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1.
Vaccine ; 37(1): 176-186, 2019 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-30054160

RESUMO

BACKGROUND: We assessed 2 investigational 11- and 12-valent vaccines, containing capsular polysaccharides of 10 serotypes as in the pneumococcal non-typeable Haemophilus influenzae protein D-conjugate vaccine (PHiD-CV) and CRM197-conjugated capsular polysaccharides of serotypes 19A (11-valent) or 19A and 6A (12-valent). METHODS: In this phase II, partially-blind, multicentre study (NCT01204658), healthy infants were randomised (1:1:1:1) to receive 11vPHiD-CV, 12vPHiD-CV, PHiD-CV, or 13-valent CRM197-conjugate pneumococcal vaccine (PCV13), at 2, 3, and 4 (primary series), and 12-15 months of age (booster dose), co-administered with DTPa-HBV-IPV/Hib. Confirmatory objectives assessed non-inferiority of investigational vaccines to comparators (PHiD-CV for common serotypes; PCV13 for 19A and 6A), in terms of percentage of infants with pneumococcal antibody concentrations ≥0.2 µg/mL and antibody geometric mean concentrations, post-primary vaccination. Reactogenicity and safety were assessed. RESULTS: 951 children received ≥1 primary dose, 919 a booster dose. Pre-defined immunological non-inferiority criteria were met simultaneously for 9/11 11vPHiD-CV serotypes (all except 23F and 19A) and 10/12 12vPHiD-CV serotypes (all except 19A and 6A); thus, non-inferiority objectives were reached. For each PHiD-CV serotype, percentages of children with antibody concentrations ≥0.2 µg/mL were ≥96.7% post-primary (except 6B [≥75.2%] and 23F [≥81.1%]), and ≥98.1% post-booster vaccination. For each PHiD-CV serotype except serotype 1, ≥81.0% and ≥93.9% of children had opsonophagocytic activity titres ≥8, post-primary and booster vaccination. AEs incidence was similar across all groups. SAEs were reported for 117 children (29 in the 11vPHiD-CV group, 26 in the 12vPHiD-CV group, 38 in the PHiD-CV group and 24 in the PCV13 group); 4 SAEs were considered vaccination-related. No fatal events were recorded. CONCLUSION: Addition of 19A and 6A CRM197-conjugates did not alter immunogenicity of the PHiD-CV conjugates; for both investigational vaccines post-booster immune responses to 10 common serotypes appeared similar to those elicited by PHiD-CV. Safety and reactogenicity profiles of the investigational vaccines were comparable to PHiD-CV. Clinical trial registry: NCT01204658.


Assuntos
Anticorpos Antibacterianos/sangue , Proteínas de Bactérias/imunologia , Proteínas de Transporte/imunologia , Imunogenicidade da Vacina , Imunoglobulina D/imunologia , Lipoproteínas/imunologia , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas/imunologia , Proteínas de Bactérias/genética , Proteínas de Transporte/genética , Vacina contra Difteria, Tétano e Coqueluche/administração & dosagem , Feminino , Haemophilus influenzae , Vacinas contra Hepatite B/administração & dosagem , Humanos , Imunização Secundária , Imunoglobulina D/genética , Lactente , Lipoproteínas/genética , Masculino , Infecções Pneumocócicas/imunologia , Vacinas Pneumocócicas/efeitos adversos , Vacina Antipólio de Vírus Inativado/administração & dosagem , Sorogrupo , Streptococcus pneumoniae , Vacinas Combinadas/administração & dosagem , Vacinas Conjugadas/efeitos adversos , Vacinas Conjugadas/imunologia
2.
Pediatrics ; 142(3)2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30068713

RESUMO

BACKGROUND: The capsular group B meningococcal vaccine (4CMenB) is recommended for children with complement deficiencies, asplenia, and splenic dysfunction; however, data on the immunogenicity of 4CMenB in these "at-risk" children are missing. METHODS: Participants aged 2 to 17 years in Italy, Spain, Poland, the United Kingdom, and Russia with complement deficiencies, asplenia, or splenic dysfunction received 2 doses of 4CMenB 2 months apart, as did healthy children in the control group. Exogenous and endogenous human complement serum bactericidal activity (SBA) was determined at baseline and 1 month after the second immunization against 4 test strains: H44/76 (assessing vaccine antigen factor H binding protein), 5/99 (Neisserial adhesion A), NZ98/254 (Porin A), and M10713 (Neisserial heparin binding antigen). RESULTS: Of 239 participants (mean age 10.3 years, 45% female), 40 children were complement deficient (9 eculizumab therapy, 4 terminal-chain deficiencies, 27 "other"), 112 children had asplenia or splenic dysfunction (8 congenital asplenia, 8 functional asplenia, 96 splenectomy), and 87 children were in the control group. After immunization, the proportions of complement-deficient participants with exogenous complement SBA titers ≥1:5 were 87% (H44/76), 95% (5/99), 68% (NZ98/254), and 73% (M10713), compared with 97%, 100%, 86%, and 94%, respectively, for asplenic children and 98%, 99%, 83%, and 99% for children in the control group. When testing with endogenous complement, strain-specific bactericidal activity was evident in only 1 eculizumab-treated participant and 1 terminal chain complement-deficient participant. CONCLUSIONS: 4CMenB administration is similarly immunogenic in healthy children and those with asplenia or splenic dysfunction. The significance of the trend to lower responses of SBA titers in complement-deficient children (especially those with terminal chain complement deficiency or those on eculizumab therapy) must be determined by ongoing surveillance for vaccine failures.

3.
Acta Gastroenterol Belg ; 81(2): 257-261, 2018 Apr-Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30024696

RESUMO

BACKGROUND AND STUDY AIMS: Inflammatory bowel disease (IBD) predisposes patients to a severe course of infections yet adherence to vaccination guidelines is low. Little is known about IBD patient attitude towards immunizations. We aimed to investigate patient attitude towards vaccinations and its influence on personal immunization coverage. PATIENTS AND METHODS: A self-completed survey was completed by 195 IBD patients. The author-designed questionnaire comprised: demographic data, IBD medical history, vaccination history, reasons of influenza vaccine refusal, and the most reliable source of information about immunizations. Moreover, patients were asked if they agree with the statement that immunizations are beneficial for a person with IBD. RESULTS: 99 patients (50%) claimed that prevention of infectious diseases is beneficial for a person with IBD but this opinion had no influence on recommended vaccination uptake. There was suboptimal vaccination coverage : hepatitis B (55%); diphteria, pertussis, tetanus (12%); hepatitis A (7%); annual influenza (6%); varicella-zoster (3%), and pneumococcal vaccine (2%). Top reasons for nonvaccination were: lack of information from a physician (47,5%), unawareness (35%), perceived lack of benefit (33%) and concerns about adverse events (26%). The most reliable source of information concerning immunizations was a gastroenterologist for the majority of IBD patients (58%) while more than 35% chose their general practitioner. CONCLUSIONS: Active promotion and information regarding beneficial role of immunizations among IBD patients and other chronically ill individuals significantly improves the quality of care. It is important to explain misconceptions about vaccines by the most reliable sources. We propose implementing an uniformed "immunization chart" for every chronically ill individual.


Assuntos
Imunização , Infecção/imunologia , Doenças Inflamatórias Intestinais/imunologia , Vacinação/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Vacinas contra Influenza/administração & dosagem , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Fatores de Risco , Inquéritos e Questionários
4.
Adv Exp Med Biol ; 2018 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-29995213

RESUMO

For the past 10 years, influenza vaccination coverage rate in Poland remains at a low 3% threshold. This low rate may be related to the unsatisfactory knowledge of vaccination, influenza, and misperception of health risks in the general population. To examine these issues, we used an online questionnaire consisting of 12 closed questions. The basic knowledge on influenza and vaccination was examined. The questionnaire was completed by 1669 persons, mostly young women. Generally, 73% of respondents passed the threshold of 70% correct answers, but important gaps in their knowledge were identified concerning the persons at risk of developing the infection (7.9% of correct answers) and the timing of vaccination (8.4% of correct answers). Although most respondents did identify the etiologic agent correctly (91.1% knew influenza is caused by a virus), only 12.3% knew that the vaccines registered in Poland contain fragments of viruses or its antigens, while 63.1% thought the vaccines contain live bacteria. In conclusion, the knowledge on influenza vaccination is deficient in the general population. Education on immunization should be prioritized to increase vaccination coverage rate in Poland.

5.
Pediatr Infect Dis J ; 37(5): 475-482, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29329168

RESUMO

BACKGROUND: Current meningococcal prime-boost vaccination schedules include separate vaccines for serogroups ACWY and B. An investigational combined serogroups ABCWY vaccine (MenABCWY) was developed to protect against clinically important Neisseria meningitidis serogroups. METHODS: In this phase 2, randomized, observer-blind, extension study (NCT01272180), participants 10-25 years of age received 1 booster dose of MenABCWY vaccine at 24 months (M) postprimary series of MenABCWY (2 doses), 4CMenB (2 doses) or MenACWY-CRM vaccine (1 dose). Immune responses to booster dose (1M postbooster) and antibody persistence (24M, 36M postprimary series) were assessed using bactericidal assay with human complement (hSBA). Reactogenicity and safety were evaluated. RESULTS: One hundred ninety participants were vaccinated. At 1M after the MenABCWY booster dose, seroresponse rates against serogroups ACWY ranged between 85% and 96%, 73% and 100% and 83% and 95% for participants previously receiving MenABCWY, 4CMenB and MenACWY-CRM, respectively. At 12M postbooster dose, ≥67% of participants across all groups had hSBA titers ≥8 for serogroups ACWY, except in 4CMenB-primed individuals for serogroup Y (45%). Across MenABCWY and 4CMenB-primed groups, hSBA titers ≥5 across serogroup B test strains were observed in 82%-100% and 29%-100% of participants at 1M and 12M postbooster, respectively. Geometric mean titers against serogroups ACWY increased from pre- to 1M postboosting with MenABCWY and persisted at 12M. The reactogenicity and safety profile of MenABCWY was similar to that of 4CMenB. CONCLUSIONS: MenABCWY may be suitable for prime-boost schedules against meningococcal disease, including regimens involving a primary series of either 4CMenB or MenACWY-CRM licensed vaccines.

6.
J Med Virol ; 90(2): 372-376, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28960454

RESUMO

The aim of this study was to report a minor outbreak of enterovirus A71 (EV-A71) infection in Poland and characterize isolates from cases of severe neurological infection detected in 2013 and 2016. Phylogenetic analysis revealed that Polish strains belonged to the C genogroup: C1, C2, and C4. Severe neurological manifestations as encephalitis or acute flaccid paralysis (AFP), were associated with all detected subgenogroups. The C2 subgenogroup was associated with the outbreak in Gdansk, with serious cases of AFP, myelitis, cerebellitis, encephalitis, but also with mild, sporadic cases of aseptic meningitis, in other Polish cities. Data from the study established relationships of EV-A71 from Poland with previously characterized strains and confirmed the importance of high quality enterovirus surveillance with international reach.


Assuntos
Surtos de Doenças , Encefalite Viral/virologia , Enterovirus Humano A/classificação , Infecções por Enterovirus/virologia , Variação Genética , Genótipo , Paraplegia/virologia , Adolescente , Pré-Escolar , Encefalite Viral/epidemiologia , Enterovirus Humano A/genética , Enterovirus Humano A/isolamento & purificação , Infecções por Enterovirus/epidemiologia , Feminino , Humanos , Lactente , Masculino , Epidemiologia Molecular , Paraplegia/epidemiologia , Polônia/epidemiologia
7.
Vaccine ; 35(35 Pt B): 4603-4611, 2017 08 16.
Artigo em Inglês | MEDLINE | ID: mdl-28729019

RESUMO

INTRODUCTION: Vaccination with formulations containing pneumococcal protein antigens such as pneumolysin toxoid (dPly) and histidine-triad protein D (PhtD) may extend serotype-related protection of pneumococcal conjugate vaccines (PCVs) against Streptococcus pneumoniae. METHODS: This phase II, multi-center, observer-blind trial conducted in Europe (NCT01204658) assessed 2 investigational vaccines containing 10 serotype-specific polysaccharide conjugates of PHiD-CV and either 10 or 30µg of dPly and PhtD each. Infants randomized 1:1:1:1 received 4 doses of PHiD-CV/dPly/PhtD-10, PHiD-CV/dPly/PhtD-30, PHiD-CV, or 13-valent PCV (PCV13), co-administered with DTPa-HBV-IPV/Hib, at ages ∼2, 3, 4 and 12-15months. Occurrences of fever >40.0°C following primary vaccination with PHiD-CV/dPly/PhtD vaccines compared to PHiD-CV (non-inferiority objective), dose superiority, safety and immunogenicity were assessed. RESULTS: 575 children received primary vaccination, and 564 booster vaccination. The non-inferiority objective was met; no fever >40.0°C causally related to vaccination was reported during primary vaccination. Incidence of adverse events appeared similar between the 3 PHiD-CV groups. Serious adverse events were reported in 13, 9, 21 (1 related to vaccination), and 17 children in the PHiD-CV/dPly/PhtD-10, PHiD-CV/dPly/PhtD-30, PHiD-CV, and PCV13 groups, respectively. PHiD-CV/dPly/PhtD-30 was superior to PHiD-CV/dPly/PhtD-10 in terms of post-dose 3 anti-Ply and Anti-PhtD antibody levels. Anti-Ply and anti-PhtD antibody levels were higher in both PHiD-CV/dPly/PhtD groups than in controls and increased from post-primary to post-booster timepoint. Post-primary and booster vaccination, for each PHiD-CV serotype, ≥98.5% of participants in PHiD-CV/dPly/PhtD groups had antibody concentrations ≥ 0.2µg/mL, except for 6B (≥72.3%) and 23F (≥82.7%) post-primary vaccination. Similar results were observed in the PHiD-CV group. Immune responses to protein D and DTPa-HBV-IPV/Hib were within similar ranges for the 3 PHiD-CV groups. CONCLUSION: Both PHiD-CV/dPly/PhtD formulations co-administered with DTPa-HBV-IPV/Hib in infants were well-tolerated and immunogenic for dPly and PhtD antigens, while immune responses to serotype-specific, protein D and co-administered antigens did not appear altered in comparison to PHiD-CV group.


Assuntos
Imunogenicidade da Vacina , Vacinas Pneumocócicas/efeitos adversos , Vacinas Pneumocócicas/imunologia , Estreptolisinas/imunologia , Anticorpos Antibacterianos/sangue , Proteínas de Bactérias/imunologia , Feminino , Febre/etiologia , Humanos , Imunização Secundária , Lactente , Masculino , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas/administração & dosagem , Sorogrupo , Streptococcus pneumoniae/química , Streptococcus pneumoniae/imunologia , Vacinação , Vacinas Combinadas/imunologia , Vacinas Conjugadas/imunologia
8.
Adv Exp Med Biol ; 980: 27-36, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28290102

RESUMO

While the Ebola outbreak in 2014 was strongly highlighted in mainstream media and perceived as a threat to public health in Poland, influenza was regarded as a triviality and the vaccination coverage was low. In the present study, by analyzing feedback from an on-line questionnaire (from November 2014 to January 2015) we assessed the knowledge concerning Ebola and influenza together with attitudes to immunization of 544 respondents (45% medical staff). The findings were that 92.6% of respondents declared readiness to vaccination before traveling to endemic regions if a vaccine against Ebola would have existed, but adverse reactions, high costs, and low effectiveness would adversely affect that decision. While 84.2% of respondents declared awareness of influenza attributing significantly to the cause of death, only 65.4% considered influenza as an actual danger for people in Poland and 46.7% thought that Poland was not an endemic region for influenza. Nearly 23% declared that they were already vaccinated against influenza. The majority of respondents (67.5%) were not going to be vaccinated. We conclude that awareness of risk related to infectious diseases is an important determinant when deciding whether to vaccinate. However, negative information about the vaccine has some bearing on the decision to get vaccinated.


Assuntos
Doenças Transmissíveis/imunologia , Vacinas contra Ebola/imunologia , Doença pelo Vírus Ebola/imunologia , Vacinas contra Influenza/imunologia , Influenza Humana/imunologia , Adulto , Surtos de Doenças , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Percepção , Polônia , Risco , Vacinação/métodos , Adulto Jovem
9.
Vaccine ; 35(15): 1926-1935, 2017 04 04.
Artigo em Inglês | MEDLINE | ID: mdl-28262330

RESUMO

OBJECTIVE: Prophylactic antipyretic use during pediatric vaccination is common. This study assessed whether paracetamol or ibuprofen prophylaxis interfere with immune responses to the 13-valent pneumococcal conjugate vaccine (PCV13) given concomitantly with the combined DTaP/HBV/IPV/Hib vaccine. METHODS: Subjects received prophylactic paracetamol or ibuprofen at 0, 6-8, and 12-16 h after vaccination, or 6-8 and 12-16 h after vaccination at 2, 3, 4, and 12months of age. At 5 and 13months, immune responses were evaluated versus responses in controls who received no prophylaxis. RESULTS: After the infant series, paracetamol recipients had lower levels of circulating serotype-specific pneumococcal anticapsular immunoglobulin G than controls, reaching significance (P<0.0125) for 5 serotypes (serotypes 3, 4, 5, 6B, and 23F) when paracetamol was started at vaccination. Opsonophagocytic activity assay (OPA) results were similar between groups. Ibuprofen did not affect pneumococcal responses, but significantly (P<0.0125) reduced antibody responses to pertussis filamentous hemagglutinin and tetanus antigens after the infant series when started at vaccination. No differences were observed for any group after the toddler dose. CONCLUSIONS: Prophylactic antipyretics affect immune responses to vaccines; these effects vary depending on the vaccine, antipyretic agent, and time of administration. In infants, paracetamol may interfere with immune responses to pneumococcal antigens, and ibuprofen may reduce responses to pertussis and tetanus antigens. The use of antipyretics for fever prophylaxis during infant vaccination merits careful consideration. ClinicalTrials.gov identifier: NCT01392378https://clinicaltrials.gov/ct2/show/NCT01392378?term=NCT01392378&rank=1.


Assuntos
Acetaminofen/administração & dosagem , Antipiréticos/administração & dosagem , Quimioprevenção/métodos , Febre/prevenção & controle , Ibuprofeno/administração & dosagem , Vacinas Pneumocócicas/efeitos adversos , Vacinas Pneumocócicas/imunologia , Anticorpos Antibacterianos/sangue , Vacina contra Difteria, Tétano e Coqueluche/efeitos adversos , Interações de Medicamentos , Feminino , Vacinas Anti-Haemophilus/efeitos adversos , Vacinas contra Hepatite B/efeitos adversos , Humanos , Lactente , Masculino , Proteínas Opsonizantes/sangue , Fagocitose , Vacinas Pneumocócicas/administração & dosagem , Vacina Antipólio de Vírus Inativado/efeitos adversos , Vacinas Combinadas/efeitos adversos
11.
Lancet Infect Dis ; 17(1): 58-67, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27745812

RESUMO

BACKGROUND: Bivalent rLP2086 is a recombinant factor H binding protein-based vaccine approved in the USA for prevention of meningococcal serogroup B disease in 10-25-year-olds. We aimed to assess the persistence of bactericidal antibodies up to 4 years after a three-dose schedule of bivalent rLP2086. METHODS: We did this randomised, single-blind, placebo-controlled, phase 2 trial at 25 sites in Australia, Poland, and Spain. In stage 1 of the study (February, 2009-May, 2010), healthy adolescents (aged 11-18 years) were randomly assigned, via an interactive voice and web-response system with computer-generated sequential random numbers, to receive either ascending doses of vaccine (60 µg, 120 µg, and 200 µg) or placebo at months 0, 2, and 6. Dispensing staff were not masked to group allocation, but allocation was concealed from principal investigators, participants and their guardians, and laboratory personnel. In stage 2 of the study (reported here), we enrolled healthy adolescents who had received three doses of 120 µg bivalent rLP2086 (the optimum dose level identified in stage 1) or saline. Immunogenicity was determined in serum bactericidal antibody assay using human complement (hSBA) by use of four meningococcal serogroup B test strains expressing vaccine-heterologous factor H binding protein variants: PMB80 (A22), PMB2001 (A56), PMB2948 (B24), and PMB2707 (B44). Immunogenicity in stage 2 was assessed at months 6, 12, 24, and 48 post-vaccination. We did analysis by intention to treat. This trial is registered as ClinicalTrials.gov number NCT00808028. FINDINGS: Between March 17, 2010, and Feb 8, 2011, 170 participants who received 120 µg of bivalent rLP2086 and 80 participants who received placebo in stage 1 of the study were entered into stage 2; 210 participants completed stage 2 up to 48 months. 1 month after the third vaccination, 93% (n=139/149) to 100% (n=48/48) of vaccine recipients achieved protective hSBA titres equal to or greater than the lower limit of quantification to each test strain, compared with 0% (n=0/25) to 35% (n=8/23) of control recipients. Despite initial declines in seroprotective hSBA titres for all four test strains, for three test strains (A22, A56, and B24), more than 50% of bivalent rLP2086 recipients continued to achieve titres equal to or greater than the lower limit of quantification at months 6 (57% [n=93/163] to 89% [n=42/47]), 12 (54% [n=84/155] to 69% [n=33/48]), 24 (53% [n=26/49] to 54% [n=82/152]), and 48 (51% [n=24/47] to 59% [n=79/134]); corresponding values in the control group were 14% (n=11/80) to 22% (n=5/23) at month 6, 13% (n=10/78) to 29% (n=22/76) at month 12, 16% (n=12/74) to 36% (n=8/22) at month 24, and 24% (n=16/68) to 35% (n=8/23) at month 48. For test strain B44, hSBA titres equal to or greater than the lower limit of quantification were shown in 37% (n=18/49) of vaccine recipients at 6 months, in 29% (n=14/48) at 12 months, in 22% (n=11/49) at 24 months, and in 20% (n=10/49) at 48 months, compared with 0% (n=0/25) of control recipients at month 6, 4% (n=1/25) at months 12 and 24, and 12% (n=3/25) at month 48. Adverse events were reported in seven (4%) of 170 participants in the bivalent rLP2086 group and two (3%) of 80 participants in the control group; no event was deemed related to vaccine. INTERPRETATION: After three doses of bivalent rLP2086, protective hSBA titres above the correlate of protection (≥1/4) were elicited up to 4 years in more than 50% of participants for three of four meningococcal serogroup B test strains representative of disease-causing meningococci expressing vaccine-heterologous antigens. Further studies will be needed to assess possible herd immunity effects with meningococcal serogroup B vaccines and the need for a booster dose to sustain individual protection against invasive meningococcal disease. FUNDING: Pfizer.


Assuntos
Antígenos de Bactérias/administração & dosagem , Proteínas de Bactérias/administração & dosagem , Infecções Meningocócicas/prevenção & controle , Vacinas Meningocócicas/administração & dosagem , Vacinas Sintéticas/imunologia , Adolescente , Anticorpos Antibacterianos/sangue , Austrália , Criança , Feminino , Seguimentos , Humanos , Masculino , Neisseria meningitidis/imunologia , Neisseria meningitidis Sorogrupo B/imunologia , Neisseria meningitidis Sorogrupo B/isolamento & purificação , Polônia , Ensaios de Anticorpos Bactericidas Séricos/métodos , Espanha , Adulto Jovem
12.
Pediatr Infect Dis J ; 36(3): 326-332, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-27902652

RESUMO

BACKGROUND: Premature infants have lower short-term immune responses to vaccination than term infants, but patterns of antibody persistence in preterm infants over longer periods are not well established. This study assessed the persistence of antibody response to the 13-valent pneumococcal conjugate vaccine (PCV13) in formerly preterm versus term infants. METHODS: In total, 100 preterm and 100 term infants received PCV13 with routine vaccines at ages 2, 3, 4 and 12 months. Serotype-specific anticapsular immunoglobulin G (IgG)-binding antibodies and opsonophagocytic activity were determined 1 and 2 years after the last PCV13 dose. RESULTS: At 1 and 2 years after the last vaccination (toddler dose), IgG geometric mean concentrations (GMCs) for all serotypes had declined from levels measured 1 month after the toddler dose but remained above pretoddler dose levels. IgG GMCs were significantly lower in preterm than term subjects for a majority of serotypes at both follow-up time points. IgG GMCs increased in both groups for some serotypes from the 1-year to 2-year follow-up, whereas others declined. Opsonophagocytic activity results supported the IgG results. CONCLUSIONS: The routine (3 + 1) vaccination schedule is likely to offer long-term protection against invasive pneumococcal disease in preterm infants and should be initiated regardless of gestational age or weight at birth, without delay of the toddler dose.


Assuntos
Anticorpos Antibacterianos/sangue , Imunoglobulina G/sangue , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas/imunologia , Streptococcus pneumoniae/imunologia , Feminino , Seguimentos , Humanos , Esquemas de Imunização , Lactente , Recém-Nascido Prematuro , Masculino , Infecções Pneumocócicas/imunologia , Vacinas Pneumocócicas/administração & dosagem , Vacinação
13.
Pol J Microbiol ; 66(3): 405-409, 2017 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-29319516

RESUMO

The objective of the present study was to describe the molecular characteristics of enteroviruses associated with hand, food, and mouth disease (HFMD) in Poland. Clinical material from HFMD cases, that occurred during 2013-2016 were examined. It has been showed that coxsackievirus A6 (CVA6), CVA10 and CVA16 were circulating in the country. Phylogenetic analysis showed that Polish CVA6 strains were divided into two distinct clusters suggesting two independent introductions. This is the first report of CVA6 infections associated with HFMD in Poland. These results emphasize the need for continuous monitoring of HFMD and facilitation of the diagnosis using molecular approaches.

14.
Vaccine ; 34(48): 5903-5906, 2016 11 21.
Artigo em Inglês | MEDLINE | ID: mdl-27997341

RESUMO

There is no published data regarding immunologic response to vaccinations in children with PFAPA syndrome (periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis). The aim of this study was to evaluate mumps, measles and rubella immunity in children with PFAPA. 31 children with PFAPA syndrome and 22 healthy children (control group - CG) were recruited to the study. All children were previously vaccinated with one dose of MMR vaccine according to the Polish obligatory vaccination schedule. The patients from both groups were evaluated for anti-measles, anti-mumps and anti-rubella IgG antibodies concentrations (ELISA tests; the reference values for protective antibody levels were 150IU/L, 16RU/L and 11IU/ml respectively). The percentage of patients with protective antibodies levels was as follows: measles - 93.55% of PFAPA and 95.45% of CG patients (p=0.77); mumps - 74.19% of PFAPA and 95.45% of CG patients (p=0.02); rubella - 80.65% of PFAPA and 90.9% of CG patients (p=0.30). CONCLUSIONS: Children with PFAPA syndrome present a good response to the measles and rubella component of the MMR vaccine, however immunity against mumps after one dose of MMR may not be sufficient. Further investigation concerning immunity against vaccine-preventable diseases and the safety of vaccinations in children with periodic fever syndromes is required.


Assuntos
Anticorpos Antivirais/sangue , Linfadenite/imunologia , Vírus do Sarampo/imunologia , Vacina contra Sarampo-Caxumba-Rubéola/imunologia , Vírus da Caxumba/imunologia , Faringite/imunologia , Vírus da Rubéola/imunologia , Estomatite Aftosa/imunologia , Pré-Escolar , Feminino , Febre/imunologia , Humanos , Esquemas de Imunização , Masculino , Sarampo/prevenção & controle , Vacina contra Sarampo-Caxumba-Rubéola/administração & dosagem , Vacina contra Sarampo-Caxumba-Rubéola/efeitos adversos , Caxumba/prevenção & controle , Rubéola (Sarampo Alemão)/prevenção & controle , Síndrome
16.
J Pediatr Hematol Oncol ; 38(5): 394-7, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27347778

RESUMO

Herpes zoster, defined as the reactivation of a latent varicella-zoster virus (VZV) infection, used to be a serious disease in immunocompromised children until recently. The aim of this study was to describe the clinical presentation of herpes zoster in hospitalized immunocompromised children compared with hospitalized immunocompetent counterparts. We reviewed the hospital charts of 72 children aged 6 months to 18 years diagnosed with herpes zoster and treated with acyclovir in our department covering a 19-year period. Forty-six of the children were immunocompromised which was mainly due to hematologic diseases. There were no differences in the age at which herpes zoster occurred, length of hospitalization, and the location or extent of the skin eruption. General symptoms were observed more frequently in the hospitalized immunocompetent patients compared with the hospitalized immunocompromised children (80% vs. 56%). The average age at which primary VZV infection occurred was higher among the immunocompromised children than the immunocompetent children with the latter group suffering from significantly more primary VZV infections during infancy. The presentation of herpes zoster in immunocompromised children is similar to that of herpes zoster in hospitalized immunocompetent children.


Assuntos
Criança Hospitalizada , Herpes Zoster/patologia , Imunocompetência , Hospedeiro Imunocomprometido , Aciclovir/uso terapêutico , Adolescente , Idade de Início , Criança , Pré-Escolar , Herpes Zoster/tratamento farmacológico , Herpesvirus Humano 3 , Humanos , Lactente , Ativação Viral
17.
Bosn J Basic Med Sci ; 16(2): 157-61, 2016 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-27131024

RESUMO

As no specific laboratory test has been identified, PFAPA (periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis) remains a diagnosis of exclusion. We searched for a practical use of procalcitonin (PCT) and C-reactive protein (CRP) in distinguishing PFAPA attacks from acute bacterial and viral infections. Levels of PCT and CRP were measured in 38 patients with PFAPA and 81 children diagnosed with an acute bacterial (n=42) or viral (n=39) infection. Statistical analysis with the use of the C4.5 algorithm resulted in the following decision tree: viral infection if CRP≤19.1 mg/L; otherwise for cases with CRP>19.1 mg/L: bacterial infection if PCT>0.65ng/mL, PFAPA if PCT≤0.65 ng/mL. The model was tested using a 10-fold cross validation and in an independent test cohort (n=30), the rule's overall accuracy was 76.4% and 90% respectively. Although limited by a small sample size, the obtained decision tree might present a potential diagnostic tool for distinguishing PFAPA flares from acute infections when interpreted cautiously and with reference to the clinical context.


Assuntos
Proteína C-Reativa/análise , Calcitonina/sangue , Febre/diagnóstico , Infecção/diagnóstico , Linfadenite/diagnóstico , Faringite/diagnóstico , Estomatite Aftosa/diagnóstico , Doença Aguda , Infecções Bacterianas/sangue , Infecções Bacterianas/diagnóstico , Criança , Pré-Escolar , Estudos de Coortes , Árvores de Decisões , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Masculino , Reprodutibilidade dos Testes , Síndrome , Viroses/sangue , Viroses/diagnóstico
18.
Reumatologia ; 54(6): 275-277, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28115776
19.
Arch Rheumatol ; 31(3): 287-289, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29900987

RESUMO

In this article, we report a nine-month-old male patient with a history of three unexplained, prolonged attacks of high fever, including one in the neonatal period, accompanied by an erythematosus, migratory rash. There was no family history that might have suggested a hereditary periodic fever syndrome, but the overall clinical picture was in accordance with tumor necrosis factor receptor-associated disease. Genetic analysis revealed two heterozygous mutations: C30Y in the tumor necrosis factor receptor superfamily 1A gene and K695R in the Mediterranean fever gene. This case shows that diagnosis of an autoinflammatory syndrome should be considered even in the youngest infants with incomplete presentation and no family history of recurrent fever.

20.
J Infect Chemother ; 22(2): 65-71, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26643900

RESUMO

A physician has to perform a benefit-risk assessment each time acyclovir is prescribed "off label" for children. A group of Polish infectious disease experts was created to develop evidence-based guidelines on the use of acyclovir in the treatment and prevention of varicella zoster and herpes simplex infections. In primary varicella zoster virus infections, oral acyclovir treatment is recommended in children over 12 years of age and should be considered in younger children who fall into one of the groups at risk of severe varicella. Intravenous acyclovir therapy in varicella is recommended in patients with immune deficiencies, newborns and in complicated cases. When there is a justified need for prevention of varicella, oral acyclovir prophylaxis may be considered if immunoglobulin cannot be administered, and if it is too late for vaccination. Oral acyclovir treatment of herpes zoster may be beneficial to otherwise healthy patients with a rash in places other than the trunk and in patients over 50 years of age. In immunocompetent patients with herpes simplex infections, indications for treatment with oral acyclovir include primary (genital herpes, skin herpes in children with atopic dermatitis, ocular herpes simplex, severe gingivostomatitis, paronychia and pharyngitis) and recurrent infections. Intravenous acyclovir should be administered for herpes infections in neonates, immunocompromised patients and patients who develop complications including neurological.


Assuntos
Aciclovir/administração & dosagem , Herpes Simples/tratamento farmacológico , Herpes Simples/prevenção & controle , Herpes Zoster/tratamento farmacológico , Herpes Zoster/prevenção & controle , Herpesvirus Humano 3/efeitos dos fármacos , Simplexvirus/efeitos dos fármacos , Antivirais/administração & dosagem , Criança , Pré-Escolar , Consenso , Humanos , Hospedeiro Imunocomprometido/efeitos dos fármacos , Lactente , Polônia
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