1
|
Tamura K, Chang B, Shimbashi R, Watanabe H, Tanabe Y, Kuronuma K, Oshima K, Maruyama T, Fujita J, Abe S, Kasahara K, Nishi J, Kubota T, Kinjo Y, Fujikura H, Fukusumi M, Shimada T, Sunagawa T, Suzuki M, Yamamoto Y, Oishi K. Dynamic changes in clinical characteristics and serotype distribution of invasive pneumococcal disease among adults in Japan after introduction of the pediatric 13-valent pneumococcal conjugate vaccine in 2013-2019. Vaccine 2022; 40:3338-3344. [PMID: 35489986 DOI: 10.1016/j.vaccine.2022.04.062] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 04/13/2022] [Accepted: 04/17/2022] [Indexed: 11/29/2022]
Abstract
Nationwide population-based surveillance for invasive pneumococcal disease (IPD) is being conducted in few Asian countries. We aimed to evaluate the clinical characteristics and serotype distribution among Japanese adult patients with IPD after introduction of the pediatric 13-valent pneumococcal conjugate vaccine (PCV13) in 2013. IPD surveillance was conducted among adults between 2013 and 2019, and 1,995 patients were analyzed by time period (early, 2013-2015; middle, 2016-2017; late, 2018-2019). We found that the period of 2018-2019 was independently associated with a lower risk of fatal outcome, compared with the period of 2013-2015. The proportion of those with serotype PCV13-nonPCV7 decreased significantly in patients aged 15-64 years and in those aged ≥ 65 years within 3 years after the introduction of pediatric PCV13. By contrast, the proportion of those with nonvaccine serotype increased significantly in those aged ≥ 65 years, but not in those aged 15-64 years. No significant change was found in the proportion of 23-valent polysaccharide pneumococcal vaccine (PPSV23)-nonPCV13 in both of adults aged 15-64 years and ≥ 65 years. The proportions of PCV15-, PCV20- and PCV24-covered serotypes were 38%, 56% and 58% in adult patients with IPD aged ≥ 65 years during the late period. Our data on the serotype distribution support an indirect effect from pediatric PCV13 use among adults, and afford a basis for estimates of protection against IPD by vaccination with newly developed PCVs in older adults in Japan.
Collapse
Affiliation(s)
- Kosuke Tamura
- Department of Research Planning, Toyama Institute of Health, Toyama, Japan
| | - Bin Chang
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Reiko Shimbashi
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hiroshi Watanabe
- Department of Infection Control and Prevention, Kurume University School of Medicine, Fukuoka, Japan
| | - Yoshinari Tanabe
- Department of Respiratory Medicine, Niigata Prefectural Shibata Hospital, Niigata, Japan
| | - Koji Kuronuma
- Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Kengo Oshima
- Department of Infectious Disease, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | | | - Jiro Fujita
- Department of Infectious, Respiratory and Digestive Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Shuichi Abe
- Department of Infectious Diseases and Infection Control, Yamagata Prefectural Central Hospital, Japan
| | - Kei Kasahara
- Center for Infectious Diseases, Nara Medical University, Nara, Japan
| | - Junichiro Nishi
- Department of Microbiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Tetsuya Kubota
- Department of Respiratory Medicine and Allergology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Yuki Kinjo
- Department of Bacteriology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroyuki Fujikura
- Center for Infectious Diseases, Nara Medical University, Nara, Japan
| | - Munehisa Fukusumi
- Center for Field Epidemic Intelligence, Research and Professional Development, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tomoe Shimada
- Center for Field Epidemic Intelligence, Research and Professional Development, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tomimasa Sunagawa
- Center for Field Epidemic Intelligence, Research and Professional Development, National Institute of Infectious Diseases, Tokyo, Japan
| | - Motoi Suzuki
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yoshihiro Yamamoto
- Department of Clinical Infectious Diseases, Toyama University Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - Kazunori Oishi
- Department of Bacteriology, Toyama Institute of Health, Toyama, Japan.
| | | |
Collapse
|
2
|
Thomas RE. Pneumococcal Pneumonia and Invasive Pneumococcal Disease in Those 65 and Older: Rates of Detection, Risk Factors, Vaccine Effectiveness, Hospitalisation and Mortality. Geriatrics (Basel) 2021; 6:13. [PMID: 33557406 PMCID: PMC7931064 DOI: 10.3390/geriatrics6010013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 12/17/2022] Open
Abstract
Pneumococcal pneumonia (PP) and invasive pneumococcal disease (IPD) are important causes of morbidity and mortality in seniors worldwide. Incidence rates and serious outcomes worsen with increasing frailty, numbers of risk factors and decreasing immune competence with increasing age. Literature reviews in Medline and Embase were performed for pneumococcal disease incidence, risk factors, vaccination rates and effectiveness in the elderly. The introduction of protein-conjugated pneumoccal vaccines (PCV) for children markedly reduced IPD and PP in seniors, but serotypes not included in vaccines and with previously low levels increased. Pneumococcal polysaccharide (PPV23) vaccination does not change nasal and pharyngeal carriage rates. Pneumococcal and influenza vaccination rates in seniors are below guideline levels, especially in older seniors and nursing home staff. Pneumococcal and influenza carriage and vaccination rates of family members, nursing home health care workers and other contacts are unknown. National vaccination programmes are effective in increasing vaccination rates. Detection of IPD and PP initially depend on clinical symptoms and new chest X ray infiltrates and then varies according to the population and laboratory tests used. To understand how seniors and especially older seniors acquire PP and IPD data are needed on pneumococcal disease and carriage rates in family members, carers and contacts. Nursing homes need reconfiguring into small units with air ventilation externally from all rooms to minimise respiratory disease transmission and dedicated staff for each unit to minimise transmision of infectious diseaases.
Collapse
Affiliation(s)
- Roger E Thomas
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada
| |
Collapse
|
3
|
MacCalman TE, Phillips-Jones MK, Harding SE. Glycoconjugate vaccines: some observations on carrier and production methods. Biotechnol Genet Eng Rev 2020; 35:93-125. [PMID: 32048549 DOI: 10.1080/02648725.2019.1703614] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Glycoconjugate vaccines use protein carriers to improve the immune response to polysaccharide antigens. The protein component allows the vaccine to interact with T cells, providing a stronger and longer-lasting immune response than a polysaccharide interacting with B cells alone. Whilst in theory the mere presence of a protein component in a vaccine should be sufficient to improve vaccine efficacy, the extent of improvement varies. In the present review, a comparison of the performances of vaccines developed with and without a protein carrier are presented. The usefulness of analytical tools for macromolecular integrity assays, in particular nuclear magnetic resonance, circular dichroism, analytical ultracentrifugation and SEC coupled to multi-angle light scattering (MALS) is indicated. Although we focus mainly on bacterial capsular polysaccharide-protein vaccines, some consideration is also given to research on experimental cancer vaccines using zwitterionic polysaccharides which, unusually for polysaccharides, are able to invoke T-cell responses and have been used in the development of potential all-polysaccharide-based cancer vaccines.A general trend of improved immunogenicity for glycoconjugate vaccines is described. Since the immunogenicity of a vaccine will also depend on carrier protein type and the way in which it has been linked to polysaccharide, the effects of different carrier proteins and production methods are also reviewed. We suggest that, in general, there is no single best carrier for use in glycoconjugate vaccines. This indicates that the choice of carrier protein is optimally made on a case-by-case basis, based on what generates the best immune response and can be produced safely in each individual case.Abbreviations: AUC: analytical ultracentrifugation; BSA: bovine serum albumin; CD: circular dichroism spectroscopy; CPS: capsular polysaccharide; CRM197: Cross Reactive Material 197; DT: diphtheria toxoid; Hib: Haemophilius influenzae type b; MALS: multi-angle light scattering; Men: Neisseria menigitidis; MHC-II: major histocompatibility complex class II; NMR: nuclear magnetic resonance spectroscopy; OMP: outer membrane protein; PRP: polyribosyl ribitol phosphate; PSA: Polysaccharide A1; Sa: Salmonella; St.: Streptococcus; SEC: size exclusion chromatography; Sta: Staphylococcus; TT: tetanus toxoid; ZPS: zwitterionic polysaccharide(s).
Collapse
Affiliation(s)
- Thomas E MacCalman
- National Centre for Macromolecular Hydrodynamics, University of Nottingham, Nottingham, UK
| | - Mary K Phillips-Jones
- National Centre for Macromolecular Hydrodynamics, University of Nottingham, Nottingham, UK
| | - Stephen E Harding
- National Centre for Macromolecular Hydrodynamics, University of Nottingham, Nottingham, UK.,Kulturhistorisk Museum, University of Oslo, Oslo, Norway
| |
Collapse
|
4
|
Houben T, Magro Dos Reis I, Oligschlaeger Y, Steinbusch H, Gijbels MJJ, Hendrikx T, Binder CJ, Cassiman D, Westerterp M, Prickaerts J, Shiri-Sverdlov R. Pneumococcal Immunization Reduces Neurological and Hepatic Symptoms in a Mouse Model for Niemann-Pick Type C1 Disease. Front Immunol 2019; 9:3089. [PMID: 30666257 PMCID: PMC6330339 DOI: 10.3389/fimmu.2018.03089] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 12/13/2018] [Indexed: 11/13/2022] Open
Abstract
Niemann-Pick type C1 (NPC1) disease is caused by a deleterious mutation in the Npc1 gene, causing lysosomal accumulation of unesterified cholesterol and sphingolipids. Consequently, NPC1 disease patients suffer from severe neurovisceral symptoms which, in the absence of effective treatments, result in premature death. NPC1 disease patients display increased plasma levels of cholesterol oxidation products such as those enriched in oxidized low-density lipoprotein (oxLDL), a pro-inflammatory mediator. While it has been shown that inflammation precedes and exacerbates symptom severity in NPC1 disease, it is unclear whether oxLDL contributes to NPC1 disease progression. In this study, we investigated the effects of increasing anti-oxLDL IgM autoantibodies on systemic and neurological symptoms in an NPC1 disease mouse model. For this purpose, Npc1nih mice were immunized with heat-inactivated S. pneumoniae, an immunogen which elicits an IgM autoantibody-mediated immune response against oxLDL. Npc1nih mice injected with heat-inactivated pneumococci displayed an improved hepatic phenotype, including liver lipid accumulation and inflammation. In addition, regression of motor skills was delayed in immunized Npc1nih. In line with these results, brain analyses showed an improved cerebellar phenotype and neuroinflammation in comparison with control-treated subjects. This study highlights the potential of the pneumococcal immunization as a novel therapeutical approach in NPC1 disease. Future research should investigate whether implementation of this therapy can improve life span and quality of life of NPC1 disease patients.
Collapse
Affiliation(s)
- Tom Houben
- Department of Molecular Genetics, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Inês Magro Dos Reis
- Department of Molecular Genetics, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Yvonne Oligschlaeger
- Department of Molecular Genetics, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Hellen Steinbusch
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Marion J J Gijbels
- Department of Molecular Genetics, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| | - Tim Hendrikx
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.,Center for Molecular Medicine, Austrian Academy of Sciences, Vienna, Austria
| | - Christoph J Binder
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.,Center for Molecular Medicine, Austrian Academy of Sciences, Vienna, Austria
| | - David Cassiman
- Liver Research Unit, University of Leuven, Leuven, Belgium.,Department of Gastroenterology-Hepatology and Metabolic Center, University Hospitals Leuven, Leuven, Belgium
| | - Marit Westerterp
- Section Molecular Genetics, Department of Pediatrics, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Jos Prickaerts
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Ronit Shiri-Sverdlov
- Department of Molecular Genetics, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, Netherlands
| |
Collapse
|
5
|
Nace DA, Archbald-Pannone LR, Ashraf MS, Drinka PJ, Frentzel E, Gaur S, Mahajan D, Mehr DR, Mercer WC, Sloane PD, Jump RLP. Pneumococcal Vaccination Guidance for Post-Acute and Long-Term Care Settings: Recommendations From AMDA's Infection Advisory Committee. J Am Med Dir Assoc 2017; 18:99-104. [PMID: 28126142 DOI: 10.1016/j.jamda.2016.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 11/09/2016] [Indexed: 11/15/2022]
Abstract
Efforts at preventing pneumococcal disease are a national health priority, particularly in older adults and especially in post-acute and long-term care settings The Advisory Committee on Immunization Practices recommends that all adults ≥65 years of age, as well as adults 18-64 years of age with specific risk factors, receive both the recently introduced polysaccharide-protein conjugate vaccine against 13 pneumococcal serotypes as well as the polysaccharide vaccine against 23 pneumococcal serotypes. Nursing facility licensure regulations require facilities to assess the pneumococcal vaccination status of each resident, provide education regarding pneumococcal vaccination, and administer the appropriate pneumococcal vaccine when indicated. Sorting out the indications and timing for 13 pneumococcal serotypes and 23 pneumococcal serotypes administration is complex and presents a significant challenge to healthcare providers. Here, we discuss the importance of pneumococcal vaccination for older adults, detail AMDA-The Society for Post-Acute and Long-Term Care Medicine (The Society)'s recommendations for pneumococcal vaccination practice and procedures, and offer guidance to postacute and long-term care providers supporting the development and effective implementation of pneumococcal vaccine policies.
Collapse
Affiliation(s)
- David A Nace
- Division of Geriatric Medicine, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA.
| | - Laurie R Archbald-Pannone
- Divisions of General, Geriatric, Palliative, and Hospital Medicine and Infectious Diseases and International Health, Department of Internal Medicine, University of Virginia, Charlottesville, VA
| | - Muhammad S Ashraf
- Division of Infectious Diseases, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE
| | - Paul J Drinka
- Divisions of Internal Medicine and Geriatric Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | | | - Swati Gaur
- Northeast Georgia Health System, Gainesville, GA; Senior Care Advances, Gainesville, GA
| | - Dheeraj Mahajan
- Chicago Internal Medicine Practice and Research (CIMPAR), Chicago, IL; University of Illinois, Chicago, IL
| | - David R Mehr
- Department of Family and Community Medicine, University of Missouri-Columbia School of Medicine, Columbia, MO
| | - William C Mercer
- Peterson Rehabilitation Hospital and Geriatric Center, Wheeling, WV; Wheeling Ohio County Health Department, Wheeling, WV
| | - Philip D Sloane
- Program on Aging, Disability and Long-Term Care, Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC
| | - Robin L P Jump
- Geriatric Research Education and Clinical Center, Division of Infectious Diseases, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH; Division of Infectious Diseases and HIV Medicine, Department of Medicine, Case Western Reserve University, Cleveland, OH
| | | |
Collapse
|
6
|
Pneumococcal Capsular Polysaccharide Immunity in the Elderly. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2017; 24:CVI.00004-17. [PMID: 28424198 DOI: 10.1128/cvi.00004-17] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Immunity to pneumococcal infections is impaired in older people, and current vaccines are poorly protective against pneumococcal disease in this population. Naturally acquired immunity to pneumococcal capsular polysaccharides develops during childhood and is robust in young adults but deteriorates with advanced age. In particular, antibody levels and function are reduced in older people. Pneumococcal vaccines are recommended for people >65 years old. However, the benefits of polysaccharide and protein-conjugated vaccines in this population are small, because of both serotype replacement and incomplete protection against vaccine serotype pneumococcal disease. In this review, we overview the immune mechanisms by which naturally acquired and vaccine-induced pneumococcal capsular polysaccharide immunity declines with age, including altered colonization dynamics, reduced opsonic activity of antibodies (particularly IgM), and impaired mucosal immunity.
Collapse
|
7
|
From Immunologically Archaic to Neoteric Glycovaccines. Vaccines (Basel) 2017; 5:vaccines5010004. [PMID: 28134792 PMCID: PMC5371740 DOI: 10.3390/vaccines5010004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 11/14/2016] [Accepted: 01/22/2017] [Indexed: 12/13/2022] Open
Abstract
Polysaccharides (PS) are present in the outermost surface of bacteria and readily come in contact with immune cells. They interact with specific antibodies, which in turn confer protection from infections. Vaccines with PS from pneumococci, meningococci, Haemophilus influenzae type b, and Salmonella typhi may be protective, although with the important constraint of failing to generate permanent immunological memory. This limitation has in part been circumvented by conjugating glycovaccines to proteins that stimulate T helper cells and facilitate the establishment of immunological memory. Currently, protection evoked by conjugated PS vaccines lasts for a few years. The same approach failed with PS from staphylococci, Streptococcus agalactiae, and Klebsiella. All those germs cause severe infections in humans and often develop resistance to antibiotic therapy. Thereby, prevention is of increasing importance to better control outbreaks. As only 23 of more than 90 pneumococcal serotypes and 4 of 13 clinically relevant Neisseria meningitidis serogroups are covered by available vaccines there is still tremendous clinical need for PS vaccines. This review focuses on glycovaccines and the immunological mechanisms for their success or failure. We discuss recent advances that may facilitate generation of high affinity anti-PS antibodies and confer specific immunity and long-lasting protection.
Collapse
|
8
|
Namkoong H, Ishii M, Funatsu Y, Kimizuka Y, Yagi K, Asami T, Asakura T, Suzuki S, Kamo T, Fujiwara H, Tasaka S, Betsuyaku T, Hasegawa N. Theory and strategy for Pneumococcal vaccines in the elderly. Hum Vaccin Immunother 2016; 12:336-43. [PMID: 26406267 PMCID: PMC5049722 DOI: 10.1080/21645515.2015.1075678] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Pneumonia is the fourth-leading cause of death globally, and Streptococcus pneumoniae is the most important causative pathogen. Because the incidence of pneumococcal diseases is likely to increase with the aging society, we should determine an optimal strategy for pneumococcal vaccination. While consensus indicates that 23-valent pneumococcal polysaccharide vaccine prevents invasive pneumococcal diseases (IPD), its effects on community-acquired pneumonia (CAP) remain controversial. Recently, a 13-valent pneumococcal conjugate vaccine (PCV13) was released. The latest clinical study (CAPiTA study) showed that PCV13 reduced vaccine-type CAP and IPD. Based on these results, the Advisory Committee on Immunization Practices recommended initial vaccination with PCV13 for the elderly. Scientific evidence regarding immunosenescence is needed to determine a more ideal vaccination strategy for the elderly with impaired innate and adaptive immunity. Continuing research on the cost effectiveness of new vaccine strategies considering constantly changing epidemiology is also warranted.
Collapse
Affiliation(s)
- Ho Namkoong
- a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan
| | - Makoto Ishii
- a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan
| | - Yohei Funatsu
- a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan
| | - Yoshifumi Kimizuka
- a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan
| | - Kazuma Yagi
- a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan
| | - Takahiro Asami
- a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan
| | - Takanori Asakura
- a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan
| | - Shoji Suzuki
- a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan
| | - Testuro Kamo
- a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan
| | - Hiroshi Fujiwara
- b Center for Infectious Diseases and Infection Control; Keio University School of Medicine ; Tokyo , Japan
| | - Sadatomo Tasaka
- a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan
| | - Tomoko Betsuyaku
- a Division of Pulmonary Medicine Department of Medicine ; Keio University School of Medicine ; Tokyo , Japan
| | - Naoki Hasegawa
- b Center for Infectious Diseases and Infection Control; Keio University School of Medicine ; Tokyo , Japan
| |
Collapse
|
9
|
Giannella M, Tedeschi S, Bartoletti M, Viale P. Prevention of infections in nursing homes: antibiotic prophylaxis versus infection control and antimicrobial stewardship measures. Expert Rev Anti Infect Ther 2016; 14:219-30. [PMID: 26655286 DOI: 10.1586/14787210.2016.1132161] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Because of the lack of structural and human resources for implementing more effective and safe preventive procedures, antimicrobial prophylaxis is often used to prevent infections in nursing homes. However, if data on the efficacy of antibiotic prophylaxis in nursing homes are null, there is a plenty of evidence that the inappropriate use of antimicrobials in this setting is associated with a high rate of colonization and infection with multi-drug-resistant organisms (MDROs), and of Clostridium difficile infection (CDI). Here, we have reviewed the infection epidemiology, the burden of MDROs and CDI, the antibiotic use and some potential infection preventive measures in nursing homes, pointing up the peculiarities of this setting and the absolute need of a more prudential use of antimicrobials.
Collapse
Affiliation(s)
- Maddalena Giannella
- a Clinic of Infectious Diseases, Department of Medical and Surgical Sciences, University of Bologna , Bologna , Italy
| | - Sara Tedeschi
- a Clinic of Infectious Diseases, Department of Medical and Surgical Sciences, University of Bologna , Bologna , Italy
| | - Michele Bartoletti
- a Clinic of Infectious Diseases, Department of Medical and Surgical Sciences, University of Bologna , Bologna , Italy
| | - Pierluigi Viale
- a Clinic of Infectious Diseases, Department of Medical and Surgical Sciences, University of Bologna , Bologna , Italy
| |
Collapse
|
10
|
Saga T, Hirokawa M. [Administration route, prevention and management of adverse events following pneumococcal vaccination in adults]. NIHON NAIKA GAKKAI ZASSHI. THE JOURNAL OF THE JAPANESE SOCIETY OF INTERNAL MEDICINE 2015; 104:2336-2342. [PMID: 28530349 DOI: 10.2169/naika.104.2336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
|
11
|
Campins Martí M. [Pneumococcal vaccines. New conjugate vaccines for adults]. Enferm Infecc Microbiol Clin 2015; 33:617-24. [PMID: 26474708 DOI: 10.1016/j.eimc.2015.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 09/08/2015] [Indexed: 01/06/2023]
Abstract
Pneumococcal infections are a significant cause of morbidity and mortality, and are one of the 10 leading causes of death worldwide. Children under 2 years have a higher incidence rate, followed by adults over 64 years. The main risk group are individuals with immunodeficiency, and those with anatomical or functional asplenia, but can also affect immunocompetent persons with certain chronic diseases. Significant progress has been made in the last 10 years in the prevention of these infections. Until a few years ago, only the 23-valent non-conjugate pneumococcal vaccine was available. Its results were controversial in terms of efficacy and effectiveness, and with serious limitations on the type of immune response induced. The current possibility of using the 13-valent conjugate vaccine in adults has led to greater expectations in improving the prevention of pneumococcal disease in these age groups.
Collapse
Affiliation(s)
- Magda Campins Martí
- Servicio de Medicina Preventiva y Epidemiología, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España.
| |
Collapse
|
12
|
Shiramoto M, Hanada R, Juergens C, Shoji Y, Yoshida M, Ballan B, Cooper D, Gruber WC, Scott DA, Schmoele-Thoma B. Immunogenicity and safety of the 13-valent pneumococcal conjugate vaccine compared to the 23-valent pneumococcal polysaccharide vaccine in elderly Japanese adults. Hum Vaccin Immunother 2015; 11:2198-206. [PMID: 26176163 PMCID: PMC4635730 DOI: 10.1080/21645515.2015.1030550] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Streptococcus pneumoniae is a major cause of severe disease worldwide, particularly in the elderly population. Due to increasing life expectancy in Japan and elsewhere, an effective vaccine which offers the possibility of prolonged protection is required. Protein conjugated pneumococcal vaccines, which have the ability to boost immunity (immunologic memory) on natural exposure or revaccination, may meet these requirements. An unconjugated 23-valent pneumococcal polysaccharide vaccine (PPSV23) has been available for decades; however data on protection against pneumonia are inconsistent. For the first time, a randomized, modified double-blind trial comparing the 13-valent pneumococcal conjugate vaccine (PCV13) with PPSV23 was conducted in PPSV23-naive adults ≥65 years of age in Japan. This study showed that statistically significantly greater functional antibody responses as measured by opsonophagocytic assays 1 month after vaccination were elicited in the PCV13 group (n = 366) compared with the PPSV23 group (n = 367) for 9 of the 12 serotypes in common with both vaccines and for serotype 6A, unique to PCV13. Local reactions collected within 14 days of vaccination were more frequent in the PCV13 (57.5%, 211/367) than PPSV23 (44.9%, 166/370) group, although severity was generally mild to moderate; systemic and adverse events were similar across groups. There were no treatment-related serious adverse events. Consistent with global studies comparing PCV13 with PPSV23, PCV13 use in Japanese subjects was safe and well-tolerated and elicited greater functional immune responses than PPSV23 for the majority of PCV13-serotypes. PCV13 has the potential to protect against pneumococcal disease in Japanese elderly adults.
Collapse
|