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Feemster K, Buchwald UK, Banniettis N, Joyce JG, Velentgas P, Chapman TJ, Yildirim I. Immunogenicity of Current and Next-Generation Pneumococcal Conjugate Vaccines in Children: Current Challenges and Upcoming Opportunities. Open Forum Infect Dis 2024; 11:ofae220. [PMID: 38770212 PMCID: PMC11103622 DOI: 10.1093/ofid/ofae220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Indexed: 05/22/2024] Open
Abstract
Global use of pneumococcal conjugate vaccines (PCVs) with increasingly broader serotype coverage has helped to reduce the burden of pneumococcal disease in children and adults. In clinical studies comparing PCVs, higher-valency PCVs have met noninferiority criteria (based on immunoglobulin G geometric mean concentrations and response rates) for most shared serotypes. A numeric trend of declining immunogenicity against shared serotypes with higher-valency PCVs has also been observed; however, the clinical relevance is uncertain, warranting additional research to evaluate the effectiveness of new vaccines. Novel conjugation processes, carriers, adjuvants, and vaccine platforms are approaches that could help maintain or improve immunogenicity and subsequent vaccine effectiveness while achieving broader protection with increasing valency in pneumococcal vaccines.
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Affiliation(s)
- Kristen Feemster
- Merck Research Laboratories, Merck & Co, Inc., Rahway, New Jersey, USA
| | - Ulrike K Buchwald
- Merck Research Laboratories, Merck & Co, Inc., Rahway, New Jersey, USA
| | | | - Joseph G Joyce
- Merck Research Laboratories, Merck & Co, Inc., Rahway, New Jersey, USA
| | | | - Timothy J Chapman
- Merck Research Laboratories, Merck & Co, Inc., Rahway, New Jersey, USA
| | - Inci Yildirim
- Department of Pediatrics, School of Medicine, Yale University, New Haven, Connecticut, USA
- Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
- Yale Institute for Global Health, Yale University, New Haven, Connecticut, USA
- Yale Center for Infection and Immunity, Yale University School of Medicine, New Haven, Connecticut, USA
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Chapman TJ, Olarte L, Dbaibo G, Houston AM, Tamms G, Lupinacci R, Feemster K, Buchwald UK, Banniettis N. PCV15, a pneumococcal conjugate vaccine, for the prevention of invasive pneumococcal disease in infants and children. Expert Rev Vaccines 2024; 23:137-147. [PMID: 38111990 DOI: 10.1080/14760584.2023.2294153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 12/07/2023] [Indexed: 12/20/2023]
Abstract
INTRODUCTION Streptococcus pneumoniae is a causative agent of pneumonia and acute otitis media (AOM), as well as invasive diseases such as meningitis and bacteremia. PCV15 (V114) is a new 15-valent pneumococcal conjugate vaccine (PCV) approved for use in individuals ≥6 weeks of age for the prevention of pneumonia, AOM, and invasive pneumococcal disease. AREAS COVERED This review summarizes the V114 Phase 3 development program leading to approval in infants and children, including pivotal studies, interchangeability and catch-up vaccination studies, and studies in at-risk populations. An integrated safety summary is presented in addition to immunogenicity and concomitant use of V114 with other routine pediatric vaccines. EXPERT OPINION Across the development program, V114 demonstrated a safety profile that is comparable to PCV13 in infants and children. Immunogenicity of V114 is comparable to PCV13 for all shared serotypes except serotype 3, where V114 demonstrated superior immunogenicity. Higher immune responses were demonstrated for V114 serotypes 22F and 33F. Results of the ongoing study to evaluate V114 efficacy against vaccine-type pneumococcal AOM and anticipated real-world evidence studies will support assessment of vaccine effectiveness and impact, with an additional question of whether higher serotype 3 immunogenicity translates to better protection against serotype 3 pneumococcal disease.
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Affiliation(s)
| | - Liset Olarte
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO, USA
| | - Ghassan Dbaibo
- Division of Pediatric Infectious Diseases, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Zhang X, Liu C, Yi Z, Zhao L, Li Z, Yao L, Feng B, Rui L, Qu B, Liu M, Cui F. What Works for Controlling Meningitis Outbreaks: A Case Study from China. Vaccines (Basel) 2023; 11:1762. [PMID: 38140167 PMCID: PMC10748221 DOI: 10.3390/vaccines11121762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/17/2023] [Accepted: 11/20/2023] [Indexed: 12/24/2023] Open
Abstract
The meningococcal meningitis (MM) vaccine reduces the incidence of MM significantly; however, outbreaks still occur in communities with high vaccine coverage. We aimed to analyze the driving factors of infection from a community outbreak. A total of 266 children aged 9 to 15 years old from the three junior high schools of Tongzi county were identified. We documented infection cases using laboratory tests and analyzed attack rates, infection rates and risk factors for transmission. The index case in School A was identified, and the attack rate in School A was 0.03%. Children showed a significantly low infection rate of MenC in School A (13.2% vs. 19.5% in total children, p = 0.002), while exhibiting significantly high infection rates of MenA in School B (44.1% vs. 24.8% in total children, p < 0.001) and MenB in School C (11.1% vs. 4.1% in total children, p = 0.015). The infection rate of MenA for females (30.0%) was higher (p = 0.055) than for males (19.9%). In School A, 63.19% of children were vaccinated against MenC, while in School B the rate was 42.65% and in School C, it was 59.26%. Three male MenC infection cases were detected as breakthrough infection cases in addition to the index case. The findings suggest that the current full-course immunization has limited long-term effectiveness and is inefficient in preventing the transmission of MM among older children.
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Affiliation(s)
- Xiyu Zhang
- Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China;
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
| | - Chunting Liu
- Guizhou Center for Disease Control and Prevention, Guiyang 550004, China; (C.L.); (L.Z.); (L.R.)
| | - Zongjun Yi
- Zunyi Center for Disease Control and Prevention, Zunyi 564600, China; (Z.Y.); (Z.L.); (B.Q.)
| | - Linglu Zhao
- Guizhou Center for Disease Control and Prevention, Guiyang 550004, China; (C.L.); (L.Z.); (L.R.)
| | - Zhongju Li
- Zunyi Center for Disease Control and Prevention, Zunyi 564600, China; (Z.Y.); (Z.L.); (B.Q.)
| | - Linhong Yao
- Tongzi Center for Disease Control and Prevention, Zunyi 563200, China; (L.Y.); (B.F.)
| | - Bufang Feng
- Tongzi Center for Disease Control and Prevention, Zunyi 563200, China; (L.Y.); (B.F.)
| | - Liping Rui
- Guizhou Center for Disease Control and Prevention, Guiyang 550004, China; (C.L.); (L.Z.); (L.R.)
| | - Bin Qu
- Zunyi Center for Disease Control and Prevention, Zunyi 564600, China; (Z.Y.); (Z.L.); (B.Q.)
| | - Ming Liu
- Guizhou Center for Disease Control and Prevention, Guiyang 550004, China; (C.L.); (L.Z.); (L.R.)
| | - Fuqiang Cui
- Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China;
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, Beijing 100191, China
- Center for Infectious Diseases and Policy Research & Global Health and Infectious Diseases Group, Peking University, Beijing 100191, China
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Chu K, Hu Y, Pan H, Wu J, Zhu D, Young MM, Luo L, Yi Z, Giardina PC, Gruber WC, Scott DA, Watson W. A randomized, open-label, phase 3 study evaluating safety and immunogenicity of 13-valent pneumococcal conjugate vaccine in Chinese infants and children under 6 years of age. Hum Vaccin Immunother 2023; 19:2235926. [PMID: 37549923 PMCID: PMC10408693 DOI: 10.1080/21645515.2023.2235926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/05/2023] [Accepted: 06/16/2023] [Indexed: 08/09/2023] Open
Abstract
Streptococcus pneumoniae causes a considerable disease burden among children in China. Many isolates exhibit antimicrobial resistance but are often serotypes covered by the 13-valent pneumococcal conjugate vaccine (PCV13). Because the approved infant immunization schedule in China allows PCV13 vaccination only for those 6 weeks to 15 months of age, this phase 3 study was conducted to evaluate PCV13 immunogenicity and safety in unvaccinated older infants and children. Eligible participants were stratified by age into four cohorts: Cohort 1 (n = 125), 6 weeks-2 months; Cohort 2 (n = 354), 7-<12 months; Cohort 3 (n = 250), 1 -<2 years; Cohort 4 (n = 207), 2-<6 years. Cohort 1 received PCV13 at ages 2, 4, and 6 months; older cohorts were randomized 2:1 to PCV13 or Haemophilus influenzae type b (Hib) vaccine using age-appropriate schedules. Within-group immune responses were assessed by immunoglobulin G (IgG) concentrations and opsonophagocytic activity (OPA) titers. Safety evaluations included solicited reactogenicity events and adverse events (AEs). IgG geometric mean concentrations and OPA geometric mean titers for all 13 PCV13 serotypes increased for all participants vaccinated with PCV13, but not those vaccinated with Hib. Immune responses in Cohorts 2-4 were generally comparable with those in Cohort 1 (the infant series) for most serotypes. PCV13 was well tolerated across cohorts, with reported AEs consistent with expectations in these age groups; no new safety signals were identified. These results suggest that PCV13 administered as a catch-up regimen to infants and children 7 months-<6 years of age in China will effectively reduce vaccine-type pneumococcal disease in this population. NCT03574389.
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Affiliation(s)
- Kai Chu
- Department of Vaccine Clinical Evaluation, Jiangsu Center for Disease Control and Prevention, Nanjing, JS, P. R. China
| | - Yuemei Hu
- Department of Vaccine Clinical Evaluation, Jiangsu Center for Disease Control and Prevention, Nanjing, JS, P. R. China
| | - Hongxing Pan
- Department of Vaccine Clinical Evaluation, Jiangsu Center for Disease Control and Prevention, Nanjing, JS, P. R. China
| | - Jingliang Wu
- Department of Infectious Disease, Huaiyin Center for Disease Control and Prevention, Huai’an, JS, P. R. China
| | - Dandan Zhu
- Department of Infectious Disease, Huaiyin Center for Disease Control and Prevention, Huai’an, JS, P. R. China
| | - Mariano M. Young
- Vaccine Research and Development, Pfizer Inc, Collegeville, PA, USA
| | - Li Luo
- Clinical Development, Pfizer Vaccine Research, Beijing, P. R. China
| | - Zhuobiao Yi
- Vaccine Research and Development, Pfizer Inc, Collegeville, PA, USA
| | | | | | - Daniel A. Scott
- Vaccine Research and Development, Pfizer Inc, Collegeville, PA, USA
| | - Wendy Watson
- Vaccine Research and Development, Pfizer Inc, Collegeville, PA, USA
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Adamu AL, Ojal J, Abubakar IA, Odeyemi KA, Bello MM, Okoromah CAN, Karia B, Karani A, Akech D, Inem V, Scott JAG, Adetifa IMO. The impact of introduction of the 10-valent pneumococcal conjugate vaccine on pneumococcal carriage in Nigeria. Nat Commun 2023; 14:2666. [PMID: 37160867 PMCID: PMC10169786 DOI: 10.1038/s41467-023-38277-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/24/2023] [Indexed: 05/11/2023] Open
Abstract
Pneumococcal conjugate vaccines (PCVs) protect against invasive pneumococcal disease (IPD) among vaccinees. However, at population level, this protection is driven by indirect effects. PCVs prevent nasopharyngeal acquisition of vaccine-serotype (VT) pneumococci, reducing onward transmission. Each disease episode is preceded by infection from a carrier, so vaccine impacts on carriage provide a minimum estimate of disease reduction in settings lacking expensive IPD surveillance. We documented carriage prevalence and vaccine coverage in two settings in Nigeria annually (2016-2020) following PCV10 introduction in 2016. Among 4,684 rural participants, VT carriage prevalence fell from 21 to 12% as childhood (<5 years) vaccine coverage rose from 7 to 84%. Among 2,135 urban participants, VT carriage prevalence fell from 16 to 9% as uptake rose from 15 to 94%. Within these ranges, carriage prevalence declined with uptake. Increasing PCV10 coverage reduced pneumococcal infection at all ages, implying at least a comparable reduction in IPD.
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Affiliation(s)
- Aishatu L Adamu
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
- Department of Infectious Diseases Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
- Department of Community Medicine, College of Health Sciences, Bayero University, Kano/Aminu Kano Teaching Hospital, Kano, Nigeria.
| | - J Ojal
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Infectious Diseases Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Isa A Abubakar
- Department of Community Medicine, College of Health Sciences, Bayero University, Kano/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Kofo A Odeyemi
- Department of Community Medicine and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Musa M Bello
- Department of Community Medicine, College of Health Sciences, Bayero University, Kano/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Christy A N Okoromah
- Department of Paediatrics and Child Health, College of Medicine, University of Lagos, Lagos, Nigeria
| | | | - Angela Karani
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Donald Akech
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Victor Inem
- Department of Community Medicine and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - J Anthony G Scott
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Infectious Diseases Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Ifedayo M O Adetifa
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Department of Infectious Diseases Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- Department of Paediatrics and Child Health, College of Medicine, University of Lagos, Lagos, Nigeria
- Nigeria Centre for Disease Control, Abuja, Nigeria
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Hlongwa L, Peter J, Mayne E. Value of diagnostic vaccination in diagnosis of humoral inborn errors of immunity. Hum Immunol 2023:S0198-8859(23)00066-6. [PMID: 37080873 DOI: 10.1016/j.humimm.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 04/11/2023] [Accepted: 04/11/2023] [Indexed: 04/22/2023]
Abstract
Inborn errors of immunity (IEIs) or primary immunodeficiency diseases, are disorders caused by genetic defects affecting immune function. Clinically, IEI presents mainly as recurrent or severe infections, immune dysregulation (autoimmunity or autoinflammatory disorders), and lymphoproliferation with or without dysmorphic features. Humoral IEIs are the largest subgroup of IEI, with a wide spectrum of quantitative and qualitative antibody defects. These disorders are normally diagnosed based on immunological evaluation; diagnostic vaccination is part of this evaluation. This review examines the importance and relevance of diagnostic vaccination in the diagnosis of humoral IEIs and different technologies which can be utilised in diagnosis.
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Affiliation(s)
- Luyanda Hlongwa
- Division of Immunology, Department of Pathology, Faculty of Health Science, University of Cape Town, South Africa
| | - Jonathan Peter
- Division of Allergology and Clinical Immunology, Groote Schuur Hospital, University of Cape Town, South Africa
| | - Elizabeth Mayne
- Division of Immunology, Department of Pathology, Faculty of Health Science, University of Cape Town, South Africa; Division of Immunology, National Health Laboratory Service, South Africa.
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Ono T, Watanabe M, Hashimoto K, Kume Y, Chishiki M, Okabe H, Sato M, Norito S, Chang B, Hosoya M. Serotypes and Antibiotic Resistance of Streptococcus pneumoniae before and after the Introduction of the 13-Valent Pneumococcal Conjugate Vaccine for Adults and Children in a Rural Area in Japan. Pathogens 2023; 12:pathogens12030493. [PMID: 36986414 PMCID: PMC10056172 DOI: 10.3390/pathogens12030493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
The increase in non-vaccine serotypes of Streptococcus pneumoniae and their multidrug resistance have become an issue following the introduction of the 13-valent pneumococcal conjugate vaccine (PCV13). In this study, we investigated the serotypes and drug resistance of S. pneumoniae detected in adult and pediatric outpatients at a hospital in a rural area of Japan between April 2012 and December 2016. Serotypes of the bacterium were identified using the capsular swelling test and multiplex polymerase chain reaction testing of DNA extracted from the specimens. Antimicrobial susceptibility was determined using the broth microdilution method. The serotype 15A was classified using multilocus sequence typing. The results showed that the prevalence of non-vaccine serotypes increased significantly in children from 50.0% in 2012-2013 to 74.1% in 2016 (p ≤ 0.006) and in adults from 15.8% in 2012-2013 to 61.5% in 2016 (p ≤ 0.026), but no increase in drug-resistant isolates was evident. However, an increase in the drug-resistant serotypes 15A and 35B was observed in children. Although isolates of these two serotypes showed cefotaxime susceptibility, cefotaxime resistance was confirmed for the serotype 15A isolates. Future trends in the spread of these isolates should be monitored with caution.
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Affiliation(s)
- Takashi Ono
- Department of Pediatrics, Minamiaizu Hospital, Minamiaizu 967-0006, Fukushima, Japan
- Department of Pediatrics, Fukushima Medical University, Fukushima 960-1295, Fukushima, Japan
| | - Masahiro Watanabe
- Department of Pediatrics, Fukushima Medical University, Fukushima 960-1295, Fukushima, Japan
| | - Koichi Hashimoto
- Department of Pediatrics, Fukushima Medical University, Fukushima 960-1295, Fukushima, Japan
| | - Yohei Kume
- Department of Pediatrics, Fukushima Medical University, Fukushima 960-1295, Fukushima, Japan
| | - Mina Chishiki
- Department of Pediatrics, Fukushima Medical University, Fukushima 960-1295, Fukushima, Japan
| | - Hisao Okabe
- Department of Pediatrics, Fukushima Medical University, Fukushima 960-1295, Fukushima, Japan
| | - Masatoki Sato
- Department of Pediatrics, Fukushima Medical University, Fukushima 960-1295, Fukushima, Japan
| | - Sakurako Norito
- Department of Pediatrics, Fukushima Medical University, Fukushima 960-1295, Fukushima, Japan
| | - Bin Chang
- Department of Bacteriology I, National Institute of Infectious Diseases, Shinjuku-ku 162-8640, Tokyo, Japan
| | - Mitsuaki Hosoya
- Department of Pediatrics, Fukushima Medical University, Fukushima 960-1295, Fukushima, Japan
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Mathematical modeling of pneumococcal transmission dynamics in response to PCV13 infant vaccination in Germany predicts increasing IPD burden due to serotypes included in next-generation PCVs. PLoS One 2023; 18:e0281261. [PMID: 36791091 PMCID: PMC9931105 DOI: 10.1371/journal.pone.0281261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 01/18/2023] [Indexed: 02/16/2023] Open
Abstract
INTRODUCTION Two next-generation pneumococcal conjugate vaccines (PCVs), a 15- and a 20-valent PCV (PCV15 and PCV20), have recently been licensed for use in adults, and PCV15 has also been licensed in children. We developed a dynamic transmission model specific for Germany, with the aim to predict carriage prevalence and invasive pneumococcal disease (IPD) burden for serotypes included in these vaccines. METHODS The model allows to follow serotype distributions longitudinally both in the absence and presence of PCV vaccinations. We considered eight age cohorts and seven serotype groups according to the composition of different pneumococcal vaccines. This comprises the additional serotypes contained in PCV15 and PCV20 but not in PCV13. RESULTS The model predicted that by continuing the current vaccine policy (standard vaccination with PCV13 in children and with PPSV23 in adults) until 2031, IPD case counts due to any serotype in children <2 years of age will remain unchanged. There will be a continuous decrease of IPD cases in adults aged 16-59y, but a 20% increase in adults ≥60y. Furthermore, there will be a steady decrease of the proportion of carriage and IPD due to serotypes included in PCV7 and PCV13 over the model horizon and a steady rise of non-PCV13 serotypes in carriage and IPD. The highest increase for both pneumococcal carriage and absolute IPD case counts was predicted for serotypes 22F and 33F (included in both PCV15 and PCV20) and serotypes 8, 10A, 11A, 12F, and 15B (included in PCV20 only), particularly in older adults. Between 2022 and 2031, serotypes included in PCV20 only are expected to cause 19.7-25.3% of IPD cases in adults ≥60y. CONCLUSIONS We conclude that introduction of next-generation PCVs for adults may prevent a substantial and increasing proportion of adult IPDs, with PCV20 having the potential to provide the broadest protection against pneumococcal disease.
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Nzoyikorera N, Diawara I, Katfy M, Katfy K, Maaloum F, Nyandwi J, Belabbes H, Elmdaghri N, Zerouali K. Serotype distribution and antimicrobial susceptibility of invasive Streptococcus pneumoniae isolates among adult and elderly population before and after introduction of pneumococcal conjugate vaccine in Casablanca, Morocco. BMC Infect Dis 2023; 23:24. [PMID: 36639755 PMCID: PMC9838000 DOI: 10.1186/s12879-023-07981-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/02/2023] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Streptococcus pneumoniae (S. pneumoniae), remains a major cause of mortality and morbidity worldwide. The objective of this study was to determine the trends of invasive pneumococcal diseases (IPD) in adult and elderly population in Casablanca (Morocco) before and after introduction of pneumococcal conjugate vaccine (PCV) by determining the distribution of pneumococcal serotypes and antibiotic resistance profile of isolated strains. METHOD The proposed study is a retrospective laboratory-based surveillance of IPD in hospitalized adult (15-59 years old) and elderly (≥ 60 years old) patients in Ibn Rochd University Hospital Centre from 2007 to 2019 (13 years). All the 250 non-duplicate clinical invasive isolates from adult and elderly patients, confirmed as S. pneumoniae according to the laboratory standard identification procedures, are included in this study. RESULTS A significant decrease of the overall incidence in IPD was observed only in adults from 0.71 to 0.54/100000 populations (P = 0.02) and to 0.47/100000 populations (P = 0.0137) in the early and mature post-vaccine period respectively compared to the pre-vaccine period. Our results also showed a significant reduction in the overall prevalence of vaccine serotypes from 28.17 to 6.90% (P = 0.0021) for the PCV-10 serotypes, and from 46.48 to 25.86% (P = 0.0164) for the PCV-13 serotypes only in the mature post-vaccine period (2015-2019). In parallel, the rate of non-vaccine serotypes did not significantly change in the early post-vaccine period (2011-2014) while it increased considerably from 54 to 74.14% (P = 0.0189) during the mature post-vaccine period. The rate of penicillin non-susceptible pneumococcal isolates decreased significantly from 23.94 to 8.77% (P = 0.02) in adult patients, and the rate of cotrimoxazole non-susceptible pneumococcal isolates significantly decreased from 29.58 to 8.77% in the early post-vaccine period (P = 0.003) and to 7.24% in the mature post-vaccine period (P = 0.0007). CONCLUSION Although childhood vaccination has considerably reduced the incidence of IPD in adult population through the herd effect, IPD remain a real public health problem due to the alarming increase in non-vaccine serotypes (NVS) and the lack of herd effect among elderly population. The rate of antibiotic resistance was relatively low. Nevertheless, resistance constitutes a serious problem to the therapeutic arsenal due to the known capacity for genetic dissemination in the pneumococcus.
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Affiliation(s)
- Néhémie Nzoyikorera
- grid.412148.a0000 0001 2180 2473Department of Microbiology, Faculty of Medicine and Pharmacy of Casablanca, Hassan II University of Casablanca, Casablanca, Morocco ,grid.501379.90000 0004 6022 6378Higher Institute of Biosciences and Biotechnology, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco ,grid.501379.90000 0004 6022 6378Laboratory of Microbial Biotechnology and Infectiology Research, Mohammed VI Center for Research & Innovation, Rabat, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco ,National Reference Laboratory, National Institute of Public Health, Bujumbura, Burundi
| | - Idrissa Diawara
- grid.501379.90000 0004 6022 6378Higher Institute of Biosciences and Biotechnology, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco ,grid.501379.90000 0004 6022 6378Laboratory of Microbial Biotechnology and Infectiology Research, Mohammed VI Center for Research & Innovation, Rabat, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Mostafa Katfy
- grid.412148.a0000 0001 2180 2473Department of Microbiology, Faculty of Medicine and Pharmacy of Casablanca, Hassan II University of Casablanca, Casablanca, Morocco ,grid.414346.00000 0004 0647 7037Bacteriology-Virology and Hospital Hygiene Laboratory, Ibn Rochd University Hospital Centre of Casablanca, Casablanca, Morocco
| | - Khalid Katfy
- grid.412148.a0000 0001 2180 2473Department of Microbiology, Faculty of Medicine and Pharmacy of Casablanca, Hassan II University of Casablanca, Casablanca, Morocco ,grid.414346.00000 0004 0647 7037Bacteriology-Virology and Hospital Hygiene Laboratory, Ibn Rochd University Hospital Centre of Casablanca, Casablanca, Morocco
| | - Fakhreddine Maaloum
- grid.412148.a0000 0001 2180 2473Department of Microbiology, Faculty of Medicine and Pharmacy of Casablanca, Hassan II University of Casablanca, Casablanca, Morocco
| | - Joseph Nyandwi
- grid.7749.d0000 0001 0723 7738Département de Médecine, Faculté de Médecine, Université du Burundi, Bujumbura, Burundi ,grid.490693.1Ministère de la Santé Publique et de la Lutte contre le Sida, Institut National de Santé Publique de Bujumbura, Bujumbura, Burundi
| | - Houria Belabbes
- grid.412148.a0000 0001 2180 2473Department of Microbiology, Faculty of Medicine and Pharmacy of Casablanca, Hassan II University of Casablanca, Casablanca, Morocco ,grid.414346.00000 0004 0647 7037Bacteriology-Virology and Hospital Hygiene Laboratory, Ibn Rochd University Hospital Centre of Casablanca, Casablanca, Morocco
| | - Naima Elmdaghri
- grid.412148.a0000 0001 2180 2473Department of Microbiology, Faculty of Medicine and Pharmacy of Casablanca, Hassan II University of Casablanca, Casablanca, Morocco ,grid.414346.00000 0004 0647 7037Bacteriology-Virology and Hospital Hygiene Laboratory, Ibn Rochd University Hospital Centre of Casablanca, Casablanca, Morocco
| | - Khalid Zerouali
- grid.412148.a0000 0001 2180 2473Department of Microbiology, Faculty of Medicine and Pharmacy of Casablanca, Hassan II University of Casablanca, Casablanca, Morocco ,grid.414346.00000 0004 0647 7037Bacteriology-Virology and Hospital Hygiene Laboratory, Ibn Rochd University Hospital Centre of Casablanca, Casablanca, Morocco
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Macaj M, Perdochova L, Jakubikova J. Streptococcus pneumoniae as cause of acute otitis media (AOM) in Slovak children in the pneumococcal conjugate vaccine era (2008-2019). Vaccine 2023; 41:452-459. [PMID: 36470684 DOI: 10.1016/j.vaccine.2022.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 11/07/2022] [Accepted: 11/10/2022] [Indexed: 12/05/2022]
Abstract
AIM Little data is available on pneumococcal serotypes and their antimicrobial resistance in the pneumococcal conjugate vaccination era in young children with acute otitis media (AOM). Here such data is provided from Slovakia, acountry with sequential introduction and parallel-use of the three commercially available pneumococcal conjugate vaccines (PCVs; PCV7; PCV13; PCV10). METHODS This observational study takes advantage of the fact that tympanocentesis is the standard of care in children with AOM in Slovakia. Over the 12 year observation period, participating pediatric ENT specialists sent samples taken during tympanocentesis from children with AOM to their local MEDIRIX laboratories for identification of bacteria. Pneumcoccal isolates were serotyped and tested for antimicrobial resistance. Incidence data could be calculated from 1 region. RESULTS Study participation and completeness of typing increased over time. Based on testing of 1,131 isolates over 12 years, PCV7-serotypes rapidly waned after PCV7 introduction in 2009 and had virtually disappeared in 2014. The maximum fraction of PCV10-only isolates (1, 5, 7F) was 2.7 % (2009) whereas the additional 3 PCV-serotypes (3, 6A, 19A) in PCV13 represented the largest proportion of pneumococcal AOM cases as of 2010. This finding remained unchanged during the period of highest PCV10-market share (2012-2017) and even until the end of the observation period (2019). The fraction of untypeable pneumococci (<6 %) and non-PCV13-serotypes (16-34 %) increased 2012-2017, but decreased again thereafter. Serotype 19A evolved as the most relevant (multidrug-) resistant pneumococcal serotype, again particularly during the time with high sales of PCV10 (2012-2017). Incidence data from the Bratislava region document a huge impact of PCV use (77 % vaccine uptake: mainly PCV13) on AOM in children < 6 years. Serotypes 19A and 3 remain the only relevant pneumococcal serotypes in young Slovakian children with AOM. CONCLUSIONS As AOM is one of the most common bacterial infections in children < 6 years, the observed benefits of PCVs in reducing vaccine serotypes have been tremendous. With sequential / parallel-use of PCVs, serotypes 3 and (MDR-) 19A today make the largest proportion (about 2/3) of pneumococcal AOM in Slovakia. This data will help to further guide the choice of pneumococcal conjugate vaccines for pediatricians and parents.
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Affiliation(s)
- Matus Macaj
- ENT Department of St. Michael's Hospital - Slovak Medical University in Bratislava, Slovakia.
| | - Lubica Perdochova
- Medirex Group, Microbiological Laboratories Inc, Department of Bacteriology, Bratislava, Slovakia
| | - Janka Jakubikova
- Children's Hospital of Comenius University, Pediatric ENT, Bratislava, Slovakia(1)
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11
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Ekinci E, Van Heirstraeten L, Willen L, Desmet S, Wouters I, Vermeulen H, Lammens C, Goossens H, Van Damme P, Verhaegen J, Beutels P, Theeten H, Malhotra-Kumar S. Serotype 19A and 6C Account for One-Third of Pneumococcal Carriage Among Belgian Day-Care Children Four Years After a Shift to a Lower-Valent PCV. J Pediatric Infect Dis Soc 2022; 12:36-42. [PMID: 36377804 PMCID: PMC9909365 DOI: 10.1093/jpids/piac117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 11/14/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Pneumococcal conjugate vaccines (PCVs) effectively reduce infection and asymptomatic carriage of Streptococcus pneumoniae vaccine serotypes. In 2016, Belgium replaced its infant PCV13 program by a 4-year period of PCV10. Concomitantly, S. pneumoniae serotype carriage was monitored together with the carriage of other nasopharyngeal pathogens in children attending day-care centers. METHODS From 2016 to 2019, a total of 3459 nasopharyngeal swabs were obtained from children aged 6-30 months. Culture and qPCR were used for the identification of S. pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus and for serotyping and antimicrobial susceptibility assessment of S. pneumoniae strains. RESULTS S. pneumoniae colonization was frequent and stable over the study years. H. influenzae and M. catarrhalis were more frequently carried (P < .001) than S. pneumoniae, by, respectively, 92.3% and 91.0% of children. Prevalence of all PCV13 serotypes together increased significantly over time from 5.8% to 19.6% (P < .001) and was attributable to the increasing prevalence of serotype 19A. Coincidently, non-vaccine serotype 6C increased (P < .001) and the overall pneumococcal non-susceptibility to tetracycline and erythromycin. Non-susceptibility to cotrimoxazole decreased (P < .001). CONCLUSIONS The switch to a PCV program no longer covering serotypes 19A, 6A, and 3 was associated with a sustained increase of serotypes 19A and 6C in healthy children, similarly as in invasive pneumococcal disease. This resulted in a re-introduction of the 13-valent conjugate vaccine during the summer of 2019.
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Affiliation(s)
- Esra Ekinci
- Corresponding Author: Esra Ekinci, Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610 Wilrijk, Belgium. E-mail:
| | | | - Laura Willen
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Antwerp, Belgium
| | - Stefanie Desmet
- Reference Centre for Pneumococci, University Hospitals Leuven, Leuven, Belgium
| | - Ine Wouters
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Antwerp, Belgium
| | | | - Christine Lammens
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Antwerp, Belgium
| | - Herman Goossens
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Antwerp, Belgium
| | - Pierre Van Damme
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Antwerp, Belgium
| | - Jan Verhaegen
- Reference Centre for Pneumococci, University Hospitals Leuven, Leuven, Belgium
| | - Philippe Beutels
- Centre for Health Economics Research and Modelling Infectious Diseases, University of Antwerp, Wilrijk, Antwerp, Belgium
| | - Heidi Theeten
- Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Antwerp, Belgium
| | - Surbhi Malhotra-Kumar
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Wilrijk, Antwerp, Belgium
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Raya Tonetti F, Clua P, Fukuyama K, Marcial G, Sacur J, Marranzino G, Tomokiyo M, Vizoso-Pinto G, Garcia-Cancino A, Kurata S, Kitazawa H, Villena J. The Ability of Postimmunobiotics from L. rhamnosus CRL1505 to Protect against Respiratory Syncytial Virus and Pneumococcal Super-Infection Is a Strain-Dependent Characteristic. Microorganisms 2022; 10:2185. [PMID: 36363777 PMCID: PMC9694915 DOI: 10.3390/microorganisms10112185] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/26/2022] [Accepted: 11/02/2022] [Indexed: 11/15/2023] Open
Abstract
Previously, we demonstrated that the non-viable strain Lacticaseibacillus rhamnosus CRL1505 (NV1505) or its purified peptidoglycan (PG1505) differentially modulated the respiratory innate antiviral immune response triggered by Toll-like receptor (TLR)-3 activation in infant mice, improving the resistance to primary respiratory syncytial virus (RSV) infection and secondary pneumococcal pneumonia. In this work, we evaluated the effect of other non-viable L. rhamnosus strains and their peptidoglycans on the respiratory immune response and their impact on primary and secondary respiratory infections. In addition, the duration of the protective effect induced by NV1505 and PG1505 as well as their ability to protect against different Streptococcus pneumoniae serotypes were evaluated. Our results showed that among the five selected L. rhamnosus strains (CRL1505, CRL498, CRL576, UCO25A and IBL027), NV1505 and NVIBL027 improved the protection against viral and pneumococcal infections by modulating the respiratory immune response. Of note, only the PG1505 presented immunomodulatory activities when compared with the other purified peptidoglycans. Studies on alveolar macrophages showed that NV1505 and PG1505 differentially modulated the expression of IL-6, IFN-γ, IFN-β, TNF-α, OAS1, RNAseL and IL-27 genes in response to RSV infection, and IL-6, IFN-γ, IL-1β, TNF-α, CCL2, CXCL2, CXCL10 and IL-27 in response to pneumococcal challenge. Furthermore, we demonstrated that NV1505 and PG1505 treatments protected mice against secondary pneumococcal pneumonia produced by different serotypes of S. pneumoniae until 30 days after stimulation with poly(I:C). This work advances the characterization of the protective effect of NV1505 and PG1505 by demonstrating that they increase resistance against the pneumococcal serotypes 3, 6B, 14 and 19F, with an effect that lasts up to 30 days after the primary viral inflammation. The results also confirm that the immunomodulatory properties of NV1505 and PG1505 are unique and are not shared by other members of this species, and suggest the existence of a capacity to stimulate trained immunity in alveolar macrophages.
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Affiliation(s)
- Fernanda Raya Tonetti
- Laboratory of Immunobiotechnology, Reference Centre for Lactobacilli (CERELA-CONICET), San Miguel de Tucuman 4000, Argentina
| | - Patricia Clua
- Laboratory of Immunobiotechnology, Reference Centre for Lactobacilli (CERELA-CONICET), San Miguel de Tucuman 4000, Argentina
| | - Kohtaro Fukuyama
- Laboratory of Animal Food Function, Food and Feed Immunology Group, Graduate School of Agricultural Science, Tohoku University, Sendai 981-8555, Japan
- Livestock Immunology Unit, International Education and Research Center for Food and Agricultural Immunology (CFAI), Graduate School of Agricultural Science, Tohoku University, Sendai 981-8555, Japan
| | - Guillermo Marcial
- Laboratory of Immunobiotechnology, Reference Centre for Lactobacilli (CERELA-CONICET), San Miguel de Tucuman 4000, Argentina
| | - Jacinto Sacur
- Infection Biology Laboratory, Instituto Superior de Investigaciones Biológicas (INSIBIO), CONICET-UNT, San Miguel de Tucuman 4000, Argentina
| | - Gabriela Marranzino
- Facultad de Ciencias de la Salud, Universidad del Norte Santo Tomás de Aquino (UNSTA), San Miguel de Tucuman 4000, Argentina
| | - Mikado Tomokiyo
- Laboratory of Animal Food Function, Food and Feed Immunology Group, Graduate School of Agricultural Science, Tohoku University, Sendai 981-8555, Japan
- Livestock Immunology Unit, International Education and Research Center for Food and Agricultural Immunology (CFAI), Graduate School of Agricultural Science, Tohoku University, Sendai 981-8555, Japan
| | - Guadalupe Vizoso-Pinto
- Infection Biology Laboratory, Instituto Superior de Investigaciones Biológicas (INSIBIO), CONICET-UNT, San Miguel de Tucuman 4000, Argentina
| | - Apolinaria Garcia-Cancino
- Laboratory of Bacterial Pathogenicity, Faculty of Biological Sciences, University of Concepcion, Concepcion 4030000, Chile
| | - Shoichiro Kurata
- Laboratory of Molecular Genetics, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai 980-8578, Japan
| | - Haruki Kitazawa
- Laboratory of Animal Food Function, Food and Feed Immunology Group, Graduate School of Agricultural Science, Tohoku University, Sendai 981-8555, Japan
- Livestock Immunology Unit, International Education and Research Center for Food and Agricultural Immunology (CFAI), Graduate School of Agricultural Science, Tohoku University, Sendai 981-8555, Japan
| | - Julio Villena
- Laboratory of Immunobiotechnology, Reference Centre for Lactobacilli (CERELA-CONICET), San Miguel de Tucuman 4000, Argentina
- Laboratory of Animal Food Function, Food and Feed Immunology Group, Graduate School of Agricultural Science, Tohoku University, Sendai 981-8555, Japan
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Lemay JA, Ricketson LJ, Kellner JD. Trends in Asymptomatic Nasopharyngeal Streptococcus pneumoniae Carriage with qPCR and Culture Analysis. Microorganisms 2022; 10:microorganisms10102074. [PMID: 36296350 PMCID: PMC9607440 DOI: 10.3390/microorganisms10102074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/15/2022] [Accepted: 10/19/2022] [Indexed: 11/26/2022] Open
Abstract
We previously reported trends in pneumococcal nasopharyngeal carriage in the post-PCV13 era as detected by conventional culture methods. Our current aim is to assess if there are fundamental differences in the clinical and demographic features of children who have pneumococcal carriage detected by qPCR compared with culture analysis. The CASPER team conducted point-prevalence surveys in 2016 in healthy children in Calgary to determine trends in overall and serotype-specific pneumococcal nasopharyngeal carriage. Being 18 months of age (p = 0.009), having at least one sibling under 2 years of age (p = 0.04), having only sibling(s) over 2 years of age (p = 0.001), and childcare attendance (p = 0.005) were associated with carriage by qPCR methods only. Having only sibling(s) older than 2 years of age was associated with carriage detected by both qPCR and culture methods (p = 0.001). No clinical factors were associated with carriage detected by both qPCR and culture compared to qPCR methods only. Both analyses are suitable methods to detect carriage; however, qPCR analysis is more sensitive and more cost-effective. As there are no fundamental differences in the children that have pneumococcal nasopharyngeal carriage detectable by qPCR methods compared to conventional culture methods, molecular analysis may be a preferable option for future carriage studies.
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Affiliation(s)
- Julie-Anne Lemay
- Department of Pediatrics, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Leah J. Ricketson
- Department of Pediatrics, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - James D. Kellner
- Department of Pediatrics, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Community Health Sciences and Department of Microbiology, Immunology & Infectious Diseases, University of Calgary, Calgary, AB T2N 1N4, Canada
- Alberta Children’s Hospital Research Institute, Calgary, AB T3B 6A8, Canada
- Correspondence:
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14
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A Response to: Letter to the Editor Regarding "Cost-Effectiveness of the 13-Valent Pneumococcal Conjugate Vaccine (PCV13) Versus Lower-Valent Alternatives in Filipino Infants". Infect Dis Ther 2022; 11:1301-1303. [PMID: 35474191 PMCID: PMC9124259 DOI: 10.1007/s40121-022-00639-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 04/11/2022] [Indexed: 11/27/2022] Open
Abstract
This communication seeks to address the questions of Dhere and colleagues in their letter on our study “Cost-effectiveness of the 13-valent pneumococcal conjugate vaccine (PCV13) versus lower-valent alternatives in Filipino infants.” We hope to provide clarity on each of the three potential misunderstandings of our cost-effectiveness analysis that were raised by Dhere and colleagues.
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15
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Induction of Susceptibility to Disseminated Infection with IgA1 Protease-Producing Encapsulated Pathogens Streptococcus pneumoniae, Haemophilus influenzae Type b, and Neisseria meningitidis. mBio 2022; 13:e0055022. [PMID: 35420467 PMCID: PMC9239265 DOI: 10.1128/mbio.00550-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae are the principal causes of bacterial meningitis. It is unexplained why only occasional individuals develop invasive infection, while the vast majority remain healthy and develop immunity when encountering these pathogens. A capsular polysaccharide and an IgA1 protease are common to these pathogens. We tested the hypothesis that patients are primed to susceptibility to invasive infection by other bacteria that express the same capsular polysaccharide but no IgA1 protease. Thereby, the subsequently colonizing pathogen may protect its surface with IgA1 protease-generated Fab fragments of IgA1 devoid of Fc-mediated effector functions. Military recruits who remained healthy when acquiring meningococci showed a significant response of inhibitory antibodies against the IgA1 protease of the colonizing clone concurrent with serum antibodies against its capsular polysaccharide. At hospitalization, 70.8% of meningitis patients carried fecal bacteria cross-reactive with the capsule of the actual pathogen, in contrast to 6% of controls (P < 0.0001). These were Escherichia coli K100, K1, and K92 in patients with infection caused by H. influenzae type b and N. meningitidis groups B and C, respectively. This concurred with a significant IgA1 response to the capsule but not to the IgA1 protease of the pathogen. The demonstrated multitude of relationships between capsular types and distinct IgA1 proteases in pneumococci suggests an alternative route of immunological priming associated with recombining bacteria. The findings support the model and offer an explanation for the rare occurrence of invasive diseases in spite of the comprehensive occurrence of the pathogens.
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16
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Regalado L D, Rivera-Olivero IA, Garcia-Bereguiain MA, Tana L, Hernandez I, Zurita J, Vidal JE, Terán E, de Waard JH. Pneumococcal Carriage Among Indigenous Kichwa Children From the Ecuadorian Andes After the 10-Valent Pneumococcal Vaccine Introduction. Pediatr Infect Dis J 2021; 40:e427-e433. [PMID: 34609109 DOI: 10.1097/inf.0000000000003291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND We assessed nasopharyngeal pneumococcal carriage in Andean Kichwa children, the largest Amerindian indigenous population in the Ecuadorian Andes. All children in our study had been vaccinated with the 10-valent pneumococcal vaccine (PCV10). METHODS Nasopharyngeal swabs from 63 families, 100 children <10 years old including 38 children under 5 years and 63 adult caregivers, from 5 different communities, were cultivated for Streptococcus pneumoniae and isolates were serotyped and antibiotic susceptibility testing was performed. RESULTS Respectively, 67% of the 38 children under 5 years old, 49% of the 62 children between 6 and 10 years old and 16% of the 100 adults were colonized with S. pneumoniae. Of these, 30.9% carried a vaccine serotype, 5.4% a serotype shared by the PCV10/13-valent pneumococcal vaccine (PCV13) vaccine and 25.5% a PCV13 serotype or PCV13 vaccine-related serotype, with 19A (10.9%) and 6C (10.9%) as the most prominent. Drug susceptibility testing revealed that 46% of the S. pneumoniae strains were susceptible to 6 tested antibiotics. However, 20.3% of the strains were multidrug-resistant or extensively drug-resistant strains, including 82% of the vaccine (-related) serotype 19A and 6C strains. CONCLUSIONS Kichwa children, vaccinated with PCV10, were highly colonized with pneumococci and should be considered a high-risk group for pneumococcal disease. Twenty-five percent of the colonizing S. pneumoniae strains were PCV13-only vaccine-targeted serotypes, and in addition to that, most were multidrug-resistant or extensively drug-resistant strains. The vaccine benefits for this population possibly will significantly increase with the introduction of PCV13.
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Affiliation(s)
- Daniela Regalado L
- From the Colegio de Ciencias de la Salud, COCSA, Universidad San Francisco de Quito
- Instituto de Microbiología, Universidad San Francisco de Quito
| | - Ismar A Rivera-Olivero
- From the Colegio de Ciencias de la Salud, COCSA, Universidad San Francisco de Quito
- One Health Research Group, Universidad de las Américas
| | | | - Leandro Tana
- From the Colegio de Ciencias de la Salud, COCSA, Universidad San Francisco de Quito
- Instituto de Microbiología, Universidad San Francisco de Quito
| | - Isabel Hernandez
- From the Colegio de Ciencias de la Salud, COCSA, Universidad San Francisco de Quito
- Facultad de Enfermería, Pontificia Universidad Católica del Ecuador
| | - Jeannete Zurita
- Unidad de investigación en Biomedicina, Zurita & Zurita Laboratorios, Quito, Ecuador
| | - Jorge E Vidal
- Department of Microbiology and Immunology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Enrique Terán
- From the Colegio de Ciencias de la Salud, COCSA, Universidad San Francisco de Quito
- Instituto de Microbiología, Universidad San Francisco de Quito
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Horn EK, Wasserman MD, Hall-Murray C, Sings HL, Chapman R, Farkouh RA. Public health impact of pneumococcal conjugate vaccination: a review of measurement challenges. Expert Rev Vaccines 2021; 20:1291-1309. [PMID: 34424123 DOI: 10.1080/14760584.2021.1971521] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Modeling analyses have attempted to quantify the global impact of pneumococcal conjugate vaccines (PCVs) on pneumococcal disease (PD), however these pediatric models face several challenges in obtaining comprehensive impact measurements. AREAS COVERED We present several measurement challenges and discuss examples from recently published pediatric modeling evaluations. Challenges include estimating the number of infants fully or partially vaccinated with PCVs, inclusion of indirect effects of vaccination, accounting for various dosing schedules, capturing effect of PCVs on nonspecific, noninvasive PD, and inclusion of adult PCV use. EXPERT OPINION The true impact of PCVs has been consistently underestimated in published analyses due to multiple measurement challenges. Nearly 100 million adults are estimated to have received PCV13 over the last decade globally, potentially preventing up to 662 thousand cases of PD. Approximately 4.1 million cases of invasive PD alone may have been averted through indirect protection. Estimates of PCV impact on noninvasive PD remain a challenge due to altered epidemiology. Program switches, incomplete vaccination, and private market uptake among children also confound PD impact estimates. Taken together, the number of averted PD cases from PCV use in the last ten years may be up to three times higher than estimated in previous studies.
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Affiliation(s)
- Emily K Horn
- Health Economics and Outcomes Research, Pfizer Inc, New York, NY, USA
| | - Matt D Wasserman
- Health Economics and Outcomes Research, Pfizer Inc, New York, NY, USA
| | - Cassandra Hall-Murray
- Vaccines Medical Development and Scientific and Clinical Affairs Pfizer, Inc, Collegeville, PA, USA
| | - Heather L Sings
- Vaccines Medical Development and Scientific and Clinical Affairs Pfizer, Inc, Collegeville, PA, USA
| | | | - Raymond A Farkouh
- Health Economics and Outcomes Research, Pfizer Inc, New York, NY, USA
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Félix S, Handem S, Nunes S, Paulo AC, Candeias C, Valente C, Simões AS, Almeida ST, Tavares DA, Brito-Avô A, de Lencastre H, Sá-Leão R. Impact of private use of the 13-valent pneumococcal conjugate vaccine (PCV13) on pneumococcal carriage among Portuguese children living in urban and rural regions. Vaccine 2021; 39:4524-4533. [PMID: 34183206 DOI: 10.1016/j.vaccine.2021.06.035] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 05/27/2021] [Accepted: 06/14/2021] [Indexed: 10/21/2022]
Abstract
In Portugal, the 13-valent pneumococcal conjugate vaccine (PCV13) was commercially available between 2010 and 2015, following a decade of private use of PCV7. We evaluated changes on serotype distribution and antimicrobial susceptibility of pneumococci carried by children living in two regions of Portugal (one urban and one rural). Three epidemiological periods were defined: pre-PCV13 (2009-2010), early-PCV13 (2011-2012), and late-PCV13 (2015-2016). Nasopharyngeal samples (n = 4,232) were obtained from children 0-6 years old attending day-care centers. Private use of PCVs was very high in both regions (>75%). Pneumococcal carriage remained stable and high over time (62.1%, 62.4% and 61.6% (p = 0.909) in the urban region; and 59.8%, 62.8%, 59.5% (p = 0.543) in the rural region). Carriage of PCV7 serotypes remained low (5.3%, 7.8% and 4.3% in the urban region; and 2.5%, 3.7% and 4.8% in the rural region). Carriage of PCV13 serotypes not targeted by PCV7 decreased in both the urban (16.4%, 7.3%, and 1.6%; p < 0.001) and rural regions (13.2%, 7.8%, and 1.9%; p < 0.001). This decline was mostly attributable to serotype 19A (14.1%, 4.4% and 1.3% in the urban region; and 11.1%, 3.6% and 0.8% in the rural region, both p < 0.001). Serotype 3 declined over time in the urban region (10.1%, 4.4%, 0.8%; p < 0.001) and had no obvious trend in the rural region (4.2%, 6.7%, 2.4%; p = 0.505). Serotype 6C decreased in both regions while serotypes 11D, 15A/B/C, 16F, 21, 22F, 23A/B, 24F, 35F, and NT were the most prevalent in the late-PCV13 period. Intermediate resistance to penicillin and non-susceptibility to erythromycin decreased significantly in both regions (19.5%, 13.3%, and 9.3%; and 25.4%, 25.9%, and 13.4%; both p < 0.001, respectively in the urban region; and 12.4%, 11.1%, and 2.8% (p < 0.001); and 15.3%, 14.7%, and 9.2% (p = 0.037), respectively, in the rural region). In conclusion, private use of PCV13 led to significant changes on the pneumococcal population carried by children in Portugal.
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Affiliation(s)
- Sofia Félix
- Laboratory of Molecular Microbiology of Human Pathogens, Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa (ITQB NOVA), Oeiras, Portugal
| | - Sara Handem
- Laboratory of Molecular Microbiology of Human Pathogens, Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa (ITQB NOVA), Oeiras, Portugal
| | - Sónia Nunes
- Laboratory of Molecular Microbiology of Human Pathogens, Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa (ITQB NOVA), Oeiras, Portugal
| | - Ana Cristina Paulo
- Laboratory of Molecular Microbiology of Human Pathogens, Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa (ITQB NOVA), Oeiras, Portugal
| | - Catarina Candeias
- Laboratory of Molecular Microbiology of Human Pathogens, Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa (ITQB NOVA), Oeiras, Portugal
| | - Carina Valente
- Laboratory of Molecular Microbiology of Human Pathogens, Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa (ITQB NOVA), Oeiras, Portugal
| | - Alexandra S Simões
- Laboratory of Molecular Microbiology of Human Pathogens, Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa (ITQB NOVA), Oeiras, Portugal
| | - Sónia T Almeida
- Laboratory of Molecular Microbiology of Human Pathogens, Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa (ITQB NOVA), Oeiras, Portugal
| | - Débora A Tavares
- Laboratory of Molecular Microbiology of Human Pathogens, Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa (ITQB NOVA), Oeiras, Portugal
| | | | - Hermínia de Lencastre
- Laboratory of Molecular Genetics, ITQB NOVA, Oeiras, Portugal; Laboratory of Microbiology and Infectious Diseases, The Rockefeller University, NY, USA
| | - Raquel Sá-Leão
- Laboratory of Molecular Microbiology of Human Pathogens, Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa (ITQB NOVA), Oeiras, Portugal.
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Garcia Quesada M, Yang Y, Bennett JC, Hayford K, Zeger SL, Feikin DR, Peterson ME, Cohen AL, Almeida SCG, Ampofo K, Ang M, Bar-Zeev N, Bruce MG, Camilli R, Chanto Chacón G, Ciruela P, Cohen C, Corcoran M, Dagan R, De Wals P, Desmet S, Diawara I, Gierke R, Guevara M, Hammitt LL, Hilty M, Ho PL, Jayasinghe S, Kleynhans J, Kristinsson KG, Ladhani SN, McGeer A, Mwenda JM, Nuorti JP, Oishi K, Ricketson LJ, Sanz JC, Savrasova L, Setchanova LP, Smith A, Valentiner-Branth P, Valenzuela MT, van der Linden M, van Sorge NM, Varon E, Winje BA, Yildirim I, Zintgraff J, Knoll MD. Serotype Distribution of Remaining Pneumococcal Meningitis in the Mature PCV10/13 Period: Findings from the PSERENADE Project. Microorganisms 2021; 9:microorganisms9040738. [PMID: 33916227 PMCID: PMC8066874 DOI: 10.3390/microorganisms9040738] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/26/2021] [Accepted: 03/28/2021] [Indexed: 11/16/2022] Open
Abstract
Pneumococcal conjugate vaccine (PCV) introduction has reduced pneumococcal meningitis incidence. The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project described the serotype distribution of remaining pneumococcal meningitis in countries using PCV10/13 for least 5-7 years with primary series uptake above 70%. The distribution was estimated using a multinomial Dirichlet regression model, stratified by PCV product and age. In PCV10-using sites (N = 8; cases = 1141), PCV10 types caused 5% of cases <5 years of age and 15% among ≥5 years; the top serotypes were 19A, 6C, and 3, together causing 42% of cases <5 years and 37% ≥5 years. In PCV13-using sites (N = 32; cases = 4503), PCV13 types caused 14% in <5 and 26% in ≥5 years; 4% and 13%, respectively, were serotype 3. Among the top serotypes are five (15BC, 8, 12F, 10A, and 22F) included in higher-valency PCVs under evaluation. Other top serotypes (24F, 23B, and 23A) are not in any known investigational product. In countries with mature vaccination programs, the proportion of pneumococcal meningitis caused by vaccine-in-use serotypes is lower (≤26% across all ages) than pre-PCV (≥70% in children). Higher-valency PCVs under evaluation target over half of remaining pneumococcal meningitis cases, but questions remain regarding generalizability to the African meningitis belt where additional data are needed.
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Affiliation(s)
| | - Yangyupei Yang
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Julia C Bennett
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Kyla Hayford
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Scott L Zeger
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | | | - Meagan E Peterson
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Adam L Cohen
- World Health Organization, 1202 Geneva, Switzerland
| | - Samanta C G Almeida
- Center of Bacteriology, National Laboratory for Meningitis and Pneumococcal Infections, Institute Adolfo Lutz (IAL), São Paulo 01246-902, Brazil
| | - Krow Ampofo
- Department of Pediatrics, Division of Pediatric Infectious Diseases, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA
| | - Michelle Ang
- National Centre for Infectious Diseases, National Public Health Laboratory, Singapore 308442, Singapore
| | - Naor Bar-Zeev
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, P.O. Box 30096, Chichiri, Blantyre 3, Malawi
| | - Michael G Bruce
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Arctic Investigations Program, Division of Preparedness and Emerging Infections, Anchorage, AK 99508, USA
| | - Romina Camilli
- Department of Infectious Diseases, Italian National Institute of Health (Istituto Superiore di Sanità, ISS), 00161 Rome, Italy
| | - Grettel Chanto Chacón
- Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud, Tres Ríos, 30301 Cartago, Costa Rica
| | - Pilar Ciruela
- CIBER Epidemiología y Salud Pública, (CIBERESP), 28029 Madrid, Spain
- Surveillance and Public Health Emergency Response, Public Health Agency of Catalonia, 08005 Barcelona, Spain
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, 2192 Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 2000 Johannesburg, South Africa
| | - Mary Corcoran
- Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland at Temple Street, Temple Street, D01 YC76 Dublin 1, Ireland
| | - Ron Dagan
- Distinguished Professor of Pediatrics and Infectious Diseases, The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Philippe De Wals
- Department of Social and Preventive Medicine, Laval University, Québec, QC G1V 0A6, Canada
| | - Stefanie Desmet
- Department of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, Belgium
- National Reference Centre for Streptococcus Pneumoniae, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Idrissa Diawara
- Faculty of Sciences and Health Techniques, Mohammed VI University of Health Sciences (UM6SS) of Casablanca, 20250 Casablanca, Morocco
- National Reference Laboratory, Mohammed VI University of Health Sciences (UM6SS), 82403 Casablanca, Morocco
| | - Ryan Gierke
- National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Marcela Guevara
- CIBER Epidemiología y Salud Pública, (CIBERESP), 28029 Madrid, Spain
- Instituto de Salud Pública de Navarra-IdiSNA, 31003 Pamplona, Spain
| | - Laura L Hammitt
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Markus Hilty
- Swiss National Reference Centre for Invasive Pneumococci, Institute for Infectious Diseases, University of Bern, 3012 Bern, Switzerland
| | - Pak-Leung Ho
- Department of Microbiology and Carol Yu Centre for Infection, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Sanjay Jayasinghe
- National Centre for Immunisation Research and Surveillance and Discipline of Child and Adolescent Health, Faculty of Medicine and Health, Children's Hospital Westmead Clinical School, University of Sydney, Westmead, NSW 2145, Australia
| | - Jackie Kleynhans
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, 2192 Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 2000 Johannesburg, South Africa
| | - Karl G Kristinsson
- Department of Clinical Microbiology, Landspitali-The National University Hospital, Hringbraut, 101 Reykjavik, Iceland
| | - Shamez N Ladhani
- Immunisation and Countermeasures Division, Public Health England, London NW9 5EQ, UK
| | - Allison McGeer
- Toronto Invasive Bacterial Diseases Network, and Department of Laboratory, Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Jason M Mwenda
- World Health Organization Regional Office for Africa, P.O. Box 06, Brazzaville, Congo
| | - J Pekka Nuorti
- Department of Health Security, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, 33100 Tampere, Finland
| | - Kazunori Oishi
- Toyama Institute of Health, Imizu, Toyama 939-0363, Japan
| | - Leah J Ricketson
- Department of Pediatrics, University of Calgary, Calgary, AB T3B 6A8, Canada
| | - Juan Carlos Sanz
- Laboratorio Regional de Salud Pública, Dirección General de Salud Pública, Comunidad de Madrid, 28053 Madrid, Spain
| | - Larisa Savrasova
- Centre for Disease Prevention and Control of Latvia, 1005 Riga, Latvia
- Doctoral Studies Department, Riga Stradinš University, 1007 Riga, Latvia
| | - Lena Petrova Setchanova
- Department of Medical Microbiology, Faculty of Medicine, Medical University of Sofia, 1431 Sofia, Bulgaria
| | - Andrew Smith
- Bacterial Respiratory Infection Service, Scottish Microbiology Reference Laboratory, NHS GG&C, Glasgow G4 0SF, UK
- College of Medical, Veterinary & Life Sciences, Glasgow Dental Hospital & School, University of Glasgow, Glasgow G2 3JZ, UK
| | - Palle Valentiner-Branth
- Infectious Disease Epidemiology and Prevention, Statens Serum Institut, DK-2300 Copenhagen S, Denmark
| | - Maria Teresa Valenzuela
- Department of Public Health and Epidemiology, Faculty of Medicine, Universidad de Los Andes, 12455 Santiago, Chile
| | - Mark van der Linden
- National Reference Center for Streptococci, Department of Medical Microbiology, University Hospital RWTH Aachen, 52074 Aachen, Germany
| | - Nina M van Sorge
- Medical Microbiology and Infection Prevention, Netherlands Reference Laboratory for Bacterial Meningitis, Amsterdam University Medical Centers, Location AMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Emmanuelle Varon
- National Reference Centre for Pneumococci, Centre Hospitalier Intercommunal de Créteil, 94000 Créteil, France
| | - Brita A Winje
- Department of Infection Control and Vaccine, Norwegian Institute of Public Health, 0456 Oslo, Norway
| | - Inci Yildirim
- Department of Pediatrics, Yale New Haven Children's Hospital, New Haven, CT 06504, USA
| | - Jonathan Zintgraff
- Servicio de Bacteriología Clínica, Departamento de Bacteriología, INEI-ANLIS "Dr. Carlos G. Malbrán", C1282 AFF Buenos Aires, Argentina
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20
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Ladhani SN, Andrews N, Ramsay ME. Summary of evidence to reduce the two-dose infant priming schedule to a single dose of the 13-valent pneumococcal conjugate vaccine in the national immunisation programme in the UK. THE LANCET. INFECTIOUS DISEASES 2020; 21:e93-e102. [PMID: 33129426 DOI: 10.1016/s1473-3099(20)30492-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 04/23/2020] [Accepted: 04/30/2020] [Indexed: 11/28/2022]
Abstract
Pneumococcal conjugate vaccines (PCVs) are highly effective in preventing invasive and non-invasive pneumococcal infections in all age groups through a combination of direct and indirect protection. In many industrialised countries with established PCV programmes, the maximum benefit of the PCV programme has already been achieved, with most cases now due to non-PCV serotypes. On Jan 1, 2020, the UK changed its childhood pneumococcal immunisation programme from a two-dose infant priming schedule with the 13-valent PCV at 8 and 16 weeks after birth, to a single priming dose at 12 weeks after birth, while retaining the 12-month booster. This decision was made after reviewing the evidence from surveillance data, clinical trials, epidemiological analyses, vaccine effectiveness estimates, and modelling studies to support the reduced schedule. In this Review, we summarise the epidemiology of pneumococcal disease in the UK, the evidence supporting the decision to implement a reduced schedule, and the national and global implications of the proposed schedule.
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Affiliation(s)
- Shamez N Ladhani
- Immunisation and Countermeasures Division, Public Health England, Colindale, London, UK; Paediatric Infectious Diseases Research Group, St George's University of London, Cranmer Terrace, London, UK.
| | - Nick Andrews
- Statistics, Modelling, and Economics Department, Public Health England, Colindale, London, UK
| | - Mary E Ramsay
- Immunisation and Countermeasures Division, Public Health England, Colindale, London, UK
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21
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Khodaei F, Ahsan A, Chamanifard M, Zamiri MJ, Ommati MM. Updated information on new coronavirus disease 2019 occurrence, drugs, and prediction of a potential receptor. J Biochem Mol Toxicol 2020; 34:e22594. [PMID: 32770858 PMCID: PMC7435514 DOI: 10.1002/jbt.22594] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/23/2020] [Accepted: 07/23/2020] [Indexed: 01/03/2023]
Abstract
The new coronavirus (COVID‐19) was first reported in Wuhan in China, on 31 December 2019. COVID‐19 is a new virus from the family of coronaviruses that can cause symptoms ranging from a simple cold to pneumonia. The virus is thought to bind to the angiotensin‐converting enzyme 2, as a well‐known mechanism to enter the cell. It then transfers its DNA to the host in which the virus replicates the DNA. The viral infection leads to severe lack of oxygen, lung oxidative stress because of reactive oxygen species generation, and overactivation of the immune system by activating immune mediators. The purpose of this review is to elaborate on the more precise mechanism(s) to manage the treatment of the disease. Regarding the mechanisms of the virus action, the suggested pharmacological and nutritional regimens have been described.
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Affiliation(s)
- Forouzan Khodaei
- Department of Bioinformatics, College of Life Sciences, Shanxi Agricultural University, Taigu, China.,Department of Toxicology, Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Shanxi Key Laboratory of Ecological Animal Science and Environmental Veterinary Medicine, College of Animal Science and Veterinary Medicine, Shanxi Agricultural University, Taigu, China
| | - Anam Ahsan
- Shanxi Key Laboratory of Ecological Animal Science and Environmental Veterinary Medicine, College of Animal Science and Veterinary Medicine, Shanxi Agricultural University, Taigu, China
| | - Mostafa Chamanifard
- Department of Medical Radiation and Nuclear Engineering, Shiraz University, Shiraz, Iran
| | - Mohammad Javad Zamiri
- Department of Animal Science, College of Agriculture, Shiraz University, Shiraz, Iran
| | - Mohammad Mehdi Ommati
- Department of Bioinformatics, College of Life Sciences, Shanxi Agricultural University, Taigu, China
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22
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Vyse A, Theilacker C, Sings H, Fletcher M. Pneumococcal immunization with conjugate vaccines – are 10-valent and 13-valent vaccines similar? Future Microbiol 2020; 15:575-577. [DOI: 10.2217/fmb-2019-0310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Andrew Vyse
- Vaccines Medical, Pfizer Limited, Walton Oaks, Surrey, UK
| | - Christian Theilacker
- Vaccines Medical Development & Scientific & Clinical Affairs, Pfizer Inc, Collegeville, PA 19426, USA
| | - Heather Sings
- Vaccines Medical Development & Scientific & Clinical Affairs, Pfizer Inc, Collegeville, PA 19426, USA
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