Τρίτη 5 Ιουλίου 2022

Distribution of Serotypes Causing Invasive Pneumococcal Disease in Children from High-Income Countries and the Impact of Pediatric Pneumococcal Vaccination

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Abstract
Background
The introduction and adoption of pneumococcal conjugate vaccines (PCVs) into pediatric national immunization programs (NIPs) has led to large decreases in invasive pneumococcal disease (IPD) incidence caused by vaccine serotypes. Despite these reductions, the global IPD burden in children remains significant.
Methods
We collected serotype-specific IPD data from surveillance systems or hospital networks of all 30 high-income countries that met inclusion criteria. Data sources included online databases, surveillance system reports, and peer-reviewed literature. Percentage of serotyped cases covered were calculated for all countries combined and by PCV type in the pediatric NIP.
Results
We identified 8012 serotyped IPD cases in children <5 or ≤5 years old. PCV13 serotype IPD caused 37.4% of total IPD cases, including 57.1% and 25.2% for countries with PCV10 or PCV13 in the pediatric NIP, respectively, most commonly due to serotypes 3 and 19A (11.4% and 13.3%, respectively, across all countries). In PCV10 countries, PCV15 and PCV20 would cover an additional 45.1% and 55.6% of IPD beyond serotypes contained in PCV10, largely due to coverage of serotype 19A. In PCV13 countries, PCV15 and PCV20 would cover an additional 10.6% and 38.2% of IPD beyond serotypes contained in PCV13. The most common IPD serotypes covered by higher valency PCVs were 10A (5.2%), 12F (5.1%), and 22F and 33F (3.5% each).
Conclusions
Much of the remaining IPD burden is due to serotypes included in PCV15 and PCV20. The inclusion of these next generation PCVs into existing pediatric NIPs may further reduce the incidence of childhood IPD.
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Keratin5-cytoskeleton-BMP4 network regulates cell phenotype conversions during cardiac regeneration

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Publication date: Available online 4 July 2022

Source: Experimental Cell Research

Author(s): Xuelong Wang, Huiping Guo, Feifei Yu, Hui Zhang, Ying Peng, Chenghui Wang, Gang Wei, Jizhou Yan

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Validation of a health-related quality of life questionnaire in patients with recurrent Clostridioides difficile infection in ECOSPOR III, a Phase 3 randomized trial

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Abstract
Background
Debilitating symptoms of recurrent Clostridioides difficile infection (rCDI) often lead to long-term effects on health-related quality-of-life (HRQOL). In ECOSPOR III, SER-109, an investigational oral microbiome therapeutic, was superior to placebo in reducing rCDI. We investigated the validity, reliability, and responsiveness of a 32-item, CDI-specific questionnaire (Cdiff32) across mental, physical, and social domains in patients with rCDI.
Methods
In this post-hoc analysis of a Phase 3 clinical trial, 182 outpatients with rCDI completed Cdiff32 and EQ-5D at baseline, 1 and 8 weeks. Cdiff32 was evaluated for item performance, internal reliability, and convergent validity. To assess known-groups validity, Cdiff32 scores were compared across recurrent versus non-recurrent patients at week 1; internal responsiveness was evaluated in non-re current patients by 8 weeks by paired t-test.
Results
All 182 patients (mean age 65.5 ± 16.5, 59.9% female) completed baseline Cdiff32. Confirmatory factor analysis identified 3 domains (physical, mental, and social relationships) with good item fit. High internal reliability was demonstrated (Cronbach's alpha = 0.94 with all subscales > 0.80). Convergent validity was evidenced by significant correlations between Cdiff32 subscales and EQ-5D (r range: 0.29-0.37, p < 0.001). Cdiff32 differentiated recurrent from non-recurrent patients at week 1 (effect sizes: 0.38-0.42; p < 0.05 overall), with significant improvement from baseline to week 8 in non-recurrent patients (effect sizes: 0.75-1.02; p < 0.001 overall).
Conclusions
Cdiff32 is a valid, reliable, and responsive disease-specific HRQOL questionnaire fit-for-purpose for interventional treatment trials. The significant improvement in non-recurrent patients by 8 weeks demonstra tes the negative impact of rCDI on HRQOL.
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