Prevention Of Pneumococcal Infections Research Articles

Evaluating clinical effectiveness and safety of pneumococcal immunization of infants

According to WHO, pneumococcal infection (PI) is considered one of the most dangerous of all vaccine-preventable diseases and, before vaccination, led to the death of up to 1.6 million people per year, of which from 0.7 to 1 million were children. In the prevention of PI, specific prevention occupies a special place. For the first time in 2014, vaccination against PI with pneumococcal conjugate vaccine was included in the national calendar of preventive vaccinations. International practice of using pneumococcal vaccine has shown that timely vaccination can produce positive results in the fight against PI. Under observation were 55 children who were vaccinated against PI with the pneumococcal polysaccharide conjugate vaccine (adsorbed), 13 valent according to the national calendar of preventive vaccinations of the Russian Federation. It was revealed that post-vaccination complications after vaccination did not occur in any child. General post-vaccination reactions were observed in the form of a short-term increase in temperature, loss of appetite and sleep disturbances, as well as local reactions in the form of edema, hyperemia, and hardening at the site of vaccine administration. We studied the incidence of community-acquired pneumonia (CAP), acute otitis media and acute respiratory infections among 55 children of the first year of life vaccinated at 2 months and 4.5 months (main group) and 50 children for various reasons not vaccinated against PI (comparison group). A study of the long-term results of 2-fold vaccination in the first year of life and revaccination at 15 months against PV based on observation of children for two years showed that children of the main group, compared with the comparison group, were 3.3 times less likely to suffer from PV, 2.7 times acute otitis and 1.7 times acute respiratory infections, p < 0.05. The data obtained show the high efficiency and safety of vaccinating children against PI with the pneumococcal vaccine.

Prevention of pneumococcal infections in childhood: two decades of progress.

This review highlights progress in combating pediatric pneumococcal disease in the era of pneumococcal conjugate vaccines (PCVs). This review is timely given the development of increased valency PCVs for potential use in children. Countries implementing vaccination programs with PCVs have witnessed dramatic reductions in cases of childhood invasive pneumococcal disease (IPD). In the US, the largest decline of IPD followed the introduction of 7-valent PCV with additional decreases following the switch to 13-valent PCV (PCV13). Despite these gains, IPD still occurs in the US but at much lower rates. Likewise, pneumonia hospitalizations and office visits for otitis media have decreased. Nasopharyngeal colonization with pneumococci has persisted due to replacement by nonvaccine serotypes: colonizing non-PCV13 serotypes have less invasive potential. The PCV era has also been marked by reductions in the proportions of pneumococcus showing nonsusceptibility or resistance to some antimicrobial agents. Furthermore, PCVs have an excellent safety profile. Despite proven safety and efficacy, childhood vaccination programs in some countries do not include PCVs, resulting in the majority of global deaths attributable to pneumococcus. Increased worldwide vaccination of children and the development of higher valency vaccines holds additional promise for further reductions in childhood IPD.

Review of global use of licensed vaccines and development of new vaccines for the prevention of pneumococcal infection

Streptococcus pneumoniae infection is the most common cause of high morbidity and mortality among children under 5 years of age, immunocompromised people, and the elderly. Despite significant success, the approved pneumococcal conjugate and polysaccharide vaccines are of limited efficacy, providing protection against a small fraction of the known pneumococcal serotypes. The rapid spread of multidrug-resistant strains exacerbates the global challenge of treating infection caused by S. pneumoniae. At the same time, the emerging new strains dictate the need to include new serotypes into vaccines. In view of this, further improvement of vaccines for the prevention of pneumococcal infections is an urgent task. The aim of this study was to review advances in the development of polysaccharide, conjugate, whole-cell pneumococcal vaccines, as well as vaccines based on protein antigens and vaccines with an antigen delivery system. Genomics and proteomics data have helped to improve approaches to the creation of polysaccharide and protein-based vaccines, as well as whole-cell vaccines with the potential for population prophylactic coverage against various pneumococcal serotypes that are not included in the licensed pneumococcal vaccines. The method of antigen delivery to the cell is of great importance in the development of vaccines. The most promising strategy for improving pneumococcal vaccines is the creation of vaccines based on bacterium-like or synthetic particles carrying several antigens, including pneumococcal surface proteins. In conclusion, it should be noted that top-priority vaccines are those that provide a wide range of protection against circulating pneumococcal serotypes and, in addition to eliciting a systemic immune response, also induce local immunity.

Clinical and Immunological Aspects of Pneumococcal Vaccination in Patients with Multiple Myeloma

Relevance. Among the groups at high risk of developing invasive pneumococcal infections, patients with multiple myeloma (MM) stand out among the highest rates of morbidity and mortality due to the presence of profound immunosuppression. Aims: to outline the current state of the problem of vaccine prevention of pneumococcal infection in patients receiving treatment for multiple myeloma, to present the evidence base for vaccination with conjugated pneumococcal vaccine. A continuous data review method was used to evaluate the studies on vaccination approaches against pneumococcal infection in patients with multiple myeloma. Conclusions. The article presents modern epidemiological data, as well as the results of original studies of clinical and immunological aspects of pneumococcal vaccination in patients with MM receiving new targeted agents and immunotherapy. The effectiveness of the use of the conjugated pneumococcal vaccine in patients treated with MM with bortezomib, lenalidomide, and ixazomib was indicated. An independent protective effect of pneumococcal vaccination has been shown as a preventive measure in a cohort of patients with MM, against the background of treatment with new targeted drugs.

Assess the effectiveness of planned teaching programme on knowledge regarding prevention of pneumococcal infections among the mothers of under five children in selected Anganwadi of Ratia, Haryana

Assess the effectiveness of planned teaching programme on knowledge regarding prevention of pneumococcal infections among the mothers of under five children in selected Anganwadi of Ratia, Haryana

Official statements of the expert meeting on pneumococcal vaccination in adults in Russia

The purpose of the meeting is to obtain an opinion on approaches and recommendations for vaccine prevention of pneumococcal infections in adults.

Serotypes and Antimicrobial Susceptibility of Nasopharyngeal Isolates of Streptococcus pneumoniae from Children Less Than 5 Years Old in Egypt.

PurposeStreptococcus pneumoniae (S. pneumoniae) is the etiology of severe and life-threatening infections in children less than 5 years old. Though pneumococcal conjugate vaccines (PCVs) are effective in the prevention of pneumococcal infections, yet they are not included in the National Immunization Program in Egypt pending the identification of pathogenic serotypes. As S. pneumoniae colonization of the pharynx predisposes to pneumonia and invasive pneumococcal disease (IPD) caused by the colonizing serotypes, identification of the nasopharyngeal (NP) serotypes can be a surrogate to the invasive serotypes. In this study, we aimed to 1. Identify the serotypes and antimicrobial susceptibility testing (AST) of Streptococcus pneumoniae colonizing the nasopharynx of Egyptian children younger than 5 years in two successive winter seasons. 2. Correlate the identified serotypes with vaccine coverage of the 13-valent conjugate pneumococcal vaccines (PCV13). 3. Compare the serotypes and AST of S. pneumoniae from NP to those of IPD that were routinely identified in our clinical laboratory during the study period.Materials and MethodsThe study was conducted in two successive winter seasons (December 2015–March 2016; December 2016–March 2017). We enrolled 334 children, aged 6 months to 5 years, attending the outpatient general clinics of Cairo University Children Hospital, excluding those with fever, signs of infection, history of antibiotic intake or hospitalization in the preceding month. We tested NP swabs for S. pneumoniae by culture and real-time PCR. Serotyping was performed by sequential multiplex PCR for all positive samples. AST was done to S. pneumoniae isolates by Vitek-2™ (BioMérieux, Marcy-L’Etoile, France). We included routinely detected S. pneumoniae from sterile body sites during the study period, and identified their serotypes and AST.ResultsPCR was positive for pneumococci in 217 out of 334 pharyngeal swabs (65%), including 186 typable samples. The most common serotypes were serotypes 1, 6ABC, 19 F, 5 and 18ABC. By culture, we isolated only 110 out of 334 pharyngeal swabs (32.9%). The theoretical coverage of the PCV13 vaccine for the detected serotypes was 77.4%. The AST of NP isolates revealed low susceptibility rates to all antimicrobials except for vancomycin, linezolid, levofloxacin and clindamycin. During the study period, we identified 40 IPD; 21 identified by PCR and 19 by culture. The commonest pneumococcal serotypes were 1, 18ABC, 6ABC and 5. The PCV13 coverage was 75%. By Vitek-2, the isolates showed 100%, 100%, 94.7%, 89.5%, 84.2%, 84.2% and 78.9% susceptibility to vancomycin, linezolid, clindamycin, levofloxacin, penicillin, cefotaxim and erythromycin, respectively.ConclusionBased on the serotype vaccine coverage and the emerging antimicrobial resistance of S. pneumoniae, PCVs will be valuable to Egyptian children.

Study of the Immunobiological Properties of Surface Protein-Containing Antigens of Streptococcus pneumoniae Serotype 6B

Relevance . Prevention of pneumococcal infection in the Russian Federation is carried out by imported polysaccharide and conjugated vaccines without taking into account the circulation of clinically significant isolates, which leads to the growth of previously rare genetic lines and serotypes that are not part of the vaccines, and does not protect against the carriage. Serotype-independent vaccines are being developed based on protective proteins and variants of whole-cell vaccines capable of providing a cross-protective effect against pneumococcus. Objective . Investigation of the protective properties of surface protein-containing antigens isolated from the immunogenic strain S. pneumoniae 6B No. 296 and their influence on key effectors of innate immunity. Materials and methods . S. pneumoniae 6B No. 296 was cultured in a semi-synthetic medium under stationary conditions at 5% CO 2 for 5-7 hours. From inactivated bacterial cells, the experimental initial protein-containing preparation was obtained - an aqueous extract (A/E), from which a 30-100 kDa fraction (FR) isolated, and from the sterile culture supernatant, the protein-containing preparation - supernatant (S/N); in the preparations, the protein content was determined. Immunobiological properties were studied after double intraperitoneal immunization of BALB/c mice. The protective activity was determined after infection with virulent strains of S. pneumoniae serotypes 6B No. 1121 and No. 3. Phagocytic activity was studied by the number of granulocytes that absorbed heat-killed FITC-labeled S. aureus cells. The expression of Toll-like receptors (TLRs) and the subpopulation structure of mouse spleen lymphocytes were investigated after staining with FITC/PE-labeled monoclonal antibodies using flow cytometry. Statistical analysis of materials was carried out using parametric and non-parametric methods using the software package «Statistica for Windows», ver. 7.0 (Stat Soft, Inc). Results . The protective effect of FR upon infection with virulent strains of homologous (6B No. 1121) and heterologous serotypes (3 No. 3) was established; S/N protected mice when infected with strain 3 No. 3. All the studied drugs led to an increase in the number of phagocytic cells (the greatest effect was observed upon immunization with FR and S/N) and stimulated the expression of TLR2 and TLR4 positive cells (there was an increase in the number of TLR2-expressing cells during immunization with FR compared with A/E). When studying the immunophenotype of mouse lymphocytes, it was noted that the preparations induced the expression of effectors of innate and adaptive immunity. Conclusions . As a result of the studies, it was shown that the protective surface protein-containing fraction with MM 30-100 kDa is from tested experimental preparations the most active stimulator of innate and adaptive immunity, and requires further study to determine the possibility of using the serotype-independent pneumococcal vaccine in the development.

Effectiveness of prevention of pneumococcal infection in workers in contact with chrysotile asbestos

The article presents an assessment of the clinical and epidemiological effectiveness of vaccination of pneumococcal infection in workers in contact with chrysotile asbestos in the workplace. The reduction of morbidity among workers in contact with chrysotile asbestos within 2 years after immunization by 1.85 times was established.

Treatment and Prevention of Pneumococcal Infection.

Streptococcus pneumoniae, a gram-positive diplococcus, is the most common cause of bacterial pneumonia. The diagnosis of pneumococcal pneumonia is usually confirmed by chest x-ray and gram stain. The most appropriate antibiotics for treatment pneumococcal infection are macrolides, beta-lactams, and quinolones. Two vaccines, PPSV23 and PCV13, are highly effective in preventing infection.

Infections Due to Streptococcus pneumoniae

Pneumococci, or Streptococcus pneumoniae, are gram-positive, lancet-shaped diplococci but may also grow in short chains. The polysaccharide polymer that forms the outer capsule of S pneumoniae is chemically and antigenically unique and is crucial to virulence. There are at least 90 distinct serotypes. The capsule allows the bacteria to resist phagocytosis by leukocytes unless the organisms have been opsonized by antibody or serum complement components. Certain pneumococcal serotypes, such as the heavily encapsulated type 3 pneumococcus, are particularly virulent. In fact, only 23 serotypes account for 80% of bacteremic pneumococcal infections in the United States; capsular polysaccharides from these 23 serotypes are incorporated into the polyvalent polysaccharide pneumococcal vaccine (PPSV23), which has been available since 1983. This review covers the epidemiology and pathogenesis of pneumococcal infections, clinical pneumococcal infections, and prevention of pneumococcal infections. Adverse outcomes in pneumococcal pneumonia, antibiotic treatment for penicillin-resistant S pneumoniae, and Centers for Disease Control and Prevention child and adolescent immunization schedules are discussed. This review contains 1 figure, 6 tables, and 41 references. Key words: bacterial pneumonia, PCV13, penicillin-resistant Streptococcus pneumoniae, pneumococcal pneumonia, pneumococcus, PPSV23, pneumonia vaccine, Streptococcus pneumoniae

Вакцинопрофилактика пневмококковых инфекций: в фокусе взрослые из организованных коллективов

Вакцинопрофилактика пневмококковых инфекций: в фокусе взрослые из организованных коллективов

An experience of vaccination against pneumococcal infection of adults at Krasnoyarsk krai

The aim of the study was to investigate efficacy of specific prevention of pneumococcal infection in high-risk group patients living at Krasnoyarsk krai. Methods. The study involved 12,080 patients with a high risk of pneumococcal infection including patients with chronic lung diseases, chronic heart failure (CHF) and diabetes mellitus. A special questionnaire was developed which included medical history for the previous 1 year and for 1 year after the vaccination. Results. CHF was diagnosed in 41.08% of patients, diabetes was diagnosed in 28.44%, chronic lung diseases were diagnosed in 30.07%; 2.4% of patients had pneumonia. PCV13 vaccine (Prevenar 13) was used in 9,986 patients (82.67%) including 5,070 patients (41.97%) vaccinated against flu and pneumococcus simultaneously. PPV23 (Pneumo-23) vaccine was used in 1,967 patients (16.28%) including 1,181 patients (9.83%) vaccinated against flu and pneumococcus simultaneously. Due to the broad-scale vaccination against pneumococcal infection, exacerbation rate reduced trice, number of hospitalisations related to exacerbations reduced by 11.5 times, morbidity of pneumonia reduced by 4.8 times, morbidity of acute respiratory infections and flu reduced by 6.6 times. Conclusion. The results confirmed high efficacy and safety of 13-valent conjugate pneumococcal vaccine and 23-valent polysaccharide pneumococcal vaccine. The vaccination allowed reducing morbidity of respiratory infection and decrease number of hospitalisations due to exacerbations of chronic diseases.

Streptococcus pneumoniae – Aspects of the implication in human pathology, epidemiology, diagnosis, treatment and prevention of pneumococcal infections

Streptococcus pneumoniae, part of the commensal flora of the nasopharynx, a bacterial conditioned pathogen, is the most common cause of respiratory tract infections. It is a fastidious bacterium that belongs to the family Streptococcaceae, genus Streptococcus. Pneumococcus has a number of virulence factors: endogenous (cellular components) and exogenous (enzymes, toxins), which play an important role in the pathogenesis of pneumococcal disease. Pneumococcal infections have different degrees of severity, from mild/moderate respiratory infections = non-invasive infections, which are the most common ones (otitis media, sinusitis, conjunctivitis), to very severe invasive infections (primary bacteremia, pneumonia with bacteremia, meningitis) – defined by the isolation of S. pneumoniae from a normally sterile place (blood, cerebrospinal fluid, pleural fluid etc.). Out of more than 90 pneumococcal serotypes, only 20 to 30 are responsible for the majority of invasive pneumococcal disease (IPD). These infections and their risk factors are summarized in the article. The diagnosis of pneumococcal disease is achieved through the isolation and identification of the pathogen, both by phenotypic and molecular methods. The treatment of the pneumococcal infections, mainly by antibiotherapy, is recommended depending on the location and severity of the infection, the results of antibiotic susceptibility testing and factors related to the human host. Regarding the emergence of antibiotic resistance in S. pneumoniae, it is very important to sustain the surveillance of pneumococcal disease and the prevention through vaccination, which determined a reduction in the incidence of IPD and antibiotic resistance. However, due to the limited use of pneumococcal vaccine, S. pneumoniae still remains the most common etiologic agent of severe infections. It is therefore necessary to implement a surveillance program to assess the burden of pneumococcal disease, in order to establish effective interventions, such as conjugate vaccines and antibiotic stewardship programs.

VACCINE PREVENTION OF PNEUMOCOCCAL INFECTIONS IN ADULTS

Pneumococcal infections (PI) is a group of acute antropozoonozes called pneumococcus that most often affects ENT organs, lungs and the central nervous system. A mechanism for transmission is air-borne – infection occurs during sneezing, coughing, conversation. The source is a sick man or a bacteria carrier. The Russian Federation is currently using pneumococcal vaccines for the prevention of PI. Polysaccharide vaccines operate under the T-independent immune response mechanism. This type of vaccine as an antigen contains the capsule polysaccharides activating the B-cell that launches the cloncal expansion of B- cells and their products of the IgM-class antibodies.

Pneumococcal vaccine in adults reduces the risk of infections caused by Streptococcus pneumoniae

Streptococcus pneumoniae is a major cause of severe disease worldwide, particularly in the risk population. Two pneumococcal vaccines are currently available for specific prevention of pneumococcal infections among adults in Russia: a 23-valent pneumococcal polysaccharide vaccine (PPSV23) and a 13-valent pneumococcal conjugate vaccine (PCV13). The article describes modern views on the effectiveness and safety of two pneumococcal vaccines in adults with underlying medical conditions and adults aged ≥ 65 years and provides current recommendations for routine use of PPSV23 and PCV13 among persons included in the risk group.

Pneumococcal colonization in older adults.

BackgroundLittle is known about pneumococcal carrier states in older adults. The main aim of this study was to evaluate pneumococcal colonization patterns among older adults in two centres in Milan, Italy, before the widespread use of the 13-valent pneumococcal vaccine (PCV13) in this age group, to investigate demographic and clinical features that are associated with pneumococcal colonization and to estimate the potential coverage offered by PCV13.ResultsAmong 417 adults ≥65 years old (171, 41.1 %, ≥75 years), 41 (9.8 %) were pneumococcal carriers. Univariate and multivariate analyses revealed that pneumococcal colonization was significantly less common among individuals with underlying co-morbidities than among those without (odds ratio [OR] 0.453, 95 % confidence interval [CI] 0.235–0.875, p = 0.018; adjusted OR 0.503, 95 % CI 0.255–0.992, p = 0.047). Moreover, among these patients, those with cardiac disease had a significantly lower risk of colonization (OR 0.308, 95 % CI 0.119–0.795, p = 0.015; adjusted OR 0.341, 95 % CI 0.13–0.894, p = 0.029). Only one vaccinated subject who received 23-valent polysaccharide pneumococcal vaccine (PPV23) was colonized. Twenty-five (89.3 %) of the subjects who were <75 years old and 9 (75.0 %) of those who were ≥75 years old were colonized by at least one of the serotypes that is included in PCV13, with serotype 19 F being the most common. Respiratory allergies as well as overall co-morbidities were more common in subjects who were positive for only non-PCV13 serotypes compared with negative subjects and those who were carriers of only PCV13 serotypes.ConclusionsAlthough this study included a relatively small number of subjects and has been performed in a limited geographic setting, results showed that pneumococcal colonization in older people is common, and the monitoring of carriers can offer useful information about the circulation of this pathogen among older people and the potential protective effect of pneumococcal vaccines. Because the colonization in most cases involves the strains that are included in PCV13, this vaccine could be useful in the prevention of pneumococcal infections in the overall population of older people. In subjects with respiratory allergies and in those with co-morbidities, the addition of the PPV23 to PCV13 should be recommended. Due to the low vaccination coverage, urgent educational programmes are required to inform older adults and their medical doctors of the risks of pneumococcal infection and the efficacy and safety of the available pneumococcal vaccines.

The prevention of pneumococcal infections.

Streptococcus pneumoniae causes considerable number of diseases like pneumonia, bacteremia or sepsis, meningitis, otitis media, sinusitis, peritonitis, endocarditis, osteomyelitis, septic arthritis, and soft tissue infection [1,2,3]. According to the Korean statistics of death, 12,021 people died of pneumonia during the year 2014, mortality is 23.7 per 100,000 people, accounting for 4.5% of deaths, which meant the fifth frequent cause of mortality in Korea [4]. However, the morbidity and mortality of pneumonia caused by S. pneumoniae was not known because the national surveillance was not yet performed. Woo et al. [2] investigated the 588 patients with pneumonia admitted in University Hospitals and co-organized with the Korean Society of Infectious Diseases, which revealed the etiological agents in 225 patients (38.3%). S. pneumoniae was identified in 57 of 225 patients (21.7%). Average length of hospital stay was 13.4 days, 61 cases (10.4%) received intensive care, 42 died and mortality was 7.1%. Six patients died of pneumococcal pneumonia, mortality rate was 14% (6/42) [2,3,4].

Prevention of Pneumococcal Infection in Children with Chronic Diseases of the Nasopharynx Reduces the Incidence of Other Respiratory Tract Infections: Results of a Comparative Prospective Study

Background: A promising approach to solving the problem of widespread infections of the respiratory tract in children is the use of specific prophylaxis against the pneumococcus. Objective : Our aim was to examine the clinical efficacy of PCV13 of children with chronic foci of infection in the nasopharynx and the changes of local factors of protection of the upper respiratory tract. Methods: We have evaluated the incidence of respiratory tract and ENT infections in children with chronic diseases of the nasopharynx. Research period: January 2011 — January 2015. Upper airway function examination included cytologic analysis — counting the main cell populations ratio in the common cytoplasm, lysozym activity and secretory immunoglobulin of class A (sIgA) in nasal secretions. Results: The study involved 876 children 2–5 years old. Main group (PCV13) amounted to 448 patients, and the control group (unvaccinated) 428. Annual dynamic observation showed a significant reduction of acute morbidity by 2 times (p < 0.001), pneumonia by 2.4 times (p = 0.042), acute bronchitis by 2.5 times (p = 0.008), concomitant ENT pathology (acute otitis media and acute exacerbations of chronic sinusitis) by 2.2 times (p = 0.001) and 2.3 times (p = 0.004), respectively. There was a positive effect of vaccination on the level of local factors of protection of the upper respiratory tract (lysozyme, sIgA, the somatic cell count in nasal secretions). Conclusion: PCV13 vaccination reduces the risk of developing acute respiratory infections and ENT infections in children with chronic diseases of the nasopharynx. This is against the background of recovery in the levels of factors of local immunity.

Prevention of pneumococcal infections during mass gathering

The interest in mass gathering and its implications has been increasing due to globalization and international travel. The potential occurrence of infectious disease outbreaks during mass gathering is most feared. In this context, respiratory tract infections are of great concern due to crowding in a limited space which facilitates and magnifies the potential of disease spread among attendees. Pneumococcal disease is best described among pilgrims to Makkah and vaccination is one of the methods for the prevention of this disease. Pneumonia was described in a mass gathering with a prevalence of 4.8/100,000 pilgrims and contributes to 15–39% of hospitalizations. Various studies showed that 7–37% of pilgrims are 65 y of age or older. The uptake of pneumococcal vaccine among pilgrims is low at 5%. There is no available data to make strong recommendations for S. pneumoniae vaccination of all pilgrims, it is important that a high risk population receive the indicated vaccination. We reviewed the available literature on the burden of pneumococcal infections during mass gathering and evaluate the available literature on pneumococcal vaccinations for attendees of mass gathering.