Infections à pneumocoque

EMC - Pédiatrie Pub Date : 2004-11-01 DOI:10.1016/j.emcped.2004.06.003

P. Brisou (Spécialiste du service de santé des Armées) , J.-M. Chamouilli (Praticien hospitalier, chef de service de pédiatrie) , T. Gaillard (Assistante du service de santé des Armées) , Y. Muzellec (Spécialiste du service de santé des Armées)

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引用次数: 5

Abstract

Currently, pneumococcal infections are a public health problem. Streptococcus pneumoniae is a leading cause of community acquired invasive and non invasive bacterial infections in infants and young children, more specifically among those under five years. Pneumococcal invasive infections, in particular meningitis, carry a mortality upper than 8 % and a high risk of sequelae. Atypical clinical expression is frequent in youngest children. Membrane immunochromatography for rapid detection of urinary C-polysaccharide antigen is one of the advances for biological diagnosis, but it remains to be evaluated in children. Due to the increasing prevalence of penicillin-resistant pneumococci, treatment has to be adapted to clinical and epidemiological features. Frequent, serious, antibiotic-resistant characters of pneumococcal infections plea for vaccine. In France, Pneumo 23^® indications were extended in 1998, and pneumococcal conjugate vaccine Prevenar^® indications were modified in 2002. Local, national and international surveys are needed to adapt treatment and vaccine strategies.

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感染:肺炎

目前，肺炎球菌感染是一个公共卫生问题。肺炎链球菌是婴幼儿社区获得性侵袭性和非侵袭性细菌感染的主要原因，特别是在五岁以下的儿童中。肺炎球菌侵袭性感染，特别是脑膜炎，死亡率超过8%，并有很高的后遗症风险。不典型临床表现常见于幼童。膜免疫层析快速检测尿c -多糖抗原是生物诊断的进展之一，但在儿童中的应用仍有待评估。由于耐青霉素肺炎球菌的流行率越来越高，治疗必须适应临床和流行病学特点。肺炎球菌感染频繁，严重，耐抗生素的特点要求疫苗。在法国，1998年延长了Pneumo 23®的适应症，2002年修改了肺炎球菌结合疫苗Prevenar®的适应症。需要进行地方、国家和国际调查，以调整治疗和疫苗战略。

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