Mogućnosti prevencije invazivne pneumokokne bolesti u djece u Hrvatskoj

master's thesis

• Title (english): The possibilities for prevention of invasive pneumococcal disease in croatian children
• Author: Ivana Martinović
• Mentor: Goran Tešović (mentor)
• Committee member: Arjana Tambić-Andrašević
• Committee member: Josip Begovac
• Committee member: Goran Tešović
• Granter: University of Zagreb; School of Medicine; (Department of Infectious Diseases); Zagreb
• Defense date and country: 2015-09-29, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Infectology

Abstract

Infekcije uzrokovane bakterijom Streptococcus pneumoniae veliki su javnozdravstveni problem diljem svijeta. Prijenosu infekcije, poglavito među djecom, pogoduju napučeni prostori, kao što su škole i vrtići. Poseban problem predstavljaju invazivne pneumokokne bolesti (IPB) - bakterijemija/sepsa, bakterijemična pneumonija i meningitis, čiji ishod može biti fatalan. O invazivnoj bolesti govorimo kada je pneumokok izoliran iz inače sterilnih medija, kao što su krv i/ili likvor. Više od milijun djece godišnje umre zbog pneumokoknih invazivnih bolesti u svijetu. Problem liječenja ovih infekcija postaje sve veći zbog narastajuće rezistencije pneumokoka na antibiotike. Većinu invazivnih oblika bolesti uzrokuje mali broj serotipova. U Hrvatskoj i u svijetu već je dugi niz godina dostupno pneumokokno konjugirano cjepivo kojim bi se invazivni oblici bolesti mogli prevenirati. Međutim, zbog sporadičnog cijepljenja, u našoj zemlji nije došlo do bitnog smanjenja incidencije invazivnih bolesti. U ovom radu je prikazana analiza 67 bolesnika do 18 godina starosti koji su liječeni u Zavodu za infektivne bolesti djece Klinike za infektivne bolesti „Dr. Fran Mihaljević“, Zagreb u periodu od 1. siječnja 2011. do 31. prosinca 2013. Analizirane su epidemiološke karakteristike djece, distribucija serotipova pneumokoka te njihova pokrivenost serotipovima koji se nalaze u tri pneumokokna cjepiva dostupna u Hrvatskoj. U 63 bolesnika došlo je do poboljšanja stanja, dok su 4 bolesnika preminula. Najučestaliji izolirani serotip je bio 14, dok se najinvazivnijim pokazao serotip 19A, koji je izoliran u dva preminula bolesnika. Samo univerzalno cijepljenje sve dojenčadi može značajno utjecati na smanjenje smrtnosti od invazivnih pneumokoknih bolesti u djetinjstvu.

Abstract (english)

Infections caused by S. pneumoniae are a major public health issue worlwide. Crowded enviroments like schools and kindergartens stimulate infection transfer among children. Invasive pneumococcal disease (IPD) like bacteraemia/sepsis, bacteremic pneumonia and bacterial meningitis could be even fatal. Invasive disease develops as a result of infection spread to normally sterile sites of the body, such as the blood and/or cerebrospinal fluid. More than a milion of children die every year due to invasive pneumococcal disease worldwide. Successful treatment of pneumococcal infections has become a big issue due to the increasing antimicrobial resistance. The majority of all IPD cases is caused by limited number of pneumococcal serotypes. Pneumococcal conjugate vaccine (PCV), available in Croatia and worldwide, pose a new possibility in prevention and reduction of IPDs. However, risk population based immunization in our country hasn't reduced the incidence of IPD significantly. This paper analized data on 67 pediatric patients treated at the Department of Pediatric Infectious Diseases at University Hospital for Infectious Diseases „Dr. Fran Mihaljević“ in the period of 2011 – 2013. Analysis included epidemiological characteristics, pneumococcal serotype distribution and serotype coverage of three diferent pneumococcal vaccines available in Croatia. Clinical improvement following antimicrobial treatment was observed in 63 patients, while 4 patients died. The most common isolated serotype was 14, while 19A proved to be the most invasive and was isolated in 2 patients with fatal outcome. Only universal vaccination of all infants could significantly decrease the IPD morbidity in Croatian children.

• Keywords: Streptococcus pneumoniae; invazivna bolest; djeca; pneumokokno cjepivo
• Keywords (english): Streptococcus pneumoniae; invasive disease; children; pneumococcal conjugate vaccine
• Language: croatian
• URN:NBN: urn:nbn:hr:105:518593
• Study programme: Title: Studies in Nursing; Study programme type: university; Study level: graduate; Academic / professional title: magistar/magistra sestrinstva (magistar/magistra sestrinstva)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2016-04-25 09:29:49