Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-3 (of 3 Records) |
Query Trace: Valenciano SJ[original query] |
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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
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 . J Pediatric Infect Dis Soc 2020 10 (4) 448-456 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. |
Invasive group A streptococcal infections among people who inject drugs and people experiencing homelessness in the United States, 2010-2017
Valenciano SJ , Onukwube J , Spiller MW , Thomas A , Como-Sabetti K , Schaffner W , Farley M , Petit S , Watt JP , Spina N , Harrison LH , Alden NB , Torres S , Arvay ML , Beall B , Van Beneden CA . Clin Infect Dis 2020 73 (11) e3718-e3726 BACKGROUND: Reported outbreaks of invasive group A Streptococcus (iGAS) infections among people who inject drugs (PWID) and people experiencing homelessness (PEH) have increased, concurrent with rising US iGAS rates. We describe epidemiology among iGAS patients with these risk factors. METHODS: We analyzed iGAS infections from population-based Active Bacterial Core surveillance (ABCs) at 10 US sites from 2010 to 2017. Cases were defined as GAS isolated from a normally sterile site or from a wound in patients with necrotizing fasciitis or streptococcal toxic shock syndrome. GAS isolates were emm typed. We categorized iGAS patients into four categories: injection drug use (IDU) only, homelessness only, both, and neither. We calculated annual change in prevalence of these risk factors using log binomial regression models. We estimated national iGAS infection rates among PWID and PEH. RESULTS: We identified 12 386 iGAS cases; IDU, homelessness, or both were documented in ~13%. Skin infections and acute skin breakdown were common among iGAS patients with documented IDU or homelessness. Endocarditis was 10-fold more frequent among iGAS patients with documented IDU only versus those with neither risk factor. Average percentage yearly increase in prevalence of IDU and homelessness among iGAS patients was 17.5% and 20.0%, respectively. iGAS infection rates among people with documented IDU or homelessness were ~14-fold and 17- to 80-fold higher, respectively, than among people without those risks. CONCLUSIONS: IDU and homelessness likely contribute to increases in US incidence of iGAS infections. Improving management of skin breakdown and early recognition of skin infection could prevent iGAS infections in these patients. |
Notes from the field: Identifying risk behaviors for invasive group A streptococcus infections among persons who inject drugs and persons experiencing homelessness - New Mexico, May 2018
Valenciano SJ , McMullen C , Torres S , Smelser C , Matanock A , Van Beneden C . MMWR Morb Mortal Wkly Rep 2019 68 (8) 205-206 In the spring of 2018, the New Mexico Department of Health (NMDOH) contacted CDC about an increase in the number and prevalence of invasive group A Streptococcus (GAS) infections reported through New Mexico’s Active Bacterial Core surveillance (ABCs) system. From 2013 to 2017, the annual rate of invasive GAS infections increased approximately 120%, from 6.8 to 14.9 per 100,000 persons, approximately double the estimated national rate (1,2). In New Mexico, the prevalence of injection drug use (IDU) reported in the medical charts of patients with invasive GAS infection during this period (1,108 patients) increased approximately 200%, from 6.4% (nine of 141 invasive GAS infections) to 20.1% (62 of 308 invasive GAS infections), and the prevalence of reported homelessness among persons with invasive GAS infections increased 125%, from 3.6% (five of 141) to 8.1% (25 of 308). IDU is a known risk factor for GAS infections; however, specific behaviors causing the recent increase in the prevalence of IDU among patients with GAS infection are unknown. Although recent outbreaks of invasive GAS infection among persons experiencing homelessness have been reported in Canada, Europe, Arizona, and Alaska, homelessness is not a well-defined risk factor for invasive GAS infection in the United States; therefore, identifying specific behaviors that might increase the risk for infection in this group might help inform prevention efforts (3–6). NMDOH requested CDC assistance in characterizing GAS disease and specific high-risk behaviors among persons who inject drugs and persons experiencing homelessness to recommend potential public health interventions to reduce disease risk and transmission among these populations. |
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