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11. |
Safety and immunogenicity of pneumococcal conjugate vaccine in combination with diphtheria, tetanus toxoid, pertussis andHaemophilus influenzaetype b conjugate vaccine |
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The Pediatric Infectious Disease Journal,
Volume 21,
Issue 10,
2002,
Page 940-946
STEPHEN OBARO,
GODWIN ENWERE,
MARIA DELORIA,
SHABBAR JAFFAR,
DAVID GOLDBLATT,
KATE BRAINSBY,
HANS HALLANDER,
PAMELA MCINNES,
BRIAN GREENWOOD,
KEITH MCADAM,
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摘要:
Background.Pneumococcal polysaccharide/protein conjugate vaccines (PnCV) are immunogenic and effective in infancy. However, an addition to the nine currently recommended vaccine injections during the first year of life of African children may be a deterrent to participation in a PnCV program. Thus we have evaluated the safety and immunogenicity of a 9-valent PnCV (Wyeth Lederle Pediatrics and Vaccines) mixed with diphtheria, tetanus toxoid, cell pertussis andHaemophilus influenzaetype b (TETRAMUNE).Methods.Healthy Gambian infants were randomized at the age of 2 months to receive three doses 1 month apart of either (1) placebo reconstituted in TETRAMUNE in the right thigh (control) or (2) PnCV in the left thigh and TETRAMUNE in the right thigh (separate) or (3) PnCV reconstituted in TETRAMUNE as a single injection in the right thigh (combined). The vaccines were given together with routine Expanded Program on Immunization vaccines. Adverse reactions were recorded after vaccination, and antibody concentrations were measured by enzyme-linked immunosorbent assays.Results.Local induration and tenderness were observed more commonly at the site of injection of TETRAMUNE than at the site of injection with PnCV after each dose of vaccination. Swelling at the site of injection was encountered more frequently at the site of administration of TETRAMUNE than at the site of administration PnCV (P< 0.00001 for Doses 1 and 2 andP< 0.0009 for Dose 3). Swelling at the site of administration of TETRAMUNE mixed with PnCV was comparable with that observed for TETRAMUNE alone. Although most mothers reported that the babies “felt hot” 24 h after each injection, febrile reactions (temperature, ≥38°C) were infrequent and resolved with antipyretics. Geometric mean titer for anti-polyribosylribitol phosphate antibody was 11.6 &mgr;g/ml [95% confidence limits (95% CI), 9.2, 14.6] in the control group and comparable with 13.3 &mgr;g/ml (95% CI 11.0, 16.0) in the combined group and significantly higher at 17.9 &mgr;g/ml (95% CI 14.7, 21.9;P= 0.01) in the separate group. Geometric mean concentrations of serotype-specific pneumococcal antibodies were higher in the combined group than the separate group for all nine serotypes. Antibody responses to diphtheria and pertussis antigens were similar in all groups. Anti-tetanus toxoid antibody concentrations were lowest in the combined group (6.66 IU/ml, 95% CI 5.77, 7.68 in the control group; 5.15 IU/ml, 95% CI 4.39, 6.03 in the combined group;P= 0.02). However, all vaccinees achieved protective antibody values.Conclusion.The combination of TETRAMUNE and PnCV is safe and immunogenic.
ISSN:0891-3668
出版商:OVID
年代:2002
数据来源: OVID
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12. |
Population-based epidemiology of invasive pneumococcal infection in children in nine urban centers in Canada, 1994 through 1998 |
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The Pediatric Infectious Disease Journal,
Volume 21,
Issue 10,
2002,
Page 947-950
GORDEAN BJORNSON,
DAVID SCHEIFELE,
SCOTT HALPERIN,
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摘要:
Purpose.To describe the epidemiology of invasive pneumococcal infections in Canadian children 0 to 12 years old.Methods.At each of nine urban centers, active surveillance was conducted to identify all cases of invasive pneumococcal infection in children during 1994 to 1998. Postal codes were used to distinguish cases resident in defined urban areas from referral cases. Census data were obtained for each defined area to calculate age-specific incidence rates. Features of population-based cases were described.Results.From an average defined population of ∼1 million children, 937 eligible cases arose. Those 6 to 17 months old had the highest average incidence rate of 98.6/100 000/year. The average cumulative risk of infection was 1 in 460 between birth and 59 months, by which age 92% of cases had occurred. Among cases younger than 2 years of age, simple bacteremia accounted for 66%, pneumonia with bacteremia accounted for 14.7% and meningitis accounted for 11% (average incidence rate, 9.0/100 000/year). An underlying illness was present in 16% of all cases. The mortality rate was 1.8%.Conclusions.Invasive pneumococcal infections are relatively common in early childhood, based on 5 years of data from nearly 20% of the Canadian population ages 0 to 12 years. These data will be valuable for calculating the economic case for universal infant vaccination with newly available vaccines.
ISSN:0891-3668
出版商:OVID
年代:2002
数据来源: OVID
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13. |
Safety and efficacy of quinupristin/dalfopristin for treatment of invasive Gram-positive infections in pediatric patients |
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The Pediatric Infectious Disease Journal,
Volume 21,
Issue 10,
2002,
Page 950-956
ANN LOEFFLER,
RICHARD DREW,
JOHN PERFECT,
NADINE GRETHE,
J. STEPHENS,
SHARON GRAY,
GEORGE TALBOT,
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摘要:
Background.Antibiotic-resistant Gram-positive pathogens are an increasingly common cause of serious pediatric infections. Although quinupristin/dalfopristin demonstrates favorable activityin vitroagainst resistant Gram-positive pathogens (including many vancomycin-resistantE. faeciumand methicillin-resistant staphylococci), published experience in the pediatric patient population is limited.Methods.We retrospectively analyzed data from the global quinupristin/dalfopristin Emergency-Use Program, which enrolled patients with serious Gram-positive infections who had no further therapy options because of resistance to, failure on or intolerance to standard antibiotic treatments. Our subset included safety and efficacy data from pediatric patients (age <18 years). There were no restrictions on underlying diseases, severity of illness or prior/concomitant antimicrobial use.Results.Between May 1995 and October 1999, 127 pediatric patients with 131 infections were enrolled. Microbiologic confirmation of etiology was available in 124 patients. All patients had 1 or more concomitant conditions, including malignancy and solid organ or bone marrow transplantation. The most frequent causative pathogens were vancomycin-resistantEnterococcus faecium(80%),Enterococcusspp. (7%), methicillin-resistantStaphylococcus aureus(6%) andStaphylococcus epidermidis(4%). All but 21 patients received intravenous quinupristin/dalfopristin 7.5 mg/kg every 8 h. The favorable clinical response rate of quinupristin/dalfopristin was 86 of 124 (69%); the favorable microbiologic response rate was 97 of 124 (78%). Eleven patients (8%) had nonvenous adverse events classified as possibly or probably related to quinupristin/dalfopristin.Conclusions.Quinupristin/dalfopristin demonstrated favorable response rates and was reasonably well-tolerated in pediatric patients with serious Gram-positive infections unable to receive alternative therapy. In our opinion quinupristin/dalfopristin is a therapeutic option for the management of such infections.
ISSN:0891-3668
出版商:OVID
年代:2002
数据来源: OVID
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14. |
Extended spectrum beta-lactamases: a therapeutic dilemma |
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The Pediatric Infectious Disease Journal,
Volume 21,
Issue 10,
2002,
Page 957-959
Jan Patterson,
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ISSN:0891-3668
出版商:OVID
年代:2002
数据来源: OVID
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15. |
Postexposure prophylaxis against human immunodeficiency virus infection after sexual assault |
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The Pediatric Infectious Disease Journal,
Volume 21,
Issue 10,
2002,
Page 959-960
Geoffrey Weinberg,
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ISSN:0891-3668
出版商:OVID
年代:2002
数据来源: OVID
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16. |
The potential of pneumococcal conjugate vaccines for children |
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The Pediatric Infectious Disease Journal,
Volume 21,
Issue 10,
2002,
Page 961-970
CYNTHIA G. WHITNEY,
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摘要:
In contrast to earlier pneumococcal vaccines, conjugate vaccines hold promise for reducing pneumococcal morbidity and mortality in infants and young children. The first commercially available conjugate vaccine formulation, which targets seven serotypes, was licensed in the US and other countries in 2000; this vaccine is now part of routine infant immunization in the US. Demand has been high and greater than vaccine supply. Clinical trials indicate that conjugate vaccines are highly efficacious against invasive pneumococcal disease and modestly efficacious against otitis media and pneumonia. In carriage studies conjugate vaccines reduced vaccine-type carriage but led to an increase in carriage of other serotypes. Remaining questions include whether less frequent transmission of vaccine serotypes will mean less disease in unvaccinated children and adults or if nonvaccine serotypes will begin to cause more disease. Monitoring disease burden after widespread use in the US is critical for understanding the effects of the vaccine. In addition making pneumococcal vaccines available for children in developing countries should be a high priority.
ISSN:0891-3668
出版商:OVID
年代:2002
数据来源: OVID
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17. |
Neural larva migrans caused by the raccoon roundwormBaylisascaris procyonis |
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The Pediatric Infectious Disease Journal,
Volume 21,
Issue 10,
2002,
Page 971-975
PATRICK GAVIN,
KEVIN KAZACOS,
TINA TAN,
WILLIAM BRINKMAN,
SHARON BYRD,
A. DAVIS,
MARILYN METS,
STANFORD SHULMAN,
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摘要:
Baylisascaris procyonis,the common raccoon roundworm, is a rare cause of devastating or fatal neural larva migrans in infants and young children. We describe the clinical features of two children from suburban Chicago who developed severe, nonfatalB. procyonisneural larva migrans. Despite treatment with albendazole and high dose corticosteroids, both patients are neurologically devastated. In many regions of North America, large populations of raccoons with high rates of endemicB. procyonisinfection live in proximity to humans, which suggests that the risk of human infection is probably substantial. In the absence of effective treatment, prevention of infection remains the most important public health strategy.
ISSN:0891-3668
出版商:OVID
年代:2002
数据来源: OVID
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18. |
Investigation of kawasaki syndrome risk factors in colorado |
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The Pediatric Infectious Disease Journal,
Volume 21,
Issue 10,
2002,
Page 976-978
Tracee Treadwell,
Ryan Maddox,
Robert Holman,
Ermias Belay,
Abtin Shahriari,
Marsha Anderson,
Jennifer Burns,
Mary Glodé,
Richard Hoffman,
Lawrence Schonberger,
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ISSN:0891-3668
出版商:OVID
年代:2002
数据来源: OVID
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19. |
Dose escalation, safety and immunogenicity study of a tetravalent meninogococcal polysaccharide diphtheria conjugate vaccine in toddlers |
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The Pediatric Infectious Disease Journal,
Volume 21,
Issue 10,
2002,
Page 978-979
Margaret Rennels,
James King,
Robert Ryall,
Susan Manoff,
Thomas Papa,
Andrea Weddle,
James Froeschle,
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ISSN:0891-3668
出版商:OVID
年代:2002
数据来源: OVID
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20. |
Fusobacteriumosteomyelitis in a child with sickle cell disease |
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The Pediatric Infectious Disease Journal,
Volume 21,
Issue 10,
2002,
Page 979-981
Sandra Murray,
Jay Lieberman,
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ISSN:0891-3668
出版商:OVID
年代:2002
数据来源: OVID
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