Prevention of Invasive Pneumococcal Disease: Problems Emerged After Some Years of the 13-Valent Pneumococcal Conjugate Vaccine Use

Principi, Nicola; Cara, Giuseppe Di; Bizzarri, Ilaria; Isidori, Chiara; Borgia, Paola; Mignini, Costanza; Saponara, Marco; Argentiero, Alberto; Esposito, Susanna

doi:10.1007/s11908-018-0607-z

Cited by 26 publications

(15 citation statements)

References 64 publications

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“…agalactiae but also for evaluating the potential impact of vaccine strategies according to the peculiarities of each geographic area. This is of particular importance when serotypes not included in vaccine schemes tend to emerge after vaccine introduction; this was the case for pneumococcal conjugate vaccines and for the Haemophilus influenza vaccine worldwide [ 43 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

Streptococcus agalactiae carriage among pregnant women living in Rio de Janeiro, Brazil, over a period of eight years

et al. 2018

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Group B Streptococcus (GBS) carriage by pregnant women is the primary risk factor for early-onset GBS neonatal sepsis. Intrapartum antibiotic prophylaxis (IAP) can prevent this transmission route, and two main approaches are recommended to base the selection of pregnant women to be submitted to IAP: the risk-based and the culture-based strategies. In Brazil, compliance to such recommendations is poor, and not much is known about GBS carriage. In the present study, 3,647 pregnant women living in Rio de Janeiro State, Brazil, were screened for GBS anogenital colonization, over a period of 8 years (2008–2015). GBS was detected in 956 (26.2%) of them, and presence of vaginal discharge was the only trait associated with a higher risk for GBS colonization. Serotypes Ia (257; 37.3%) and II (137; 19.9%) were the most frequent among 689 (72.1% of the total) GBS isolates evaluated, followed by NT isolates (84; 12.1%), serotype Ib (77; 11.1%), V (63; 9.1%), III (47; 6.8%) and IV (24; 3.5%). Estimated coverage of major serotype-based GBS vaccines currently under clinical trials would vary from 65.2% to 84.3%. All 689 isolates tested were susceptible to ampicillin and vancomycin. Resistance to chloramphenicol, clindamycin, erythromycin, levofloxacin, and tetracycline was observed in 5% (35), 2% (14), 14% (97), 5% (35) and 86% (592) of the isolates, respectively. No significant fluctuations in colonization rates, serotype distribution and antimicrobial susceptibility profiles were observed throughout the period of time investigated. The culture-based approach for IAP recommendation showed to be the best choice for the population investigated when compared to the risk-based, since the first did not increase the number of pregnant women submitted to antibiotic therapy and covered a larger number of women who were actually colonized by GBS. The fact the not all isolates were available for additional characterization, and serotype IX antiserum was not available for testing represent limitations of this study. Nevertheless, to the best of our knowledge, this is the largest investigation on GBS carriage among pregnant women in Brazil up to date, and results are useful for improving GBS prevention and treatment strategies.

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Section: Discussionmentioning

confidence: 99%

Streptococcus agalactiae carriage among pregnant women living in Rio de Janeiro, Brazil, over a period of eight years

et al. 2018

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“…S. pneumoniae is a Gram-positive coccus that can survive under both aerobic and anaerobic conditions [59]. It causes mucosal and invasive infections in children and adults, most commonly acute otitis media (AOM), community-acquired pneumonia (CAP), and invasive pneumococcal diseases (IPD), such as bacteraemia and meningitis [60][61][62][63][64].…”

Section: Pneumococcal Vaccinationmentioning

confidence: 99%

Vaccination against Paediatric Respiratory Pathogens

et al. 2019

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Acute respiratory infections (ARIs) are extremely common in children, especially those under 5 years old. They can lead to complications, super-infection, respiratory failure, and even compromised respiratory function in adulthood. For some of the responsible pathogens, vaccines are available. This review reports current issues about vaccines against the main respiratory pathogens to highlight the available strategies to reduce the burden of paediatric respiratory disease. The optimal use of influenza, pneumococcal, pertussis and measles vaccines is required in order to reduce ARI burden. Vaccination coverage rates must be improved to achieve the full benefits of these vaccines. Recently, advances in the knowledge of respiratory syncytial virus structural biology and immunology as well as the development of new techniques to generate vaccine candidates have increased the number of promising vaccines even against this harmful pathogen.

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“…Vaccines are only partially effective. Polysaccharide pneumococcal conjugate vaccines protect from the infections of no more than 13 pneumococcal serotypes although more than 90 serotypes can cause disease [6]. Finally, influenza vaccines are effective in no more than 80% of vaccinated children, with significant reduction of efficacy when mismatch between circulating vital strains and strains included in the vaccine occurs [7].…”

Section: Introductionmentioning

confidence: 99%

A randomized, placebo-controlled, double-blinded, single-centre, phase IV trial to assess the efficacy and safety of OM-85 in children suffering from recurrent respiratory tract infections

et al. 2019

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Background Over many years, OM-85, a lysate of 21 common bacterial respiratory pathogens, has been demonstrated to prevent respiratory recurrences in children. However, further studies are needed to explore the true importance of OM-85 in the prevention of respiratory tract infections (RTIs) in children. This study was planned to further contribute to the evaluation of the role played by OM-85 in prevention of recurrent RTIs in children. Methods This study was a randomized (3:3:1), placebo-controlled, double-blind, single-centre, phase IV trial carried out in Italy to assess the efficacy of OM-85 (Broncho-Vaxom ® ; Vifor Pharma; Meyrin 2/Geneva, Switzerland) in reducing the number of new RTI episodes in 288 children aged 1 to 6 years with a history of recurrent RTIs and to compare the efficacy of the standard 3-month regimen with that of administration of OM-85 for 6 months during a 6-month study period. Results The number of RTIs and of children who experienced at least one RTI were significantly lower among patients receiving OM-85 for 3 months than among those given placebo (33% vs 65.1%, p < 0.0001). Differences were statistically significant for upper RTIs (i.e., common cold/viral pharyngitis and acute otitis media; p < 0.0001 and p = 0.006, respectively). Days of absence from day-care for children and working days lost by parents were significantly lower in the group with children treated with OM-85 for 3 months than in the placebo group (p = 0.007 and p = 0.004, respectively). No difference was seen between children who received OM-85 for 3 and those who received OM-85 for 6 months. The prevalence of atopy as well as the history of recurrent wheezing and age of the study child did not influence the results. Benefit was maximally evident among children with a history of frequent recurrences. OM-85 was well tolerated and safe, even in children who received an influenza vaccination. Conclusions The use of OM-85 for 3 months in 3 series of 10 consecutive days each time reduces the risk of recurrent RTIs in children, with a favourable safety profile. The greater effect observed in children prone to several respiratory episodes than in non-prone children seems to indicate that this lysate should be administered especially to children with a proven high susceptibility to RTIs.

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Prevention of Invasive Pneumococcal Disease: Problems Emerged After Some Years of the 13-Valent Pneumococcal Conjugate Vaccine Use

Cited by 26 publications

References 64 publications

Streptococcus agalactiae carriage among pregnant women living in Rio de Janeiro, Brazil, over a period of eight years

Streptococcus agalactiae carriage among pregnant women living in Rio de Janeiro, Brazil, over a period of eight years

Vaccination against Paediatric Respiratory Pathogens

A randomized, placebo-controlled, double-blinded, single-centre, phase IV trial to assess the efficacy and safety of OM-85 in children suffering from recurrent respiratory tract infections

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