https://www.wikidoc.org/index.php?title=Streptococcus_pneumoniae_infection&feed=atom&action=history
Streptococcus pneumoniae infection - Revision history
2024-03-28T17:29:46Z
Revision history for this page on the wiki
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https://www.wikidoc.org/index.php?title=Streptococcus_pneumoniae_infection&diff=1323291&oldid=prev
Usama Talib at 18:41, 5 July 2017
2017-07-05T18:41:12Z
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Older revision</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 18:41, 5 July 2017</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Overview==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Overview==</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>'''''Streptococcus pneumoniae''''', or '''pneumococcus''', is a [[Gram-positive]] bacterium. It is a diplococcus, [[Hemolysis (microbiology)|alpha-hemolytic]] member of the ''[[Streptococcus]]'' [[genus]].<ref name="Sherris">{{cite book | author = Ryan KJ; Ray CG (editors) | title = Sherris Medical Microbiology | edition = 4th ed. | publisher = McGraw Hill | year = 2004 | id = ISBN 0-8385-8529-9 }}</ref> During the 19th century pneumonia was heavily associated with this pathogen. ''[[S. pneumoniae]]'' is known to be the cause of various different infections apart from [[pneumonia]] including [[endocarditis]], [[meningitis]], [[pericarditis]], [[brain abscess]], [[otitis media]], [[osteomyelitis]], [[acute sinusitis]], [[septic arthritis]], [[peritonitis]], and [[cellulitis]]. In children as well as adults, ''[[Streptococcus pneumoniae|S. pneumoniae]]'' is the most common cause of [[otitis media]] as well as [[Bacterial meningitis|bacterial meningiti]]<nowiki/>s.<ref>{{cite journal |author=Dagan R |title=Treatment of acute otitis media - challenges in the era of antibiotic resistance |journal=Vaccine |volume=19 Suppl 1 |issue= |pages=S9-S16 |year= |pmid=11163457}}</ref> [[Pneumonia]] caused by ''S. pneumoniae'' is usually found at the extremes of the age (in old or very young individuals). ''[[Streptococcus viridans]]'' also belongs to the family of alpha hemolytic bacteria but can e distinguished from ''[[Streptococcus pneumoniae|S. pneumoniae]]'' by an [[optochin]] test. ''[[Streptococcus viridans]]'' are found to be insensitive to [[optochin]] where as ''[[S. pneumoniae]]'' are found to be [[Optochin|optochin sensitive]]. The most potent [[virulence factor]] of ''[[Streptococcus pneumoniae|S. pneumoniae]]'' is its [[Polysaccharide encapsulated bacteria|polysaccharide capsule]]. Up to 91 various types of capsules have been discovered; each of these differ in virulence, drug resistance, [[prevalence|prevalence,]] and distribution.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>'''''Streptococcus pneumoniae''''', or '''pneumococcus''', is a [[Gram-positive]] bacterium. It is a diplococcus, [[Hemolysis (microbiology)|alpha-hemolytic]] member of the ''[[Streptococcus]]'' [[genus]].<ref name="Sherris">{{cite book | author = Ryan KJ; Ray CG (editors) | title = Sherris Medical Microbiology | edition = 4th ed. | publisher = McGraw Hill | year = 2004 | id = ISBN 0-8385-8529-9 }}</ref> During the 19th century pneumonia was heavily associated with this pathogen. ''[[S. pneumoniae]]'' is known to be the cause of various different infections apart from [[pneumonia]] including [[endocarditis]], [[meningitis]], [[pericarditis]], [[brain abscess]], [[otitis media]], [[osteomyelitis]], [[acute sinusitis]], [[septic arthritis]], [[peritonitis]], and [[cellulitis]]. In children as well as adults, ''[[Streptococcus pneumoniae|S. pneumoniae]]'' is the most common cause of [[otitis media]] as well as [[Bacterial meningitis|bacterial meningiti]]<nowiki/>s.<ref>{{cite journal |author=Dagan R |title=Treatment of acute otitis media - challenges in the era of antibiotic resistance |journal=Vaccine |volume=19 Suppl 1 |issue= |pages=S9-S16 |year= |pmid=11163457}}</ref> [[Pneumonia]] caused by ''<ins style="font-weight: bold; text-decoration: none;">[[</ins>S. pneumoniae<ins style="font-weight: bold; text-decoration: none;">]]</ins>'' is usually found at the extremes of the age (in old or very young individuals). ''[[Streptococcus viridans]]'' also belongs to the family of alpha hemolytic bacteria but can e distinguished from ''[[Streptococcus pneumoniae|S. pneumoniae]]'' by an [[optochin]] test. ''[[Streptococcus viridans]]'' are found to be insensitive to [[optochin]] where as ''[[S. pneumoniae]]'' are found to be [[Optochin|optochin sensitive]]. The most potent [[virulence factor]] of ''[[Streptococcus pneumoniae|S. pneumoniae]]'' is its [[Polysaccharide encapsulated bacteria|polysaccharide capsule]]. Up to 91 various types of capsules have been discovered; each of these differ in <ins style="font-weight: bold; text-decoration: none;">[[</ins>virulence<ins style="font-weight: bold; text-decoration: none;">]]</ins>, drug resistance, [[prevalence|prevalence,]] and distribution.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Classification==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Classification==</div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>[[Medical diagnosis|Diagnosis]] of [[streptococcus pneumoniae]] infection is generally made based on clinical suspicion along with a positive culture from a sample from virtually any place in the body. </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>[[Medical diagnosis|Diagnosis]] of [[streptococcus pneumoniae]] infection is generally made based on clinical suspicion along with a positive culture from a sample from virtually any place in the body. </div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*An [[Antistreptolysin O titer|ASO titre]] of >200 units is significant.<ref name="Siemieniuk 2011">{{cite journal|last=Siemieniuk|first=Reed A.C.|coauthors= Gregson, Dan B.; Gill, M. John |title=The persisting burden of invasive pneumococcal disease in HIV patients: an observational cohort study|journal=BMC Infectious Diseases|date=Nov 2011|volume=11|doi=10.1186/1471-2334-11-314|pmid=22078162|url=http://www.biomedcentral.com/content/pdf/1471-2334-11-314.pdf|pages=314|pmc=3226630}}</ref> </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*An [[Antistreptolysin O titer|ASO titre]] of >200 units is significant.<ref name="Siemieniuk 2011">{{cite journal|last=Siemieniuk|first=Reed A.C.|coauthors= Gregson, Dan B.; Gill, M. John |title=The persisting burden of invasive pneumococcal disease in HIV patients: an observational cohort study|journal=BMC Infectious Diseases|date=Nov 2011|volume=11|doi=10.1186/1471-2334-11-314|pmid=22078162|url=http://www.biomedcentral.com/content/pdf/1471-2334-11-314.pdf|pages=314|pmc=3226630}}</ref> </div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*''S. pneumoniae'' is, in general, [[optochin]] sensitive, although [[optochin]] resistance has been observed.<ref>{{Cite journal |title=Optochin resistance in ''Streptococcus pneumoniae'': mechanism, significance, and clinical implications |journal=Journal of Infectious Diseases |url=http://www.journals.uchicago.edu/doi/pdf/10.1086/322803?cookieSet=1 |volume=184 |issue=5 |pages=582–590 |year=2001 |pmid=11474432 |doi=10.1086/322803 |author8=Pikis A, Campos JM, Rodriguez WJ, Keith JM |last1=Pikis |first1=A |last2=Campos |first2=JM |last3=Rodriguez |first3=WJ |last4=Keith |first4=JM}}</ref></div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*''<ins style="font-weight: bold; text-decoration: none;">[[</ins>S. pneumoniae<ins style="font-weight: bold; text-decoration: none;">]]</ins>'' is, in general, [[optochin]] sensitive, although [[optochin]] resistance has been observed.<ref>{{Cite journal |title=Optochin resistance in ''Streptococcus pneumoniae'': mechanism, significance, and clinical implications |journal=Journal of Infectious Diseases |url=http://www.journals.uchicago.edu/doi/pdf/10.1086/322803?cookieSet=1 |volume=184 |issue=5 |pages=582–590 |year=2001 |pmid=11474432 |doi=10.1086/322803 |author8=Pikis A, Campos JM, Rodriguez WJ, Keith JM |last1=Pikis |first1=A |last2=Campos |first2=JM |last3=Rodriguez |first3=WJ |last4=Keith |first4=JM}}</ref></div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*Atromentin and leucomelone possess antibacterial activity, inhibiting the [[enzyme]] [[enoyl-acyl carrier protein reductase]], (essential for the [[fatty acid metabolism#Synthesis|biosynthesis]] of [[fatty acid]]s) in ''S. pneumoniae''.<ref name="Zheng2006">{{cite journal |author=Zheng CJ, Sohn MJ, Kim WG. |year=2006 |title=Atromentin and [[leucomelone]], the first inhibitors specific to enoyl-ACP reductase (FabK) of ''Streptococcus pneumoniae'' |journal=Journal of Antibiotics |volume=59 |issue=12 |pages=808–12 |doi=10.1038/ja.2006.108 |pmid=17323650}}</ref></div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*Atromentin and leucomelone possess antibacterial activity, inhibiting the [[enzyme]] [[enoyl-acyl carrier protein reductase]], (essential for the [[fatty acid metabolism#Synthesis|biosynthesis]] of [[fatty acid]]s) in ''<ins style="font-weight: bold; text-decoration: none;">[[</ins>S. pneumoniae<ins style="font-weight: bold; text-decoration: none;">]]</ins>''.<ref name="Zheng2006">{{cite journal |author=Zheng CJ, Sohn MJ, Kim WG. |year=2006 |title=Atromentin and [[leucomelone]], the first inhibitors specific to enoyl-ACP reductase (FabK) of ''Streptococcus pneumoniae'' |journal=Journal of Antibiotics |volume=59 |issue=12 |pages=808–12 |doi=10.1038/ja.2006.108 |pmid=17323650}}</ref></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Treatment==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Treatment==</div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>:::* 1.1 '''[[Penicillin]] sensitive (minimum inhibitory concentration < 2 mcg/ml)'''</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>:::* 1.1 '''[[Penicillin]] sensitive (minimum inhibitory concentration < 2 mcg/ml)'''</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>::::* Preferred regimen: [[Penicillin G]] 5-24 MU IV in equally divided doses q4-6h, [[Amoxicillin]] 1 g PO tid (+/- macrolide)</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>::::* Preferred regimen: [[Penicillin G]] 5-24 MU IV in equally divided doses q4-6h, [[Amoxicillin]] 1 g PO tid (+/- macrolide)</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>::::* Alternative regimen: Macrolides ([[Azithromycin]] (IV) 500 mg IV qd for at least 2 days followed by 500 mg PO qd 7-10 days or [[Clarithromycin]] extended-release tablets 1000 mg PO qd for 7 days) and oral Cephalosporins-[[Cefpodoxime]] 200 mg PO bd, ([[Cefprozil]] 500 mg PO bd, [[Cefditoren]] 400 mg PO bd, [[Cefdinir]] 300 mg PO bd), {{or}} parenteral Cephalosporins-[[Ceftriaxone]] 2 g IV q24h (or [[Cefotaxime]] 1-2 g IV q6-8h), [[Clindamycin]] 600-1200 mg IV/IM q6-12h, do not give single IM doses > 600 mg; IV infusion rates should not exceed 30 mg/min , [[Doxycycline]] 100 mg PO bd, respiratory flouroquniolones.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>::::* Alternative regimen: Macrolides ([[Azithromycin]] (IV) 500 mg IV qd for at least 2 days followed by 500 mg PO qd 7-10 days or [[Clarithromycin]] extended-release tablets 1000 mg PO qd for 7 days) and oral <ins style="font-weight: bold; text-decoration: none;">[[</ins>Cephalosporins<ins style="font-weight: bold; text-decoration: none;">]]</ins>-[[Cefpodoxime]] 200 mg PO bd, ([[Cefprozil]] 500 mg PO bd, [[Cefditoren]] 400 mg PO bd, [[Cefdinir]] 300 mg PO bd), {{or}} parenteral Cephalosporins-[[Ceftriaxone]] 2 g IV q24h (or [[Cefotaxime]] 1-2 g IV q6-8h), [[Clindamycin]] 600-1200 mg IV/IM q6-12h, do not give single IM doses > 600 mg; IV infusion rates should not exceed 30 mg/min , [[Doxycycline]] 100 mg PO bd, respiratory <ins style="font-weight: bold; text-decoration: none;">[[Quinolones|</ins>flouroquniolones<ins style="font-weight: bold; text-decoration: none;">]]</ins>.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>:::* 1.2 '''[[Penicillin]]-resistant ([[Penicillin]] minimum inhibitory concentration ≥ 2 mcg/ml)'''</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>:::* 1.2 '''[[Penicillin]]-resistant ([[Penicillin]] minimum inhibitory concentration ≥ 2 mcg/ml)'''</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>::::* Preferred regimen: [[Ceftriaxone]] 2 g IV q24h (or [[Cefotaxime]] 1-2 g IV q6-8h), respiratory [[Flouroquniolones]] [[Levofloxacin]] (Levaquin) 500 mg IV/PO q24h for 7-14 days or 750 mg IV/PO q24h for 5 days (or [[Moxifloxacin]] (Avelox) 400 mg PO/IV over 60 minutes q24h for 7-14 days) </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>::::* Preferred regimen: [[Ceftriaxone]] 2 g IV q24h (or [[Cefotaxime]] 1-2 g IV q6-8h), respiratory [[Flouroquniolones]] [[Levofloxacin]] (Levaquin) 500 mg IV/PO q24h for 7-14 days or 750 mg IV/PO q24h for 5 days (or [[Moxifloxacin]] (Avelox) 400 mg PO/IV over 60 minutes q24h for 7-14 days) </div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>::* 2.'''Endocarditis'''<ref name="pmid15956145">{{cite journal| author=Baddour LM, Wilson WR, Bayer AS, Fowler VG, Bolger AF, Levison ME et al.| title=Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. | journal=Circulation | year= 2005 | volume= 111 | issue= 23 | pages= e394-434 | pmid=15956145 | doi=10.1161/CIRCULATIONAHA.105.165564 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15956145 }}</ref></div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>::* 2.'''Endocarditis'''<ref name="pmid15956145">{{cite journal| author=Baddour LM, Wilson WR, Bayer AS, Fowler VG, Bolger AF, Levison ME et al.| title=Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. | journal=Circulation | year= 2005 | volume= 111 | issue= 23 | pages= e394-434 | pmid=15956145 | doi=10.1161/CIRCULATIONAHA.105.165564 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15956145 }}</ref></div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>:::* Preferred regimen (1): Aqueous crystalline [[Penicillin-G]] 6 MU q4-6h IV for 4 weeks</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>:::* Preferred regimen (1): Aqueous crystalline [[<ins style="font-weight: bold; text-decoration: none;">Penicillin G|</ins>Penicillin-G]] 6 MU q4-6h IV for 4 weeks</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>:::* Preferred regimen (2) (who are unable to tolerate beta lactams therapy): [[Vancomycin]] 15 mg/kg IV q12h (target trough concentration, 10-15 mcg/mL); for troughs of 15-20 mcg/mL (MIC, 1 mcg/mL or less), 15-20 mg/kg (actual body weight) IV q8-12h for most patients with normal renal function</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>:::* Preferred regimen (2) (who are unable to tolerate beta lactams therapy): [[Vancomycin]] 15 mg/kg IV q12h (target trough concentration, 10-15 mcg/mL); for troughs of 15-20 mcg/mL (MIC, 1 mcg/mL or less), 15-20 mg/kg (actual body weight) IV q8-12h for most patients with normal renal function</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>:::* Preferred regimen (3) (If the isolate is resistant (MIC 2 g/mL) to cefotaxime): [[Cefotaxime]] 1-2 g q8-12h IV/IM (max dose: 12 g/24 hr) {{and}} [[Vancomycin]] 15 mg/kg/day IV q12h {{and}} [[Rifampin]] 300 mg IV/PO q8h for 6 weeks, in combination with appropriate antimicrobial therapy</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>:::* Preferred regimen (3) (If the isolate is resistant (MIC 2 g/mL) to cefotaxime): [[Cefotaxime]] 1-2 g q8-12h IV/IM (max dose: 12 g/24 hr) {{and}} [[Vancomycin]] 15 mg/kg/day IV q12h {{and}} [[Rifampin]] 300 mg IV/PO q8h for 6 weeks, in combination with appropriate antimicrobial therapy</div></td></tr>
</table>
Usama Talib
https://www.wikidoc.org/index.php?title=Streptococcus_pneumoniae_infection&diff=1321456&oldid=prev
Tarek Nafee: /* Laboratory Diagnosis */
2017-06-27T19:21:00Z
<p><span dir="auto"><span class="autocomment">Laboratory Diagnosis</span></span></p>
<table style="background-color: #fff; color: #202122;" data-mw="interface">
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<tr class="diff-title" lang="en">
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Older revision</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 19:21, 27 June 2017</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>===Laboratory Diagnosis===</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>===Laboratory Diagnosis===</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>[[Medical diagnosis|Diagnosis]] of [[streptococcus pneumoniae]] infection is generally made based on clinical suspicion along with a positive culture from a sample from virtually any place in the body. </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>[[Medical diagnosis|Diagnosis]] of [[streptococcus pneumoniae]] infection is generally made based on clinical suspicion along with a positive culture from a sample from virtually any place in the body. </div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*An ASO <del style="font-weight: bold; text-decoration: none;">Titre </del>of >200 units is significant.<ref name="Siemieniuk 2011">{{cite journal|last=Siemieniuk|first=Reed A.C.|coauthors= Gregson, Dan B.; Gill, M. John |title=The persisting burden of invasive pneumococcal disease in HIV patients: an observational cohort study|journal=BMC Infectious Diseases|date=Nov 2011|volume=11|doi=10.1186/1471-2334-11-314|pmid=22078162|url=http://www.biomedcentral.com/content/pdf/1471-2334-11-314.pdf|pages=314|pmc=3226630}}</ref> </div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*An <ins style="font-weight: bold; text-decoration: none;">[[Antistreptolysin O titer|</ins>ASO <ins style="font-weight: bold; text-decoration: none;">titre]] </ins>of >200 units is significant.<ref name="Siemieniuk 2011">{{cite journal|last=Siemieniuk|first=Reed A.C.|coauthors= Gregson, Dan B.; Gill, M. John |title=The persisting burden of invasive pneumococcal disease in HIV patients: an observational cohort study|journal=BMC Infectious Diseases|date=Nov 2011|volume=11|doi=10.1186/1471-2334-11-314|pmid=22078162|url=http://www.biomedcentral.com/content/pdf/1471-2334-11-314.pdf|pages=314|pmc=3226630}}</ref> </div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*''S. pneumoniae'' is, in general, [[optochin]] sensitive, although optochin resistance has been observed.<ref>{{Cite journal |title=Optochin resistance in ''Streptococcus pneumoniae'': mechanism, significance, and clinical implications |journal=Journal of Infectious Diseases |url=http://www.journals.uchicago.edu/doi/pdf/10.1086/322803?cookieSet=1 |volume=184 |issue=5 |pages=582–590 |year=2001 |pmid=11474432 |doi=10.1086/322803 |author8=Pikis A, Campos JM, Rodriguez WJ, Keith JM |last1=Pikis |first1=A |last2=Campos |first2=JM |last3=Rodriguez |first3=WJ |last4=Keith |first4=JM}}</ref></div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*''S. pneumoniae'' is, in general, [[optochin]] sensitive, although <ins style="font-weight: bold; text-decoration: none;">[[</ins>optochin<ins style="font-weight: bold; text-decoration: none;">]] </ins>resistance has been observed.<ref>{{Cite journal |title=Optochin resistance in ''Streptococcus pneumoniae'': mechanism, significance, and clinical implications |journal=Journal of Infectious Diseases |url=http://www.journals.uchicago.edu/doi/pdf/10.1086/322803?cookieSet=1 |volume=184 |issue=5 |pages=582–590 |year=2001 |pmid=11474432 |doi=10.1086/322803 |author8=Pikis A, Campos JM, Rodriguez WJ, Keith JM |last1=Pikis |first1=A |last2=Campos |first2=JM |last3=Rodriguez |first3=WJ |last4=Keith |first4=JM}}</ref></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*Atromentin and leucomelone possess antibacterial activity, inhibiting the [[enzyme]] [[enoyl-acyl carrier protein reductase]], (essential for the [[fatty acid metabolism#Synthesis|biosynthesis]] of [[fatty acid]]s) in ''S. pneumoniae''.<ref name="Zheng2006">{{cite journal |author=Zheng CJ, Sohn MJ, Kim WG. |year=2006 |title=Atromentin and [[leucomelone]], the first inhibitors specific to enoyl-ACP reductase (FabK) of ''Streptococcus pneumoniae'' |journal=Journal of Antibiotics |volume=59 |issue=12 |pages=808–12 |doi=10.1038/ja.2006.108 |pmid=17323650}}</ref></div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*Atromentin and leucomelone possess antibacterial activity, inhibiting the [[enzyme]] [[enoyl-acyl carrier protein reductase]], (essential for the [[fatty acid metabolism#Synthesis|biosynthesis]] of [[fatty acid]]s) in ''S. pneumoniae''.<ref name="Zheng2006">{{cite journal |author=Zheng CJ, Sohn MJ, Kim WG. |year=2006 |title=Atromentin and [[leucomelone]], the first inhibitors specific to enoyl-ACP reductase (FabK) of ''Streptococcus pneumoniae'' |journal=Journal of Antibiotics |volume=59 |issue=12 |pages=808–12 |doi=10.1038/ja.2006.108 |pmid=17323650}}</ref></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* '''General principles'''</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>* '''General principles'''</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>:::* 1. Pneumovax (23-valent) prevents bacteremia; impact on rates of CAP are modest or nil.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>:::* 1. Pneumovax (23-valent) prevents bacteremia; impact on rates of CAP are modest or nil.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>:::* 2. Prevnar vaccine for children <2 yrs age prevents invasive pneumococcal infection in adults by herd effect. Impact is impressive with rates of invasive pneumococcal infection down 80% in peds and 20-40% in adults.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>:::* 2. <ins style="font-weight: bold; text-decoration: none;">[[</ins>Prevnar<ins style="font-weight: bold; text-decoration: none;">]] </ins>vaccine for children <2 yrs age prevents invasive pneumococcal infection in adults by herd effect. Impact is impressive with rates of invasive pneumococcal infection down 80% in peds and 20-40% in adults.</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>:::* 3. Risk for bacteremia in splenectomy, HIV, smokers, black race, multiple myeloma, asthma.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>:::* 3. Risk for <ins style="font-weight: bold; text-decoration: none;">[[</ins>bacteremia<ins style="font-weight: bold; text-decoration: none;">]] </ins>in <ins style="font-weight: bold; text-decoration: none;">[[</ins>splenectomy<ins style="font-weight: bold; text-decoration: none;">]]</ins>, <ins style="font-weight: bold; text-decoration: none;">[[Human Immunodeficiency Virus (</ins>HIV<ins style="font-weight: bold; text-decoration: none;">)|HIV]]</ins>, smokers, black race, <ins style="font-weight: bold; text-decoration: none;">[[</ins>multiple myeloma<ins style="font-weight: bold; text-decoration: none;">]]</ins>, <ins style="font-weight: bold; text-decoration: none;">[[</ins>asthma<ins style="font-weight: bold; text-decoration: none;">]]</ins>.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>===Vaccination in the USA===</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>===Vaccination in the USA===</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*A heptavalent pneumococcal [[conjugate vaccine]] vaccine (PCV 7) (e.g. [[Prevnar]]) is recommended in the USA since 2000 for all children between 2 to 23 months of age. PCV 7 is also recommended for children between 24 to 59 months of age if they are at risk of getting the infection. </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*A heptavalent pneumococcal [[conjugate vaccine]] vaccine (PCV 7) (e.g. [[Prevnar]]) is recommended in the USA since 2000 for all children between 2 to 23 months of age. PCV 7 is also recommended for children between 24 to 59 months of age if they are at risk of getting the infection. </div></td></tr>
</table>
Tarek Nafee
https://www.wikidoc.org/index.php?title=Streptococcus_pneumoniae_infection&diff=1321455&oldid=prev
Tarek Nafee: /* Overview */
2017-06-27T19:15:02Z
<p><span dir="auto"><span class="autocomment">Overview</span></span></p>
<table style="background-color: #fff; color: #202122;" data-mw="interface">
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<col class="diff-marker" />
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Older revision</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 19:15, 27 June 2017</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Overview==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Overview==</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>'''''Streptococcus pneumoniae''''', or '''pneumococcus''', is a [[Gram-positive]] bacterium. It is a diplococcus, [[Hemolysis (microbiology)|alpha-hemolytic]] member of the ''[[Streptococcus]]'' [[genus]].<ref name="Sherris">{{cite book | author = Ryan KJ; Ray CG (editors) | title = Sherris Medical Microbiology | edition = 4th ed. | publisher = McGraw Hill | year = 2004 | id = ISBN 0-8385-8529-9 }}</ref> During the 19th century pneumonia was heavily associated with this pathogen. ''[[S. pneumoniae]]'' is known to be the cause of various different infections apart from [[pneumonia]]<del style="font-weight: bold; text-decoration: none;">. These infections known to be cause by ''S. pneumoniae'' include, </del>[[endocarditis]], [[meningitis]], [[pericarditis]], [[brain abscess]], [[otitis media]], [[osteomyelitis]], [[acute sinusitis]], [[septic arthritis]], [[peritonitis]], and [[cellulitis]]. In children as well as adults, ''[[Streptococcus pneumoniae|S. pneumoniae]]'' is most <del style="font-weight: bold; text-decoration: none;">commonly found to be the </del>cause of otitis media as well as bacterial <del style="font-weight: bold; text-decoration: none;">meningitis</del>.<ref>{{cite journal |author=Dagan R |title=Treatment of acute otitis media - challenges in the era of antibiotic resistance |journal=Vaccine |volume=19 Suppl 1 |issue= |pages=S9-S16 |year= |pmid=11163457}}</ref> Pneumonia caused by ''S. pneumoniae'' is usually found at the extremes of the age <del style="font-weight: bold; text-decoration: none;">i.e </del>in old or very young individuals. ''[[Streptococcus viridans]]'' also belongs to the family of alpha hemolytic bacteria but can e distinguished from ''[[Streptococcus pneumoniae|S. pneumoniae]]'' by an [[optochin]] test. ''[[Streptococcus viridans]]'' are found to be <del style="font-weight: bold; text-decoration: none;">not sensitive for this test </del>where as ''[[S. pneumoniae]]'' are found to be optochin sensitive.<del style="font-weight: bold; text-decoration: none;">''S. pneumonia'' coccoid, gram-positive, capsule containing bacteria which appear to be "lancet shape" on gram stain. Another characteristic </del>of ''[[Streptococcus pneumoniae|S. pneumoniae]] is <del style="font-weight: bold; text-decoration: none;">that </del>its [[<del style="font-weight: bold; text-decoration: none;">virulence factor</del>]] <del style="font-weight: bold; text-decoration: none;">is the'' polysaccharide capsule</del>. <del style="font-weight: bold; text-decoration: none;">According to some estimates up </del>to 91 various types of <del style="font-weight: bold; text-decoration: none;">capsule, differing </del>in virulence, drug resistance, [[prevalence]] and distribution<del style="font-weight: bold; text-decoration: none;">, have been identified</del>.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>'''''Streptococcus pneumoniae''''', or '''pneumococcus''', is a [[Gram-positive]] bacterium. It is a diplococcus, [[Hemolysis (microbiology)|alpha-hemolytic]] member of the ''[[Streptococcus]]'' [[genus]].<ref name="Sherris">{{cite book | author = Ryan KJ; Ray CG (editors) | title = Sherris Medical Microbiology | edition = 4th ed. | publisher = McGraw Hill | year = 2004 | id = ISBN 0-8385-8529-9 }}</ref> During the 19th century pneumonia was heavily associated with this pathogen. ''[[S. pneumoniae]]'' is known to be the cause of various different infections apart from [[pneumonia]] <ins style="font-weight: bold; text-decoration: none;">including </ins>[[endocarditis]], [[meningitis]], [[pericarditis]], [[brain abscess]], [[otitis media]], [[osteomyelitis]], [[acute sinusitis]], [[septic arthritis]], [[peritonitis]], and [[cellulitis]]. In children as well as adults, ''[[Streptococcus pneumoniae|S. pneumoniae]]'' is <ins style="font-weight: bold; text-decoration: none;">the </ins>most <ins style="font-weight: bold; text-decoration: none;">common </ins>cause of <ins style="font-weight: bold; text-decoration: none;">[[</ins>otitis media<ins style="font-weight: bold; text-decoration: none;">]] </ins>as well as <ins style="font-weight: bold; text-decoration: none;">[[Bacterial meningitis|</ins>bacterial <ins style="font-weight: bold; text-decoration: none;">meningiti]]<nowiki/>s</ins>.<ref>{{cite journal |author=Dagan R |title=Treatment of acute otitis media - challenges in the era of antibiotic resistance |journal=Vaccine |volume=19 Suppl 1 |issue= |pages=S9-S16 |year= |pmid=11163457}}</ref> <ins style="font-weight: bold; text-decoration: none;">[[</ins>Pneumonia<ins style="font-weight: bold; text-decoration: none;">]] </ins>caused by ''S. pneumoniae'' is usually found at the extremes of the age <ins style="font-weight: bold; text-decoration: none;">(</ins>in old or very young individuals<ins style="font-weight: bold; text-decoration: none;">)</ins>. ''[[Streptococcus viridans]]'' also belongs to the family of alpha hemolytic bacteria but can e distinguished from ''[[Streptococcus pneumoniae|S. pneumoniae]]'' by an [[optochin]] test. ''[[Streptococcus viridans]]'' are found to be <ins style="font-weight: bold; text-decoration: none;">insensitive to [[optochin]] </ins>where as ''[[S. pneumoniae]]'' are found to be <ins style="font-weight: bold; text-decoration: none;">[[Optochin|</ins>optochin sensitive<ins style="font-weight: bold; text-decoration: none;">]]</ins>. <ins style="font-weight: bold; text-decoration: none;">The most potent [[virulence factor]] </ins>of ''[[Streptococcus pneumoniae|S. pneumoniae]]<ins style="font-weight: bold; text-decoration: none;">'' </ins>is its [[<ins style="font-weight: bold; text-decoration: none;">Polysaccharide encapsulated bacteria|polysaccharide capsule</ins>]]. <ins style="font-weight: bold; text-decoration: none;">Up </ins>to 91 various types of <ins style="font-weight: bold; text-decoration: none;">capsules have been discovered; each of these differ </ins>in virulence, drug resistance, [[prevalence<ins style="font-weight: bold; text-decoration: none;">|prevalence,</ins>]] and distribution.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Classification==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Classification==</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>Streptococcus pneumoniae infections <del style="font-weight: bold; text-decoration: none;">can </del>be classified as:</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>Streptococcus pneumoniae infections <ins style="font-weight: bold; text-decoration: none;">may </ins>be classified as <ins style="font-weight: bold; text-decoration: none;">follows</ins>:</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*[[Community-acquired pneumonia|Community Acquired Pneumonia]]</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*[[Community-acquired pneumonia|Community Acquired Pneumonia]]</div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Laboratory Findings== </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Laboratory Findings== </div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>Depending on the nature of infection, an appropriate sample is collected for laboratory identification.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>Depending on the nature of infection, an appropriate sample is collected <ins style="font-weight: bold; text-decoration: none;">from the infected area </ins>for laboratory identification. <ins style="font-weight: bold; text-decoration: none;">Commonly found </ins></div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>* Pneumococci are gram positive, cocci, seen in pairs or chains. </div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>* <ins style="font-weight: bold; text-decoration: none;">[[</ins>Pneumococci<ins style="font-weight: bold; text-decoration: none;">]] </ins>are gram positive, cocci, seen in pairs or chains. </div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*When cultured on [[blood agar]] plates with added [[optochin]] antibiotic disk, <del style="font-weight: bold; text-decoration: none;">Pneumococci </del>show [[hemolysis (microbiology)|alpha-hemolytic]] colonies and a clear zone of inhibition around the disk meaning <del style="font-weight: bold; text-decoration: none;">Pneumococci </del>are sensitive to the antibiotic. </div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*When cultured on [[blood agar]] plates with added [[optochin]] antibiotic disk, <ins style="font-weight: bold; text-decoration: none;">[[pneumococci]] </ins>show [[hemolysis (microbiology)|alpha-hemolytic]] colonies and a clear zone of inhibition around the disk meaning <ins style="font-weight: bold; text-decoration: none;">[[pneumococci]] </ins>are sensitive to the <ins style="font-weight: bold; text-decoration: none;">[[</ins>antibiotic<ins style="font-weight: bold; text-decoration: none;">]]</ins>. </div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*Pneumococci are also bile soluble. </div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*<ins style="font-weight: bold; text-decoration: none;">[[</ins>Pneumococci<ins style="font-weight: bold; text-decoration: none;">]] </ins>are also <ins style="font-weight: bold; text-decoration: none;">[[</ins>bile<ins style="font-weight: bold; text-decoration: none;">]] </ins>soluble. </div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*Similar to other [[streptococci]], <del style="font-weight: bold; text-decoration: none;">Pneumococci </del>are [[catalase]] negative. </div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*Similar to other [[streptococci]], <ins style="font-weight: bold; text-decoration: none;">[[pneumococci]] </ins>are [[catalase]] negative. </div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*[[Quellung]] test to identify specific capsular polysaccharides may also be done.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*[[Quellung]] test to identify specific capsular <ins style="font-weight: bold; text-decoration: none;">[[</ins>polysaccharides<ins style="font-weight: bold; text-decoration: none;">]] </ins>may also be done.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>===Laboratory Diagnosis===</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>===Laboratory Diagnosis===</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>[[Medical diagnosis|Diagnosis]] of <del style="font-weight: bold; text-decoration: none;">Streptococcus </del>pneumoniae infection is generally made based on clinical suspicion along with a positive culture from a sample from virtually any place in the body. </div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>[[Medical diagnosis|Diagnosis]] of <ins style="font-weight: bold; text-decoration: none;">[[streptococcus </ins>pneumoniae<ins style="font-weight: bold; text-decoration: none;">]] </ins>infection is generally made based on clinical suspicion along with a positive culture from a sample from virtually any place in the body. </div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*An ASO Titre of >200 units is significant.<ref name="Siemieniuk 2011">{{cite journal|last=Siemieniuk|first=Reed A.C.|coauthors= Gregson, Dan B.; Gill, M. John |title=The persisting burden of invasive pneumococcal disease in HIV patients: an observational cohort study|journal=BMC Infectious Diseases|date=Nov 2011|volume=11|doi=10.1186/1471-2334-11-314|pmid=22078162|url=http://www.biomedcentral.com/content/pdf/1471-2334-11-314.pdf|pages=314|pmc=3226630}}</ref> </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*An ASO Titre of >200 units is significant.<ref name="Siemieniuk 2011">{{cite journal|last=Siemieniuk|first=Reed A.C.|coauthors= Gregson, Dan B.; Gill, M. John |title=The persisting burden of invasive pneumococcal disease in HIV patients: an observational cohort study|journal=BMC Infectious Diseases|date=Nov 2011|volume=11|doi=10.1186/1471-2334-11-314|pmid=22078162|url=http://www.biomedcentral.com/content/pdf/1471-2334-11-314.pdf|pages=314|pmc=3226630}}</ref> </div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*''S. pneumoniae'' is, in general, [[optochin]] sensitive, although optochin resistance has been observed.<ref>{{Cite journal |title=Optochin resistance in ''Streptococcus pneumoniae'': mechanism, significance, and clinical implications |journal=Journal of Infectious Diseases |url=http://www.journals.uchicago.edu/doi/pdf/10.1086/322803?cookieSet=1 |volume=184 |issue=5 |pages=582–590 |year=2001 |pmid=11474432 |doi=10.1086/322803 |author8=Pikis A, Campos JM, Rodriguez WJ, Keith JM |last1=Pikis |first1=A |last2=Campos |first2=JM |last3=Rodriguez |first3=WJ |last4=Keith |first4=JM}}</ref></div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*''S. pneumoniae'' is, in general, [[optochin]] sensitive, although optochin resistance has been observed.<ref>{{Cite journal |title=Optochin resistance in ''Streptococcus pneumoniae'': mechanism, significance, and clinical implications |journal=Journal of Infectious Diseases |url=http://www.journals.uchicago.edu/doi/pdf/10.1086/322803?cookieSet=1 |volume=184 |issue=5 |pages=582–590 |year=2001 |pmid=11474432 |doi=10.1086/322803 |author8=Pikis A, Campos JM, Rodriguez WJ, Keith JM |last1=Pikis |first1=A |last2=Campos |first2=JM |last3=Rodriguez |first3=WJ |last4=Keith |first4=JM}}</ref></div></td></tr>
</table>
Tarek Nafee
https://www.wikidoc.org/index.php?title=Streptococcus_pneumoniae_infection&diff=1320869&oldid=prev
Usama Talib at 14:42, 26 June 2017
2017-06-26T14:42:02Z
<p></p>
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 14:42, 26 June 2017</td>
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<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>{{SK}} </div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>{{SK}} <ins style="font-weight: bold; text-decoration: none;">Strep pnumoniae; Strep pneumoniae infection</ins></div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Overview==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Overview==</div></td></tr>
</table>
Usama Talib
https://www.wikidoc.org/index.php?title=Streptococcus_pneumoniae_infection&diff=1320858&oldid=prev
Usama Talib at 14:37, 26 June 2017
2017-06-26T14:37:30Z
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Overview==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Overview==</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>'''''Streptococcus pneumoniae''''', or '''pneumococcus''', is a [[Gram-positive]] bacterium. It is a diplococcus, [[Hemolysis (microbiology)|alpha-hemolytic]] member of the ''[[Streptococcus]]'' [[genus]].<ref name="Sherris">{{cite book | author = Ryan KJ; Ray CG (editors) | title = Sherris Medical Microbiology | edition = 4th ed. | publisher = McGraw Hill | year = 2004 | id = ISBN 0-8385-8529-9 }}</ref> During the 19th century pneumonia was heavily associated with this pathogen. ''S. pneumoniae'' is known to be the cause of various different infections apart from [[pneumonia]]. These infections known to be cause by ''S. pneumoniae'' include, [[endocarditis]], [[meningitis]], [[pericarditis]], [[brain abscess]], [[otitis media]], [[osteomyelitis]], [[acute sinusitis]], [[septic arthritis]], [[peritonitis]], and [[cellulitis]]. In children as well as adults, ''S. pneumoniae'' is most commonly found to be the cause of otitis media as well as bacterial meningitis.<ref>{{cite journal |author=Dagan R |title=Treatment of acute otitis media - challenges in the era of antibiotic resistance |journal=Vaccine |volume=19 Suppl 1 |issue= |pages=S9-S16 |year= |pmid=11163457}}</ref> Pneumonia caused by ''S. pneumoniae'' is usually found at the extremes of the age i.e in old or very young individuals. ''[[Streptococcus viridans]]'' also belongs to the family of alpha hemolytic bacteria but can e distinguished from ''S. pneumoniae'' by an [[optochin]] test. ''[[Streptococcus viridans]]'' are found to be not sensitive for this test where as ''S. pneumoniae'' are found to be optochin sensitive.''S. pneumonia'' coccoid, gram-positive, capsule containing bacteria which appear to be "lancet shape" on gram stain. Another characteristic of ''S. pneumoniae is that its virulence factor is the'' polysaccharide capsule. According to some estimates up to 91 various types of capsule, differing in virulence, drug resistance, prevalence and distribution, have been identified.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>'''''Streptococcus pneumoniae''''', or '''pneumococcus''', is a [[Gram-positive]] bacterium. It is a diplococcus, [[Hemolysis (microbiology)|alpha-hemolytic]] member of the ''[[Streptococcus]]'' [[genus]].<ref name="Sherris">{{cite book | author = Ryan KJ; Ray CG (editors) | title = Sherris Medical Microbiology | edition = 4th ed. | publisher = McGraw Hill | year = 2004 | id = ISBN 0-8385-8529-9 }}</ref> During the 19th century pneumonia was heavily associated with this pathogen. ''<ins style="font-weight: bold; text-decoration: none;">[[</ins>S. pneumoniae<ins style="font-weight: bold; text-decoration: none;">]]</ins>'' is known to be the cause of various different infections apart from [[pneumonia]]. These infections known to be cause by ''S. pneumoniae'' include, [[endocarditis]], [[meningitis]], [[pericarditis]], [[brain abscess]], [[otitis media]], [[osteomyelitis]], [[acute sinusitis]], [[septic arthritis]], [[peritonitis]], and [[cellulitis]]. In children as well as adults, ''<ins style="font-weight: bold; text-decoration: none;">[[Streptococcus pneumoniae|</ins>S. pneumoniae<ins style="font-weight: bold; text-decoration: none;">]]</ins>'' is most commonly found to be the cause of otitis media as well as bacterial meningitis.<ref>{{cite journal |author=Dagan R |title=Treatment of acute otitis media - challenges in the era of antibiotic resistance |journal=Vaccine |volume=19 Suppl 1 |issue= |pages=S9-S16 |year= |pmid=11163457}}</ref> Pneumonia caused by ''S. pneumoniae'' is usually found at the extremes of the age i.e in old or very young individuals. ''[[Streptococcus viridans]]'' also belongs to the family of alpha hemolytic bacteria but can e distinguished from ''<ins style="font-weight: bold; text-decoration: none;">[[Streptococcus pneumoniae|</ins>S. pneumoniae<ins style="font-weight: bold; text-decoration: none;">]]</ins>'' by an [[optochin]] test. ''[[Streptococcus viridans]]'' are found to be not sensitive for this test where as ''<ins style="font-weight: bold; text-decoration: none;">[[</ins>S. pneumoniae<ins style="font-weight: bold; text-decoration: none;">]]</ins>'' are found to be optochin sensitive.''S. pneumonia'' coccoid, gram-positive, capsule containing bacteria which appear to be "lancet shape" on gram stain. Another characteristic of ''<ins style="font-weight: bold; text-decoration: none;">[[Streptococcus pneumoniae|</ins>S. pneumoniae<ins style="font-weight: bold; text-decoration: none;">]] </ins>is that its <ins style="font-weight: bold; text-decoration: none;">[[</ins>virulence factor<ins style="font-weight: bold; text-decoration: none;">]] </ins>is the'' polysaccharide capsule. According to some estimates up to 91 various types of capsule, differing in virulence, drug resistance, <ins style="font-weight: bold; text-decoration: none;">[[</ins>prevalence<ins style="font-weight: bold; text-decoration: none;">]] </ins>and distribution, have been identified.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Classification==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Classification==</div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>::::* Preferred regimen: [[Vancomycin]] 15 mg/kg/day IV q12h {{and}} a third-generation cephalosporin ([[Ceftriaxone]] 2 g IV q12h {{or}} [[Cefotaxime]] 2 g IV q4h or 3 g q6h) {{and}} [[Rifampin]] 600 mg IV qd in combination with [[Vancomycin]]</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>::::* Preferred regimen: [[Vancomycin]] 15 mg/kg/day IV q12h {{and}} a third-generation cephalosporin ([[Ceftriaxone]] 2 g IV q12h {{or}} [[Cefotaxime]] 2 g IV q4h or 3 g q6h) {{and}} [[Rifampin]] 600 mg IV qd in combination with [[Vancomycin]]</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>::::* Alternative regimen: [[Meropenem]], fluoroquinolones </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>::::* Alternative regimen: [[Meropenem]], fluoroquinolones </div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>::::: Note: Middle ear infections (otitis media), peritoneum infections (spontaneous bacterial peritonitis), pericardium infections (purulent pericarditis), skin infections (cellulitis) and eye infections (conjunctivitis) caused by Streptococcus pneumonia.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>::::: Note: Middle ear infections (<ins style="font-weight: bold; text-decoration: none;">[[</ins>otitis media<ins style="font-weight: bold; text-decoration: none;">]]</ins>), peritoneum infections (<ins style="font-weight: bold; text-decoration: none;">[[</ins>spontaneous bacterial peritonitis<ins style="font-weight: bold; text-decoration: none;">]]</ins>), pericardium infections (purulent <ins style="font-weight: bold; text-decoration: none;">[[</ins>pericarditis<ins style="font-weight: bold; text-decoration: none;">]]</ins>), skin infections (<ins style="font-weight: bold; text-decoration: none;">[[</ins>cellulitis<ins style="font-weight: bold; text-decoration: none;">]]</ins>) and eye infections (<ins style="font-weight: bold; text-decoration: none;">[[</ins>conjunctivitis<ins style="font-weight: bold; text-decoration: none;">]]</ins>) caused by <ins style="font-weight: bold; text-decoration: none;">''[[</ins>Streptococcus pneumonia<ins style="font-weight: bold; text-decoration: none;">]]''</ins>.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Prevention==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Prevention==</div></td></tr>
</table>
Usama Talib
https://www.wikidoc.org/index.php?title=Streptococcus_pneumoniae_infection&diff=1320821&oldid=prev
Usama Talib at 14:09, 26 June 2017
2017-06-26T14:09:43Z
<p></p>
<table style="background-color: #fff; color: #202122;" data-mw="interface">
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Older revision</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 14:09, 26 June 2017</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l89">Line 89:</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>:::* 3. Risk for bacteremia in splenectomy, HIV, smokers, black race, multiple myeloma, asthma.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>:::* 3. Risk for bacteremia in splenectomy, HIV, smokers, black race, multiple myeloma, asthma.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>===Vaccination in the USA===</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>===Vaccination in the USA===</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*A heptavalent pneumococcal [[conjugate vaccine]] vaccine (PCV 7) (e.g. [[Prevnar]]) is recommended in the USA since 2000 for all children between 2 to 23 months of age. PCV 7 is also recommended for children between 24 to 59 months of age if they are at risk of getting the infection. The vaccination is generally given as a 4-doses series at 2, 4, 6 & 12 - 14 months of age. The PCV 7 provides a good protection is good against deep pneumococcal infections (especially septicemia and meningitis). <del style="font-weight: bold; text-decoration: none;">Similar </del>9- and 13-valent <del style="font-weight: bold; text-decoration: none;">vaccines are also being tested</del>. <del style="font-weight: bold; text-decoration: none;">Yet, </del>if the child is <del style="font-weight: bold; text-decoration: none;">exposed to </del>a serotype <del style="font-weight: bold; text-decoration: none;">of pneumococcus </del>that is not <del style="font-weight: bold; text-decoration: none;">contained in </del>the vaccine<del style="font-weight: bold; text-decoration: none;">, he/she is not afforded any protection</del>. The ability of capsular-polysaccharide conjugate vaccines to promote the spread of non-covered serotypes and the limitation has led to research into vaccines that would provide species-wide protection.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*A heptavalent pneumococcal [[conjugate vaccine]] vaccine (PCV 7) (e.g. [[Prevnar]]) is recommended in the USA since 2000 for all children between 2 to 23 months of age. PCV 7 is also recommended for children between 24 to 59 months of age if they are at risk of getting the infection. </div></td></tr>
<tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*</ins>The vaccination is generally given as a 4-doses series at 2, 4, 6 & 12 - 14 months of age. </div></td></tr>
<tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*</ins>The PCV 7 provides a good protection is good against deep pneumococcal infections (especially septicemia and meningitis). <ins style="font-weight: bold; text-decoration: none;">Some new vaccines being tested are </ins>9- and 13-valent. <ins style="font-weight: bold; text-decoration: none;">No protection is offered </ins>if the child is <ins style="font-weight: bold; text-decoration: none;">infected by </ins>a <ins style="font-weight: bold; text-decoration: none;">pneumococcus </ins>serotype that is not <ins style="font-weight: bold; text-decoration: none;">a component of </ins>the <ins style="font-weight: bold; text-decoration: none;">current </ins>vaccine. The ability of capsular-polysaccharide conjugate vaccines to promote the spread of non-covered serotypes and the limitation has led to research into vaccines that would provide species-wide protection.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*Pneumovax™ which is one trade name for the [[Pneumococcal polysaccharide vaccine]] approximately provides 85% protection for 5 or more years in individuals younger than age 55. Individuals at a high risk of infection such as those who are 65 years or older are recommended to get the vaccine. Generally it is a single once in a lifetime dose as it is associated with high risk of side effects with repitition. The standard 23-valent vaccines are not effective for children who are less than two years old. </div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*Pneumovax™ which is one trade name for the [[Pneumococcal polysaccharide vaccine]] <ins style="font-weight: bold; text-decoration: none;">which </ins>approximately provides 85% protection for 5 or more years in individuals younger than age 55. <ins style="font-weight: bold; text-decoration: none;"> </ins></div></td></tr>
<tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*</ins>Individuals at a high risk of infection such as those who are 65 years or older are recommended to get the vaccine. <ins style="font-weight: bold; text-decoration: none;"> </ins></div></td></tr>
<tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">*</ins>Generally it is a single once in a lifetime dose as it is associated with high risk of side effects with repitition. The standard 23-valent vaccines are not effective for children who are less than two years old. </div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*The [[American College of Physicians]] in its current guidelines recommends immunization administration between 2 to 65 years old in the presence of indications, or at age 65. If someone received the immunization before age 60, the guidelines call for a one-time revaccination. </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*The [[American College of Physicians]] in its current guidelines recommends immunization administration between 2 to 65 years old in the presence of indications, or at age 65. If someone received the immunization before age 60, the guidelines call for a one-time revaccination. </div></td></tr>
</table>
Usama Talib
https://www.wikidoc.org/index.php?title=Streptococcus_pneumoniae_infection&diff=1320772&oldid=prev
Usama Talib at 13:01, 26 June 2017
2017-06-26T13:01:29Z
<p></p>
<table style="background-color: #fff; color: #202122;" data-mw="interface">
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<col class="diff-marker" />
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<tr class="diff-title" lang="en">
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Older revision</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 13:01, 26 June 2017</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Overview==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Overview==</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>'''''Streptococcus pneumoniae''''', or '''pneumococcus''', is a [[Gram-positive]] bacterium. It is a diplococcus, [[Hemolysis (microbiology)|alpha-hemolytic]] member of the ''[[Streptococcus]]'' [[genus]] .<ref name="Sherris">{{cite book | author = Ryan KJ; Ray CG (editors) | title = Sherris Medical Microbiology | edition = 4th ed. | publisher = McGraw Hill | year = 2004 | id = ISBN 0-8385-8529-9 }}</ref> During the 19th century pneumonia was heavily associated with this pathogen. ''S. pneumoniae'' is known to be the cause of various different infections apart from [[pneumonia]]. These infections known to be cause by ''S. pneumoniae'' include, [[endocarditis]], [[meningitis]], [[pericarditis]], [[brain abscess]], [[otitis media]], [[osteomyelitis]], [[acute sinusitis]], [[septic arthritis]], [[peritonitis]], and [[cellulitis]]. In children as well as adults, ''S. pneumoniae'' is most commonly found to be the cause of otitis media as well as bacterial meningitis.<ref>{{cite journal |author=Dagan R |title=Treatment of acute otitis media - challenges in the era of antibiotic resistance |journal=Vaccine |volume=19 Suppl 1 |issue= |pages=S9-S16 |year= |pmid=11163457}}</ref> Pneumonia caused by ''S. pneumoniae'' is usually found at the extremes of the age i.e in old or very young individuals. ''[[Streptococcus viridans]]'' also belongs to the family of alpha hemolytic bacteria but can e distinguished from ''S. pneumoniae'' by an [[optochin]] test. ''[[Streptococcus viridans]]'' are found to be not sensitive for this test where as ''S. pneumoniae'' are found to be optochin sensitive.''S. pneumonia'' coccoid, gram-positive, capsule containing bacteria which appear to be "lancet shape" on gram stain. <del style="font-weight: bold; text-decoration: none;">It has a polysaccharide capsule </del>that <del style="font-weight: bold; text-decoration: none;">acts as a </del>virulence factor <del style="font-weight: bold; text-decoration: none;">for </del>the <del style="font-weight: bold; text-decoration: none;">organism; </del>91 <del style="font-weight: bold; text-decoration: none;">different capsular </del>types <del style="font-weight: bold; text-decoration: none;">are known</del>, <del style="font-weight: bold; text-decoration: none;">and these types differ </del>in virulence, prevalence, <del style="font-weight: bold; text-decoration: none;">and extent of drug resistance</del>.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>'''''Streptococcus pneumoniae''''', or '''pneumococcus''', is a [[Gram-positive]] bacterium. It is a diplococcus, [[Hemolysis (microbiology)|alpha-hemolytic]] member of the ''[[Streptococcus]]'' [[genus]].<ref name="Sherris">{{cite book | author = Ryan KJ; Ray CG (editors) | title = Sherris Medical Microbiology | edition = 4th ed. | publisher = McGraw Hill | year = 2004 | id = ISBN 0-8385-8529-9 }}</ref> During the 19th century pneumonia was heavily associated with this pathogen. ''S. pneumoniae'' is known to be the cause of various different infections apart from [[pneumonia]]. These infections known to be cause by ''S. pneumoniae'' include, [[endocarditis]], [[meningitis]], [[pericarditis]], [[brain abscess]], [[otitis media]], [[osteomyelitis]], [[acute sinusitis]], [[septic arthritis]], [[peritonitis]], and [[cellulitis]]. In children as well as adults, ''S. pneumoniae'' is most commonly found to be the cause of otitis media as well as bacterial meningitis.<ref>{{cite journal |author=Dagan R |title=Treatment of acute otitis media - challenges in the era of antibiotic resistance |journal=Vaccine |volume=19 Suppl 1 |issue= |pages=S9-S16 |year= |pmid=11163457}}</ref> Pneumonia caused by ''S. pneumoniae'' is usually found at the extremes of the age i.e in old or very young individuals. ''[[Streptococcus viridans]]'' also belongs to the family of alpha hemolytic bacteria but can e distinguished from ''S. pneumoniae'' by an [[optochin]] test. ''[[Streptococcus viridans]]'' are found to be not sensitive for this test where as ''S. pneumoniae'' are found to be optochin sensitive.''S. pneumonia'' coccoid, gram-positive, capsule containing bacteria which appear to be "lancet shape" on gram stain. <ins style="font-weight: bold; text-decoration: none;">Another characteristic of ''S. pneumoniae is </ins>that <ins style="font-weight: bold; text-decoration: none;">its </ins>virulence factor <ins style="font-weight: bold; text-decoration: none;">is </ins>the<ins style="font-weight: bold; text-decoration: none;">'' polysaccharide capsule. According to some estimates up to </ins>91 <ins style="font-weight: bold; text-decoration: none;">various </ins>types <ins style="font-weight: bold; text-decoration: none;">of capsule</ins>, <ins style="font-weight: bold; text-decoration: none;">differing </ins>in virulence<ins style="font-weight: bold; text-decoration: none;">, drug resistance</ins>, prevalence <ins style="font-weight: bold; text-decoration: none;">and distribution</ins>, <ins style="font-weight: bold; text-decoration: none;">have been identified</ins>.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Classification==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Classification==</div></td></tr>
</table>
Usama Talib
https://www.wikidoc.org/index.php?title=Streptococcus_pneumoniae_infection&diff=1320755&oldid=prev
Usama Talib at 19:23, 25 June 2017
2017-06-25T19:23:11Z
<p></p>
<table style="background-color: #fff; color: #202122;" data-mw="interface">
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">← Older revision</td>
<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 19:23, 25 June 2017</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>{{SK}} </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>{{SK}} </div></td></tr>
<tr><td colspan="2" class="diff-side-deleted"></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Overview==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Overview==</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>'''''Streptococcus pneumoniae''''', or '''pneumococcus''', is a [[Gram-positive]], [[Hemolysis (microbiology)|alpha-hemolytic]] <del style="font-weight: bold; text-decoration: none;">diplococcus [[bacterium]] and a </del>member of the [[<del style="font-weight: bold; text-decoration: none;">genus</del>]] ''[[<del style="font-weight: bold; text-decoration: none;">Streptococcus</del>]]<del style="font-weight: bold; text-decoration: none;">''</del>.<ref name="Sherris">{{cite book | author = Ryan KJ; Ray CG (editors) | title = Sherris Medical Microbiology | edition = 4th ed. | publisher = McGraw Hill | year = 2004 | id = ISBN 0-8385-8529-9 }}</ref> <del style="font-weight: bold; text-decoration: none;">A significant human [[</del>pathogen<del style="font-weight: bold; text-decoration: none;">]], </del>''S. pneumoniae'' <del style="font-weight: bold; text-decoration: none;">was recognized as a major </del>cause of [[pneumonia]] <del style="font-weight: bold; text-decoration: none;">in the late 19th century and is the subject of many </del>[[<del style="font-weight: bold; text-decoration: none;">humoral immunity</del>]] <del style="font-weight: bold; text-decoration: none;">studies. Despite the name</del>, <del style="font-weight: bold; text-decoration: none;">the organism causes many types of infection other than </del>[[<del style="font-weight: bold; text-decoration: none;">pneumonia</del>]], <del style="font-weight: bold; text-decoration: none;">including </del>[[<del style="font-weight: bold; text-decoration: none;">acute sinusitis</del>]], [[<del style="font-weight: bold; text-decoration: none;">otitis media</del>]], [[<del style="font-weight: bold; text-decoration: none;">meningitis</del>]], [[osteomyelitis]], [[<del style="font-weight: bold; text-decoration: none;">septic arthritis</del>]], [[<del style="font-weight: bold; text-decoration: none;">endocarditis</del>]], [[peritonitis]], <del style="font-weight: bold; text-decoration: none;">[[pericarditis]], </del>[[cellulitis]], <del style="font-weight: bold; text-decoration: none;">and [[brain abscess]]. </del>''S. pneumoniae'' is the <del style="font-weight: bold; text-decoration: none;">most common </del>cause of bacterial meningitis <del style="font-weight: bold; text-decoration: none;">in adults and children, and is one of the top two isolates found in otitis media</del>.<ref>{{cite journal |author=Dagan R |title=Treatment of acute otitis media - challenges in the era of antibiotic resistance |journal=Vaccine |volume=19 Suppl 1 |issue= |pages=S9-S16 |year= |pmid=11163457}}</ref> <del style="font-weight: bold; text-decoration: none;">Pneumococcal pneumonia is more common in the very young and the very old. </del>''S. pneumoniae'' <del style="font-weight: bold; text-decoration: none;">can be differentiated from </del>''[[Streptococcus viridans]]''<del style="font-weight: bold; text-decoration: none;">, which is </del>also alpha hemolytic<del style="font-weight: bold; text-decoration: none;">, using </del>an [[optochin]] test<del style="font-weight: bold; text-decoration: none;">, </del>as ''S. pneumoniae'' <del style="font-weight: bold; text-decoration: none;">is </del>optochin sensitive. <del style="font-weight: bold; text-decoration: none;">The encapsulated</del>, gram-positive <del style="font-weight: bold; text-decoration: none;">coccoid </del>bacteria <del style="font-weight: bold; text-decoration: none;">have a distinctive morphology </del>on gram stain<del style="font-weight: bold; text-decoration: none;">, the so-called, "lancet shape</del>.<del style="font-weight: bold; text-decoration: none;">" </del>It has a polysaccharide capsule that acts as a virulence factor for the organism; 91 different capsular types are known, and these types differ in virulence, prevalence, and extent of drug resistance.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>'''''Streptococcus pneumoniae''''', or '''pneumococcus''', is a [[Gram-positive]] <ins style="font-weight: bold; text-decoration: none;">bacterium. It is a diplococcus</ins>, [[Hemolysis (microbiology)|alpha-hemolytic]] member of the <ins style="font-weight: bold; text-decoration: none;">''</ins>[[<ins style="font-weight: bold; text-decoration: none;">Streptococcus</ins>]]'' [[<ins style="font-weight: bold; text-decoration: none;">genus</ins>]] .<ref name="Sherris">{{cite book | author = Ryan KJ; Ray CG (editors) | title = Sherris Medical Microbiology | edition = 4th ed. | publisher = McGraw Hill | year = 2004 | id = ISBN 0-8385-8529-9 }}</ref> <ins style="font-weight: bold; text-decoration: none;"> During the 19th century pneumonia was heavily associated with this </ins>pathogen<ins style="font-weight: bold; text-decoration: none;">. </ins>''S. pneumoniae'' <ins style="font-weight: bold; text-decoration: none;">is known to be the </ins>cause of <ins style="font-weight: bold; text-decoration: none;">various different infections apart from </ins>[[pneumonia]]<ins style="font-weight: bold; text-decoration: none;">. These infections known to be cause by ''S. pneumoniae'' include, </ins>[[<ins style="font-weight: bold; text-decoration: none;">endocarditis</ins>]], [[<ins style="font-weight: bold; text-decoration: none;">meningitis</ins>]], [[<ins style="font-weight: bold; text-decoration: none;">pericarditis</ins>]], [[<ins style="font-weight: bold; text-decoration: none;">brain abscess</ins>]], [[<ins style="font-weight: bold; text-decoration: none;">otitis media</ins>]], [[osteomyelitis]], [[<ins style="font-weight: bold; text-decoration: none;">acute sinusitis</ins>]], [[<ins style="font-weight: bold; text-decoration: none;">septic arthritis</ins>]], [[peritonitis]], <ins style="font-weight: bold; text-decoration: none;">and </ins>[[cellulitis]]<ins style="font-weight: bold; text-decoration: none;">. In children as well as adults</ins>, <ins style="font-weight: bold; text-decoration: none;"> </ins>''S. pneumoniae'' is <ins style="font-weight: bold; text-decoration: none;">most commonly found to be </ins>the cause of <ins style="font-weight: bold; text-decoration: none;">otitis media as well as </ins>bacterial meningitis.<ref>{{cite journal |author=Dagan R |title=Treatment of acute otitis media - challenges in the era of antibiotic resistance |journal=Vaccine |volume=19 Suppl 1 |issue= |pages=S9-S16 |year= |pmid=11163457}}</ref> <ins style="font-weight: bold; text-decoration: none;">Pneumonia caused by </ins>''S. pneumoniae'' <ins style="font-weight: bold; text-decoration: none;">is usually found at the extremes of the age i.e in old or very young individuals. </ins>''[[Streptococcus viridans]]'' also <ins style="font-weight: bold; text-decoration: none;">belongs to the family of </ins>alpha hemolytic <ins style="font-weight: bold; text-decoration: none;">bacteria but can e distinguished from ''S. pneumoniae'' by </ins>an [[optochin]] test<ins style="font-weight: bold; text-decoration: none;">. ''[[Streptococcus viridans]]'' are found to be not sensitive for this test where </ins>as ''S. pneumoniae'' <ins style="font-weight: bold; text-decoration: none;">are found to be </ins>optochin sensitive.<ins style="font-weight: bold; text-decoration: none;">''S. pneumonia'' coccoid</ins>, gram-positive<ins style="font-weight: bold; text-decoration: none;">, capsule containing </ins>bacteria <ins style="font-weight: bold; text-decoration: none;">which appear to be "lancet shape" </ins>on gram stain. <ins style="font-weight: bold; text-decoration: none;"> </ins>It has a polysaccharide capsule that acts as a virulence factor for the organism; 91 different capsular types are known, and these types differ in virulence, prevalence, and extent of drug resistance.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Classification==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Classification==</div></td></tr>
</table>
Usama Talib
https://www.wikidoc.org/index.php?title=Streptococcus_pneumoniae_infection&diff=1320635&oldid=prev
Usama Talib at 21:03, 23 June 2017
2017-06-23T21:03:03Z
<p></p>
<table style="background-color: #fff; color: #202122;" data-mw="interface">
<col class="diff-marker" />
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<col class="diff-marker" />
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<tr class="diff-title" lang="en">
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 21:03, 23 June 2017</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>{{SK}} </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>{{SK}} </div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Overview==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Overview==</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>'''''Streptococcus pneumoniae''''', or '''pneumococcus''', is a [[Gram-positive]], [[Hemolysis (microbiology)|alpha-hemolytic]] diplococcus [[bacterium]] and a member of the [[genus]] ''[[Streptococcus]]''.<ref name=Sherris>{{cite book | author = Ryan KJ; Ray CG (editors) | title = Sherris Medical Microbiology | edition = 4th ed. | publisher = McGraw Hill | year = 2004 | id = ISBN 0-8385-8529-9 }}</ref> A significant human [[pathogen]], ''S. pneumoniae'' was recognized as a major cause of [[pneumonia]] in the late 19th century and is the subject of many [[humoral immunity]] studies. Despite the name, the organism causes many types of infection other than [[pneumonia]], including [[acute sinusitis]], [[otitis media]], [[meningitis]], [[osteomyelitis]], [[septic arthritis]], [[endocarditis]], [[peritonitis]], [[pericarditis]], [[cellulitis]], and [[brain abscess]]. ''S. pneumoniae'' is the most common cause of bacterial meningitis in adults and children, and is one of the top two isolates found in otitis media.<ref>{{cite journal |author=Dagan R |title=Treatment of acute otitis media - challenges in the era of antibiotic resistance |journal=Vaccine |volume=19 Suppl 1 |issue= |pages=S9-S16 |year= |pmid=11163457}}</ref> Pneumococcal pneumonia is more common in the very young and the very old. ''S. pneumoniae'' can be differentiated from ''[[Streptococcus viridans]]'', which is also alpha hemolytic, using an [[optochin]] test, as ''S. pneumoniae'' is optochin sensitive. The encapsulated, gram-positive coccoid bacteria have a distinctive morphology on gram stain, the so-called, "lancet shape." It has a polysaccharide capsule that acts as a virulence factor for the organism; 91 different capsular types are known, and these types differ in virulence, prevalence, and extent of drug resistance.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>'''''Streptococcus pneumoniae''''', or '''pneumococcus''', is a [[Gram-positive]], [[Hemolysis (microbiology)|alpha-hemolytic]] diplococcus [[bacterium]] and a member of the [[genus]] ''[[Streptococcus]]''.<ref name=<ins style="font-weight: bold; text-decoration: none;">"</ins>Sherris<ins style="font-weight: bold; text-decoration: none;">"</ins>>{{cite book | author = Ryan KJ; Ray CG (editors) | title = Sherris Medical Microbiology | edition = 4th ed. | publisher = McGraw Hill | year = 2004 | id = ISBN 0-8385-8529-9 }}</ref> A significant human [[pathogen]], ''S. pneumoniae'' was recognized as a major cause of [[pneumonia]] in the late 19th century and is the subject of many [[humoral immunity]] studies. Despite the name, the organism causes many types of infection other than [[pneumonia]], including [[acute sinusitis]], [[otitis media]], [[meningitis]], [[osteomyelitis]], [[septic arthritis]], [[endocarditis]], [[peritonitis]], [[pericarditis]], [[cellulitis]], and [[brain abscess]]. ''S. pneumoniae'' is the most common cause of bacterial meningitis in adults and children, and is one of the top two isolates found in otitis media.<ref>{{cite journal |author=Dagan R |title=Treatment of acute otitis media - challenges in the era of antibiotic resistance |journal=Vaccine |volume=19 Suppl 1 |issue= |pages=S9-S16 |year= |pmid=11163457}}</ref> Pneumococcal pneumonia is more common in the very young and the very old. ''S. pneumoniae'' can be differentiated from ''[[Streptococcus viridans]]'', which is also alpha hemolytic, using an [[optochin]] test, as ''S. pneumoniae'' is optochin sensitive. The encapsulated, gram-positive coccoid bacteria have a distinctive morphology on gram stain, the so-called, "lancet shape." It has a polysaccharide capsule that acts as a virulence factor for the organism; 91 different capsular types are known, and these types differ in virulence, prevalence, and extent of drug resistance.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Classification==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Classification==</div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*An ASO Titre of >200 units is significant.<ref name="Siemieniuk 2011">{{cite journal|last=Siemieniuk|first=Reed A.C.|coauthors= Gregson, Dan B.; Gill, M. John |title=The persisting burden of invasive pneumococcal disease in HIV patients: an observational cohort study|journal=BMC Infectious Diseases|date=Nov 2011|volume=11|doi=10.1186/1471-2334-11-314|pmid=22078162|url=http://www.biomedcentral.com/content/pdf/1471-2334-11-314.pdf|pages=314|pmc=3226630}}</ref> </div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*An ASO Titre of >200 units is significant.<ref name="Siemieniuk 2011">{{cite journal|last=Siemieniuk|first=Reed A.C.|coauthors= Gregson, Dan B.; Gill, M. John |title=The persisting burden of invasive pneumococcal disease in HIV patients: an observational cohort study|journal=BMC Infectious Diseases|date=Nov 2011|volume=11|doi=10.1186/1471-2334-11-314|pmid=22078162|url=http://www.biomedcentral.com/content/pdf/1471-2334-11-314.pdf|pages=314|pmc=3226630}}</ref> </div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*''S. pneumoniae'' is, in general, [[optochin]] sensitive, although optochin resistance has been observed.<ref>{{Cite journal |title=Optochin resistance in ''Streptococcus pneumoniae'': mechanism, significance, and clinical implications |journal=Journal of Infectious Diseases |url=http://www.journals.uchicago.edu/doi/pdf/10.1086/322803?cookieSet=1 |volume=184 |issue=5 |pages=582–590 |year=2001 |pmid=11474432 |doi=10.1086/322803 |author8=Pikis A, Campos JM, Rodriguez WJ, Keith JM |last1=Pikis |first1=A |last2=Campos |first2=JM |last3=Rodriguez |first3=WJ |last4=Keith |first4=JM}}</ref></div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>*''S. pneumoniae'' is, in general, [[optochin]] sensitive, although optochin resistance has been observed.<ref>{{Cite journal |title=Optochin resistance in ''Streptococcus pneumoniae'': mechanism, significance, and clinical implications |journal=Journal of Infectious Diseases |url=http://www.journals.uchicago.edu/doi/pdf/10.1086/322803?cookieSet=1 |volume=184 |issue=5 |pages=582–590 |year=2001 |pmid=11474432 |doi=10.1086/322803 |author8=Pikis A, Campos JM, Rodriguez WJ, Keith JM |last1=Pikis |first1=A |last2=Campos |first2=JM |last3=Rodriguez |first3=WJ |last4=Keith |first4=JM}}</ref></div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*Atromentin and leucomelone possess antibacterial activity, inhibiting the [[enzyme]] [[enoyl-acyl carrier protein reductase]], (essential for the [[fatty acid metabolism#Synthesis|biosynthesis]] of [[fatty acid]]s) in ''S. pneumoniae''.<ref name=Zheng2006>{{cite journal |author=Zheng CJ, Sohn MJ, Kim WG. |year=2006 |title=Atromentin and [[leucomelone]], the first inhibitors specific to enoyl-ACP reductase (FabK) of ''Streptococcus pneumoniae'' |journal=Journal of Antibiotics |volume=59 |issue=12 |pages=808–12 |doi=10.1038/ja.2006.108 |pmid=17323650}}</ref></div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*Atromentin and leucomelone possess antibacterial activity, inhibiting the [[enzyme]] [[enoyl-acyl carrier protein reductase]], (essential for the [[fatty acid metabolism#Synthesis|biosynthesis]] of [[fatty acid]]s) in ''S. pneumoniae''.<ref name=<ins style="font-weight: bold; text-decoration: none;">"</ins>Zheng2006<ins style="font-weight: bold; text-decoration: none;">"</ins>>{{cite journal |author=Zheng CJ, Sohn MJ, Kim WG. |year=2006 |title=Atromentin and [[leucomelone]], the first inhibitors specific to enoyl-ACP reductase (FabK) of ''Streptococcus pneumoniae'' |journal=Journal of Antibiotics |volume=59 |issue=12 |pages=808–12 |doi=10.1038/ja.2006.108 |pmid=17323650}}</ref></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Treatment==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==Treatment==</div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>:::* 3. Risk for bacteremia in splenectomy, HIV, smokers, black race, multiple myeloma, asthma.</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>:::* 3. Risk for bacteremia in splenectomy, HIV, smokers, black race, multiple myeloma, asthma.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>===Vaccination in the USA===</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>===Vaccination in the USA===</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*<del style="font-weight: bold; text-decoration: none;">In the USA, a </del>heptavalent pneumococcal [[conjugate vaccine]] vaccine (PCV 7) (e.g. [[Prevnar]]) is recommended since 2000 for all children <del style="font-weight: bold; text-decoration: none;">aged </del>2<del style="font-weight: bold; text-decoration: none;">-</del>23 months <del style="font-weight: bold; text-decoration: none;">and </del>for <del style="font-weight: bold; text-decoration: none;">at-risk </del>children <del style="font-weight: bold; text-decoration: none;">aged </del>24<del style="font-weight: bold; text-decoration: none;">-</del>59 months. The <del style="font-weight: bold; text-decoration: none;">normally </del>4-doses series <del style="font-weight: bold; text-decoration: none;">is given </del>at 2, 4, 6 & 12 - 14 months of age. <del style="font-weight: bold; text-decoration: none;">Protection </del>is good against deep pneumococcal infections (especially septicemia and meningitis). Similar 9- and 13-valent vaccines are being tested. Yet, if the child is exposed to a serotype of pneumococcus that is not contained in the vaccine, he/she is not afforded any protection. <del style="font-weight: bold; text-decoration: none;">This limitation, and the </del>ability of capsular-polysaccharide conjugate vaccines to promote the spread of non-covered serotypes<del style="font-weight: bold; text-decoration: none;">, </del>has led to research into vaccines that would provide species-wide protection.</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*<ins style="font-weight: bold; text-decoration: none;">A </ins>heptavalent pneumococcal [[conjugate vaccine]] vaccine (PCV 7) (e.g. [[Prevnar]]) is recommended <ins style="font-weight: bold; text-decoration: none;">in the USA </ins>since 2000 for all children <ins style="font-weight: bold; text-decoration: none;">between </ins>2 <ins style="font-weight: bold; text-decoration: none;">to </ins>23 months <ins style="font-weight: bold; text-decoration: none;">of age. PCV 7 is also recommended </ins>for children <ins style="font-weight: bold; text-decoration: none;">between </ins>24 <ins style="font-weight: bold; text-decoration: none;">to </ins>59 months <ins style="font-weight: bold; text-decoration: none;">of age if they are at risk of getting the infection</ins>. The <ins style="font-weight: bold; text-decoration: none;">vaccination is generally given as a </ins>4-doses series at 2, 4, 6 & 12 - 14 months of age. <ins style="font-weight: bold; text-decoration: none;">The PCV 7 provides a good protection </ins>is good against deep pneumococcal infections (especially septicemia and meningitis). Similar 9- and 13-valent vaccines are <ins style="font-weight: bold; text-decoration: none;">also </ins>being tested. Yet, if the child is exposed to a serotype of pneumococcus that is not contained in the vaccine, he/she is not afforded any protection. <ins style="font-weight: bold; text-decoration: none;">The </ins>ability of capsular-polysaccharide conjugate vaccines to promote the spread of non-covered serotypes <ins style="font-weight: bold; text-decoration: none;">and the limitation </ins>has led to research into vaccines that would provide species-wide protection.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*[[Pneumococcal polysaccharide vaccine]] <del style="font-weight: bold; text-decoration: none;">(Pneumovax™ is one brand) gives at least </del>85% protection in <del style="font-weight: bold; text-decoration: none;">those under </del>55 <del style="font-weight: bold; text-decoration: none;">years of age for five years or longer</del>. <del style="font-weight: bold; text-decoration: none;">Immunization is suggested for those </del>at <del style="font-weight: bold; text-decoration: none;">highest </del>risk of infection<del style="font-weight: bold; text-decoration: none;">, including </del>those 65 years or older<del style="font-weight: bold; text-decoration: none;">, and generally should be </del>a single lifetime dose <del style="font-weight: bold; text-decoration: none;">(</del>high risk side effects <del style="font-weight: bold; text-decoration: none;">if repeated)</del>. The standard 23-valent vaccines are <del style="font-weight: bold; text-decoration: none;">ineffective </del>for children <del style="font-weight: bold; text-decoration: none;">under </del>two years old. </div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*<ins style="font-weight: bold; text-decoration: none;">Pneumovax™ which is one trade name for the </ins>[[Pneumococcal polysaccharide vaccine]] <ins style="font-weight: bold; text-decoration: none;">approximately provides </ins>85% protection <ins style="font-weight: bold; text-decoration: none;">for 5 or more years </ins>in <ins style="font-weight: bold; text-decoration: none;">individuals younger than age </ins>55. <ins style="font-weight: bold; text-decoration: none;">Individuals </ins>at <ins style="font-weight: bold; text-decoration: none;">a high </ins>risk of infection <ins style="font-weight: bold; text-decoration: none;">such as </ins>those <ins style="font-weight: bold; text-decoration: none;">who are </ins>65 years or older <ins style="font-weight: bold; text-decoration: none;">are recommended to get the vaccine. Generally it is </ins>a single <ins style="font-weight: bold; text-decoration: none;">once in a </ins>lifetime dose <ins style="font-weight: bold; text-decoration: none;">as it is associated with </ins>high risk <ins style="font-weight: bold; text-decoration: none;">of </ins>side effects <ins style="font-weight: bold; text-decoration: none;">with repitition</ins>. The standard 23-valent vaccines are <ins style="font-weight: bold; text-decoration: none;">not effective </ins>for children <ins style="font-weight: bold; text-decoration: none;">who are less than </ins>two years old. </div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*The <del style="font-weight: bold; text-decoration: none;">current guidelines of the </del>[[American College of Physicians]] <del style="font-weight: bold; text-decoration: none;">call for </del>administration <del style="font-weight: bold; text-decoration: none;">of the immunization </del>between <del style="font-weight: bold; text-decoration: none;">ages </del>2 <del style="font-weight: bold; text-decoration: none;">and </del>65 <del style="font-weight: bold; text-decoration: none;">when indicated</del>, or at age 65. If someone received the immunization before age 60, the guidelines call for a one-time revaccination. </div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*The [[American College of Physicians]] <ins style="font-weight: bold; text-decoration: none;">in its current guidelines recommends immunization </ins>administration between 2 <ins style="font-weight: bold; text-decoration: none;">to </ins>65 <ins style="font-weight: bold; text-decoration: none;">years old in the presence of indications</ins>, or at age 65. If someone received the immunization before age 60, the guidelines call for a one-time revaccination. </div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*''<del style="font-weight: bold; text-decoration: none;">Revaccination</del>'' <del style="font-weight: bold; text-decoration: none;">at periodic intervals is also indicated </del>for those <del style="font-weight: bold; text-decoration: none;">with other </del>conditions <del style="font-weight: bold; text-decoration: none;">such as </del>[[asplenia]] or [[nephrotic syndrome]].</div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*''<ins style="font-weight: bold; text-decoration: none;">Periodic revaccination</ins>'' <ins style="font-weight: bold; text-decoration: none;"> </ins>for those <ins style="font-weight: bold; text-decoration: none;">who have </ins>conditions <ins style="font-weight: bold; text-decoration: none;">like </ins>[[asplenia]] or [[nephrotic syndrome]] <ins style="font-weight: bold; text-decoration: none;">is indicated</ins>.</div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>===Vaccination in the UK===</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>===Vaccination in the UK===</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*It was announced in February 2006 that the UK government would introduce vaccination with the conjugate vaccine in children aged 2, 4 and 13 months.<ref name="BBCVac">[http://news.bbc.co.uk/1/hi/health/4692908.stm "Children to be given new vaccine"] ''BBC News'', [[February 08]], [[2006]], retrieved [[August 25]], [[2006]]</ref><ref name="DoHPress">[http://www.dh.gov.uk/PublicationsAndStatistics/PressReleases/PressReleasesNotices/fs/en?CONTENT_ID=4128036&chk=PI8e57 <del style="font-weight: bold; text-decoration: none;"> </del>"Pneumococcal vaccine added to the childhood immunisation programme"] [[February 08]], [[2006]]</ref> This is expected to start on [[September 4]], [[2006]] and is to include changes to the immunisation programme in general.<ref name="MRF">[http://www.meningitis.org/sect5/subsect12/page1 "Changes to the immunisation programme in the UK"] ''Meningitis Research Foundation'', retrieved [[August 25]], [[2006]]</ref></div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*It was announced in February 2006 that the UK government would introduce vaccination with the conjugate vaccine in children aged 2, 4 and 13 months.<ref name="BBCVac">[http://news.bbc.co.uk/1/hi/health/4692908.stm "Children to be given new vaccine"] ''BBC News'', [[February 08]], [[2006]], retrieved [[August 25]], [[2006]]</ref><ref name="DoHPress">[http://www.dh.gov.uk/PublicationsAndStatistics/PressReleases/PressReleasesNotices/fs/en?CONTENT_ID=4128036&chk=PI8e57 "Pneumococcal vaccine added to the childhood immunisation programme"] [[February 08]], [[2006]]</ref> This is expected to start on [[September 4]], [[2006]] and is to include changes to the immunisation programme in general.<ref name="MRF">[http://www.meningitis.org/sect5/subsect12/page1 "Changes to the immunisation programme in the UK"] ''Meningitis Research Foundation'', retrieved [[August 25]], [[2006]]</ref></div></td></tr>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>===Vaccination Worldwide===</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>===Vaccination Worldwide===</div></td></tr>
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Usama Talib
https://www.wikidoc.org/index.php?title=Streptococcus_pneumoniae_infection&diff=1320602&oldid=prev
Usama Talib: /* Vaccination Worldwide */
2017-06-23T19:49:13Z
<p><span dir="auto"><span class="autocomment">Vaccination Worldwide</span></span></p>
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<td colspan="2" style="background-color: #fff; color: #202122; text-align: center;">Revision as of 19:49, 23 June 2017</td>
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<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>===Vaccination Worldwide===</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>===Vaccination Worldwide===</div></td></tr>
<tr><td class="diff-marker" data-marker="−"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>*[[PneumoADIP|Pneumococcal vaccines Accelerated Development and Introduction Plan (PnemoADIP)]] <del style="font-weight: bold; text-decoration: none;">is a program to accelerate the evaluation and access to new pneumococcal vaccines in the developing world</del>. <del style="font-weight: bold; text-decoration: none;"> PneumoADIP is funded by the </del>[[Global Alliance for Vaccines and Immunization|Global Alliance for Vaccines and Immunization (GAVI)]]. <del style="font-weight: bold; text-decoration: none;"> Thirty GAVI </del>countries <del style="font-weight: bold; text-decoration: none;">have expressed </del>interest in participating by 2010. <del style="font-weight: bold; text-decoration: none;"> PneumoADIP aims to save </del>5.4 million children by 2030.<ref name="PneumoADIP website">[http://www.pneumoadip.com "PneumoADIP website"]</ref></div></td><td class="diff-marker" data-marker="+"></td><td style="color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>*<ins style="font-weight: bold; text-decoration: none;">In the developing world a plan to accomplish the accelerated new pneumococcal vaccines evaluation and access is done according to the </ins>[[PneumoADIP|Pneumococcal vaccines Accelerated Development and Introduction Plan (PnemoADIP)]]. [[Global Alliance for Vaccines and Immunization|Global Alliance for Vaccines and Immunization (GAVI)]] <ins style="font-weight: bold; text-decoration: none;">funds this plan for new pneumococcal vaccines</ins>. <ins style="font-weight: bold; text-decoration: none;">Almost 30 </ins>countries <ins style="font-weight: bold; text-decoration: none;">in this list showed </ins>interest in participating by 2010. <ins style="font-weight: bold; text-decoration: none;">An estimated </ins>5.4 million <ins style="font-weight: bold; text-decoration: none;">lives of the </ins>children <ins style="font-weight: bold; text-decoration: none;">can be saved by PneumoADIP </ins>by 2030.<ref name="PneumoADIP website">[http://www.pneumoadip.com "PneumoADIP website"]</ref></div></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><br/></td></tr>
<tr><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==References==</div></td><td class="diff-marker"></td><td style="background-color: #f8f9fa; color: #202122; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #eaecf0; vertical-align: top; white-space: pre-wrap;"><div>==References==</div></td></tr>
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Usama Talib