1
|
Hascelik G, Soyletir G, Gulay Z, Sancak B, Yaman A, Gurler N, Aydemir SS, Bayramoglu G, Aydin F, Cekin Y, Birinci A, Ozakin C, Akpolat N, Ozhak Baysan B, Gultekin M, Zer Y, Sanal L, Arabaci C, Ay Altintop Y, Ozturk C, Ceyhan M. Serotype distribution of Streptococcus pneumoniae and pneumococcal vaccine coverage in adults in Turkey between 2015 and 2018. Ann Med 2023; 55:266-275. [PMID: 36579976 PMCID: PMC9809394 DOI: 10.1080/07853890.2022.2160877] [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] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To evaluate the serotype distribution and antibiotic resistance in pneumococcal infections in adults and to provide a perspective regarding serotype coverage of both current and future pneumococcal vaccines. PATIENTS AND METHODS This passive surveillance study was conducted with the Streptococcus pneumoniae strains isolated from the specimens of patients with pneumonia (materials isolated from bronchoalveolar lavage), bacteraemia, meningitis, pleuritis and peritonitis between 2015 and 2018. Serogrouping and serotyping were performed by latex particle agglutination and by conventional Quellung reaction using commercial type-specific antisera, respectively. The strains were analysed for penicillin, cefotaxime, erythromycin and moxifloxacin susceptibilities by E-test. RESULTS In the whole study group (410 samples from adults aged ≥18 years), the most frequent serotypes were 3 (14.1%), 19 F (12%) and 1 (9.3%). The vaccine coverage for PCV13, PCV15, PCV20 and PPV23 was 63.9%, 66.6%, 74.1% and 75.9%, respectively, in all isolates. Penicillin non-susceptibility in invasive pneumococcal disease (IPD) was 70.8% and 57.1% in the patients aged <65 and ≥65 years, respectively. About 21.1% and 4.3% of the patients with and without IPD had cefotaxime resistance. Non-susceptibility to erythromycin and moxifloxacin was 38.2% and 1.2%, respectively. CONCLUSIONS The results revealed that novel PCV vaccines may provide improved coverage as compared with the currently available vaccine, PCV13. The significant antibiotic resistance rates imply the need to extend the serotype coverage of the vaccines. Continuing the surveillance in pneumococcal diseases is critical to explore the serotype distribution and incidence changes of IPD cases in the population and to inform policy makers to make necessary improvements in the national immunization programmes.Key messagesThis multicentre study demonstrated the most recent serotype distribution and antibiotic resistance in adult population in Turkey.Shifting from PCV13 to novel conjugated vaccines will significantly increase the coverage.Continuing the surveillance in pneumococcal diseases is critical to explore the serotype distribution changes and the incidence of cases with invasive pneumococcal disease in the population.
Collapse
Affiliation(s)
- Gulsen Hascelik
- Department of Medical Microbiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Guner Soyletir
- Department of Medical Microbiology, Marmara University, Pendik Training and Research Hospital, Istanbul, Turkey
| | - Zeynep Gulay
- Department of Medical Microbiology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Banu Sancak
- Department of Medical Microbiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Akgun Yaman
- Department of Medical Microbiology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Nezahat Gurler
- Department of Microbiology and Clinical Microbiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Sabire Sohret Aydemir
- Department of Medical Microbiology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Gulcin Bayramoglu
- Department of Medical Microbiology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Faruk Aydin
- Department of Medical Microbiology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Yesim Cekin
- Department of Medical Microbiology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Asuman Birinci
- Department of Medical Microbiology, Faculty of Medicine, Samsun Ondokuz Mayıs University, Samsun, Turkey
| | - Cuneyt Ozakin
- Department of Medical Microbiology, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey
| | - Nezahat Akpolat
- Department of Medical Microbiology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Betil Ozhak Baysan
- Department of Medical Microbiology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Meral Gultekin
- Department of Medical Microbiology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Yasemin Zer
- Department of Microbiology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Laser Sanal
- Department of Clinical Microbiology, Ankara Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Cigdem Arabaci
- Department of Microbiology and Clinical Microbiology, Istanbul Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Yasemin Ay Altintop
- Department of Medical Microbiology, Kayseri City Training and Research Hospital, Kayseri, Turkey
| | - Candan Ozturk
- Department of Medical Microbiology, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Mehmet Ceyhan
- Department of Pediatric Infectious Diseases, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| |
Collapse
|
2
|
El‐Beyrouty C, Buckler R, Mitchell M, Phillips S, Groome S. Pneumococcal vaccination—A literature review and practice guideline update. Pharmacotherapy 2022; 42:724-740. [DOI: 10.1002/phar.2723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/21/2022] [Accepted: 06/27/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Claudine El‐Beyrouty
- Department of Pharmacy Thomas Jefferson University Hospital Philadelphia Pennsylvania USA
| | - Rebecca Buckler
- Department of Pharmacy Thomas Jefferson University Hospital Philadelphia Pennsylvania USA
| | - Meghan Mitchell
- Department of Pharmacy Thomas Jefferson University Hospital Philadelphia Pennsylvania USA
| | - Samantha Phillips
- Department of Pharmacy Thomas Jefferson University Hospital Philadelphia Pennsylvania USA
| | - Sara Groome
- Department of Pharmacy Thomas Jefferson University Hospital Philadelphia Pennsylvania USA
| |
Collapse
|
3
|
ÖZARSLAN F, BARAN AKSAKAL FN. Altmışbeş Yaş ve Üzeri Erişkinlerde Pnömokok Bağışıklaması ve Ülkemizdeki Pnömokok Aşı Uygulamaları. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2022. [DOI: 10.17517/ksutfd.1082905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Sorunu ortaya çıkmadan önlemek şüphesiz tedaviye göre kolay ve ucuz bir yöntemdir. Birinci basamak sağlık hizmetlerinin esasını oluşturan koruyucu sağlık hizmetlerinden aşılama, aşı ile önlenebilir hastalıkların önlenmesi ve bu hastalıklara bağlı kayıpların azaltılabilmesi için olmazsa olmazdır. Yaşlılarda ve yüksek riskli erişkinlerde önemli morbidite ve mortaliteye sebep olan pnömokok infeksiyonlarına karşı ülkemizde uygulanan iki tip aşı vardır: konjuge pnömokok aşısı ve polisakkarid pnömokok aşısı. Erişkinlerde pnömokok aşılarının yararı kanıtlanmış olmasına rağmen aşı uygulanma oranları hedeflenen düzeyde olmadığı için iyileştirme çalışmalarına ihtiyaç vardır. Birinci basamak çalışanları başta olmak üzere aşı uygulayıcılarının eğitilmesi ve farkındalığının artırılması, topluma aşıların yararları ve olası riskleri hakkında yeterli bilgi verilmesi, sağlık kontrollerinin ve kayıtların düzenli olması, aşıların yeterli miktarda ve ücretsiz olarak sağlanması gerekmektedir.
Bu derleme erişkinlerde pnömokok aşı uygulamalarında mevcut durumu gözden geçirmek ve aşılama oranlarını arttırmak için yapılması gereken uygulamaları vurgulamak amacıyla yazılmıştır.
Collapse
|
4
|
Hentschker C, Maaß S, Junker S, Hecker M, Hammerschmidt S, Otto A, Becher D. Comprehensive Spectral Library from the Pathogenic Bacterium Streptococcus pneumoniae with Focus on Phosphoproteins. J Proteome Res 2020; 19:1435-1446. [DOI: 10.1021/acs.jproteome.9b00615] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Christian Hentschker
- Department of Microbial Proteomics, Institute of Microbiology; University of Greifswald, Felix-Hausdorff-Str. 8, 17489 Greifswald, Germany
| | - Sandra Maaß
- Department of Microbial Proteomics, Institute of Microbiology; University of Greifswald, Felix-Hausdorff-Str. 8, 17489 Greifswald, Germany
| | - Sabryna Junker
- Department of Microbial Proteomics, Institute of Microbiology; University of Greifswald, Felix-Hausdorff-Str. 8, 17489 Greifswald, Germany
| | - Michael Hecker
- Department of Microbial Physiology and Molecular Biology, Institute of Microbiology; University of Greifswald, Felix-Hausdorff-Str. 8, 17489 Greifswald, Germany
| | - Sven Hammerschmidt
- Department of Molecular Genetics and Infection Biology, Interfaculty Institute for Genetics and Functional Genomics, University of Greifswald, Felix-Hausdorff-Str. 8, 17489 Greifswald, Germany
| | - Andreas Otto
- Department of Microbial Proteomics, Institute of Microbiology; University of Greifswald, Felix-Hausdorff-Str. 8, 17489 Greifswald, Germany
| | - Dörte Becher
- Department of Microbial Proteomics, Institute of Microbiology; University of Greifswald, Felix-Hausdorff-Str. 8, 17489 Greifswald, Germany
| |
Collapse
|
5
|
Hesselstrand R, Nagel J, Saxne T, Geborek P, Skattum L, Kapetanovic MC. Immunogenicity and safety of pneumococcal vaccination in patients with systemic sclerosis. Rheumatology (Oxford) 2018; 57:625-630. [PMID: 29325173 DOI: 10.1093/rheumatology/kex471] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Indexed: 12/30/2022] Open
Abstract
Objective To study the impact of disease and treatment with DMARDs on antibody response elicited by either pneumococcal conjugate vaccine (PCV13) or pneumococcal polysaccharide vaccine (PPV23) in patients with SSc. Methods Forty-four SSc patients and 49 controls received a dose of either PCV13 or PPV23. Twelve patients were treated with DMARDs. Antibody levels to pneumococcal polysaccharides 6B and 23 F were measured before and 4-6 weeks after vaccination using ELISA. Antibody functionality was studied using opsonophagocytic assay performed on serotype 23 F. Results Number of patients, percentage female and mean age (years) at vaccination were: 32, 94%, 57.5 years in SSc without DMARDs; 12, 100%, 55.5 years in SSc on DMARDs and 49, 63% and 50.6 years in controls. Post-vaccination antibody levels for both serotypes increased significantly in SSc without DMARDs and controls (P < 0.001), but in SSc on DMARDs only for 6B (P = 0.041). Compared with the other groups, patients with SSc receiving DMARDs had lower post-vaccination antibody levels for both serotypes. Opsonophagocytic assay increased significantly in all three groups. No significant difference in immunogenicity between PCV13 and PPV23 was seen. Conclusion Pneumococcal vaccination using either PCV13 or PPV23 yielded satisfactory antibody response in SSc patients without DMARD treatment, but a lower response in patients treated with synthetic DMARDs. Type of pneumococcal vaccine (conjugate or polysaccharide) did not significantly influence antibody response. Trial registration ClinicalTrials.gov, http://clinicaltrials.gov, NCT02240888.
Collapse
Affiliation(s)
- Roger Hesselstrand
- Department of Clinical Sciences, Lund, Section for Rheumatology, Lund University and Skåne University Hospital, Lund, Sweden
| | - Johanna Nagel
- Department of Clinical Sciences, Lund, Section for Rheumatology, Lund University and Skåne University Hospital, Lund, Sweden
| | - Tore Saxne
- Department of Clinical Sciences, Lund, Section for Rheumatology, Lund University and Skåne University Hospital, Lund, Sweden
| | - Pierre Geborek
- Department of Clinical Sciences, Lund, Section for Rheumatology, Lund University and Skåne University Hospital, Lund, Sweden
| | - Lillemor Skattum
- Department of Laboratory Medicine, Section of Microbiology, Immunology and Glycobiology, Lund University, Lund, Sweden.,Clinical Immunology and Transfusion Medicine University and Regional Laboratories, Region Skåne, Lund, Sweden
| | - Meliha C Kapetanovic
- Department of Clinical Sciences, Lund, Section for Rheumatology, Lund University and Skåne University Hospital, Lund, Sweden
| |
Collapse
|
6
|
Mizuno Y. [Progress in Diagnostic Technology and Management of Infectious Diseases. Topics: IV. Measures for Infection Qontrol; 2. Immunization for adults]. ACTA ACUST UNITED AC 2016; 103:2741-7. [PMID: 27522815 DOI: 10.2169/naika.103.2741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
7
|
Cohen PR. Injection Site Lichenoid Dermatitis Following Pneumococcal Vaccination: Report and Review of Cutaneous Conditions Occurring at Vaccination Sites. Dermatol Ther (Heidelb) 2016; 6:287-98. [PMID: 26988991 PMCID: PMC4906099 DOI: 10.1007/s13555-016-0105-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Indexed: 11/30/2022] Open
Abstract
Background Cutaneous dermatoses and malignancies have occurred at the sites of vaccines. Purpose To describe a man who developed a lichenoid dermatitis at the pneumococcal vaccine injection site and to review cutaneous dermatoses and malignancies occurring at vaccination sites. Methods PubMed was used to search the following terms, separately and in combination: adverse, condition, cutaneous, dermatosis, dermatitis, injection, PCV13, pneumococcal, pneumonia, prevnar, reaction, skin, site, vaccination, and vaccine. All papers were reviewed, and relevant manuscripts, along with their reference citations, were evaluated. Results Several vaccines—including bacillus Calmette-Guerin, hepatitis B, influenza, leishmaniasis, meningitis, pneumococcal, smallpox, tetanus (alone and in combination with diphtheria, pertussis, polio, Haemophilus influenza type B or plague and yellow fever), and varicella-zoster—have been associated with post-vaccination site reactions. A 70-year-old male developed a lichenoid dermatitis that occurred at the pneumococcal vaccine injection site within 2 weeks after PCV13 vaccination; the erythematous nodule resolved spontaneously within 9 weeks following immunization. Conclusions Dermatoses at the injection sites of vaccines can be granulomatous, immunity-related conditions, infections, lichenoid, neutrophilic, or pseudolymphomatous. Basal cell carcinoma and squamous cell carcinoma are the most common vaccination site-associated malignancies; however, melanoma and sarcomas (dermatofibrosarcoma protuberans, fibrosarcoma, and malignant fibrous histiocytoma) are also smallpox vaccine-related site neoplasms. A cutaneous immunocompromised district that is created by vaccine-induced local immunologic changes is hypothesized to be the pathogenesis of vaccination site reactions.
Collapse
Affiliation(s)
- Philip R Cohen
- Department of Dermatology, University of California San Diego, San Diego, CA, USA.
| |
Collapse
|
8
|
Ahn JG, Kim HW, Choi HJ, Lee JH, Kim KH. Functional immune responses to twelve serotypes after immunization with a 23-valent pneumococcal polysaccharide vaccine in older adults. Vaccine 2015; 33:4770-5. [PMID: 26277073 DOI: 10.1016/j.vaccine.2015.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Revised: 06/23/2015] [Accepted: 08/02/2015] [Indexed: 01/26/2023]
Abstract
BACKGROUND The 23-valent pneumococcal polysaccharide vaccine (PPSV23) was introduced as part of the national immunization program for the elderly (≥65 years of age) in Korea on 2013. To evaluate immune responses in this population, serotype-specific anti-pneumococcal antibodies were studied with opsonophagocytic assay (OPA). METHODS Pneumococcal vaccine-naïve participants ≥65 years of age were enrolled. They were divided into two groups according to their age: 30 in (65-74 years) and 32 in group (≥75 years). The functional antibody response was determined by multiplexed OPA (MOPA) for 12 serotypes (1, 3, 4, 5, 6B, 7F, 9V, 14, 18C, 19A, 19F, and 23F) before and 4 weeks after vaccination with PPSV23. RESULTS Geometric mean titers (GMTs) to all tested serotypes significantly increased in both groups after vaccination compared to those before vaccination. There were no significant differences in either the fold rise (post-vaccination to pre-vaccination) or the percentage of participants with a ≥4-fold increase in OPA titers between two groups for any of the 12 serotypes. Following vaccination, GMT for serotype 9V was higher in group 1 than in group 2 (P=0.011). CONCLUSIONS PPSV23 induces functional immune response for 12 vaccine serotypes in both age groups. Further analysis is needed for the remaining 11 serotypes in the PPSV23, in order to develop a better understanding of the immune responses induced by PPV23 in older adults.
Collapse
Affiliation(s)
- Jong Gyun Ahn
- Department of Pediatrics and Center for Vaccine Evaluation and Study, Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Han Wool Kim
- Department of Pediatrics and Center for Vaccine Evaluation and Study, Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Hee Jung Choi
- Division of Infectious Diseases, Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Jin Hwa Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Kyung-Hyo Kim
- Department of Pediatrics and Center for Vaccine Evaluation and Study, Medical Research Institute, Ewha Womans University School of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
9
|
|
10
|
Song JY, Cheong HJ, Tsai TF, Chang HA, Choi MJ, Jeon JH, Kang SH, Jeong EJ, Noh JY, Kim WJ. Immunogenicity and safety of concomitant MF59-adjuvanted influenza vaccine and 23-valent pneumococcal polysaccharide vaccine administration in older adults. Vaccine 2015; 33:4647-52. [PMID: 25980426 DOI: 10.1016/j.vaccine.2015.05.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 04/20/2015] [Accepted: 05/04/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Concomitant administration of influenza and pneumococcal vaccines facilitates their uptake by older adults; however, data on immunogenicity and safety of concomitant administration of adjuvanted trivalent inactivated influenza vaccine (aIIV3) and 23-valent pneumococcal polysaccharide vaccine (PPSV23) have not been reported. METHODS Subjects aged ≥65 years (N=224) were randomized 1:1:1:1 to receive MF59-aIIV3 alone, MF59-aIIV3+PPSV23 in contralateral arms, MF59-aIIV3+PPSV23 in the same arm or PPSV23 alone (Clinical Trial Number - NCT02225327). Hemagglutination inhibition assay and multiplex opsonophagocytic killing assay were used to compare immunogenicity after single or concomitant vaccination. RESULTS All groups met immunogenicity criteria for the influenza vaccine in older adults with similar seroconversion rates and geometric mean fold-increases, irrespective of concomitant vaccinations and injection site. For each pneumococcal serotype, opsonic index (OI) increased markedly after the PPSV23 vaccination, irrespective of the concomitant influenza vaccine. All subjects showed an OI≥8 for serotypes 6B, 18C and 19A post-vaccination, with a suggestion that the ipsilateral concomitant vaccination might be associated with higher OIs for some antigens. Local and systemic adverse events were more common in subjects receiving PPSV23 compared to those receiving aIIV3 alone. CONCLUSIONS No interference was observed with antibody responses to influenza or pneumococcal antigens when aIIV3 and PPSV23 were administered concomitantly.
Collapse
Affiliation(s)
- Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea; Asian Pacific Influenza Institute (APII), Korea University College of Medicine, Seoul, Republic of Korea.
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea; Asian Pacific Influenza Institute (APII), Korea University College of Medicine, Seoul, Republic of Korea.
| | - T F Tsai
- Novartis Vaccines, Cambridge, MA, USA
| | | | - Min Joo Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Ji Ho Jeon
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Seong Hee Kang
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Eun Ju Jeong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Ji Yun Noh
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea; Asian Pacific Influenza Institute (APII), Korea University College of Medicine, Seoul, Republic of Korea
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea; Asian Pacific Influenza Institute (APII), Korea University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
11
|
Kwetkat A, Hagel S, Forstner C, Pletz MW. [Pneumococcal vaccination for prevention of pneumonia]. Z Gerontol Geriatr 2015; 48:614-8. [PMID: 25877774 DOI: 10.1007/s00391-015-0887-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: 12/15/2014] [Accepted: 03/09/2015] [Indexed: 10/23/2022]
Abstract
Aging of the immune system, so-called immunosenescence, is well documented as the cause of increased infection rates and severe, often complicated courses of infections in older adults. This is particularly true for pneumococcal pneumonia in older adults; therefore, the standing committee on vaccination of the Robert Koch Institute (STIKO) recommends a once only vaccination with 23-valent pneumococcal polysaccharide vaccine for all persons aged 60 years and over. Furthermore, the 13-valent pneumococcal conjugate vaccine is also available for administration in adults and is recommended by the STIKO for particular indications. The advantage of the pneumococcal conjugate vaccine is the additional induction of a T-cell dependent immune response that leads to good immunogenicity despite immunosenescence. Initial data from a recent randomized controlled trial, so far only presented at conferences, confirm that the conjugate vaccine also provides protection against non-bacteremic pneumococcal pneumonia, which is not provided by the polysaccharide vaccine. Thus, there are two vaccines for prevention of pneumococcal diseases: one with a broader range of serotype coverage but with an uncertain protection against non-bacteremic pneumococcal pneumonia and another one with less serotype coverage but more effective protection. Vaccination of children with the conjugate vaccine also leads to a rapid decrease of infections by the 13 vaccine serotypes even in adults because of herd protection effects. For prevention of pneumonia in older adults the additional benefit of a concurrent application of influenza vaccine and pneumococcal vaccine should be considered.
Collapse
Affiliation(s)
- A Kwetkat
- Klinik für Geriatrie, Universitätsklinikum Jena, Bachstr. 18, 07743, Jena, Deutschland.
| | - S Hagel
- Zentrum für Infektionsmedizin und Krankenhaushygiene, Universitätsklinikum Jena, Jena, Deutschland
| | - C Forstner
- Zentrum für Infektionsmedizin und Krankenhaushygiene, Universitätsklinikum Jena, Jena, Deutschland.,Universitätsklinik für Innere Medizin I, Klin. Abt. f. Infektionen und Tropenmedizin, Medizinische Universität Wien, Wien, Österreich
| | - M W Pletz
- Zentrum für Infektionsmedizin und Krankenhaushygiene, Universitätsklinikum Jena, Jena, Deutschland
| |
Collapse
|
12
|
Prospective cohort study on the effectiveness of influenza and pneumococcal vaccines in preventing pneumonia development and hospitalization. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2014; 22:229-34. [PMID: 25540271 DOI: 10.1128/cvi.00673-14] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Pneumonia and acute exacerbation of chronic illness are leading causes of influenza-related hospitalization. Therefore, influenza and pneumococcal vaccinations are strongly recommended for adults with comorbidities. Using a hospital-based influenza surveillance system, we performed a multicenter, prospective cohort study of patients visiting emergency rooms with influenza-like illness (ILI) during the influenza epidemic period in 2013 to 2014. Patients aged ≥ 19 years were enrolled, and clinical data were collected. Multivariate analyses were performed to estimate the effectiveness of influenza and pneumococcal vaccination in preventing pneumonia development and hospitalization. During study periods, 2,262 patients with ILI were registered. Among 2,217 patients with available vaccination records, 31.9% (707 patients) and 9.7% (216 patients) had received influenza and pneumococcal vaccines, respectively. Among patients who had been administered a pneumococcal vaccine, 94.4% had received the 23-valent polysaccharide vaccine (PPV23). The adjusted rates of effectiveness of the influenza vaccine for preventing pneumonia development and hospitalization were 64.0% (95% confidence interval [CI] = 29% to 81%) and 35.0% (95% CI = 12% to 52%), respectively. Pneumococcal vaccination did not reduce pneumonia development or hospitalization. In conclusion, influenza rather than PPV23 vaccination may reduce pneumonia development and hospitalization in patients with preceding ILI.
Collapse
|
13
|
Feldman C, Anderson R. Review: Current and new generation pneumococcal vaccines. J Infect 2014; 69:309-25. [DOI: 10.1016/j.jinf.2014.06.006] [Citation(s) in RCA: 141] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 06/16/2014] [Indexed: 12/22/2022]
|
14
|
Abstract
The real disease burden due to Streptococcus pneumoniae infections are underrecognised worldwide both by the lay public and by the medical community in general. In infants and children pneumococcal otitis media is the most common reason for antimicrobial treatment, while the far less frequent, though potentially life threatening pneumococcal pleuropneumonia, sepsis and pneumococcal meningitis are high risk conditions even if the causative pneumococcus is not multiresistant. Asplenic patients, patients with chronic underlying conditions, and/or those receiving immunosuppressive therapy are at risk of serious pneumococcal disease regardless of age. Morbidity and mortality due to pneumococcal pneumonia is most common in the elderly, and has not changed during the last decades in spite of all efforts in improving therapy and care. Presently the majority of the pneumococcal infections are preventable by active immunization. In this work the author briefly outlines the results of the pneumococcal prevention programs worldwide and in Hungary using presently available 10-valent, 13-valent protein conjugate and 23-valent polysaccharide pneumococcal vaccines. Also, the author describes the recently approved indications of the 13-valent pneumococcal conjugate vaccine such as its use in all age groups, discusses future challenges of these prevention programs.
Collapse
Affiliation(s)
- Zsófia Mészner
- Állami Népegészségügyi és Tisztiorvosi Szolgálat Országos Gyermekegészségügyi Intézet Budapest Diószegi út 64. 1113
| |
Collapse
|
15
|
Weil-Olivier C, Gaillat J. Can the success of pneumococcal conjugate vaccines for the prevention of pneumococcal diseases in children be extrapolated to adults? Vaccine 2014; 32:2022-6. [PMID: 24565755 DOI: 10.1016/j.vaccine.2014.02.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 12/13/2013] [Accepted: 02/06/2014] [Indexed: 11/26/2022]
Abstract
Before conjugate pneumococcal vaccines (PCVs) were introduced it was estimated that Streptococcus pneumoniae caused 500,000 cases of pneumonia, 50,000 cases of bacteremia and 3000 cases of meningitis annually in the United States in both children and adults. After 10 years of routine use of the 7-valent pneumococcal conjugate vaccine (PCV7) the incidence of vaccine-type pneumococcal diseases (PDs) had significantly decreased in vaccinated children (direct effect) and unvaccinated subjects of all ages (indirect effect). Second generation, higher-valent PCVs, especially 13-valent (PCV13), routinely implemented since 2010, have reduced the incidence of PDs caused by the six additional non-PCV7 serotypes, in both vaccinated and unvaccinated subjects. The licence for this vaccine has recently been extended to include adults aged 18 to 49 in Europe. Although PCV13 has an indirect effect on IPD in adults, this will probably not achieve the same level of disease control in adults and the elderly (especially those at high risk) as that obtained in vaccinated children. As highlighted in this paper, differences exist between children and adults for PD manifestations (incidence, morbidity and mortality) and serotypes isolated in nasopharyngeal carriage and diseases, so benefits from adult vaccination must be considered in this light. PCV13 induces an immune response in adults that is non-inferior for all serotypes common with the 23-valent plain polysaccharide vaccine that is currently recommended for adults and even superior for many serotypes. Although there is no evidence that this immune response translates to clinical efficacy in adults as seen in children, the results from a randomised trial in The Netherlands, expected in 2014, should provide the missing evidence. This evidence and efficient surveillance systems should provide the necessary data, essential for policy makers in their decisions on adult pneumococcal vaccination policies.
Collapse
Affiliation(s)
- Catherine Weil-Olivier
- Department of Pediatrics, University Denis Diderot, 5 Rue Thomas Mann, 75013 Paris, France.
| | - Jacques Gaillat
- Department of Infectious Diseases, CH Annecy, 1 Avenue de l'Hôpital, Metz-Tessy BP 90074, 74374 Pringy Cedex, France.
| |
Collapse
|
16
|
Affiliation(s)
- Joon Young Song
- Division of Infectious Disease, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Asian Pacific Influenza Institute, Seoul, Korea
| | - Hee Jin Cheong
- Division of Infectious Disease, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Asian Pacific Influenza Institute, Seoul, Korea
| |
Collapse
|
17
|
|
18
|
Ruiz-Aragón J, Márquez Peláez S, Molina-Linde JM, Grande-Tejada AM. Safety and immunogenicity of 13-valent pneumococcal conjugate vaccine in infants: a meta-analysis. Vaccine 2013; 31:5349-58. [PMID: 24055349 DOI: 10.1016/j.vaccine.2013.09.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 09/04/2013] [Accepted: 09/06/2013] [Indexed: 11/30/2022]
Abstract
Pneumococcal infections are a major cause of morbidity and mortality worldwide. Pneumococcal conjugate vaccines represent major progress in the prevention of invasive pneumococcal disease in the paediatric population. We performed a meta-analysis, in accordance with the PRISMA statement, in order to assess the immunogenicity and safety of 13-valent pneumococcal conjugate vaccines in infants. A literary search was conducted using electronic databases and specialized journals were searched manually. Inclusion criteria were: clinical trials with infants vaccinated with 13-valent pneumococcal conjugate, compared to 7-valent vaccine. We recorded the results in terms of the immunogenicity and safety of the vaccines. The quality of the studies included was assessed using the CASP and Jadad checklists. We included nine randomized clinical trials of 258 potentially relevant references in the meta-analysis. The studies included had high-moderate quality. Both vaccines were well tolerated in all groups of infants, and most local reactions and systemic events were of mild or medium intensity and typical of any injected vaccine. All studies included in the meta-analysis showed high immunogenicity for both pneumococcal vaccines in all tested serotypes. An anti-polysaccharide antibody concentration of ≥0.35 μg/mL was achieved in at least 89% of the infants. Our results suggest that the 13-valent pneumococcal conjugate vaccine has a similar safety profile, and is as effective as, the 7-valent vaccine in the prevention of invasive pneumococcal disease caused by the seven common serotypes, and could provide expanded protection against the six additional serotypes.
Collapse
Affiliation(s)
- J Ruiz-Aragón
- Research Group of Pediatrics Infectious Diseases, Virgen del Rocío UH, Seville, Spain.
| | | | | | | |
Collapse
|
19
|
|