Streptococcus pneumoniae outbreaks and implications for transmission and control: a systematic review.
Streptococcus pneumoniae outbreaks and implications for transmission and control: a systematic review.
复制标题
DOI：
10.1186/s41479-018-0055-4
复制
发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Weber DJ
中科院分区：
文献类型：
--
作者：
Zivich PN;Grabenstein JD;Becker-Dreps SI;Weber DJ
肺炎链球菌能够引起多种感染综合征，偶尔会引起暴发。这次审查的目的是更新以前的疫情审查，确定控制措施，并对传播发表意见。我们对已发表的S.肺炎暴发，定义为至少两个连锁的S.肺炎。共识别出98篇文章（86篇呼吸道疾病; 8篇结膜炎; 2篇中耳炎; 1篇手术部位; 1篇多发性），详细描述了1916年至2017年期间发生的94起独特疫情。报告的血清型包括1、2、3、4、5、7 F、8、12 F、14、20和23 F，以及血清群6、9、15、19、22。肺炎球菌爆发的中位发病率为7.0%（四分位距：2.4%，13%）。中位病死率为12.9%（四分位距：0%，29.2%）。受疫情影响最大的年龄组是老年人（60.3%）和年轻人（34.2%）。暴发发生在拥挤的环境中，如大学/学校/日托所、军营、医院病房和长期护理设施。在评估疫苗接种覆盖率的暴发中，低初始疫苗接种或再接种覆盖率是常见的。大多数（73.1%）报告的暴发报告对至少一种抗生素不敏感，对青霉素（56.0%）和红霉素（52.6%）不敏感是常见的。有证据表明，疫情中的传播可以通过多种方式发生，包括携带者、受感染者或医疗器械。有几个病例在接触后不久（< 72小时）发病。呼吸道爆发使用感染预防（55.6%），预防性疫苗接种（63.5%）和预防性抗生素（50.5%），以防止未来的病例。PPSV 23涵盖了所有报告的暴发血清型。PCV 13覆盖了16种血清型中的10种。对于结膜爆发，仅使用感染预防策略。为了预防呼吸道疾病暴发的最初发生，接种疫苗和再接种疫苗可能是最好的预防措施。一旦爆发，应使用疫苗接种和感染预防策略。可考虑对高风险暴露个体进行抗生素预防，但已有报告称在暴发期间出现了抗生素耐药性。从最初接触到发病的时间很短，这表明肺炎球菌定植不是肺炎球菌呼吸道感染的先决条件。本文的在线版本（10.1186/s41479-018-0055-4）包含补充材料，可供授权用户使用。
Streptococcus pneumoniae is capable of causing multiple infectious syndromes and occasionally causes outbreaks. The objective of this review is to update prior outbreak reviews, identify control measures, and comment on transmission. We conducted a review of published S. pneumoniae outbreaks, defined as at least two linked cases of S. pneumoniae. A total of 98 articles (86 respiratory; 8 conjunctivitis; 2 otitis media; 1 surgical site; 1 multiple), detailing 94 unique outbreaks occurring between 1916 to 2017 were identified. Reported serotypes included 1, 2, 3, 4, 5, 7F, 8, 12F, 14, 20, and 23F, and serogroups 6, 9, 15, 19, 22. The median attack rate for pneumococcal outbreaks was 7.0% (Interquartile range: 2.4%, 13%). The median case-fatality ratio was 12.9% (interquartile range: 0%, 29.2%). Age groups most affected by outbreaks were older adults (60.3%) and young adults (34.2%). Outbreaks occurred in crowded settings, such as universities/schools/daycares, military barracks, hospital wards, and long-term care facilities. Of outbreaks that assessed vaccination coverage, low initial vaccination or revaccination coverage was common. Most (73.1%) of reported outbreaks reported non-susceptibility to at least one antibiotic, with non-susceptibility to penicillin (56.0%) and erythromycin (52.6%) being common. Evidence suggests transmission in outbreaks can occur through multiple modes, including carriers, infected individuals, or medical devices. Several cases developed disease shortly after exposure (< 72 h). Respiratory outbreaks used infection prevention (55.6%), prophylactic vaccination (63.5%), and prophylactic antibiotics (50.5%) to prevent future cases. PPSV23 covered all reported outbreak serotypes. PCV13 covered 10 of 16 serotypes. For conjunctival outbreaks, only infection prevention strategies were used. To prevent the initial occurrence of respiratory outbreaks, vaccination and revaccination is likely the best preventive measure. Once an outbreak occurs, vaccination and infection-prevention strategies should be utilized. Antibiotic prophylaxis may be considered for high-risk exposed individuals, but development of antibiotic resistance during outbreaks has been reported. The short period between initial exposure and development of disease indicates that pneumococcal colonization is not a prerequisite for pneumococcal respiratory infection. The online version of this article (10.1186/s41479-018-0055-4) contains supplementary material, which is available to authorized users.
登录
查看更多内容
影响因子：
5.5
作者：
Crum, NF;Wallace, MR;Earhart, KC
通讯作者：
Earhart, KC
影响因子：
4.5
作者：
Carter, RJ;Sorensen, G;Layton, M
通讯作者：
Layton, M
影响因子：
11.8
作者：
Craig, AS;Erwin, PC;Butler, JC
通讯作者：
Butler, JC
影响因子：
5.5
作者：
Balicer, Ran D.;Zarka, Salman;Dagan, Ron
通讯作者：
Dagan, Ron
影响因子：
11.8
作者：
Crum, NF;Barrozo, CP;Russell, KL
通讯作者：
Russell, KL