Asunto(s)
Antígenos Bacterianos/sangre , Proteínas de la Membrana Bacteriana Externa/análisis , Bordetella pertussis/aislamiento & purificación , Vacuna contra la Tos Ferina/inmunología , Factores de Virulencia de Bordetella/análisis , Tos Ferina/epidemiología , Adolescente , Adulto , Anciano , Bordetella pertussis/inmunología , Niño , Preescolar , Ensayo de Inmunoadsorción Enzimática , Proteínas Fimbrias/sangre , Hemaglutininas/sangre , Humanos , Lactante , Persona de Mediana Edad , Toxina del Pertussis/sangre , Vacuna contra la Tos Ferina/uso terapéutico , Prevalencia , Estudios Retrospectivos , Eslovenia/epidemiología , Adulto JovenRESUMEN
We report here on the identification of the first meningococcal meningitis case in Slovenia caused by Neisseria meningitidis serogroup Z' in December 2010. The 19-year-old patient had not left the country during the incubation period. The patient was hospitalised and given the antibiotic treatment with cefotaxime very early in the course of the disease. The patient did not develop any complications during hospitalisation and was discharged on 5 January 2011.
Asunto(s)
Antibacterianos/uso terapéutico , Cefotaxima/uso terapéutico , Meningitis Meningocócica/tratamiento farmacológico , Neisseria meningitidis/aislamiento & purificación , Adulto , Trazado de Contacto , Humanos , Masculino , Meningitis Meningocócica/sangre , Meningitis Meningocócica/diagnóstico , Meningitis Meningocócica/epidemiología , Neisseria meningitidis/clasificación , Reacción en Cadena de la Polimerasa , Profilaxis Posexposición , Serotipificación , Eslovenia , Resultado del TratamientoRESUMEN
The objectives of our study were to describe the epidemiology of invasive Haemophilus influenzae disease from 1993 to 2008 in Slovenia, a country with routine H. influenzae serotype b (Hib) conjugate vaccination since the year 2000. A total of 292 isolates of H. influenzae, recovered from a normally sterile site, were collected in the study period. The isolates were serotyped by slide agglutination and antibiotic susceptibility was determined. One hundred and eight isolates received after the year 2000 were serotyped by slide agglutination and by polymerase chain reaction (PCR) capsule typing, and both methods were compared. After the introduction of the routine Hib vaccination, the incidence of H. influenzae disease in children under the age of 5 years has decreased by 87.6% and type b was replaced by non-typeable H. influenzae as the predominant serotype. The proportion of serotype b decreased from 85.3% in the pre-vaccination period to 13.0% in the vaccination period and the proportion of non-capsulated isolates increased from 12.0 to 85.2%. The study of genetic relatedness by pulsed-field gel electrophoresis (PFGE) demonstrated that the isolates of serotypes b and f were genetically homogeneous within the serotype. The results of our national surveillance showed that the vaccine has been very efficient in preventing Hib invasive disease in Slovenia. Nevertheless, we see a need for further monitoring of invasive H. influenzae infections at a national level.
Asunto(s)
Infecciones por Haemophilus/epidemiología , Infecciones por Haemophilus/microbiología , Haemophilus influenzae/clasificación , Haemophilus influenzae/aislamiento & purificación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Pruebas de Aglutinación , Antibacterianos/farmacología , Niño , Preescolar , Análisis por Conglomerados , Dermatoglifia del ADN , Electroforesis en Gel de Campo Pulsado , Femenino , Haemophilus influenzae/efectos de los fármacos , Haemophilus influenzae/inmunología , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Serotipificación , Eslovenia/epidemiología , Adulto JovenRESUMEN
Invasive strains of Neisseria meningitidis isolated from sterile body fluids of children aged 0-14 years were intentionally collected in nine Slovenian laboratories, and sent to the laboratory of the National Institute of Public Health, Ljubljana for final evaluation. From 1993-1999 we collected 53 invasive strains from children presented in this study. The incidence rate of invasive diseases in children shows that there is a rapid fall from 4.74/100,000 in 1993 to 0.90/100,000 in 1999. Invasive diseases predominated in children in the age group 0-1 year (19.6 cases per 100,000 children); followed by the age groups 2-4 years, 5-9 years and 10-14 years. The results of serogrouping indicate that the largest proportion of meningococci isolated (90%) were group B, while 8% of isolates were group C and only 2% group Y. The serotype/serosubtype distribution shows that the most frequent serotype (excluding 19 non-typable NT strains) was serotype 22, which was expressed in 9 strains and the most frequent serosubtype (excluding 11 NST strains) was P1.5,2 found in 7 strains. The most frequently isolated strains (excluding NT/NST strains) were B:22:P1.14; B:NT:P1.5 and B:NT:P1.16. Thirty-one strains collected during 1993-1995 were analysed by multilocus enzyme electrophoresis (MEE). There were 25 electrophoretic types (ETs) among 31 strains; the strains were very heterogeneous with only four ETs being represented by more than one strain. Study shows that meningococcal disease is still endemic in Slovenia.
Asunto(s)
Infecciones Meningocócicas/epidemiología , Neisseria meningitidis/clasificación , Adolescente , Niño , Preescolar , Ensayo de Inmunoadsorción Enzimática , Humanos , Incidencia , Lactante , Recién Nacido , Neisseria meningitidis/genética , Neisseria meningitidis/aislamiento & purificación , Serotipificación , Eslovenia/epidemiologíaRESUMEN
The correlation between increased macrolide consumption and the resistance of Streptococcus pyogenes, Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis to macrolides in Slovenia from 1994 to 1999 was evaluated. The outpatient consumption of macrolides increased from 1.89 to 3.84 defined daily doses (DDD)/1000 inhabitants/day during the observation period. This increase in macrolide consumption was paralleled by a steady increase in macrolide resistance in S. pyogenes (from 0 to 7.4%, r = 0.90, P = 0.014) and upper respiratory S. pneumoniae isolates (from 0 to 9%, r = 0.82, P = 0.044). In other pathogens studied, no significant increase was detected.
Asunto(s)
Antibacterianos/administración & dosificación , Antibacterianos/farmacología , Bacterias/efectos de los fármacos , Farmacorresistencia Microbiana , Atención Ambulatoria , Antibacterianos/uso terapéutico , Haemophilus influenzae/efectos de los fármacos , Humanos , Modelos Lineales , Macrólidos , Pruebas de Sensibilidad Microbiana , Moraxella catarrhalis/efectos de los fármacos , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Eslovenia/epidemiología , Streptococcus pneumoniae/efectos de los fármacos , Streptococcus pyogenes/efectos de los fármacos , Factores de TiempoRESUMEN
The epidemiology of meningococcal disease was studied prospectively in Slovenia from 1993 to 1999 in children and from 1995 to 1999 in adults. Patients with meningococci isolated from normally sterile body sites were included in the study. Altogether 75 patients (57 children, 18 adults) were found with meningococcal diseases. The overall yearly incidence was 0.43 per 100000 inhabitants. The highest annual incidence (18.5/100000) was found in children between 1 month and 1 year of age. The case to fatality ratio was 4.1%. Group B meningococci were isolated most frequently (84.7%), followed by group C (11.1%). In six patients (8.3%) isolates were less susceptible to penicillin. Four of these were successfully treated with penicillin alone.
Asunto(s)
Antibacterianos/farmacología , Infecciones Meningocócicas/epidemiología , Neisseria meningitidis/efectos de los fármacos , Adulto , Humanos , Incidencia , Lactante , Infecciones Meningocócicas/microbiología , Pruebas de Sensibilidad Microbiana , Neisseria meningitidis/inmunología , Estudios Prospectivos , Serotipificación , Eslovenia/epidemiologíaRESUMEN
The impact of increased macrolide consumption on the resistance of common respiratory pathogens to erythromycin and azithromycin was evaluated. The study focused mainly on azithromycin. During the period from 1991 to 1996, a 3.5-fold increase in macrolide prescriptions for outpatients was observed in Slovenia. Compared to 1994, when no macrolide resistance was evident in Streptococcus pyogenes and noninvasive Streptococcus pneumoniae, a significant increase in macrolide resistance was observed in these two pathogens in 1997. Moraxella catarrhalis remained uniformly susceptible to macrolides. Close monitoring of macrolide resistance of common respiratory pathogens is thus necessary.
Asunto(s)
Antibacterianos/farmacología , Infecciones del Sistema Respiratorio/microbiología , Antibacterianos/uso terapéutico , Azitromicina/farmacología , Azitromicina/uso terapéutico , Prescripciones de Medicamentos , Farmacorresistencia Microbiana , Utilización de Medicamentos , Eritromicina/farmacología , Eritromicina/uso terapéutico , Humanos , Moraxella/efectos de los fármacos , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Streptococcus/efectos de los fármacosRESUMEN
The susceptibility of 108 Streptococcus pneumoniae strains isolated from normally sterile body sites during 1993-1995 in Slovenia has been studied. Overall resistance to penicillin, erythromycin, trimethoprim-sulfamethoxazole, cefuroxime, cefaclor and chloramphenicol was 16.6, 0.9, 26.8, 0, 4.5 and 4.6%, respectively. All penicillin-resistant isolates (intermediate resistance) were susceptible to cefotaxime, ceftriaxone and vancomycin. Isolates less susceptible to penicillin were also significantly less sensitive to chloramphenicol, cefaclor and trimethoprim-sulfamethoxazole than penicillin-sensitive strains. Pneumococci isolated in children were significantly (p < 0.05) more resistant to trimethoprim-sulfamethoxazole than those isolated in adults. The study demonstrated moderate resistance rate of S. pneumoniae to penicillin and trimethoprim-sulfamethoxazole and a low-level resistance rate to erythromycin, cefaclor and chloramphenicol. No straightforward correlation between overall consumption of antibiotics and antimicrobial resistance was found.