Hyporesponsiveness to the infecting serotype after vaccination of children with seven-valent pneumococcal conjugate vaccine following invasive pneumococcal disease

Tamura, Kazuyo; Matsubara, Kousaku; Ishiwada, Naruhiko; Nishi, Junichiro; Ohnishi, Hiroyuki; Suga, Shigeru; Ihara, Toshiaki; Chang, Bin; Akeda, Yukihiro; Oishi, Kazunori

doi:10.1016/j.vaccine.2014.01.031

Cited by 11 publications

(14 citation statements)

References 24 publications

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“…In children who had been vaccinated with PCV prior to developing invasive pneumococcal disease, antibody levels directly after the infection were lower against the infecting serotype compared to other vaccine serotypes [ 9 ]. Furthermore, it has been observed that some children with invasive pneumococcal disease remained hyporesponsive to the infecting pneumococcal serotype, even after recovery [ 9 , 10 ]. A possible explanation for this phenomenon is that hyporesponsiveness to PCV can be caused by pneumococcal carriership at time of vaccination.…”

Section: Discussionmentioning

confidence: 99%

Case report on a defective antibody response against pneumococcal serotype 9V in a patient with a single episode of pneumonia

et al. 2017

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BackgroundPatients with recurrent respiratory tract infections and an impaired response to pneumococcal polysaccharide vaccination are diagnosed with a specific antibody deficiency. In adult patients with pneumococcal pneumonia an impaired antibody response to the infecting pneumococcal serotype can sometimes be found. It is unknown whether these patients are unable to produce an adequate anti-polysaccharide antibody response to pneumococcal vaccination after recovery.Case presentationThe authors describe a case of invasive pneumonia caused by Streptococcus pneumoniae serotype 9V in a previously healthy 35-year-old female. This patient did not produce serotype-specific antibodies against the infecting serotype during disease. After pneumococcal polysaccharide vaccination 3 months after recovery, she responded adequately to most other pneumococcal serotypes, but still had no response to the infecting serotype 9V. However, after 9 years (and prior to pneumococcal-conjugate vaccination) normal antibody levels against 9V were found. These antibody levels further increased after pneumococcal-conjugate vaccination.ConclusionThe authors believe that this case is the first description of a temporary deficient response to the infecting pneumococcal serotype in adults, while other reports with similar observations all involved children.

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Section: Discussionmentioning

confidence: 99%

Case report on a defective antibody response against pneumococcal serotype 9V in a patient with a single episode of pneumonia

et al. 2017

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“…First, no marked increase in IgG for a specific serotype was detected after vaccination, probably because of immune paralysis (27). Second, no sufficient opsonization activity was found, probably because of the lower avidity of serotype-specific IgG against pneumococcal infection (17,30). Third, pneumococcal carriage in the nasopharynx was detected, which may also be caused by immune paralysis (32,33).…”

Section: Discussionmentioning

confidence: 99%

“…To prevent infections caused by bacteria, immunizations containing pneumococcal vaccines were recommended. However, hyporesponsiveness to serotype 6B of S. pneumoniae after vaccination has been frequently reported (27)(28)(29)(30). The same ST4250 S. pneumoniae strain, or one that was at least genetically closely related, was identified as the responsible bacterium in these infectious cases.…”

Section: Discussionmentioning

confidence: 99%

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Capsule Switching and Antimicrobial Resistance Acquired during Repeated Streptococcus pneumoniae Pneumonia Episodes

et al. 2015

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e Streptococcus pneumoniae colonizes the nasopharyngeal mucus in healthy people and causes otitis media, pneumonia, bacteremia, and meningitis. In this study, we analyzed an S. pneumoniae strain that caused 7 repeated pneumonia episodes in an 80-month-old patient with cerebral palsy during a period of 25 months. A total of 10 S. pneumoniae strains were obtained from sputum samples, and serotype 6B was isolated from samples from the first 5 episodes, whereas serotype 6A was isolated from samples from the last 2. Whole-genome sequencing showed clonality of the 10 isolates with 10 single nucleotide polymorphisms (SNPs) in the genomes. Among these SNPs, one single point mutation in the wciP gene was presumed to relate to the serotype switching from 6B to 6A, and the other mutations in parC and gyrA were related to fluoroquinolone resistance. These results suggested that an S. pneumoniae strain, which asymptomatically colonized the patient's nasopharynx or was horizontally transmitted from an asymptomatic carrier, caused the repeated pneumonia events. Phenotypic variations in the capsule type and antimicrobial susceptibility occurred during the carrier state. Hyporesponsiveness to serotypes 6B and 6A of S. pneumoniae was found even after vaccination with the 7-valent pneumococcal conjugate vaccine and the 23-valent pneumococcal polysaccharide vaccine. After an additional vaccination with the 13-valent pneumococcal conjugate vaccine, opsonic activities for both serotypes 6A and 6B significantly increased and are expected to prevent relapse by the same strain. Streptococcus pneumoniae is the etiologic agent of several bacterial diseases, such as otitis media, pneumonia, bacteremia, and meningitis (1-3), and it can asymptomatically colonize a child's nasopharynx for months (4). Colonization by S. pneumoniae is a prerequisite for various types of pneumococcal diseases and the source of transmission of the bacterium between people (5, 6). In Japan, approximately 80% of 3-year-old children were colonized by this bacterium, which may cause pneumococcal diseases, at least once (7).Since 2000, the widespread use of 7-and 13-valent pneumococcal conjugate vaccines (PCV7 and PCV13, respectively) has reduced the incidence of pneumococcal infections (8-11) and the colonization rate of the vaccine serotypes but has not affected the overall colonization (12-15). In Japan, PCV7 was introduced in 2010 and was replaced by PCV13 in November 2013. After 2011, invasive pneumococcal disease (IPD) caused by S. pneumoniae isolates belonging to serotypes included in the PCV7 decreased (16). However, some unusual vaccine failures and/or breakthrough infection cases were reported together with the hyporesponsiveness to one or several serotypes (17).Since 2011, we have observed repeated pneumococcal pneumonia episodes in a child who has an underlying disease. Although vaccinations with PCV7 were performed, an additional 6 pneumococcal pneumonia infections occurred during the following 24 months. In this longitudinal study, we analyzed 10 S. pneu...

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“…The GMCs of serotype-specific IgG for all PCV7 serotypes other than serotype 6B were significantly increased after the last PCV7 dose compared with those at the time of IPD onset (Table 1 ), as were the GMTs of OIs for all PCV7 serotypes (Table 2 ). These data suggest that PCV7 is generally immunogenic for pediatric patients with IPD, with an exception for the infecting serotypes [ 12 ].…”

Section: Pneumococcal Diseases and Pneumococcal Conjugate Vaccinementioning

confidence: 99%

Global Control of Pneumococcal Infections by Pneumococcal Vaccines

2014

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Streptococcus pneumoniae is a major worldwide cause of morbidity and mortality. Pneumococcal carriage is considered to be an important source of horizontal spread of this pathogen within the community. Pneumococcal conjugate vaccine (PCV) is capable of inducing serotype-specific antibodies in sera of infants, and has been suggested to reduce nasopharyngeal carriage of vaccine-type pneumococci in children. PCV is generally immunogenic for pediatric patients with invasive pneumococcal disease, with an exception for the infecting serotypes. Based on evidences from the clinical trials of PCV, the health impact of childhood pneumococcal pneumonia appears to be high in developing countries where most of global childhood pneumonia deaths occur. PCV vaccination may prevent hundreds of deaths per 100,000 children vaccinated in developing countries, while PCV vaccination is expected to prevent less than 10 deaths per 100,000 children vaccinated in the developed countries. Therefore, the WHO has proposed a strategy to reduce the incidence of severe pneumonia by 75% in child less than 5 years of age compared to 2010 levels by 2025.

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Hyporesponsiveness to the infecting serotype after vaccination of children with seven-valent pneumococcal conjugate vaccine following invasive pneumococcal disease

Cited by 11 publications

References 24 publications

Case report on a defective antibody response against pneumococcal serotype 9V in a patient with a single episode of pneumonia

Case report on a defective antibody response against pneumococcal serotype 9V in a patient with a single episode of pneumonia

Capsule Switching and Antimicrobial Resistance Acquired during Repeated Streptococcus pneumoniae Pneumonia Episodes

Global Control of Pneumococcal Infections by Pneumococcal Vaccines

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