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Comparison of early onset sepsis and community-acquired late onset sepsis in infants less than 3 months of age

Background We compared demographic and clinical characteristics of early-onset sepsis (EOS) and community-acquired late onset sepsis (CA-LOS) in infants. Methods Our medical center is the sole hospital in southern-Israel, enabling incidence calculations. EOS (<7 days) and CA-LOS (7–90 days) episodes recorded between 2007 and 2013 were reviewed. Univariate and multivariate...

Real-World Effectiveness of Pentavalent Rotavirus Vaccine Among Bedouin and Jewish Children in Southern Israel

Background. Pentavalent rotavirus vaccine (RV5) was introduced into the Israeli National Immunization Program in January 2011. We determined RV5 vaccine effectiveness (VE) in southern Israel, a region characterized by 2 distinct populations: Bedouins living in a low- to middle-income, semirural setting, and Jews living in a high-income, urban setting. Methods. We enrolled vaccine...

Seasonality of Both Bacteremic and Nonbacteremic Pneumonia Coincides With Viral Lower Respiratory Tract Infections in Early Childhood, in Contrast to Nonpneumonia Invasive Pneumococcal Disease, in the Pre-Pneumococcal Conjugate Vaccine Era

We assessed the seasonality of viral lower respiratory tract infections (V-LRI), bacteremic pneumonia, nonbacteremic pneumonia and nonpneumonia invasive pneumococcal diseases (IPD) in the pre-PCV era. Both bacteremic and nonbacteremic pneumonia seasonality peaked in winter, coinciding with V-LRI seasonality, whereas non-pneumonia IPD peaked in autumn before V-LRI increase...

Near-Elimination of Otitis Media Caused by 13-Valent Pneumococcal Conjugate Vaccine (PCV) Serotypes in Southern Israel Shortly After Sequential Introduction of 7-Valent/13-Valent PCV

Background. Otitis media (OM) is common in early childhood. Streptococcus pneumoniae caused approximately 30%–60% of episodes before the pneumococcal conjugate vaccine (PCV) era. The 7-valent PCV (PCV7) was introduced to the Israeli National Immunization Plan in July 2009, and was gradually replaced by the 13-valent PCV (PCV13) starting in November 2010. We aimed at assessing the...

Mixed Pneumococcal–Nontypeable Haemophilus influenzae Otitis Media Is a Distinct Clinical Entity With Unique Epidemiologic Characteristics and Pneumococcal Serotype Distribution

Background. Complex (ie, recurrent, nonresponsive, or chronic) otitis media (OM) is frequent and is often caused by a mixed-pathogen infection with biofilm formation. We conducted this study to characterize children with OM due to mixed Streptococcus pneumoniae and nontypeable Haemophilus influenzae (NTHi) infections (M-OM) and those with OM due to single, S. pneumoniae–only...

Comparative Immunogenicity and Efficacy of 13-Valent and 7-Valent Pneumococcal Conjugate Vaccines in Reducing Nasopharyngeal Colonization: A Randomized Double-Blind Trial

Background. The 13-valent pneumococcal conjugate vaccine (PCV13) was licensed to replace the 7-valent pneumococcal conjugate vaccine (PCV7) based on serological noninferiority criteria. To date no randomized PCV13 pediatric trial has included clinical endpoints. Methods. This randomized double-blind trial compared the impact of PCV13 versus PCV7 on nasopharyngeal (NP...

Nasopharyngeal Carriage of Streptococcus pneumoniae Shortly before Vaccination with a Pneumococcal Conjugate Vaccine Causes Serotype-Specific Hyporesponsiveness in Early Infancy

Background. The antibody response to pneumococcal conjugate vaccines (PCVs) in infants is variable. Factors responsible for this variability have not been fully elucidated. The objective of this study was to investigate whether pneumococcal carriage around the time of the first dose of 7-valent PCV (PCV7) affects serotype-specific immunologic response. Methods. Healthy 2-month...

Acute Otitis Media Caused by Moraxella catarrhalis: Epidemiologic and Clinical Characteristics

Background.This study describes the epidemiologic, microbiologic, and otologic features and selected signs and symptoms of acute otitis media (AOM) caused by Moraxella catarrhalis and compares them with AOM caused by other bacterial pathogens. Methods.Patients aged <5 years with culture-positive AOM from whom a middle ear fluid specimen was obtained and cultured during 1999–2006...

Introduction and Proliferation of Multidrug-Resistant Streptococcus pneumoniae Serotype 19A Clones That Cause Acute Otitis Media in an Unvaccinated Population

BackgroundIntroduction of the 7-valent pneumococcal conjugate vaccine (PCV7) in the United States in 2000 was temporally associated with an increase in the incidence of disease caused by Streptococcus pneumoniae serotype 19A (Sp19A) and with increasing drug resistance within this serotype. A causative role of PCV7 was speculated. We prospectively studied the dynamics of acute...

What is the mechanism for persistent coexistence of drug-susceptible and drug-resistant strains of Streptococcus pneumoniae?

Ron Dagan Marc Lipsitch Caroline Colijn () Ted Cohen Christophe Fraser William Hanage Edward Goldstein Noga Givon-Lavi drug-susceptible and drug-resistant strains of Streptococcus Articles on

Epidemiologic Evidence for Serotype-Specific Acquired Immunity to Pneumococcal Carriage

Nasopharyngeal carriage of Streptococcus pneumoniae is required for transmission of the bacteria and for invasive disease. There have been conflicting reports as to whether protection against carriage is serotype specific and which immune mechanisms drive carriage. Analyzing longitudinal carriage data from Israeli toddlers in day care, we found a lower risk of colonization with...

Seasonality of Antibiotic-Resistant Streptococcus pneumoniae That Causes Acute Otitis Media: A Clue for an Antibiotic-Restriction Policy?

BackgroundIt is unclear whether reducing antibiotic prescriptions can reduce rates of resistance once resistance becomes prevalent. We attempted to determine whether reduced antibiotic consumption, which is observed yearly in children during the warm season, is associated with a reduction in antibiotic resistance in pneumococcal acute otitis media (AOM) MethodsAntibiotic...

The Contribution of Smoking and Exposure to Tobacco Smoke to Streptococcus pneumoniae and Haemophilus influenzae Carriage in Children and Their Mothers

Background. Exposure to tobacco smoke is associated with higher risk of Streptococcus pneumoniae and Haemophilus influenzae infection. The aim of this study was to determine the influence of smoking and exposure to tobacco smoke on S. pneumoniae and H. influenzae carriage rates in children and their mothers. Patients and methods. We performed a cross-sectional surveillance study...

Spread of Streptococcus pneumoniae and Antibiotic-Resistant S. pneumoniae from Day-Care Center Attendees to Their Younger Siblings

A prospective study was conducted to determine the association between pneumococcal carriage among 36 infants and young toddlers cared for at home and carriage among their older siblings who attended 8 day-care centers (DCCs); 71 pneumococcal strains acquired by the younger siblings were compared with those present in the DCCs for 6 months. In 76% of cases, ⩾1 strain identical by...

Serum Serotype-Specific Pneumococcal Anticapsular Immunoglobulin G Concentrations after Immunization with a 9-Valent Conjugate Pneumococcal Vaccine Correlate with Nasopharyngeal Acquisition of Pneumococcus

BackgroundImmunization with pneumococcal conjugate vaccines (PCVs) reduces nasopharyngeal colonization by Streptococcus pneumoniae. We attempted to correlate postvaccination serum serotype-specific pneumococcal anticapsular immunoglobulin (Ig) G concentrations with new acquisitions of vaccine-type (VT) serotypes and the VT-related serotype 6A MethodsA total of 132 day care center...

Acute Otitis Media Caused by Streptococcus pyogenes in Children

Background. Streptococcus pyogenes, or group A β-hemolytic Streptococcus (GAS), is an important causative agent of bacterial pharyngotonsillititis and skin, soft-tissue, and invasive infections. Although it is also an important pathogen in acute otitis media (AOM), its exact role has not been determined. Methods. Patients aged 0–18 years with AOM, from whom a specimen of middle...

Contribution of IL-1 to resistance to Streptococcus pneumoniae infection

The role of IL-1 in susceptibility to Streptococcus pneumoniae infection was studied in mice deficient in genes of the IL-1 family [i.e. IL-1α−/−, IL-1β−/−, IL-1α/β−/− and IL-1R antagonist (IL-1Ra)−/− mice] following intra-nasal inoculation. Intra-nasal inoculation of S. pneumoniae of IL-1β−/− and IL-1α/β−/− mice displayed significantly lower survival rates and higher...

A Decade (1989–1998) of Pediatric Invasive Pneumococcal Disease in 2 Populations Residing in 1 Geographic Location: Implications for Vaccine Choice

During 1 decade (1989–1998), data on invasive pneumococcal disease were collected prospectively to assess the burden of disease among Jewish and Bedouin children in southern Israel and the potential reduction in illness that can be achieved by using conjugate vaccines. Data on 513 children <15 years old with bacteriologically proven invasive pneumococcal disease were obtained...

The Important Role of Nontypable Streptococcus pneumoniae International Clones in Acute Conjunctivitis

BackgroundIn a recent epidemiological study in southern Israel, nontypable Streptococcus pneumoniae isolates were found to be highly associated with sporadic cases of acute conjunctivitis (AC). The purpose of the present study was to evaluate the relative importance in causing AC of the absence of capsule versus genotype properties MethodsDNA typing by pulsed-field gel...

Nutritional Status and Diarrheal Illness as Independent Risk Factors for Alveolar Pneumonia

Community-acquired alveolar pneumonia (CAAP) is typically associated with bacterial infections and is especially prevalent in vulnerable populations worldwide. The authors studied nutritional status and diarrheal history as risk factors for CAAP in Bedouin children <5 years of age living in Israel. In this prospective case-control study (2001–2002), 334 children with...