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Pneumococcal vaccine in adults

Kaile Chen, Xiyan Zhang, Wei Shan, Genming Zhao, Tao Zhang
OBJECTIVE: Thirteen-valent pneumococcal conjugate vaccines (PCV13) was licensed for optional use in mainland China since 2017, but the uptake is low. To update the research evidence for the pneumococcal serotype distribution of pre-PCV era and to estimate the potential impact of PCVs, we performed a meta-analysis on the relevant publications concerning the Chinese population. METHODS: This systematic review and meta-analysis were conducted on the pneumococcal serotype distribution publications in mainland China from 2000 to 2016...
February 16, 2018: Human Vaccines & Immunotherapeutics
A R Domínguez-Alegría, V Pintado, I Barbolla
Invasive pneumococcal disease is a severe infection that mainly affects patients with associated comorbidity. The paediatric conjugate vaccination has resulted in a change in the adult vaccination strategy. The antibiotic resistance of pneumococcus is not currently a severe problem. Nevertheless, the World Health Organisation has included pneumococcus among the bacteria whose treatment requires the introduction of new drugs, such as ceftaroline and ceftobiprole. Although the scientific evidence is still limited, the combination of beta-lactams and macrolides is recommended as empiric therapy for bacteraemic pneumococcal pneumonia...
February 12, 2018: Revista Clínica Española
Satoshi Kakiuchi, Motoi Suzuki, Bhim Gopal Dhoubhadel, Akitsugu Furumoto, Hiroyuki Ito, Kei Matsuki, Yoshiko Tsuchihashi, Norichika Asoh, Michio Yasunami, Koya Ariyoshi, Konosuke Morimoto
The lack of reliable diagnostic tests for detecting vaccine serotype pneumococcal pneumonia (VTPP) remains a challenging issue in pneumococcal vaccine studies. This study assessed the performances of high-throughput nanofluidic PCR-based pneumococcal serotyping and quantification assay methods using sputum samples (nanofluidic Sp-qPCR) to diagnose the 13-valent pneumococcal conjugate VTPP compared with that of the serotype-specific urinary antigen detection (UAD) assay using urine samples. Adult pneumonia patients from Japan were enrolled in this study between September 2012 and August 2014...
February 14, 2018: Journal of Clinical Microbiology
Priya Daniel, Chamira Rodrigo, Thomas Bewick, Carmen Sheppard, Sonia Greenwood, Tricia M McKeever, Caroline Trotter, Wei Shen Lim
There is debate regarding the value of vaccinating adults with the 13-valent pneumococcal conjugate vaccine (PCV-13). This analysis was conducted to investigate the risk of PCV-13 serotype community acquired pneumonia (CAP) in hospitalised adults with co-morbid disease and risk factors for pneumococcal disease in the UK. Consecutive adults hospitalised (2008-2013) with a primary diagnosis of CAP, were recruited. Pneumococcal aetiology disease was identified by use of pneumococcal urinary antigen detection and serotype identification using a validated multiplex immunoassay or serum latex agglutination...
February 10, 2018: Vaccine
José A Suaya, Qin Jiang, Daniel A Scott, William C Gruber, Chris Webber, Beate Schmoele-Thoma, Cassandra K Hall-Murray, Luis Jodar, Raul E Isturiz
BACKGROUND: Individuals with certain chronic medical conditions are at higher risk of developing pneumonia and pneumococcal disease than those without. Using data from the Community-Acquired Pneumonia Immunization Trial in Adults (CAPiTA), this post hoc analysis assessed the efficacy of the 13-valent pneumococcal conjugate vaccine (PCV13) in adults aged ≥65 years with at-risk conditions. METHODS: The Community-Acquired Pneumonia Immunization Trial in Adults (CAPiTA) was a double-blind, parallel-group, randomized, placebo-controlled study in the Netherlands in which adults aged ≥65 years received either PCV13 or placebo...
February 8, 2018: Vaccine
Lander Willem, Adriaan Blommaert, Germaine Hanquet, Nancy Thiry, Joke Bilcke, Heidi Theeten, Jan Verhaegen, Herman Goossens, Philippe Beutels
Streptococcus pneumoniae causes a high disease burden including pneumonia, meningitis and septicemia. Both a polysaccharide vaccine targeting 23 serotypes (PPV23) and a 13-valent conjugate vaccine (PCV13) are indicated for persons aged over 50 years. We developed and parameterized a static multi-cohort model to estimate the incremental cost-effectiveness and budget-impact of these vaccines at different uptake levels. Using three different vaccine efficacy scenarios regarding non-invasive pneumococcal pneumonia and extensive uni- and multivariate sensitivity analyses, we found a strong preference for PPV23 over PCV13 in all age groups at willingness to pay levels below €300 000 per quality adjusted life year (QALY)...
February 8, 2018: Human Vaccines & Immunotherapeutics
Hakan Ozdogu, Can Boga, Suheyl Asma, Ilknur Kozanoglu, Cigdem Gereklioglu, Mahmut Yeral, Nurhilal Turgut Buyukkurt, Soner Solmaz, Aslı Korur, Pelin Aytan, Erkan Maytalman, Mutlu Kasar
The Eastern Mediterranean is among the regions where sickle cell disease (SCD) is common. The morbidity and mortality of this disease can be postponed to adulthood through therapies implemented in childhood. The present study focuses on the organ damage-reducing effects of the Baskent Sickle Cell Medical Care Development Program (BASCARE), which was developed by a team who lives in this region and has approximately 25 years of experience. The deliverables of the program included the development of an electronic health recording system (PRANA) and electronic vaccination system; the use of low citrate infusion in routine prophylactic automatic erythrocyte exchange (ARCE) programs including pregnant women; the use of leukocyte-filtered and irradiated blood for transfusion; the use of magnetic resonance imaging methods (T2) for the management of transfusion-related hemosiderosis; and the implementation of an allogeneic hematopoietic stem cell transplantation protocol for adult patients...
February 2018: Medicine (Baltimore)
Georgios Tsivgoulis, Aristeidis H Katsanos, Ramin Zand, Muhammad Fawad Ishfaq, Muhammad Taimur Malik, Theodore Karapanayiotides, Konstantinos Voumvourakis, Sotirios Tsiodras, John Parissis
There is mounting evidence supporting infection as an independent risk factor for ischemic stroke (IS), while preliminary data indicate that vaccination may prevent IS. We performed a systematic review and meta-analysis of available randomized clinical trials (RCTs) or prospective observational cohorts reporting associations of influenza vaccination (IV) and/or pneumococcal vaccination (PV) with IS. We identified a total of 12 studies (543,311 patients; 47.4% vaccinated). Vaccination was not related to the risk of IS (RR=1...
March 15, 2018: Journal of the Neurological Sciences
Juthaporn Cowan, Thuy Linh Do, Sacha Desjardins, Karamchand Ramotar, Vicente Corrales-Medina, Donald William Cameron
Background: Patients with humoral immune deficiency are susceptible to invasive pneumococcal disease (IPD). This study estimates the prevalence of underlying hypogammaglobulinemia in admitted IPD cases and examines whether IPD cases had received preventative treatment. Methods: All adult IPD cases (Streptococcus pneumoniae in blood or cerebrospinal fluid) admitted to The Ottawa Hospital (TOH) from January 2013 to December 2015 were identified through the Eastern Ontario Regional Laboratory...
February 1, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Shamez N Ladhani, Sarah Collins, Abdelmajid Djennad, Carmen L Sheppard, Ray Borrow, Norman K Fry, Nicholas J Andrews, Elizabeth Miller, Mary E Ramsay
BACKGROUND: Pneumococcal conjugate vaccines (PCVs) have substantially reduced the incidence of invasive pneumococcal disease caused by vaccine serotypes; however, replacement disease with non-PCV serotypes remains a concern. We describe the population effect of the seven-valent and 13-valent PCVs (PCV7 and PCV13) on invasive pneumococcal disease in England and Wales. METHODS: Using national invasive pneumococcal disease surveillance data for 2016/17, we compared incidence rate ratios (IRRs) against pre-PCV13 (2008/09-2009/10) and pre-PCV7 (2000/01-2005/06) baselines...
January 25, 2018: Lancet Infectious Diseases
C Chen, J G Wood, P Beutels, R Menzies, C R MacIntyre, S Dirmesropian, J F Reyes, P McIntyre, A T Newall
While the impact of the timeliness of vaccine administration has been well-studied for childhood vaccinations, there has been little detailed quantitative analysis on the potential impact of the timeliness of vaccinations in older adults. The aim of this study was to explore the impact of implementing more realistic observed uptake distributions, taking into the account reduced vaccine efficacy but higher pneumococcal disease burden with increasing age beyond 65 years. A multi-cohort Markov model was constructed to evaluate the cost-effectiveness of a pneumococcal (PCV13) immunisation program in Australia, assuming two different uptake modelling approaches...
January 30, 2018: Vaccine
Jeffrey Pernica, Stuart Harman, April Kam, Jacob Bailey, Redjana Carciumaru, Sarah Khan, Martha Fulford, Lehana Thabane, Robert Slinger, Cheryl Main, Marek Smieja, Mark Loeb
BACKGROUND: Community-acquired pneumonia (CAP) is commonly diagnosed in children. The Infectious Disease Society of America guidelines recommend 10 days of high-dose amoxicillin for the treatment of non-severe CAP but 5-day "short course" therapy may be just as effective. Randomized trials in adults have already demonstrated non-inferiority of 5-day short-course treatment for adults hospitalized with severe CAP and for adults with mild CAP treated as outpatients. Minimizing exposure to antimicrobials is desirable to avoid harms including diarrhoea, rashes, severe allergic reactions, increased circulating antimicrobial resistance, and microbiome disruption...
February 1, 2018: Trials
Chang-Hua Chen, Ming-Shiang Wu, I-Chien Wu
Older adults, particularly those with chronic obstructive pulmonary disease, are advised to receive 23-valent pneumococcal polysaccharide vaccine (PPV23). However, the PPV23 vaccination rate in Taiwan and the determinants of receipt remain unclear.We analyzed the data of 1475 community-dwelling older adults aged ≥75 years who participated in the Healthy Aging Longitudinal Study in Taiwan. Each participant received assessments of PPV23 status, sociodemographic factors (age, sex, education level, marital status, living alone, and occupation), and health-related factors (chronic diseases, smoking status, alcohol intake, physical activities, cognitive status, and physical performance)...
February 2018: Medicine (Baltimore)
Sarah L Cutrona, Jessica G Golden, Sarah L Goff, Jessica Ogarek, Bruce Barton, Lloyd Fisher, Peggy Preusse, Devi Sundaresan, Lawrence Garber, Kathleen M Mazor
BACKGROUND: Patient reminders for influenza vaccination, delivered via electronic health record (EHR) patient portal messages and interactive voice response (IVR) calls, offer an innovative approach to improving patient care. OBJECTIVE: To test the effectiveness of portal and IVR outreach in improving rates of influenza vaccination. DESIGN: Randomized controlled trial of EHR portal messages and IVR calls promoting influenza vaccination. PARTICIPANTS: Adults with no documented influenza vaccination 2 months after the start of influenza season (2014-2015)...
January 30, 2018: Journal of General Internal Medicine
David Allard, Roxanne Charlebois, Loise Gilbert, John Stagg, Pavel Chrobak
Many individuals at risk of streptococcal infection respond poorly to the pneumococcal polysaccharide vaccine Pneumovax 23. Identification of actionable pathways able to enhance Pneumovax responsiveness is highly relevant. We investigated the contribution of the extracellular adenosine pathway regulated by the ecto-nucleotidase CD73 in Pneumovax-induced antibody responses. Using gene-targeted mice, we demonstrated that CD73-or A2a adenosine receptor deficiency significantly delayed isotype switching. Nevertheless, CD73- or A2aR- deficient adult mice ultimately produced antigen-specific IgG3 and controlled Streptococcus pneumoniae infection as efficiently as wild type (WT) mice...
2018: PloS One
Olga Ochoa-Gondar, Ángel Vila-Córcoles, Cinta de Diego, Eva Satué, Angel Vila-Rovira, María Aragón
OBJECTIVES: To know antipneumococcal vaccination coverages among Catalonian adults and evaluate the adequacy of vaccine use according to 3 distinct current vaccination guidelines. DESIGN: Population-based cross-sectional study. SETTING: Primary Health Care. Catalonia, Spain. PARTICIPANTS: A total of 2,033,465 individuals≥50 years-old registered in the Catalonian Health Institute. MAIN MEASUREMENTS: Vaccination status for the 23-valent pneumococcal polysaccharide vaccine (PPV23) and/or the 13-valent pneumococcal conjugate vaccine (PCV13) was revised at 1/01/2015...
January 17, 2018: Atencion Primaria
Paul Loubet, Pierre Verger, Vered Abitbol, Laurent Peyrin-Biroulet, Odile Launay
BACKGROUND: Despite specific immunization guidelines for immunocompromised patients, there is a dearth of studies on inflammatory bowel disease (IBD) population in France. AIMS: To estimate the prevalence and predictors of influenza and pneumococcal vaccination rates in a sample of French IBD adults. METHODS: An anonymous online survey was submitted to members of several French immunocompromised patients' associations during the winter 2016...
January 2, 2018: Digestive and Liver Disease
Angela R Wateska, Mary Patricia Nowalk, Richard K Zimmerman, Kenneth J Smith, Chyongchiou J Lin
BACKGROUND: Adults aged 18-64 years with comorbid conditions are at high risk for complications of certain vaccine-preventable diseases, including influenza and pneumococcal disease. The 4 Pillars™ Practice Transformation Program (4 Pillars Program) increases uptake of pneumococcal polysaccharide vaccine, influenza vaccine and tetanus-diphtheria-acellular pertussis vaccine by 5-10% among adults with high-risk medical conditions, but its cost-effectiveness is unknown. METHODS: A decision tree model estimated the cost-effectiveness of implementing the 4 Pillars Program in primary care practices compared to no program for a population of adults 18-64 years of age at high risk of illness complications over a 10 year time horizon...
January 25, 2018: BMC Infectious Diseases
Nicola Principi, Giuseppe Di Cara, Ilaria Bizzarri, Chiara Isidori, Paola Borgia, Costanza Mignini, Marco Saponara, Alberto Argentiero, Susanna Esposito
Starting from 2010, the 13-valent pneumococcal conjugate vaccine (PCV13) was introduced in several countries. This paper discusses some of the problems recently emerged after PCV13 use and their clinical impact. The impact of PCV13 has been relevant and has saved millions of children and adults by severe infectious diseases. However, it seems likely that in the future, effectiveness of the vaccine might be even higher than that presently evidenced. This is because long-term administration of PCV13 to the pediatric population can favor a more extensive reduction of nasopharyngeal colonization with vaccine serotypes of both vaccinated and unvaccinated subjects and further reduce invasive pneumococcal disease in all the individuals (herd immunity)...
January 24, 2018: Current Infectious Disease Reports
Juan D Castro, Sofía M Siccha, Martha Egoavil, Eduardo Chaparro, Roger Hernandez, Wilda Silva, Olguita Del Águila, Andrés Saenz, Francisco Campos, Isabel Reyes, María E Castillo, Theresa J Ochoa
OBJECTIVES.: To describe the clinical characteristics, antibiotic resistance, and distribution of serotypes of bacterial strains that cause invasive pneumococcal disease (IPD) in adults. MATERIALS AND METHODS.: Case series. Pneumococcal strains were isolated from 2009 to 2011 from hospitalized adult patients with IPD in five hospitals and two laboratories located in Lima. RESULTS.: The analysis of data from 43 patients with IPD indicated that 58...
October 2017: Revista Peruana de Medicina Experimental y Salud Pública
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