Pentavalent pneumococcal oligosaccharide conjugate vaccine PncCRM is well-tolerated and able to induce an antibody response in infants

Åhman, Heidi; Käyhty, Helena; P, Tamminen; Vuorela, Arja; Malinoski, Frank; Eskola, Juhani

doi:10.1097/00006454-199602000-00009

Cited by 129 publications

(41 citation statements)

References 30 publications

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“…Culturing only one site significantly reduced the recovery of H. influenzae at all ages. NP cultures for S. pneumoniae detected close to 100% of isolates in children but only 58% of isolates in mothers.Streptococcus pneumoniae and Haemophilus influenzae are important bacterial pathogens causing infections in young children and in elderly patients (1,22,23). Both organisms commonly colonize the mucosal membrane of the nasopharynx and throat of healthy children, and most children are colonized at some point during the first 2 years of life (10, 15).…”

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confidence: 99%

Relative Importance of Nasopharyngeal versus Oropharyngeal Sampling for Isolation of Streptococcus pneumoniae and Haemophilus influenzae from Healthy and Sick Individuals Varies with Age

Greenberg¹,

Broides

Blancovich³

et al. 2004

J Clin Microbiol

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Streptococcus pneumoniae and Haemophilus influenzae carriage is a useful index for measuring the emergence of resistance and outcome in vaccination trials. We performed a study to determine which sampling site, nasopharynx (NP) or oropharynx (OP), yields the highest rate of S. pneumoniae and H. influenzae isolation at different ages. Both NP and OP cultures were obtained from 216 children aged <60 months and their mothers. The total S. pneumoniae carriage rate was 68% among children and 15% among mothers (P < 0.001). Using NP alone for the isolation of S. pneumoniae would have missed 2, 2, and 42% and using OP alone would have missed 77, 66, and 45% of S. pneumoniae in children aged 0 to 23 months, 24 to 59 months, and mothers, respectively. Using NP cultures alone for H. influenzae would have missed 23, 24, and 81% of the isolates, respectively. The respective figures for H. influenzae isolation from OP alone are 38, 29, and 9%. In children, S. pneumoniae was carried mainly in the NP while H. influenzae was equally carried in the NP and OP. In mothers, S. pneumoniae was carried equally in the NP and OP while H. influenzae was carried significantly more often in the OP. In children, H. influenzae colonization increased during illness, mainly in the NP. Culturing only one site significantly reduced the recovery of H. influenzae at all ages. NP cultures for S. pneumoniae detected close to 100% of isolates in children but only 58% of isolates in mothers.Streptococcus pneumoniae and Haemophilus influenzae are important bacterial pathogens causing infections in young children and in elderly patients (1,22,23). Both organisms commonly colonize the mucosal membrane of the nasopharynx and throat of healthy children, and most children are colonized at some point during the first 2 years of life (10, 15). Information on the nasopharyngeal (NP) and oropharyngeal (OP) carriage rate of both organisms is crucial to understanding disease epidemiology, since these organisms can spread from colonized sites to adjacent mucosal tissues to cause mucosal infections or, in the case of S. pneumoniae, invade the bloodstream to cause bacteremia and meningitis. In addition to carriage in the upper respiratory tract, the organism can spread from person to person (16,17,24). Furthermore, studying the organisms carried in the upper respiratory tract provides useful information on the emergence of resistance in clinical isolates (18,27). It is also important to evaluate the mucosal carriage of the organisms in vaccine trials as an index of potential herd protection.Nasopharyngeal sampling is considered superior to OP sampling for detecting S. pneumoniae, especially in young children (25), but there are other contradictory results showing that in adults OP sampling yields higher isolation rates (4, 16). Only a few carriage studies have directly compared different sampling methods for the detection of S. pneumoniae and H. influenzae (4, 6, 25; R. Dagan, O. Zamir, M. Sikuler-Cohen, P. Yagupsky, P. Peeters, and M. Hohenboken, Abstr. 41st Intersc...

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confidence: 99%

Relative Importance of Nasopharyngeal versus Oropharyngeal Sampling for Isolation of Streptococcus pneumoniae and Haemophilus influenzae from Healthy and Sick Individuals Varies with Age

Greenberg¹,

Broides

Blancovich³

et al. 2004

J Clin Microbiol

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“…Conjugate pneumococcal vaccines containing five or seven polysaccharides have been found to be immunogenic in the first year of life in several studies (1,3,31). However, these vaccines are still experimental and the small number of serotype polysaccharides included in the vaccines may limit the coverage they offer.…”

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confidence: 99%

862 Transplacental transmission of serotype-specific pneumococcal antibodies in a Brazilian population

Calvalho¹,

Sampaio²,

Solé³

et al. 1996

Journal of Allergy and Clinical Immunology

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The highest incidence of severe pneumococcal infections in children occurs in the first 6 months of life; however, immunization of infants with the existing polysaccharide vaccines is ineffective. We wished to determine the prevalence of immunoglobulin G (IgG) pneumococcal antibodies in unimmunized Brazilian mothers and their transplacental transmission to term and preterm infants. Total IgG, IgG1 and -2 subclass levels, and IgG antibodies against Streptococcus pneumoniae serotypes 1, 3, 6B, 9V, and 14 were determined in 15 pairs of mothers and term newborns (gestational age, >37 weeks) and in 18 pairs of mothers and preterm newborns (gestational age, 32 to 36 weeks). Serotype-specific anti-pneumococcal antibodies were detected by a recently standardized enzyme-linked immunosorbent assay calibrated with the 89-SF reference serum. Varying percentages of the mothers had antibody concentrations below arbitrarily defined protective levels: 33% for serotype 1, 67% for serotype 3, 30% for serotype 6B, 52% for serotype 9V, and 22% for serotype 14. In term newborns, IgG1 concentrations were slightly higher than maternal concentrations; in preterm newborns, the concentrations were much lower. Concentrations of IgG2 in term and preterm infants were significantly lower than in the mothers. Transplacental transmission of antibodies to serotypes 3 and 14 was clearly different from that of antibodies to serotypes 1, 6B, and 9V. Concentrations of IgG antibodies against serotypes 3 and 14 were similar to or higher than those of the mothers; against serotypes 1, 6B, and 9V they ranged from 77 to 83% of maternal concentrations in term newborns and also in preterm infants, although transplacental transmission of antibodies was proportionally lower for each specific serotype in preterm than in term infants. These data are relevant for developing strategies to protect infants against pneumococcal infections in the first months of life. Our findings and a review of existing information stress the importance of understanding the relationships among pneumococcal immunization, IgG subclass antibodies to individual serotypes, transplacental transport, half-life, and antibody function and their protective values against infection.Pneumococcal infections cause high morbidity and mortality in children during the first 2 years of life, with the highest incidence of severe, systemic pneumococcal infections occurring in the first year of life (15,18). Immunization of infants with the existing polysaccharide vaccines, however, becomes effective only after 2 years of age.Conjugate pneumococcal vaccines containing five or seven polysaccharides have been found to be immunogenic in the first year of life in several studies (1,3,31). However, these vaccines are still experimental and the small number of serotype polysaccharides included in the vaccines may limit the coverage they offer. A 10-year study of 308 cases of meningitis in children under 2 years of age in São Paulo, Brazil (48), reveals that vaccine formula B, which includes serotypes 1, 5,...

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“…Large studies have shown that a pneumococcal conjugate vaccine is immunogenic and reduces invasive disease in infants and children. [33][34][35] …”

Section: Discussionmentioning

confidence: 99%

Carriage of antibiotic-resistant pneumococci in a cohort of a daycare center

Gómez-Barreto¹,

Calderón-Jaimes²,

Rodrı́guez³

et al. 2002

Salud pública Méx

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ResumenObjetivo. Analizar longitudinalmente la dinámica de colonización por Streptococcus pneumoniae, determinar la prevalencia, los factores de riesgo potencial para la colonización nasofaríngea con cepas de neumococo resistentes, determinar los serotipos y el perfil de sensibilidad a varios fár-macos antimicrobianos. Material y métodos. Estudio prospectivo de una cohorte de niños de guardería, hecho de septiembre de 1997 a septiembre de 1999 entre 53 niños asistentes a la guardería del Hospital Infantil de México Federico Gómez, atendida por 20 empleados. Todos los participantes fueron seguidos en forma prospectiva, tomándose exudado nasofaríngeo cada cuatro meses. Los S. pneumoniae aislados se tipificaron y sometieron a pruebas de sensibilidad a diversos fármacos. Las razones de momios y la prueba exacta de Fisher o ji cuadrada se efectuaron a través de tablas de contingencia; se utilizaron intervalos de confianza a 95% para las razones de momios. Para el análisis se empleó el programa estadístico EPI INFO, versión 6.04 a. Resultados. S. pneumoniae se recuperó de 45/53 niños en una o más de las tomas. Se aisló un total de 178 cepas. El promedio de portador fue de 47%. Sólo siete adultos adquirieron un neumococo durante el estudio. Los tipos 6, 14, 19 y 23 representaron 77% del total. Se encontró elevada resistencia a la penicilina y eritromicina. Conclusiones. El estado de portador nasofaríngeo de S. pneumoniae, es un proceso dinámico. La colonización ocurre durante los primeros meses de vida y comprende solamente unos cuantos serotipos de neumococo. El estado portador disminuye conforme avanza la edad. Se encontró alta proporción de portadores con cepas resistentes de neumococo. Los niños que recibieron varios cursos de antimicrobianos, fueron Patients were enrolled in the study during a two-year period from September 1997 to September 1999. All the participants were followed prospectively, swabbing them every four months. The strains recovered were typed and screened for susceptibility to several antibiotics. The daycare records were reviewed also. Odds ratios and fisher's exact test: or chi square test of significance were computed from contingency tables as appropriate. Exact 95% confidence intervals were computed for odds ratios. Data analysis was performed using Epi statistics program version 6.04 a.Results. Pneumococci were recovered from 45/53 of the infants at one or more visits. A total of 178 isolates were carried. The carriage rate was 47%. Only 7 adults acquired pneumococci during the study. Types 6,14,19 and 23 were prevalent and represented 77% of the total. Antibioticresistant strains were higher to penicillin and erythromycin. Conclusions. Children were frequent carriers of pneumococci, the rate of carriage was high in infancy and tended to decrease with age. The types commonly carried by children were the same as those causing invasive disease. There is a high proportion of carriers with antibiotic-resistant S. pneumoniae strains. Children who have had frequent antimicrobial courses are at p...

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Pentavalent pneumococcal oligosaccharide conjugate vaccine PncCRM is well-tolerated and able to induce an antibody response in infants

Cited by 129 publications

References 30 publications

Relative Importance of Nasopharyngeal versus Oropharyngeal Sampling for Isolation of Streptococcus pneumoniae and Haemophilus influenzae from Healthy and Sick Individuals Varies with Age

Relative Importance of Nasopharyngeal versus Oropharyngeal Sampling for Isolation of Streptococcus pneumoniae and Haemophilus influenzae from Healthy and Sick Individuals Varies with Age

862 Transplacental transmission of serotype-specific pneumococcal antibodies in a Brazilian population

Carriage of antibiotic-resistant pneumococci in a cohort of a daycare center

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