{"id":25863,"date":"2024-06-04T17:17:53","date_gmt":"2024-06-04T15:17:53","guid":{"rendered":"https:\/\/idibell.cat\/?p=25863"},"modified":"2024-06-04T17:18:21","modified_gmt":"2024-06-04T15:18:21","slug":"la-malaltia-pneumococica-invasiva-en-adults-causada-pel-serotipus-3-te-alta-mortalitat-i-necessita-de-proteccio-per-vacunacio","status":"publish","type":"post","link":"https:\/\/idibell.cat\/2024\/06\/la-malaltia-pneumococica-invasiva-en-adults-causada-pel-serotipus-3-te-alta-mortalitat-i-necessita-de-proteccio-per-vacunacio\/","title":{"rendered":"La malaltia pneumoc\u00f2cica invasiva en adults causada pel serotipus 3 t\u00e9 alta mortalitat i necessita de protecci\u00f3 per vacunaci\u00f3"},"content":{"rendered":"<p>Un estudi recent publicat a <a href=\"https:\/\/www.thelancet.com\/journals\/lanepe\/article\/PIIS2666-7762(24)00080-2\/fulltext\"><strong><em>The Lancet Regional Health<\/em><\/strong><\/a> i coordinat per <a href=\"https:\/\/idibell.cat\/recerca\/area-de-medicina-translacional\/programa-de-malalties-infeccioses-i-transplantaments\/epidemiologia-de-les-infeccions-bacterianes-investigacio-de-la-patogenesis-i-bases-moleculars-de-la-resistencia-als-antimicrobians\/\">Carme Ardanuy, investigadora de l&#8217;IDIBELL<\/a> i especialista en microbiologia cl\u00ednica de l&#8217;Hospital Universitari de Bellvitge, ha analitzat l&#8217;evoluci\u00f3 de la malaltia pneumoc\u00f2cica causada pel serotipus 3 a Espanya en les \u00faltimes tres d\u00e8cades (1989-2020). Entre les seves principals conclusions es destaca que<strong><em> &#8220;la vacunaci\u00f3 infantil no ha tingut l&#8217;impacte esperat de protecci\u00f3 de grup en la malaltia pneumoc\u00f2cica causada pel serotipus 3 en adults pel que aquest grup de poblaci\u00f3 necessita de protecci\u00f3 directa per vacunaci\u00f3&#8221;,<\/em><\/strong> comenta Ardanuy, tamb\u00e9 cap de grup del CIBERES.<\/p>\n<p>&nbsp;<\/p>\n<p><strong><em>Streptococcus pneumoniae<\/em><\/strong>, el pneumococ, \u00e9s un patogen oportunista que colonitza les vies respirat\u00f2ries i pot ocasionar infeccions greus com meningitis o pneum\u00f2nia. De fet, <em>S. pneumoniae<\/em> continua sent la primera causa de mortalitat en malalties respirat\u00f2ries a nivell mundial. Actualment, s&#8217;han descrit m\u00e9s de 100 variacions gen\u00e8tiques diferents conegudes com a serotipus, tot i que hi ha difer\u00e8ncies en la capacitat invasiva i la mortalitat associada entre ells. La malaltia pneumoc\u00f2cica invasiva (ENI) causada per pneumococs del serotipus 3 s&#8217;associa a una elevada mortalitat i, tot i que la vacuna conjugada 13-13 (PCV13) inclou aquest serotipus, la seva incid\u00e8ncia continua sent elevada.<\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong>An\u00e0lisi gen\u00f2mica<\/strong><\/p>\n<p>El treball tamb\u00e9 va realitzar un estudi de seq\u00fcenciaci\u00f3 completa del genoma, revelant que els pneumococs del serotipus 3 tenen dos llinatges principals, un dels quals, el llinatge CC180-GPSC12, ha anat augmentant en freq\u00fc\u00e8ncia al llarg dels anys. Tot i que ambd\u00f3s llinatges s\u00f3n gen\u00e8ticament homogenis, el CC180-GPSC12 presenta una major diversitat gen\u00e8tica amb m\u00e9s pres\u00e8ncia de profagaments i elements gen\u00e8tics m\u00f2bils.\u00a0<em>&#8220;Alguns d&#8217;aquests elements confereixen resist\u00e8ncia als antibi\u00f2tics la qual cosa \u00e9s preocupant&#8221;, <\/em>comenta la Dra.<\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong>Dades cl\u00edniques i tend\u00e8ncies<\/strong><\/p>\n<p>Aix\u00ed, la pneum\u00f2nia va ser la principal forma de presentaci\u00f3 de la malaltia, i m\u00e9s de la meitat dels pacients presentaven tamb\u00e9 alguna comorbilitat, sent la diabetis mellitus la m\u00e9s freq\u00fcent. La mortalitat als 30 dies va ser elevada, tot i que es va observar un descens al llarg del per\u00edode d&#8217;estudi del 32,4% al 16,7. No es van observar difer\u00e8ncies significatives quant a les caracter\u00edstiques cl\u00edniques dels pacients i la mortalitat dels casos causats per ambd\u00f3s llinatges.<\/p>\n<p>&nbsp;<\/p>\n<p>A m\u00e9s, l&#8217;estudi va revelar que, la incid\u00e8ncia general de la malaltia pneumoc\u00f2cica invasiva (ENI) va disminuir de 21.0 a 12.9 casos per cada 100,000 habitants entre els per\u00edodes abans i despr\u00e9s de la introducci\u00f3 de la vacuna PCV13 demostrant la protecci\u00f3 de grup.\u00a0Aix\u00f2 \u00e9s degut a que la colonitzaci\u00f3 per pneumococ (portador asimptom\u00e0tic) \u00e9s m\u00e9s freq\u00fcent en nens, i la vacunaci\u00f3 disminueix la concentraci\u00f3 dels pneumococs dels serotipus inclosos en la vacuna per la qual cosa hi ha menys transmissi\u00f3.\u00a0Malauradament, aquest no \u00e9s el cas de l&#8217;ENI causada pel serotipus 3, incl\u00f2s en la PCV13, la incid\u00e8ncia espec\u00edfica del qual es va mantenir estable. Aix\u00ed doncs, la protecci\u00f3 indirecta de la vacunaci\u00f3 infantil no va tenir impacte en l&#8217;ENI causada per aquest serotipus concret en l&#8217;adult.<\/p>\n<p>&nbsp;<\/p>\n<p>La recent introducci\u00f3 de les noves vacunes conjugades (m\u00e9s efectives) per a la vacunaci\u00f3 de la poblaci\u00f3 adulta \u00e9s una eina important en el control de les malalties pneumoc\u00f2ciques de l&#8217;adult. <em>&#8220;Es necessita incrementar les taxes de vacunaci\u00f3 davant l&#8217;adult per tenir una bona protecci\u00f3 directa en els grups de risc com majors de 65 anys, immunodeprimits, o pacients amb comorbilitats per aconseguir la mateixa efectivitat que ja s&#8217;ha demostrat en nens<\/em>&#8221; conclou la Dra Ardanuy.<\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p>Aquest estudi, realitzat en el marc del Programa de Pneum\u00f2nia de l&#8217;\u00e0rea de Malalties Respirat\u00f2ries del Centre d&#8217;Investigaci\u00f3 Biom\u00e8dica en Xarxa (CIBER), compta amb la col\u00b7laboraci\u00f3 d\u2019investigadors del CIBER de Malalties Infeccioses (CIBERINFEC) i dels hospitals Gregorio Mara\u00f1\u00f3n (Madrid), Donostia (Pa\u00eds Basc), Vall d&#8217;Hebron, Parc Taul\u00ed, Germans Trias i Pujol i Bellvitge (Catalunya), aix\u00ed com del Laboratori de Refer\u00e8ncia de Pneumococs, de l&#8217; Institut de Salut Carlos III, i del Barcelona Supercomputing Center.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><em>L\u2019Institut d&#8217;Investigaci\u00f3 Biom\u00e8dica de Bellvitge (IDIBELL) \u00e9s un centre de recerca en biomedicina creat l\u2019any 2004. Est\u00e0 participat per l&#8217;Hospital Universitari de Bellvitge i l\u2019Hospital de Viladecans de l&#8217;Institut Catal\u00e0 de la Salut, l&#8217;Institut Catal\u00e0 d&#8217;Oncologia, la Universitat de Barcelona i l\u2019Ajuntament de l\u2019Hospitalet de Llobregat.<\/em><\/p>\n<p><em>L\u2019IDIBELL \u00e9s membre del Campus d&#8217;Excel\u00b7l\u00e8ncia Internacional de la Universitat de Barcelona HUBc i forma part de la instituci\u00f3 CERCA de la Generalitat de Catalunya. L&#8217;any 2009 es va convertir en un dels cinc primers centres d\u2019investigaci\u00f3 espanyols acreditats com a institut d\u2019investigaci\u00f3 sanit\u00e0ria per l\u2019Instituto de Salud Carlos III. A m\u00e9s, forma part del programa \u201cHR Excellence in Research\u201d de la Uni\u00f3 Europea i \u00e9s membre de EATRIS i REGIC. Des de l\u2019any 2018, l\u2019IDIBELL \u00e9s un Centro Acreditado de la Fundaci\u00f3n Cient\u00edfica AECC (FCAECC).<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Es coneixen m\u00e9s de 100 serotipus de pneumococs, i la malaltia pneumoc\u00f2cica invasiva (ENI) causada pel serotipus 3 est\u00e0 vinculada a una alta taxa de mortalitat.<\/p>\n","protected":false},"author":8,"featured_media":25864,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"default","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[480,334,479],"tags":[],"publishpress_future_action":{"enabled":false,"date":"2024-07-15 23:22:49","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category"},"_links":{"self":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/25863"}],"collection":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/comments?post=25863"}],"version-history":[{"count":2,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/25863\/revisions"}],"predecessor-version":[{"id":25866,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/25863\/revisions\/25866"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/media\/25864"}],"wp:attachment":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/media?parent=25863"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/categories?post=25863"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/tags?post=25863"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}