Administration of protein-conjugate pneumococcal vaccine to patients who have invasive disease after splenectomy despite their having received 23-valent pneumococcal polysaccharide vaccine.
J Infect Dis
; 191(7): 1063-7, 2005 Apr 01.
Article
en En
| MEDLINE
| ID: mdl-15747240
ABSTRACT
Patients who undergo splenectomy are at greatly increased risk for overwhelming pneumococcal bacteremia and death. Twenty-three-valent pneumococcal polysaccharide vaccine (PPV-23), which contains capsular polysaccharides (PSs) from 23 common serotypes of Streptococcus pneumoniae, is strongly recommended for such patients. The capacity to respond to PPV-23 by producing immunoglobulin (Ig) G is genetically regulated. Some proportion of adults do not respond and, despite postsplenectomy administration of PPV-23, may remain susceptible to recurrent pneumococcal sepsis. Here, we describe 2 patients who had recurring pneumococcal bacteremia after undergoing splenectomy despite having received numerous doses of PPV-23. Heptavalent protein-conjugate pneumococcal vaccine (PCPV-7) was then administered, and it induced high levels of IgG to all 7 PSs; in one of the patients, functional activity against 5 of the 7 PSs was demonstrable, both in vitro and in vivo. Recurrent pneumococcal bacteremia in patients who have undergone splenectomy may indicate a genetically regulated failure to respond to PPV-23; PCPV-7 may stimulate production of IgG to PSs in such patients.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Infecciones Neumocócicas
/
Esplenectomía
/
Streptococcus pneumoniae
/
Vacunas Meningococicas
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Vacunas Neumococicas
/
Anticuerpos Antibacterianos
Límite:
Adult
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Infect Dis
Año:
2005
Tipo del documento:
Article
País de afiliación:
Estados Unidos