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Pneumokokna bolest i cijepljenje protiv pneumokoka

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Presentation on theme: "Pneumokokna bolest i cijepljenje protiv pneumokoka"— Presentation transcript:

1 Pneumokokna bolest i cijepljenje protiv pneumokoka
Goran Tešović Klinika za infektivne bolesti „Dr. Fran Mihaljević” Medicinski fakultet Sveučilišta u Zagrebu Simpozij „Bolesti koje se sprječavaju cijepljenjem”, Zagreb, 25. svibnja g.

2 Nazofarinks – najznačajnija biološka niša, početak bolesti, mjesto djelovanja CV…

3 Ključna uloga polisaharidne kapsule – „kapsularnog” serotipa!
Nazofarinks – najznačajnija biološka niša, početak bolesti, mjesto djelovanja CV… Ključna uloga polisaharidne kapsule – „kapsularnog” serotipa!

4 Ključna uloga polisaharidne kapsule – „kapsularnog” serotipa!
Različiti kapsularni tipovi: različito dugo perzistiraju na sluznici; imaju različit invazijski potencijal; uzrokuju različite kliničke sindrome;

5 Ključna uloga polisaharidne kapsule – „kapsularnog” serotipa!
Različiti kapsularni tipovi: različito dugo perzistiraju na sluznici; imaju različit invazijski potencijal; uzrokuju različite kliničke sindrome;

6 Ključna uloga polisaharidne kapsule – „kapsularnog” serotipa!
Sleeman KL, Griffiths D, Shackley F, et al. Capsular serotype-specific attack rates and duration of carriage of Streptococcus pneumoniae in a population of children. J Infect Dis Sep 1;194:682-8.

7 Ključna uloga polisaharidne kapsule – „kapsularnog” serotipa!
Različiti kapsularni tipovi: različito dugo perzistiraju na sluznici; imaju različit invazijski potencijal; uzrokuju različite kliničke sindrome;

8 Ključna uloga polisaharidne kapsule – „kapsularnog” serotipa!
Sá-Leão R, Pinto F, Aguiar S, et al. Analysis of invasiveness of pneumococcal serotypes and clones circulating in Portugal before widespread use of conjugate vaccines reveals heterogeneous behavior of clones expressing the same serotype. J Clin Microbiol. 2011;49:

9 Ključna uloga polisaharidne kapsule – „kapsularnog” serotipa!
Različiti kapsularni tipovi: različito dugo perzistiraju na sluznici; imaju različit invazijski potencijal; uzrokuju različite kliničke sindrome;

10 Ključna uloga polisaharidne kapsule – „kapsularnog” serotipa!
Rodgers GL, Arguedas A, Cohen R, Dagan R. Global serotype distribution among Streptococcus pneumoniae isolates causing otitis media in children: potential implications for pneumococcal conjugate vaccines. Vaccine 2009;27:

11 Ključna uloga polisaharidne kapsule – „kapsularnog” serotipa!
Rodgers GL, Arguedas A, Cohen R, Dagan R. Global serotype distribution among Streptococcus pneumoniae isolates causing otitis media in children: potential implications for pneumococcal conjugate vaccines. Vaccine 2009;27:

12 Ključna uloga polisaharidne kapsule – „kapsularnog” serotipa!
Song JY, Nahm MH, Moseley MA. Clinical implications of pneumococcal serotypes: invasive disease potential, clinical presentations, and antibiotic resistance. J Korean Med Sci. 2013;28:4-15.

13 Koje su direktne posljedice PCV na pneumokokno kliconoštvo, bolest…

14 Koje su direktne posljedice PCV na pneumokokno kliconoštvo, bolest…
MMWR 2008;57(6):144-8.

15 Koje su direktne posljedice PCV na pneumokokno kliconoštvo, bolest…
Lancet 2007;369:

16 Koje su direktne posljedice PCV na pneumokokno kliconoštvo, bolest…
Pediatrics 2008;121:

17 Koje su direktne posljedice PCV na pneumokokno kliconoštvo, bolest…
J Infect Dis 2007;196:

18 Koje su direktne posljedice PCV na pneumokokno kliconoštvo, bolest…
Early Trends for Invasive Pneumococcal Infections in Children After the Introduction of the 13-valent Pneumococcal Conjugate Vaccine. Kaplan, Sheldon; Barson, William; Lin, Philana; Romero, Jose; Bradley, John; Tan, Tina; Hoffman, Jill; Givner, Laurence; Mason, Edward Pediatric Infectious Disease Journal. 32(3): , March 2013. DOI: /INF.0b013e b

19 Koje su direktne posljedice PCV na pneumokokno kliconoštvo, bolest…
Angoulvant F, et al. Clin Infect Dis. 2014;58(7):

20 Koje su direktne posljedice PCV na pneumokokno kliconoštvo, bolest…
Arrows: 1. PCV7 in private market, 2. PCV7 introduced to the Israeli NIP, 3. PCV13 introduced to the Israeli NIP, 4. >70% of children 7-11 months received ≥2 doses of PCV13. Ben-Shimol S, Givon-Lavi N, Leibovitz E, Raiz S, Greenberg D, Dagan R. Near elimination of otitis media caused by the PCV13 serotypes in Southern Israel shortly after sequential introduction of PCV7/PCV13. Clin Infect Dis Aug 25. pii: ciu683.

21 Koje su direktne posljedice PCV na pneumokokno kliconoštvo, bolest…

22 Koje su direktne posljedice PCV na pneumokokno kliconoštvo, bolest…

23 Koje su direktne posljedice PCV na pneumokokno kliconoštvo, bolest…

24 Koje su direktne posljedice PCV na pneumokokno kliconoštvo, bolest…

25 Koje su direktne posljedice PCV na pneumokokno kliconoštvo, bolest…

26 Koje su direktne posljedice PCV na pneumokokno kliconoštvo, bolest…

27 Koje su direktne posljedice PCV na pneumokokno kliconoštvo, bolest…

28 Koje su direktne posljedice PCV na pneumokokno kliconoštvo, bolest…

29 Koje su direktne posljedice PCV na pneumokokno kliconoštvo, bolest…
THL Report – Infectious Diseases in Finland 2015

30 Koje su direktne posljedice PCV na pneumokokno kliconoštvo, bolest…
Best et al, Vaccine, 34:3840–3847, 2016

31 Koje su direktne posljedice PCV na pneumokokno kliconoštvo, bolest…
IPD cases/100,000 Regev-Yochay, Dagan et al, Vaccine 2017:35:

32 Koje su direktne posljedice PCV na pneumokokno kliconoštvo, bolest…

33

34

35 Engleska i Wales (<5 godina)
PCV13 2+1 *nije statistički značajno Waight PA, et al. Lancet Infect Dis. Published online 20 March 2015.

36 Moore MR, et al. Lancet Infect Dis. 2015;15(3):301-309.
SAD (<5 godina) PCV13 3+1 PCV7 2000 PCV13 2010 31% redukcija (vs 2007–2010) Moore MR, et al. Lancet Infect Dis. 2015;15(3):

37

38

39 Koje su direktne posljedice PCV na pneumokokno kliconoštvo, bolest…
Broj sojeva Butić I, Tešović G: Neobjavljeni podaci, 2017.

40 Koje su direktne posljedice PCV na pneumokokno kliconoštvo, bolest…
Broj sojeva Butić I, Tešović G: Neobjavljeni podaci, 2017.

41 Koje su direktne posljedice PCV na pneumokokno kliconoštvo, bolest…
Broj sojeva Butić I, Tešović G: Neobjavljeni podaci, 2017.

42 Zaključci PCV značajno utječe na epidemiologiju neinvazivnih i invazivnih oblika pneumokokne bolesti. PCV potiče zamjenu serotipova („novi” serotipovi popunjavaju „nišu”. Serotipovi (pa tako i zamjenski) značajno se razlikuju u invazijskom potencijalu, antimikrobnoj osjetljivosti… Poznavanje lokalne seroepidemiologije značajno je za donošenje odluke o tome koje je PCV optimalan izbor za NIP.

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