarrahalis, 100 isolates (9.5%); and Streptococcus pyogenes, 54 isolates (5%). Streptococcus pneumoniae serotyping was performed in 346/511 isolates (68%) recovered during years 1999–2006. The most common serotypes were 19F (101/30.0%), 14 (46/13.7%), 3 (34/10.1%), 6B (30/8.9%) and 23F (23/6.8%). Analysis performed per years showed a higher prevalence of serotype 3 Streptococcus pneumoniae during the study period 2004 and 2005. During the entire study period (1999–2006) serotype 3 was most commonly isolated in children older than 24 months (61.2% vs 40.6%;P = 0.05) and showed a lower rate of penicillin non-susceptibility (4.0% vs 18%; P = 0.003).Streptococcus pneumoniae serotype 3 is an important pathogen in Costa Rican children with otitis media, especially in children older than 24 months of age (P = 0.05). Most serotype 3 isolates were susceptible to penicillin, cephalosporins, macrolides and quinolones.Streptococcus pneumoniae (S. pneumoniae) is one of the most common bacterial pathogens producing invasive and non-invasive disease in healthy and immunocomprised hosts [1]. Invasive
Estado actual de la vacuna recombinante contra el virus del papiloma humano
Chan Acón,Wendy; Aguilar Morales,Lara; Soley,Carolina; Arguedas Mohs,Adriano;
Acta Médica Costarricense , 2008,
Abstract: genital human papillomavirus (hpv) is one of the most common sexually transmitted infections worldwide. millions of persons are now infected and the lifetime risk of hpv infection exceeds 50%. hpv is approximately 100% related to the total cases of cervical cancer, 100% of cervical intraepithelial neoplasias grade 1, 2, and 3; 40% of vulva, vagina and penile cancer, 100% of genital warts, 100% of recurrent respiratory papillomatosis and 12% of head and neck cancer. licensed vaccines, gardasil? and cervarix?, are composed of a noninfectious mixture of hpv type-specific virus-like particles prepared from the l1 proteins produced by recombinant dna technology and adsorbed in a aluminum-containing adjuvant. data from several studies of both vaccines reported a range of efficacy of 98,9 % to 100.0% for the prevention of cervical, vulvar and vaginal intraepithelial neoplasias degrees 2 and 3, and therefore, cervical, vulvar and vaginal cancer related to the vph-16/18; in addition to in situ adenocarcinomas and genital warts caused by vph-16/18/6/11. the effectiveness for both vaccines is maintained for at least 5 years. at the moment no therapeutic effect has been attributed and the vaccine use is prophylactic, nevertheless, vaccination should not be considered as a substitute for cervical cancer screening.
Principios farmacocinéticos y farmacodinámicos en el tratamiento de ni?os con otitis media
Aguilar-Morales,Lara; Soley-Gutiérrez,Carolina; Arguedas-Mohs,Adriano;
Acta Médica Costarricense , 2006,
Abstract: because acute respiratory infections and particularly acute otitis media (aom), are the most common cause of antimicrobial prescription in pediatric patients, it is important to optimize antimicrobial therapies. it is essential that before prescribing an antimicrobial agent, the aom diagnosis is well established and the local microbiological pattern is known. the present review incorporates novel concepts for the selection of the antimicrobial therapy in children with aom taking into account pharmacokinetic and pharmacodynamic principles applied to microbiologycal concepts. these new concepts have revolutionized the treatment of diverse infectious diseases in pediatric patients and particularly in the treatment of children with otitis media.
Avances en el desarrollo de las vacunas neumocócicas conjugadas
Chan-Acón,Wendy; Abdelnour,Arturo; Soley-Gutiérrez,Carolina; Arguedas-Mohs,Adriano;
Acta Médica Costarricense , 2010,
Abstract: streptococcus pneumoniae is one of the major pathogens causing invasive and non invasive infections in children younger than 5 years as well as in the elderly. primary clinical syndromes associated with pneumococcal infections are pneumonia, bacteremia, acute otitis media and meningitis. this microorganism contributes importantly to morbidity and mortality among children under 5 years of age, it is estimated that 1,000, 000 deaths occurs per year in that age range alone, mostly from developing countries, thus becoming a serious public health problem around the globe. in year 2000 the first heptavalent conjugated pneumococcal vaccine was licensed in the united states of america, it differed from the already available polysaccharide pneumococcal vaccine, by its ability to provide an effective immune response for the protection of children under the age of 2. the efficacy of the heptavalent conjugated vaccine reported in initial clinical trials was 97, 4% against invasive pneumococcal disease related to vaccine serotypes (4, 9v, 14, 19f, 23f, 18c and 6b). different health authorities worldwide, including the european medicines agency (emea) had approved the introduction of a 10-valent formulation which includes all 7 pcv7 serotypes plus serotypes 1, 5 and 7f; 8 serotypes are conjugated with protein d as a novel carrier, an element found in the outer core of the non-typeable haemophilus influenzae. another new conjugated vaccine is being assessed by several regulatory entities such as the food and drug administration (fda) and emea and in chile is already approved. this 13-valent formulation includes the 10 serotypes contained in the 10-valent vaccine plus serotypes 3, 6a and 19a, all conjugated to the carrier protein crm197. these new formulations pretend to enhance vaccine coverage against s. pneumoniae including the frequent serotypes in developing countries (1 and 5) and emerging serotypes such as serotypes 3, 6a, 17f and 9a after a decade of pcv7 immunization.
Estado actual de la vacuna recombinante contra el virus del papiloma humano
Chan Acón,Wendy; Aguilar Morales,Lara; Soley,Carolina; Arguedas Mohs,Adriano;
Acta Pediátrica Costarricense , 2008,
Abstract: genital human papillomavirus (hpv) is one of the most common sexually transmitted infections worldwide. millions of persons are now infected and the lifetime risk of hpv infection exceeds 50%. hpv is approximately 100% related to the total cases of cervical cancer, 100% of cervical intraepithelial neoplasias grade 1, 2, and 3; 40% of vulva, vagina and penile cancer, 100% of genital warts, 100% of recurrent respiratory papillomatosis and 12% of head and neck cancer. licensed vaccines, gardasil? and cervarix?, are composed of a noninfectious mixture of hpv type-specific virus-like particles prepared from the l1 proteins produced by recombinant dna technology and adsorbed in a aluminum-containing adjuvant. data from several studies of both vaccines reported a range of efficacy of 98,9 % to 100.0% for the prevention of cervical, vulvar and vaginal intraepithelial neoplasias degrees 2 and 3, and therefore, cervical, vulvar and vaginal cancer related to the vph-16/18; in addition to in situ adenocarcinomas and genital warts caused by vph-16/18/6/11. the effectiveness for both vaccines is maintained for at least 5 years. at the moment no therapeutic effect has been attributed and the vaccine use is prophylactic, nevertheless, vaccination should not be considered as a substitute for cervical cancer screening.
Estado actual de la vacuna conjugada contra Streptococcus pneumoniae
Hernán Sierra- Fernandez,Malka Schultz- Faingezicht,Carolina Soley-Gutiérrez,Silvia Guevara- Jiménez
Acta Médica Costarricense , 2006,
Abstract: Las infecciones por Streptococcus pneumoniae son frecuentes en la población pediátrica especialmente en los ni os menores de 2 a os. El S. pneumoniae puede producir infecciones invasoras con una alta tasa de mortalidad y morbilidad como lo son las meningitis bacterianas, la neumonía y bacteremias siendo a la vez el agente que con mayor frecuencia se detecta en el oído medio de ni os con otitis media. En la actualidad existe una vacuna conjugada contra esta bacteria que protege contra los siete serotipos de S. pneumoniae más frecuentes en el mundo y que a su vez son los mismos serotipos que presentan una mayor incidencia de resistencia a los antibioticos de uso frecuente. La vacuna no solo protege contra este tipo de infecciones sino que se ha demostrado que disminuye la colonización nasofaringea de los ni os que han recibido la vacuna produciendo a su vez, una reducción en el numero de infecciones, por esta bacteria, en poblaciones de personas mayores de 5 a os, incluyendo adultos y personas mayores a los 65 a os (efecto reba o). Con base en los serotipos aislados en ni os costarricenses con otitis media, se puede calcular que la cobertura de esta vacuna en Costa Rica sería de aproximadamente un 74% e incluyendo mayoritariamente, los serotipos que presentan resistencia antimicrobriana más frecuentemente. The heptavalent S. pneumoniae conjugate vaccine has shown to be safe and effective in preventing pediatric invasive infections and otitis media caused by S. pneumoniae. The routine use of these vaccines has dramatically reduced the incidence of invasive pneumococcal diseases in children younger than 2 years old and because of a reduction in colonization of the children’s nasopharynx, the transmission from child to adult has been reduced and the number of secondary S. pneumoniae infections in adults. Another benefit of the routine use of this vaccine has been the reduction of vaccine-type antimicrobial resistant strains. Based on the S. pneumoniae serotype distribution in Costa Rica, the predicted vaccine protection is calculated in 74%.
Principios farmacocinéticos y farmacodinámicos en el tratamiento de ni os con otitis media
Lara Aguilar-Morales,Carolina Soley-Gutiérrez,Adriano Arguedas-Mohs
Acta Médica Costarricense , 2006,
Abstract: Debido a que la otitis media aguda, es la primera causa de uso de antibióticos en la edad pediátrica, es importante lograr una utilización adecuada y racional de los antibióticos en estas patologías, siendo imprescindible que antes de iniciar un tratamiento antimicrobiano se haga un buen diagnóstico clínico y se conozca el patrón microbiológico y de susceptibilidad antimicrobiana prevaleciente. La presente revisión incorpora conceptos novedosos para seleccionar la terapia antimicrobiana en ni os con otitis media, tomando en cuenta principios farmacocinéticos y farmacodinámicos aplicados a conceptos microbiológicos. Estos nuevos conceptos han revolucionado el tratamiento de diversos procesos infecciosos en pediatría y superan los criterios, un poco más simples, en los que se define únicamente si una bacteria es sensible o resistente a un determinado antibiótico, incorporando aspectos fundamentarles como lo son la biodisponibilidad, la penetración del antimicrobiano al oído medio, la dosis recomendada y los intervalos entre cada dosificación. Because acute respiratory infections and particularly acute otitis media (AOM), are the most common cause of antimicrobial prescription in pediatric patients, it is important to optimize antimicrobial therapies. It is essential that before prescribing an antimicrobial agent, the AOM diagnosis is well established and the local microbiological pattern is known. The present review incorporates novel concepts for the selection of the antimicrobial therapy in children with AOM taking into account pharmacokinetic and pharmacodynamic principles applied to microbiologycal concepts. These new concepts have revolutionized the treatment of diverse infectious diseases in pediatric patients and particularly in the treatment of children with otitis media.
Avances en el desarrollo de las vacunas neumocócicas conjugadas Update on Pneumococcal Conjugate Vaccines
Wendy Chan-Acón,Arturo Abdelnour,Carolina Soley-Gutiérrez,Adriano Arguedas-Mohs
Acta Médica Costarricense , 2010,
Abstract: El Streptococcus pneumoniae se encuentra entre los mayores patógenos causantes de infecciones invasoras y no invasoras en los dos extremos de la vida: en ni os menores de 5 a os y en personas mayores de 65 a os de edad. Las principales manifestaciones asociadas a infecciones neumocócicas son: neumonía, bacteriemia febril, septicemia, otitis media y meningitis. Esta bacteria es uno de los principales agentes involucrados en la mortalidad infantil, con un estimado de 1, 000,000 de muertes globales por a o, en ni os menores de 5 a os de edad, la mayoría provenientes de países en vías de desarrollo, por lo que es considerada como un serio problema para la salud pública alrededor del mundo. En el 2000 se introdujo al mercado de los Estados Unidos de Norte América, la primera vacuna neumocócica conjugada, que a diferencia de la ya disponible vacuna neumocócica polisacárida, es capaz de proporcionar una respuesta inmune efectiva para la protección de ni os menores de 2 a os. La eficacia reportada para la vacuna conjugada heptavalente en los ensayos clínicos iniciales fue de un 97.4% contra la enfermedad neumocócica invasora producida por los serotipos incluidos en la vacuna (4, 9V, 14, 19F, 23F, 18C y 6B). En la actualidad diferentes entidades regulatorias, incluyendo la Agencia Europea de Medicamentos (EMEA), han autorizado la comercialización de la vacuna conjugada 10-valente, en la que, además de los serotipos descritos para la vacuna 7-valente, se incluyen los serotipos 1, 5 y 7F; de estos diez serotipos, ocho se encuentran conjugados con la proteína transportadora D, un elemento que se encuentra en la porción externa del Haemophilus influenzae. La otra nueva vacuna conjugada que está en fase de análisis por diferentes entidades regulatorias, incluyendo la Administración de Alimentos y Drogas de los Estados Unidos (FDA) y la EMEA, pero que ya fue aprobada en Chile, es la que contiene 13 serotipos: los diez de la vacuna 10-valente y los serotipos 3, 6A y 19A. En el caso de la vacuna 13-valente, todos los serotipos están conjugados con el transportador CRM197. Estas nuevas formulaciones pretenden ampliar la cobertura contra el S. pneumoniae, incluyendo serotipos frecuentes en países en vías de desarrollo (serotipo 1 y 5) y serotipos emergentes luego de una década de la vacunación con la vacuna 7-valente, como son: 3, 6A, 17F y 19A. Streptococcus pneumoniae is one of the major pathogens causing invasive and non invasive infections in children younger than 5 years as well as in the elderly. Primary clinical syndromes associated with pneumococcal infections are
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