RESUMO
Hexavalent chromium (Cr(VI)) contamination poses serious health and environmental risks. Chromium biosorption has been employed as an effective means of eradicating Cr(VI) contamination. However, research on chromium desorption from chromium-loaded biosorbents is scarce despite its importance in facilitating industrial-scale chromium biosorption. In this study, single- and two-stage chromium desorption from chromium-loaded Cupressus lusitanica bark (CLB) was conducted. Thirty eluent solutions were evaluated first; the highest single-stage chromium desorption efficiencies were achieved when eluent solutions of 0.5 M NaOH, 0.5 M H2SO4, and 0.5 M H2C2O4 were used. Subsequently, two-stage kinetic studies of chromium desorption were performed. The results revealed that using 0.5 M NaOH solution in the first stage and 0.5 M H2C2O4 in the second stage enabled the recovery of almost all the chromium initially bound to CLB (desorption efficiency = 95.9-96.1%) within long (168 h) and short (3 h) desorption periods at each stage. This study clearly demonstrated that the oxidation state of the recovered chromium depends on the chemical nature and concentration of the eluent solution. The results suggest the possible regeneration of chromium-loaded CLB for its subsequent use in other biosorption/desorption cycles.
RESUMO
This work reports a sensitive SERS substrate based on graphene oxide (GO) and quantum-sized ZrO2 nanoparticles (GO/ZrO2) for label-free determination of the organophosphate pesticide methyl parathion (MP). The enhanced light-matter interactions and the consequent SERS effect in these substrates resulted from the effective charge transfer (CT) mechanism attributed to synergistic contributions of three main factors: i) the strong molecular adherence of the MP molecules and the ZrO2 surface which allows the first layer-effect, ii) the relatively abundant surface defects in low dimensional ZrO2 semiconductor NPs, which act as intermediate electronic states that reduce the large bandgap barrier, and iii) the hindered charge recombination derived from the transference of the photoinduced holes to the GO layer. This mechanism allowed an enhancement factor of 8.78 × 104 for GO/ZrO2-based substrates, which is more than 5-fold higher than the enhancement observed for platforms without GO. A detection limit of 0.12 µM was achieved with an outstanding repeatability (variation ≤4.5%) and a linear range up to 10 µM, which is sensitive enough to determine the maximal MP concentration permissible in drinking water according to international regulations. Furthermore, recovery rates between 97.4 and 102.1% were determined in irrigation water runoffs, strawberry and black tea extracts, demonstrating the reliability of the hybrid GO/ZrO2 substrate for the organophosphate pesticides quantification in samples related to agri-food sectors and environmental monitoring.
Assuntos
Grafite , Inseticidas , Nanopartículas Metálicas , Metil Paration , Reprodutibilidade dos Testes , Nanopartículas Metálicas/química , Grafite/químicaRESUMO
Inclusion of the 10-valent pneumococcal conjugated vaccine (PCV10) in the Chilean infant vaccination Program in 2011 was followed by a reduction of hospital admissions and pneumonia-related deaths in this age group. However, a progressive increase of serotype 19A pneumococcal isolates (not included in PCV10) has been observed. According to the analysis of pneumococcal strains performed by the national reference laboratory of the Institute of Public Health as part of a national surveillance on invasive pneumococcal infections, the relative proportion of serotype 19A isolates increased from <5% before 2010 to 12-23% in years 2014-2015. Serotype 19A represented 4-8% of the isolates in the pre-vaccine era among children less than 2 years, increasing to 25% during 2014. This increase has been documented in two-thirds of the national territory. Aimong children <5 years of age, 25% of 19A serotype isolates from non-meningeal infections were penicillin resistant wheras from meningeal infections near 100% were penicillin resistant. Genetic analysis indicates that 48% of these 19A strains belong to clonal complex 320, recognized for its pandemic potential and high antimicrobial resistance. Among children, most invasive infections secondary to serotype 19A have occurred in patients fully vaccinated with PCV10. These epidemiological changes indicate an increase in invasive pneumococcal infections by serotype 19A in Chile and the need to control this problem by changing the current PCV10 for the PCV13 vaccine containing serotype 19A.
Assuntos
Comitês Consultivos/normas , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas/uso terapêutico , Streptococcus pneumoniae/classificação , Vacinação/normas , Criança , Chile , Farmacorresistência Bacteriana , Humanos , SorogrupoRESUMO
La incorporación de la vacuna conjugada antineumocóc-cica 10 valente (PCV10) en lactantes en Chile el año 2011 ha permitido reducir las hospitalizaciones y muertes por neumonía en este grupo etario. Sin embargo, se ha observado desde entonces un aumento progresivo de los aislados de Streptococcus pneumoniae del serotipo 19A no incluido en la vacuna en uso (de < 5% del total de cepas recibidas en el Laboratorio de Referencia Nacional del Instituto de Salud Pública para vigilancia de infecciones invasores causadas por S. pneumoniae hasta el año 2010, a 12-23% en los años 2014-2015). En lactantes, el serotipo 19A representaba 4 a 8% de los aislados en la era pre vacuna, porcentaje que se incrementa a 25% el 2014. Este aumento ha ocurrido en dos terceras partes de las regiones administrativas del país. Cepas del serotipo 19A de pacientes menores de 5 años, muestran 25% de resistencia a penicilina para aislados extra-meníngeos y casi 100% para aislados de meningitis. El análisis genético de las cepas del serotipo 19A ha demostrado que 48% pertenecen al complejo clonal 320 de carácter pandémico y asociado a resistencia antimicrobiana. Además, casi todas las infecciones invasoras por serotipo 19A en niños se han dado en pacientes con esquema completo de vacunación PCV10. Los cambios epidemiológicos presentados indican la emergencia de infecciones invasoras por el serotipo 19A y la necesidad de controlar este problema con el cambio de la vacuna PCV10 a la vacuna PCV13 que contiene el serotipo 19A.
Inclusion of the 10-valent pneumococcal conjugated vaccine (PCV10) in the Chilean infant vaccination Program in 2011 was followed by a reduction of hospital admissions and pneumonia-related deaths in this age group. However, a progressive increase of serotype 19A pneumococcal isolates (not included in PCV10) has been observed. According to the analysis of pneumococcal strains performed by the national reference laboratory of the Institute of Public Health as part of a national surveillance on invasive pneumococcal infections, the relative proportion of serotype 19A isolates increased from <5% before 2010 to 12-23% in years 2014-2015. Serotype 19A represented 4-8% of the isolates in the pre-vaccine era among children less than 2 years, increasing to 25% during 2014. This increase has been documented in two-thirds of the national territory. Aimong children <5 years of age, 25% of 19A serotype isolates from non-meningeal infections were penicillin resistant wheras from meningeal infections near 100% were penicillin resistant. Genetic analysis indicates that 48% of these 19A strains belong to clonal complex 320, recognized for its pandemic potential and high antimicrobial resistance. Among children, most invasive infections secondary to serotype 19A have occurred in patients fully vaccinated with PCV10. These epidemiological changes indicate an increase in invasive pneumococcal infections by serotype 19A in Chile and the need to control this problem by changing the current PCV10 for the PCV13 vaccine containing serotype 19A.
Assuntos
Humanos , Criança , Infecções Pneumocócicas/prevenção & controle , Streptococcus pneumoniae/classificação , Vacinação/normas , Vacinas Pneumocócicas/uso terapêutico , Comitês Consultivos/normas , Chile , Farmacorresistência Bacteriana , SorogrupoRESUMO
Arsenic release from the abandoned mines and its fate in a local stream were studied. Physicochemical parameters, metals/metalloids and arsenic species were determined. One of the mine drainages was found as a point source of contamination with 309 µg L(-1) of dissolved arsenic; this concentration declined rapidly to 10.5 µg L(-1) about 2 km downstream. Data analysis confirmed that oxidation of As(III) released from the primary sulfide minerals was favored by the increase of pH and oxidation reduction potential; the results obtained in multivariate approach indicated that self-purification of water was due to association of As(V) with secondary solid phase containing Fe, Mn, Ca.
Assuntos
Arsênio/análise , Monitoramento Ambiental , Mineração , Rios/química , Poluentes Químicos da Água/análise , Sedimentos Geológicos/química , México , PrataRESUMO
We previously demonstrated the immunogenicity and tolerability of the serogroup B meningococcal vaccine, 4CMenB (Bexsero), in 11-17 y-olds randomized to receive 1, 2, or 3 doses at 1, 2, or 6 mo intervals. Participants in this extension study provided an additional blood sample 18-24 mo after last vaccine dose, to assess persistence of serum bactericidal activity with human complement (hSBA), and to compare with age-matched 4CMenB-naïve controls. In the original study, one month after one 4CMenB dose, 93% of subjects had seroprotective hSBA titers (≥4) against indicator serogroup B strains for individual vaccine antigens (fHbp, NadA and NZOMV), increasing to ~100% after two or three doses. After 18-24 mo, 62-73% of subjects given one dose had titers ≥4 against the three antigens, significantly lower rates than after two (77-94%) or three (86-97%) doses. Only proportions with titers ≥ 4 against NZOMV were significantly different between the two (77%) and three (90%, p < 0.0001) dose groups. These results confirm that two doses of 4CMenB, administered 1 to 6 mo apart, provide good levels of bactericidal activity against serogroup B meningococci, which were sustained at least 18-24 mo in over 64% of adolescents for all three tested vaccine-related antigens.
Assuntos
Anticorpos Antibacterianos/sangue , Vacinas Meningocócicas/administração & dosagem , Vacinas Meningocócicas/imunologia , Neisseria meningitidis/imunologia , Adolescente , Atividade Bactericida do Sangue , Criança , Proteínas do Sistema Complemento/imunologia , Feminino , Humanos , Masculino , Adulto JovemRESUMO
In Chile, an increased number of notifications of cases of whooping cough was detected at the beginning of October 2010, and maintained through 2012. Accumulated cases during 2011 were 2,581 (15.0 per 100,000), which is greater than the number of cases registered during the period 2008-2010 (2,460 cases). On the other hand, the local sanitary authority introduced a modification of pertussis vaccination schedule (starting 2012), which consists in the replacement of the second booster of pertussis vaccine (DTwP, administered to 4-year-old children) as well as diphtheria-tetanus toxoid (dT, administered to second grade scholars) for an acellular pertussis vaccine with reduced antigenic content (dTpa), which will be administrated to first grade scholars. The Consultive Committee of Immunizations considers that the modification is adequate, since it extends the age of protection, reducing at least in theory the infection in older scholars and adolescents -who are significant sources of transmission of Bordetella pertussis to infants- using an adequate vaccine formulation (acellular pertussis vaccine). The available evidence regarding vaccination in special groups (adolescents and adults, health-care workers and pregnant women) and cocooning strategy are commented.
Assuntos
Conferências de Consenso como Assunto , Vacinas contra Difteria, Tétano e Coqueluche Acelular/normas , Vacinação em Massa/métodos , Coqueluche/prevenção & controle , Adolescente , Adulto , Pré-Escolar , Chile/epidemiologia , Feminino , Humanos , Esquemas de Imunização , Lactente , Masculino , Avaliação de Resultados em Cuidados de Saúde , Gravidez , Coqueluche/epidemiologia , Adulto JovemRESUMO
In Chile, an increased number of notifications of cases of whooping cough was detected at the beginning of October 2010, and maintained through 2012. Accumulated cases during 2011 were 2,581 (15.0 per 100,000), which is greater than the number of cases registered during the period 2008-2010 (2,460 cases). On the other hand, the local sanitary authority introduced a modification of pertussis vaccination schedule (starting 2012), which consists in the replacement of the second booster of pertussis vaccine (DTwP, administered to 4-year-old children) as well as diphtheria-tetanus toxoid (dT, administered to second grade scholars) for an acellular pertussis vaccine with reduced antigenic content (dTpa), which will be administrated to first grade scholars. The Consultive Committee of Immunizations considers that the modification is adequate, since it extends the age of protection, reducing at least in theory the infection in older scholars and adolescents -who are significant sources of transmission of Bordetella pertussis to infants- using an adequate vaccine formulation (acellular pertussis vaccine). The available evidence regarding vaccination in special groups (adolescents and adults, health-care workers and pregnant women) and cocooning strategy are commented.
En Chile, a comienzos del mes de octubre de 2010 se detectó un aumento en la notiicación de casos de coqueluche, dinámica que se ha mantenido a la fecha (abril 2012). El número de casos acumulados durante 2011 ascendió a 2.581 (15,0/100.000 hab.), cifra superior al número de casos registrados durante el período 2008-2010 (2.460 casos). Por su parte, a partir de 2012 la autoridad sanitaria introdujo una modiicación en el esquema de vacunación anti-pertussis, consistente en el reemplazo del segundo refuerzo de vacuna antipertussis (DTwP, administrada a los 4 años) y del refuerzo de toxoide diftérico-tetánico (dT, administrado en segundo básico) por la vacuna anti-pertussis acelular de contenido antigénico reducido (dTpa), a ser administrada en primero básico. El Comité Consultivo de Inmunizaciones considera la modificación adecuada, por cuanto permite extender el tiempo de protección, reduciendo al menos en teoría la infección en escolares mayores y adolescentes -quienes son importantes fuente de contagio de Bordetella pertussis para los lactantes- utilizando una adecuada formulación de vacuna (vacuna antipertussis acelular). Se comenta la evidencia disponible sobre vacunación anti-pertussis en grupos especiales (adolescentes y adultos, funcionarios de la salud y mujeres embarazadas), y la estrategia de vacunación de capullo.
Assuntos
Adolescente , Adulto , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Gravidez , Adulto Jovem , Conferências de Consenso como Assunto , Vacinas contra Difteria, Tétano e Coqueluche Acelular/normas , Vacinação em Massa/métodos , Coqueluche/prevenção & controle , Chile/epidemiologia , Esquemas de Imunização , Avaliação de Resultados em Cuidados de Saúde , Coqueluche/epidemiologiaRESUMO
BACKGROUND: Effective glycoconjugate vaccines against Neisseria meningitidis serogroups A, C, W-135, and Y have been developed, but serogroup B remains a major cause of severe invasive disease in infants and adolescents worldwide. We assessed immunogenicity and tolerability of a four-component vaccine (4CMenB) in adolescents. METHODS: We did a randomised, observer-blind, placebo-controlled, study at 12 sites in Santiago and Valparaíso, Chile. Adolescents aged 11-17 years received one, two, or three doses of 4CMenB at 1 month, 2 month, or 6 month intervals. Immunogenicity was assessed as serum bactericidal activity using human complement (hSBA) against three reference strains for individual vaccine antigens, and assessed by ELISA against the fourth strain. Local and systemic reactions were recorded 7 days after each vaccination, and adverse events were monitored throughout the study. Participants were initially randomised to five groups (3:3:3:3:1) during the primary phase to receive either one dose, two doses 1 or 2 months apart, or three doses of 4CMenB, or three doses of placebo, with an additional three groups generated for the booster phase. All subjects received at least one dose of 4CMenB. Geometric mean titres, proportions of participants with serum bactericidal antibody titres of 4 or more, and Clopper-Pearson 95% CIs were calculated. The study is registered with ClinicalTrials.gov, number NCT00661713. FINDINGS: Overall, 1631 adolescents (mean age 13·8 [SD 1·9] years) received at least one dose of 4CMenB. After two or three doses, 99-100% of recipients had hSBA titres of 4 or more against test strains, compared with 92-97% after one dose (p<0·0145) and 29-50% after placebo. At 6 months 91-100% of participants still had titres of 4 or more for each strain after two or three doses, but only 73-76% after one dose; seroresponse rates reached 99-100% for each strain after second or third doses at 6 months. Local and systemic reaction rates were similar after each 4CMenB injection and did not increase with subsequent doses, but remained higher than placebo. No vaccine-related serious adverse events were reported and no significant safety signals were identified. INTERPRETATION: On the basis of immunogenicity responses this study provides evidence for an adolescent 4CMenB vaccine schedule of two doses, 1-6 months apart, to provide protection against meningococcal B infection. The extent of this protection against meningococcus B variants circulating worldwide will be determined by national surveys. FUNDING: Novartis Vaccines and Diagnostics.
Assuntos
Infecções Meningocócicas/prevenção & controle , Vacinas Meningocócicas/efeitos adversos , Vacinas Meningocócicas/imunologia , Neisseria meningitidis Sorogrupo B/imunologia , Adolescente , Análise de Variância , Criança , Chile , Feminino , Humanos , Masculino , Infecções Meningocócicas/imunologia , Vacinas Meningocócicas/administração & dosagem , Método Simples-Cego , Resultado do Tratamento , Vacinação/métodosRESUMO
To inform World Health Organization recommendations regarding use of Haemophilus influenzae type b (Hib) vaccines in national immunization programs, a multi-country evaluation of trends in Hib meningitis incidence and prevalence of nasopharyngeal Hib carriage was conducted in four South American countries using either a primary, three-dose immunization schedule without a booster dose or with a booster dose in the second year of life. Surveillance data suggest that high coverage of Hib conjugate vaccine sustained low incidence of Hib meningitis and low prevalence of Hib carriage whether or not a booster dose was used.
Assuntos
Vacinas Anti-Haemophilus/administração & dosagem , Vacinas Anti-Haemophilus/imunologia , Haemophilus influenzae tipo b/imunologia , Haemophilus influenzae tipo b/isolamento & purificação , Meningite por Haemophilus/epidemiologia , Meningite por Haemophilus/prevenção & controle , Vacinação/métodos , Pré-Escolar , Feminino , Humanos , Imunização Secundária/métodos , Incidência , Lactente , Masculino , Meningite por Haemophilus/microbiologia , América do Sul/epidemiologiaRESUMO
The safety and immunogenicity of the 10-valent pneumococcal nontypeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV, Synflorix™) were assessed in 240 healthy Chilean children randomized to receive 3 doses of PHiD-CV (PHiD-CV group) or hepatitis A vaccine (HAV control group) at 2-4-6 months of age. All were offered 1 HAV dose at 12 months (outside study). The PHiD-CV group received a second HAV dose at 18-21 months and PHiD-CV booster at 20-23 months. The HAV control group received 2 PHiD-CV catch-up doses at 18-21 and 20-23 months. Adverse events were recorded and pneumococcal antibody responses and opsonophagocytic activity (OPA) were measured. Both PHiD-CV vaccination schedules were well tolerated and immunogenic against the pneumococcal vaccine serotypes and protein D. The reactogenicity of PHiD-CV primary, booster and catch-up doses was in line with previous PHiD-CV studies, although generally higher than with HAV. For each vaccine serotype, the percentage of subjects with antibody concentrations ≥0.2 µg/ml (GSK's 22F-inhibition ELISA) was at least 93.2% following 3 PHiD-CV primary doses and at least 97.4% post-booster; percentages with OPA titers ≥8 were at least 91.7% post-booster. After 2-dose catch-up, at least 94.3% of children had antibody concentrations ≥0.2 µg/ml against each serotype except 6B (84.3%); at least 95.2% had OPA titers ≥8 except against serotypes 1, 5 and 6B. In conclusion, the safety profiles of 2 PHiD-CV vaccination schedules (3-dose primary plus booster and 2-dose catch-up) were in line with previous studies and PHiD-CV was immunogenic for all 10 vaccine serotypes and protein D.
Assuntos
Infecções por Haemophilus/epidemiologia , Infecções por Haemophilus/prevenção & controle , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas/efeitos adversos , Vacinas Pneumocócicas/imunologia , Anticorpos Antibacterianos/sangue , Pré-Escolar , Chile/epidemiologia , Feminino , Humanos , Imunização Secundária/métodos , Lactente , Masculino , Vacinas Pneumocócicas/administração & dosagem , Vacinação/métodosRESUMO
OBJECTIVES: To determine the direct medical costs of health care services for cases of invasive pneumococcal disease (IPD) and pneumonia acquired in the community and confirmed by radiology (NAC-Rx) among Chilean children. METHODS: A prospective follow-up study of the health services delivered to 594 children 0-35 months of age with IPD and 1 489 children 1-35 months with NAC-Rx, diagnosed and treated by organizations within public health network of the Región Metropolitana de Chile. The value of the health services was established according to rates supplied by the Fondo Nacional de Salud (FONASA, the National Health Fund) and prices charged by two private clinics. The national IPD and NAC-Rx rates were estimated to calculate the total national economic burden for the population covered by state health insurance. RESULTS: The mean cost of cases requiring hospitalization was US$ 1 056.20 for IPD and US$ 594.80 for NAC-Rx, while that of cases treated by out-patient services was US$ 77.70 and US$ 65.20, respectively. The cost of the same services for in-patient care at the private clinics was US$ 4 484.10 and US$ 2 962.70 at one clinic and US$ 9 967.50 and US$ 6 578.40 at the other. The estimated national annual cost of services for children under 5 years of age, according to FONASA rates, was US$ 789 045 for IPD and US$ 13 823 289 for NAC-Rx. CONCLUSIONS: The high demand for services and financial resources for NAC-Rx in children 0-3 years of age is a tremendously powerful public health reason to support the routine use of pneumococcal vaccination in Chilean children.
Assuntos
Custos de Cuidados de Saúde , Pneumonia Pneumocócica/economia , Pneumonia Pneumocócica/terapia , Pré-Escolar , Chile , Infecções Comunitárias Adquiridas/etiologia , Infecções Comunitárias Adquiridas/terapia , Feminino , Seguimentos , Humanos , Lactente , Masculino , Pneumonia Pneumocócica/diagnóstico por imagem , Estudos Prospectivos , RadiografiaRESUMO
OBJETIVOS: Determinar los costos médicos directos relacionados con la atención sanitaria de los casos de enfermedades neumocócicas invasoras (ENI) y neumonías adquiridas en la comunidad confirmadas mediante radiología (NAC-Rx) en niños chilenos. MÉTODO: Estudio de seguimiento prospectivo de las prestaciones de salud entregadas a 594 niños de 0 a 35 meses con ENI y 1489 niños de 1 a 35 meses con NAC-Rx, diagnosticados y tratados en establecimientos de la red pública de salud de la Región Metropolitana de Chile. Las prestaciones se valoraron según las tarifas del Fondo Nacional de Salud (FONASA) y los precios de dos clínicas privadas. Se estimó la incidencia nacional anual de ENI y NAC-Rx para calcular la carga económica total nacional de la población afiliada al seguro de salud estatal. RESULTADOS: Los costos promedio de los casos que requirieron hospitalización fueron US$ 1056,20 para las ENI y US$ 594,80 para las NAC-Rx, mientras que para los casos tratados en forma ambulatoria fueron US$ 77,70 y US$ 65,20, respectivamente. Los precios por los mismos servicios de internación fueron US$ 4484,10 y US$ 2962,70 en una de las clínicas privadas y US$ 9967,50 y US$ 6578,40 en la otra. El costo anual nacional estimado de la atención de los niños menores de 5 años según las tarifas de FONASA fue de US$ 789045 para las ENI y US$ 13823289 para las NAC-Rx. CONCLUSIONES: La alta demanda asistencial y económica por NAC-Rx en niños de 0 a 3 años es una razón de salud pública tremendamente poderosa que apoya el uso sistemático de la vacunación antineumocócica en niños chilenos.
OBJECTIVES: To determine the direct medical costs of health care services for cases of invasive pneumococcal disease (IPD) and pneumonia acquired in the community and confirmed by radiology (NAC-Rx) among Chilean children. METHODS: A prospective follow-up study of the health services delivered to 594 children 0-35 months of age with IPD and 1 489 children 1-35 months with NAC-Rx, diagnosed and treated by organizations within public health network of the Región Metropolitana de Chile. The value of the health services was established according to rates supplied by the Fondo Nacional de Salud (FONASA, the National Health Fund) and prices charged by two private clinics. The national IPD and NAC-Rx rates were estimated to calculate the total national economic burden for the population covered by state health insurance. RESULTS: The mean cost of cases requiring hospitalization was US$ 1056.20 for IPD and US$ 594.80 for NAC-Rx, while that of cases treated by out-patient services was US$ 77.70 and US$ 65.20, respectively. The cost of the same services for in-patient care at the private clinics was US$ 4484.10 and US$ 2962.70 at one clinic and US$ 9967.50 and US$ 6578.40 at the other. The estimated national annual cost of services for children under 5 years of age, according to FONASA rates, was US$ 789045 for IPD and US$ 13823289 for NAC-Rx. CONCLUSION: The high demand for services and financial resources for NAC-Rx in children 0-3 years of age is a tremendously powerful public health reason to support the routine use of pneumococcal vaccination in Chilean children.
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Custos de Cuidados de Saúde , Pneumonia Pneumocócica/economia , Pneumonia Pneumocócica/terapia , Chile , Infecções Comunitárias Adquiridas/etiologia , Infecções Comunitárias Adquiridas/terapia , Seguimentos , Pneumonia Pneumocócica , Estudos ProspectivosRESUMO
Previously healthy children hospitalized with respiratory syncytial virus (RSV) received motavizumab (3, 15, or 30 mg/kg intravenously), an RSV-specific monoclonal antibody, or placebo. Safety, tolerability, motavizumab concentrations, and immunogenicity were assessed. Cultivatable RSV in the upper respiratory tract was significantly reduced with motavizumab compared with placebo day 1 post-treatment. No adverse events were considered motavizumab-related by site investigators.
Assuntos
Anticorpos Monoclonais/efeitos adversos , Anticorpos Monoclonais/farmacologia , Antivirais/efeitos adversos , Antivirais/farmacologia , Infecções por Vírus Respiratório Sincicial/tratamento farmacológico , Infecções por Vírus Respiratório Sincicial/prevenção & controle , Vírus Sincicial Respiratório Humano/efeitos dos fármacos , Anticorpos Monoclonais/administração & dosagem , Anticorpos Monoclonais Humanizados , Anticorpos Neutralizantes/administração & dosagem , Anticorpos Neutralizantes/efeitos adversos , Anticorpos Neutralizantes/farmacologia , Antivirais/administração & dosagem , Feminino , Humanos , Lactente , Masculino , Placebos/administração & dosagem , Vírus Sincicial Respiratório Humano/imunologia , Sistema Respiratório/virologiaRESUMO
We evaluated the immunogenicity and safety of an investigational combination of 9-valent pneumococcal conjugate vaccine (PCV9) and meningococcal group C conjugate (MnCC) vaccine (PCV9-MnCC) administered concomitantly with Haemophilus influenzae type b (Hib) conjugate vaccine, and of a combination of the three vaccines mixed together as a single injection (Hib-PCV9-MnCC), and compared them to separately administered PCV9 and MnCC dispensed to Chilean infants at 2, 4, and 6 months of age. The frequency of adverse events was similar among groups. Recipients of PCV9 alone or in combination with the other vaccines mounted significant antibody responses to the nine pneumococcal serotypes in PCV9, with >88% achieving protective levels of > or =0.35microg/mL. For serotypes 6B, 9V, and 5, recipients of PCV9 alone had significantly higher geometric mean concentrations (GMCs) than those of the other vaccine groups. Similarly, the GMC of anti-PRP antibodies was significantly lower among recipients of Hib-PCV9-MnCC than among those who received Hib vaccine separately from PCV9 or MnCC. In Chilean infants, PCV9, PCV9-MnCC, and Hib-PCV9-MnCC were highly immunogenic and safe. Overall, interactions of PCV9, MnCC and Hib affected the magnitude (GMC) of the primary antibody responses to some of the antigens, but not the percentage of subjects who achieved protective antibody thresholds.