Assessment of Postvaccine Immunity against Streptococcus pneumoniae in Patients with Asplenia, including an Analysis of Its Impact on Bacterial Flora of the Upper Respiratory Tract and Incidence of Infections.

Alina Olender,Katarzyna Małkińska,Jacek Tabarkiewicz,Ewelina Grywalska,Elżbieta Pels,Jacek Roliński

doi:10.1155/2018/1691347

Alina Olender, Katarzyna Małkińska + Show 4 more

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https://doi.org/10.1155/2018/1691347

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Abstract

S. pneumoniae is a microorganism that may cause a serious threat in postsplenectomy patients due to a potentially invasive course of infection. In order to assess a protective activity after vaccination with the 23-valent vaccine, we made an analysis of the level of antibodies in patients with asplenia compared to a control group of healthy donors. Additionally, colonization by potentially pathogenic microorganisms of the upper respiratory tract was analyzed to determine the carrier state by strains with vaccine serotype. No such strains were found in the research, yet three non-vaccine-serotype strains were found. Colonization of the upper respiratory tract by potentially pathogenic microorganisms may be connected with increased susceptibility observed and incidence of infections in patients with asplenia. However, colonization by S. pneumoniae may not have an effect on the level of specific antibodies with the 23-valent vaccine against S. pneumoniae (PPV23) in postsplenectomy patients and healthy people. The response to vaccination against S. pneumoniae showed a lower level of specific antibodies in patients with splenectomy performed more than 2 years before the test than in patients with a recently removed spleen, i.e., from 1 month to 2 years before the test. Vaccination against pneumococci also has positive effects on incidence of other etiology infections, which is of high significance in the prophylaxis of infectious diseases in this group of patients.

Highlights

Persons after spleen removal are a special group of patients in which a course of infection may be dangerous and life-threatening, especially in the case of encapsulated bacteria such as Streptococcus pneumoniae
Pneumococci infections in patients with asplenia cause a bigger threat of bacteremia and meningitis, in the form of invasive pneumococcal disease (IPD) or overwhelming postsplenectomy infection (OPSI), which is characterized by a high death rate mainly in such patients [1]
More than 50% of OPSI cases are caused by S. pneumoniae, which increases a risk of sepsis by 5-6 times [1]

Summary

Introduction

Persons after spleen removal are a special group of patients in which a course of infection may be dangerous and life-threatening, especially in the case of encapsulated bacteria such as Streptococcus pneumoniae. Pneumococci infections in patients with asplenia cause a bigger threat of bacteremia and meningitis, in the form of invasive pneumococcal disease (IPD) or overwhelming postsplenectomy infection (OPSI), which is characterized by a high death rate mainly in such patients [1] In this group of patients, as a result of the acquired immunodeficiency, a risk of cardiovascular complications is higher due to the impaired coagulation processes, reduced blood filtration, and disorders of blood vessel endothelium [2]. S. pneumoniae is a microorganism that may come into the composition of physiological flora colonizing the upper respiratory tract It usually occurs as asymptomatic carrier state, which in the event of immunodeficiency, may be a source of endogenic infections. It is significant that prophylactic actions should include research on their effectiveness concerning the occurrence of colonization as a potential source of endogenic infections and a general predisposition to infections that potentially may change nonspecifically as a result of vaccination

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