Læknablaðið : fylgirit - 03.01.2017, Blaðsíða 29

X V I I I V Í S I N D A R Á Ð S T E F N A H Í
F Y L G I R I T 9 1
LÆKNAblaðið/Fylgirit 91 2017/103 29
P < 0.05). TNFi adherence was shorter in obese patients, the median TNFi
duration was 2.5 years (95% CI 1.7, 3.2) in obese vs 5.9 (4.1, 7.7) in non-o-
bese patients (P < 0.01). A EULAR good or moderate (EGOM) response
was achieved by 55% of obese vs 65% of non-obese patients (P = 0.02).
Inmultivariable analyses, obesity increased the risk of TNFi withdrawal
[HR 1.6 (95% CI 1.3, 2.0)] and reduced odds for EGOM response [OR 0.47
(95% CI 0.29, 0.72)]. The impact of obesitywas significant across genders
and TNFi types.
Conclusion: Obesity wasassociated with higher disease activity and
seemed to diminish response and adherence to TNFIs in PsA.
E 72 Reduced carriage of vaccine type pneumococci in children
following vaccination with the 10-valent pneumococcal vaccine
Samúel Sigurðsson1, Helga Erlendsdóttir2, Birgir Hrafnkelsson3, Karl G.
Kristinsson2, Ásgeir Haraldsson4
1Faculty of Medicine, University of Iceland, 2Department of Clinical Microbiology, Landspitali,
University Hospital, 3Department of Mathematics, University of Iceland, 4Children’s Hospital
Iceland, Landspitali, University Hospital
samuelsigurds@gmail.com
Introduction: Vaccination with the 10-valent pneumococcal conjugate
vaccine (PCV-10) was initiated in Iceland in 2011 for children born in 2011
and later without catch-up.
Aim: To determine the impact of PCV-10 on nasopharyngeal carriage of
pneumococci.
Methods: An ongoing, repeated cross-sectional study where nasoph-
aryngeal swabs were collected in March every year from 2009-2015, from
children attending 15 Day Care Centres in the Reykjavik capital area.
Isolates were cultured selectively for pneumococci and serotyped with
PCR and/or latex agglutination. To attain compatible age distribution,
only children < 4 years of age were included and the Non-Vaccine Eligible
cohorts (NVEC, born ≤2010) compared with the Vaccine Eligible Cohorts
(VEC, born ≥2011). To exclude possible herd effect bias NVECs sampled
in 2013 and later were excluded.
Results: There were 917 isolates in the VEC and 387 in the NVEC included
in this study. The average age was higher in the NVEC than the VEC (2.89
vs 2.80, p=0.02). Nosignificant differences was in carriage (69.5% in both
groups) or sex (51.5% vs 53.8% males). Vaccine types represented 51.1%
and 4.5% of the pneumococcal isolates for NVEC and VEC respectively.
Pooled vaccine efficacy for acquisition of vaccine types for the VEC
compared to the NVEC was 94% (95%CI:90-96%). For the vaccine-associ-
ated serotypes (6A and 19A) a 33% (95%CI:1%-55%) reduction was found.
There was a significant increased prevalence of the non-vaccine serotypes
in the VEC.
Conclusion: Vaccine serotypes were almost eliminated from carriage
following the vaccination. In addition, a reduction of vaccine-associated
serotypes (6A,19A) was seen, indicating possible cross-reactivity.
E 73 Decreased anti-microbial resistance in healthy children
attending Day Care Centres after pneumococcal vaccination in
Iceland
Samúel Sigurðsson1, Helga Erlendsdóttir2, Birgir Hrafnkelsson3, Karl G.
Kristinsson2, Ásgeir Haraldsson4
1Faculty of Medicine, University of Iceland, 2Department of Clinical Microbiology, Landspitali,
University Hospital, 3Department of Mathematics, University of Iceland, 4Children’s Hospital
Iceland, Landspitali, University Hospital
samuelsigurds@gmail.com
Introduction: 10-valent pneumococcal conjugate vaccination (PHiD-
CV) was initiated in Iceland for children born in 2011 and later, without
catchup.
Aim: To determine the impact of PHiD-CV on anti-microbial resistance
of pneumococcal isolates in children attending Day Care Centres (DCCs).
Methods: Cross-sectional carriage studies were conducted every March
2009-2015 and NP swabs collected from children attending DCCs in
Reykjavik, for pneumococcal culture, susceptibility testing and serotyp-
ing. Resistant and intermediately resistant isolates were defined as non-
-susceptible, and multi-resistance as non-susceptibility to >3 antimicrobial
classes. To attain comparable age distribution, only children <4 years of
age were included; the Non-Vaccine Eligible cohorts (NVEC, born 2010
and earlier) were compared to the Vaccine Eligible Cohorts (VEC, born
2011 and later). To exclude possible herd effect bias NVECs sampled in
2013 and later were excluded. Non-typeable pneumococci were excluded.
Results: 870 pneumococcal isolates were included in the NVEC and 365 in
the VEC. There were no significant differences in carriage (69.5% vs 70.1%,
p=0.8) between the groups. The NVEC group had higher parent reported
recent antibiotic usage (p<0.05) and average age (2.89 vs 2.80, p<0.05) than
the VEC. The NVEC group excibited higher MIC against Penicillin than
the VEC. Non-susceptibility to erythromycin, co-trimoxazole and multi-
-resistance declined significantly (NVEC vs. VEC: 13.1% vs. 9.0%, p<0.05,
22.2% vs 12.1%, p<0.001 and 9.3% vs 4.4%, p=0.004, respectively). In NVEC
serotype 19F caused 89.0% of multi-resistance, in VEC serotype 15 was the
most prevalent.
Conclusion: Emerging non-vaccine serotypes exhibit lower anti-microbial
resistance, mainly driven by the reduction of serotype 19F.
E 74 Cell membrane permeable but not impermeable carbonic
anhydrase inhibitors dilate pre-contracted pig retinal arteries
Þór Eysteinsson1, Hrönn Guðmundsdóttir1, Arnar Ö. Harðarson1, Fabrizio Carta2,
Claudiu Supruran2
1Physiology, University of Iceland, 2 Neurofarba University of Florence
thoreys@hi.is
Introduction: Carbonic anhydrase inhibitors (CAI’s) are used to lower
intraocular pressure in glaucoma. Some have also been found to elevate
retinal PO2 and dilate retinal arteries. But the mechanism is unknown.
The aim is to identify which carbonic anhydrase isoenzymes are involved
in control of vascular wall tension, and whether located intracellularly
or on the surface of cell membranes. Selective membrane permeable and
impermeable CAI’s were used for this purpose.
Materials and methods: Dissected segments of porcine retinal arteries
were mounted in a wire myograph for measurement of contractile activity
and precontracted with 10-6M U-46619, a prostaglandin analog, added
to the organ bath. With the vascular tone stabilized the CAI’s tested
were applied separately to the bath, and the effects of each on the tone
recorded. Results are presented as mean ± SEM percentage of the max-
imum vasodilation, as compared to the prior vasoconstriction induced by
10-6M U-46619.
Results: The membrane permeable CAI dorzolamide (10-3M) induced a
mean relaxation of 76 ± 8% (p < 0.02) when precontracted with U-46619.
Benzolamide, considered a membrane impermeable CAI, induced a
dose-dependent, significant mean relaxation of 85 ± 8% (p < 0.01). The pyr-
idinium derivative FC5-207A (10-3M), a membrane impermeable CAI, had
no effects on vascular wall tension. Three other membrane impermeable
CAIs, sulfonamides MB9-512B, MB9-523R9A, and MB9-527R2A, had no
significant effects on wall tension.