64 results on '"pneumococcal vaccine"'
Search Results
2. Pneumococcal carriage among high-risk adults in a country with nonmandatory pneumococcal vaccination during the coronavirus disease 2019 pandemic
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Thundon Ngamprasertchai, Pinyo Rattanaumpawan, Jaranit Kaewkungwal, Pochamana Phisalprapa, Piriyaporn Chongtrakool, Anusak Kerdsin, Viravarn Luvira, Janjira Thaipadungpanit, Rattagan Kajeekul, Jintana Srisompong, Picha Yincharoen, Kulkanya Chokephaibulkit, and Saranath Lawpoolsri
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Coronavirus diseases 2019 ,Streptococcus pneumoniae ,Severe acute respiratory syndrome coronavirus 2 ,Carriage ,Pneumococcal vaccine ,And Thailand ,Infectious and parasitic diseases ,RC109-216 ,Public aspects of medicine ,RA1-1270 - Abstract
Background: Streptococcus pneumoniae carriage is a prerequisite for clinical infections and is used to make public health decisions on vaccine licensure. Pneumococcal carriage data among high-risk Thai adults are needed before national vaccine program introduction. The association between coronavirus disease 2019 (COVID-19) and pneumococcal carriage were also investigated. Methods: During the COVID-19 pandemic, a multi-center cross-sectional study was conducted among high-risk Thai adults from September 2021 to November 2022. Pneumococcal carriage and serotypes were investigated using both conventional and molecular methods. Demographics and co-morbidities were determined for carriage while accounting for case clustering from various study sites. Results: A total of 370 individuals were enrolled. The prevalence of pneumococcal carriage, as determined by the molecular method, was 30.8 % (95 % confidence interval (CI): 26.1–35.8), while after excluding non-typeable pneumococci from the oropharyngeal sample, the carriage prevalence was 20.8 % (95 % CI: 16.79–25.31). The serotype coverage rates by pneumococcal vaccine were 12.3 %, 13.1 %, and 16.4 % for PCV13, PCV15 or PCV20, and PPSV23, respectively, while the non-vaccine type was the majority (45.1 %). The most common serotype was 19B/C (35.5 %), followed by 6 A/B/C/D (10.7 %). The age group under 65 years was associated with a higher pneumococcal carriage rate than the age group 85 and older (odds ratio (OR): 5.01, 95 % CI: 1.75–14.36). There was no significant difference between SARS-CoV-2 and carriage status. Conclusions: The prevalence of pneumococcal carriage in Thais was high. The majority of serotypes were not covered by the vaccine. Further studies on the link between carriage serotypes and disease are required. The magnitude and serotype distribution of carriage were comparable in the SARS-CoV-2 positive and negative groups.
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- 2023
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3. Routine vaccination for influenza and pneumococcal disease and its effect on COVID-19 in a population of Dutch older adults
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Esther J.M. Taks, Konstantin Föhse, Simone J.C.F.M. Moorlag, Jacobien Hoogerwerf, Reinout van Crevel, Cornelis H. van Werkhoven, Mihai G. Netea, and Jaap ten Oever
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Influenza vaccine ,Pneumococcal vaccine ,Older adults ,COVID-19 ,Trained immunity ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Objectives: Protective heterologous beneficial effects of vaccines have been reported, and in this study we aimed to assess the impact of routine pneumococcal and influenza vaccination on the incidence and symptom duration of COVID-19 in a population of Dutch older adults. Methods: This cohort study is a secondary analysis of the BCG-CORONA-ELDERLY study, a randomised controlled trial on the effect of BCG vaccination on the cumulative incidence of respiratory tract infections requiring medical intervention in adults ≥60 years. The primary outcome was the cumulative incidence of a self-reported positive SARS-CoV-2 PCR test, and was assessed using a Fine-Gray competing risks model adjusted for baseline characteristics at enrolment. We analysed data from November 1st 2020 until the end of the main study in May 2021. Results: Routine vaccination data 2020/2021 were available for 1963/2014 (97.5 %) participants; 44/1963 (2.2 %) were excluded due to COVID-19 before vaccination. 1076/1919 (56.1 %) had received the influenza vaccine and 289/1919 (15.1 %) the pneumococcal vaccine. The cumulative incidence of COVID-19 was 0.030 (95 %CI 0.021–0.041) in those vaccinated against influenza compared to 0.029 (95 %CI 0.019–0.041) in the unvaccinated group (subdistribution hazard ratio (SDHR) 1.018; 95 %CI 0.602–1.721). For pneumococcal vaccination the cumulative incidence was 0.031 (95 %CI 0.015–0.056) for the vaccinated and 0.029 (95 %CI 0.022–0.038) for non-vaccinated individuals (SDHR 0.961; 95 %CI 0.443–2.085). BCG vaccination in the previous year and sex were not significant effect modifiers in the primary analysis. Duration of fever, cough and dyspnoea was also not significantly different between treatment arms. Conclusion: Neither influenza nor pneumococcal vaccination was associated with a lower incidence or shorter duration of COVID-19 symptoms in older adults.
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- 2023
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4. Chronic medical conditions associated with invasive pneumococcal diseases in inpatients in teaching hospitals in São Paulo city: Estimating antimicrobial susceptibility and serotype-coverage of pneumococcal vaccines
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Renato A. Kfouri, Maria-Cristina C. Brandileone, Marco Aurélio P. Sáfadi, Rosana Richtmann, Alfredo E. Gilio, Flavia Rossi, Thais Guimarães, Ana Luiza Bierrenbach, and José C. Moraes
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Invasive pneumococcal diseases ,Comorbidity ,Chronic diseases ,Antimicrobial resistance ,Pneumococcal serotypes ,Pneumococcal vaccine ,Infectious and parasitic diseases ,RC109-216 ,Microbiology ,QR1-502 - Abstract
Background: Chronic conditions increase the risk of invasive pneumococcal diseases (IPD). Pneumococcal vaccination remarkably reduced IPD morbimortality in vulnerable populations. In Brazil, pneumococcal vaccines are included in the National Immunization Program (PNI): PCV10 for < 2 years-old, and PPV23 for high risk-patients aged ≥ 2 years and institutionalized ≥ 60 years. PCV13 is available in private clinics and recommended in the PNI for individuals with certain underlying conditions. Methods: A retrospective study was performed using clinical data from all inpatients from five hospitals with IPD from 2016 to 2018 and the corresponding data on serotype and antimicrobial-non-susceptibility of pneumococcus. Vaccine-serotype-coverage was estimated. Patients were classified according to presence of comorbidities: healthy, without comorbidities; at-risk, included immunocompetent persons with specific medical conditions; high-risk, with immunocompromising conditions and others Results: 406 IPD cases were evaluated. Among 324 cases with information on medical conditions, children < 5 years were mostly healthy (55.9%), while presence of comorbidity prevailed in adults ≥ 18 years old (> 82.0%). Presence of ≥1 risk condition was reported in ≥ 34.8% of adults. High-risk conditions were more frequent than at-risk in all age groups. Among high-risk comorbidity (n = 211), cancer (28%), HIV/AIDS (25.7%) and hematological diseases (24.5%) were the most frequent. Among at-risk conditions (n = 89), asthma (16.5%) and diabetes (8.1%) were the most frequent. Among 404 isolates, 42.9% belonged to five serotypes: 19A (14.1%), 3 (8.7%), 6C (7.7%), 4 and 8 (6.2% each); 19A and 6C expressed antimicrobial-non-susceptibility. The vaccine-serotype-coverage was: PCV10, 19.1%, PCV13, 43.8%; PCV15, 47.8%; PCV20, 62.9%; PCV21, 65.8%, and PPV23, 67.3%. Information on hospital outcome was available for 283 patients, of which 28.6% died. Mortality was 54.2% for those with meningitis. Conclusion: Vaccine with expanded valence of serotypes is necessary to offer broad prevention to IPD. The present data contribute to pneumococcal vaccination public health policies for vulnerable patients, mainly those with comorbidity and the elderly.
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- 2023
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5. Pneumococcal vaccines for prevention of adult pneumonia.
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Morimoto K and Masuda S
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Streptococcus pneumoniae, pneumococcus, is one of most important bacterial pathogens in adult community-acquired pneumonia. Although it can cause a variety of illness including invasive diseases (IPD), pneumonia has a greater impact than IPD from the perspective of health economics. 23 valent pneumococcal polysaccharide vaccine (PPSV23) and 13 valent pneumococcal conjugate vaccine (PCV13) have been recommended for people ≥65 years old until recently based on evidence in preventing IPD and pneumonia. Because the introduction and dissemination of PCVs for infants and its effects on herd immunity have led 'serotype replacement' in adult IPD and pneumococcal pneumonia since the 2000s, serotypes targeted by vaccines have sifted accordingly. With the availability of PCV21 this year, in addition to PCV15 and PCV20, vaccine prevention strategies for adult pneumococcal pneumonia need to be reconsidered. In this narrative review, we discuss current and future challenges regarding pneumococcal vaccines to prevent adult pneumococcal pneumonia., (Copyright © 2024. Published by Elsevier B.V.)
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- 2024
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6. National surveillance of antimicrobial susceptibilities to dalbavancin, telavancin, tedizolid, eravacycline, omadacycline and other comparator antibiotics and serotype distribution of invasive Streptococcus pneumoniae isolates in adults: results from the Surveillance of Multicenter Antimicrobial Resistance in Taiwan (SMART) programme in 2017–2020
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Ying-Chun Chien, Yu-Lin Lee, Po-Yu Liu, Min-Chi Lu, Pei-Lan Shao, Po-Liang Lu, Shu-Hsing Cheng, Chi-Ying Lin, Ting-Shu Wu, Muh-Yong Yen, Lih-Shinn Wang, Chang-Pan Liu, Wen-Sen Lee, Zhi-Yuan Shi, Yao-Shen Chen, Fu-Der Wang, Shu-Hui Tseng, Yu-Hui Chen, Wang-Huei Sheng, Chun-Ming Lee, Yen-Hsu Chen, Wen-Chien Ko, and Po-Ren Hsueh
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Streptococcus pneumoniae ,Serotype ,Antimicrobial susceptibility ,Pneumococcal vaccine ,Case fatality rate ,Taiwan ,Microbiology ,QR1-502 - Abstract
ABSTRACT: Objectives: The aim of this study was to investigate the trends in serotypes and in vitro antimicrobial susceptibility of Streptococcus pneumoniae causing adult invasive pneumococcal disease (IPD) to dalbavancin, telavancin, tedizolid, eravacycline, omadacycline and other comparator antibiotics from 2017–2020 following implementation of the 13-valent pneumococcal conjugate vaccine (PCV-13) and during the COVID-19 (coronavirus disease 2019) pandemic. Methods: During the study period, 237 S. pneumoniae isolates were collected from non-duplicate patients, covering 15.0% of IPD cases in Taiwan. Antimicrobial susceptibility testing was performed using a Sensititre® system. A latex agglutination method (ImmuLex™ Pneumotest Kit) was used to determine serotypes. Results: Susceptibility rates were high for vancomycin (100%), teicoplanin (100%) and linezolid (100%), followed by ceftaroline (non-meningitis) (98.3%), moxifloxacin (94.9%) and quinupristin/dalfopristin (89.9%). MIC50 and MIC90 values of dalbavancin, telavancin, tedizolid, eravacycline and omadacycline were generally low. Non-vaccine serotype 23A was the leading cause of IPD across the adult age range. Isolates of serotype 15B were slightly fewer than those of PCV-13 serotypes in patients aged ≥65 years. The overall case fatality rate was 15.2% (36/237) but was especially high for non-PCV-13 serotype 15B (21.4%; 3/14). Vaccine coverage was 44.7% for PCV-13 and 49.4% for the 23-valent pneumococcal polysaccharide vaccine (PPSV-23), but was 57% for both PCV-13 and PPSV-23. Conclusion: The incidence of IPD was stationary after PCV-13 introduction and only dramatically decreased in the COVID-19 pandemic in 2020. The MIC50 and MIC90 values of dalbavancin, telavancin, tedizolid, eravacycline, omadacycline were generally low for S. pneumoniae causing adult IPD.
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- 2021
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7. Comparative effectiveness of pneumococcal vaccination strategies to prevent invasive pneumococcal disease: a population-based cohort study at the veterans health administration in the United States.
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Hasegawa S, Jones MP, Kakiuchi S, Perencevich EN, and Goto M
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Objectives: Comparative effectiveness of 13-valent pneumococcal conjugate vaccine (PCV13), 23-valent polysaccharide vaccine (PPSV23), and their combinations for adults in preventing invasive pneumococcal disease (IPD) has yet to be thoroughly investigated. We aimed to estimate the comparative effectiveness of preventing IPD, using population-based data from the Veterans Health Administration (VHA) in the United States., Methods: We included all patients who were between 65 and 74 years, had established primary care within VHA between 2005 and 2021, and had not received any prior pneumococcal vaccination. We measured time-to-event from cohort enrolment to the onset of IPD, considering death a competing risk event, and used Cox regression models to estimate cause-specific hazards. PCV13 only, PPSV23 only, PCV13 after PPSV23, and PPSV23 after PCV13 were incorporated into models as time-dependent covariates. Patient demographics and comorbidities were also included in the model., Results: A total of 3 044 067 patients were enrolled in the cohort, with 863 958 deaths (28.4%) and 1731 cases of IPD (0.06%) during the study period. The overall incidence rate of IPD in this population was 5.36 per 100 000 patient-years. A total of 921 070 patients (30.3%) received at least one dose of effective pneumococcal vaccine. In multivariate analysis adjusted for comorbidities, PCV13 alone was not associated with the reduced risk of IPD, whereas PPSV23 had protective association with IPD incidence (adjusted hazard ratio [aHR], 0.70; 95% CI, 0.59-0.83). When combined, PCV13 followed by PPSV23 had a stronger protective association (aHR, 0.54; [0.36-0.83]) compared with PPSV23 followed by PCV13 (aHR, 0.73; [0.58-0.91])., Discussion: In this large cohort study at the VHA, the combination of PCV13 and PPSV23, particularly PCV13 followed by PPSV23, was associated with a lower risk of IPD, indicating additional benefits in combined vaccinations with potential importance in vaccination order. Further studies are needed to evaluate the effect of newer pneumococcal vaccines., (Copyright © 2024 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)
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- 2024
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8. Pneumococcus beyond an Austrian syndrome – A case report
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Gonçalo Guerreiro, André Pina Monteiro, Luís Coelho, and Pedro Póvoa
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Pneumococcus ,Invasive pneumococcal disease ,Austrian syndrome ,Splenectomy ,Pneumococcal vaccine ,Infectious and parasitic diseases ,RC109-216 - Abstract
Austrian syndrome is a rare entity characterized by Osler’s triad: endocarditis, pneumonia and meningitis, caused by Streptococcus pneumoniae (Austrian, 1957 [1]). This aggressive syndrome is associated with high morbidity and mortality, often due to the involvement of the heart valves and their destruction (Nogué et al., 2019 [2], Araji et al., 2008 [3]).We present a case of Austrian syndrome in a splenectomised elderly patient with an unusual presentation: septic arthritis complicated by endocarditis, septic cerebral emboli, meningitis and pneumonia. Despite appropriate therapy, the prognosis remained poor and the patient died at day 7.
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- 2022
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9. Uptake of pneumococcal vaccination in older people in northern Israel
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Sophia Eilat-Tsanani and Ayelet Vashitz-Giwnewer
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Pneumococcal vaccine ,Older adults ,Clinic visits ,Early detection of cancer ,Influenza vaccine ,Medicine - Abstract
The 23-valent pneumococcal vaccine is recommended for people aged 65 years and over, to prevent pneumonia, a leading cause of infectious morbidity in older people. This study assessed pneumococcal vaccination in people aged 65–74 years living in northern Israel who were eligible for the pneumococcal vaccine since introduction free of charge. This retrospective study used the database of Clalit Health Services, the largest health maintenance organization in Israel.We fitted a Cox regression model to assess associations of vaccine uptake with sociodemographic and clinical characteristics, and a Wilcoxon rank-sum test and Chi-square test to assess associations of vaccine uptake with the performance of other health-related activities.The analysis included 20,591 people. People aged 65–70 were more likely to take the vaccine than people aged 71–74 [HR = 1.8; CI: 1.6–1.9]. Jews were more likely to take it than Arabs [HR = 1.1; CI: 1.0–1.2], and men were more likely to take it than women [HR = 1.1; CI: 1.0–1.2]. In women who took the vaccine, the rate of performance of mammography was higher (61.9 % ± 45.3 vs 50.3% ± 44.5, p
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- 2021
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10. Trends in influenza and pneumococcal vaccine coverage in Thai patients with type 2 diabetes mellitus 2010–2018: Experience from a tertiary diabetes center in Bangkok
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Yotsapon Thewjitcharoen, Siriwan Butadej, Areeya Malidaeng, Nalin Yenseung, Soontaree Nakasatien, Nampetch Lekpittaya, Worawit Kittipoom, Sirinate Krittiyawong, and Thep Himathongkam
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Influenza vaccine ,Pneumococcal vaccine ,Type 2 Diabetes Mellitus ,Coverage rate ,Bangkok ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
Trends in influenza and pneumococcal vaccine coverage in Thai patients with type 2 diabetes mellitus 2010–2018: Experience from a tertiary diabetes center in Bangkok. Background: Routine vaccination is an important part of preventive services in treating patients with type 2 diabetes (T2DM). There are no available data in temporal trends of vaccination coverage rates in both influenza and pneumococcal vaccines among Thai patients with T2DM. Aim: This study aimed to elucidate influenza and pneumococcal vaccination trends and to identify factors that affect vaccination rates in those patients. Method: A retrospective study of randomly medical records stratified by 13 diabetologists was conducted in patients with T2DM from 2010 to 2018 at Theptarin Hospital, a private multi-disciplinary diabetes center in Bangkok. Adherence to influenza and pneumococcal vaccinations according to current guidance on adult immunization in Thailand had been studied. The rate of both vaccinations from each diabetologist had also been recorded. Results: A total of 2114 medical records (female 51.7%, mean age 65.2 ± 12.8 years, BMI 26.5 ± 4.6 kg/m2, A1C 7.1 ± 1.3%, median duration of diabetes 13 years) were retrospectively reviewed covering a 9-year period. We audited 3554 selected outpatient visits for influenza and pneumococcal vaccinations rates as key performance index in each year. The overall vaccination rate was 39.6% for influenza, 17.4% for the pneumococcal vaccine, and only 13.7%, for both vaccines. The trends of influenza vaccination rates increased from 32.9% in 2010 to 52.2% in 2018 but the trends of pneumococcal vaccination rates were relatively stable at less than 20%. The rate of both vaccinations varied considerably from 0 to 44% among our diabetologists. Age ≥ 65 years, duration of DM ≥ 15 years, the presence of chronic respiratory disease, and moderate to severe Charlson Comorbidity Index (CCI) score were positively associated with both received vaccinations. Conclusions: The completeness and timeliness of influenza and pneumococcal vaccinations were unsatisfactory in Thai patients with T2DM. More efforts are needed to increase both influenza and pneumococcal vaccination rates.
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- 2020
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11. Carriage of Streptococcus pneumoniae in children under five years of age prior to pneumococcal vaccine introduction in Southeast Asia: A systematic review and meta-analysis (2001–2019)
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Wa Ode Dwi Daningrat, Catherine Satzke, Dodi Safari, Ira Marti Ayu, and Hafsah Amalia
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Microbiology (medical) ,Serotype ,medicine.medical_specialty ,medicine.disease_cause ,Serogroup ,Microbiology ,Pneumococcal conjugate vaccine ,Pneumococcal Infections ,Pneumococcal Vaccines ,Internal medicine ,Nasopharynx ,Epidemiology ,Streptococcus pneumoniae ,medicine ,Prevalence ,Immunology and Allergy ,Humans ,Child ,Vaccines, Conjugate ,General Immunology and Microbiology ,Under-five ,business.industry ,Infant ,General Medicine ,Southeast Asia ,Streptococcus pneumoniae carriage ,QR1-502 ,Infectious Diseases ,Carriage ,Pneumococcal vaccine ,Meta-analysis ,Child, Preschool ,Carrier State ,business ,Cambodia ,medicine.drug - Abstract
A number of pneumococcal carriage studies in children have been conducted in recent years. However, summary data of carriage prevalence and serotype distribution from South East Asia Region (SEAR) are limited. This may lead to the misconception that Streptococcus pneumoniae vaccine-types are uncommon in the region. Systematic reviews of pneumococcal carriage and the distribution of serotypes are critically important for evidence-based decision-making. We aimed to summarize published data on the serotype prevalence of S. pneumoniae carried in the nasopharynx of children under 5 years of age in SEAR. We performed a systematic review and meta-analysis for relevant studies on S. pneumoniae carriage conducted prior to PCV program implementation from online journal databases published between January 2001 to December 2019. The pooled prevalence of S. pneumoniae in healthy children under 5 years of age in SEAR was 36.0% (95% CI 34.2%-37.8%), and ranged from 68.0% (95% CI: 61.9%-74.0%) in Cambodia to 7.6% (95% CI: 5.7%-9.6%) in Malaysia. Serotypes 6A/B, 23F and 19F were the most common serotypes in children
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- 2022
12. Vaccination coverage and predictors of influenza, pneumococcal, herpes zoster, tetanus, measles, and hepatitis B vaccine uptake among adults in Greece.
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Tsiligianni I, Bouloukaki I, Papazisis G, Paganas A, Chatzimanolis E, Kalatharas M, Platakis I, Tirodimos I, Dardavesis T, and Tsimtsiou Z
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- Humans, Greece, Female, Male, Adult, Middle Aged, Pneumococcal Vaccines administration & dosage, Young Adult, Aged, Influenza Vaccines administration & dosage, Surveys and Questionnaires, Measles Vaccine administration & dosage, Adolescent, Herpes Zoster prevention & control, Herpes Zoster epidemiology, Herpes Zoster Vaccine administration & dosage, Vaccination statistics & numerical data, Immunization Programs statistics & numerical data, Vaccination Coverage statistics & numerical data, Hepatitis B Vaccines administration & dosage
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Objectives: Insufficient adult vaccination coverage rates remain an international challenge. This nationwide study aimed at exploring vaccination coverage and predictors of influenza, pneumococcal, herpes zoster, tetanus, measles, and hepatitis B vaccine uptake, following the recommendations of the National Immunization Program for adults., Study Design: This was a multicenter, mixed-methods study conducted at 23 primary care units in six different regions of Greece., Methods: A pretested questionnaire was administered to three randomly selected adults who visited each practice daily for 30 consecutive working days., Results: Among the 1571 participants, vaccination coverage for influenza in the high-risk groups was 55%, 36% for pneumococcal disease, 12% for herpes zoster (HZ), 21% for tetanus, 33% for measles, and 11% for hepatitis B. Perception of low susceptibility to disease due to good health status, concerns about side-effects and vaccines' efficacy, and mistrust in pharmaceutical companies were among common factors associated with the vaccines uptake. The strongest factor associated with the participants' vaccination status was their doctor's recommendation (odds ratio [95% confidence interval] influenza: 6.06 [4.52-8.14], pneumococcal disease: 15.73 [10.98-22.52], HZ: 17.01 [9.05-31.96], tetanus: 23.93 [16.20-35.35], measles: 33.47 [16.85-66.47], and hepatitis B: 73.92 [17.47-312.74]). Being well-informed about each vaccine was also a predictor of its uptake., Conclusions: Vaccination coverage was suboptimal and especially low in tetanus, HZ, and hepatitis B immunization. Person-centered approach, with provision of appropriate information about vaccines' safety and efficacy, responding to each patient's needs, as well as physicians' strong recommendation for vaccination are considered crucial to advocate against the spread of vaccine misinformation and increase vaccination coverage., (Copyright © 2023 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)
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- 2023
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13. Clinical characteristics and antimicrobial susceptibility of non-vaccine serotype Streptococcus pneumoniae in adult Japanese patients with pneumonia.
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Akata K, Yamasaki K, Noguchi S, Chang B, Nemoto K, Ikegami H, Kawanami T, Mukae H, and Yatera K
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Background: Non-vaccine serotype (NVT) pneumococcal pneumonia in Japan has increased with the spread of pneumococcal vaccinations. However, there is no data regarding the clinical background and antimicrobial susceptibility of NVT isolates compared with those of vaccine serotype (VT) isolates in adult pneumococcal pneumonia., Methods: The serotypes and antimicrobial susceptibilities of pneumococcal isolates obtained from patients with pneumonia at the University of Occupational and Environmental Health, Japan, from January 2011 to December 2020 were retrospectively evaluated along with the patients' clinical information., Results: In total, 252 patients with pneumococcal pneumonia (98 NVT and 154 VT isolates) were included. Among NVTs, the most common serotype was 35B, followed by 15A, 34, 6C, 23A, and 15C. The MIC
50 and MIC90 of each antibiotic in 35B and 15A tend to be higher than those in 34, 6C, and 23A. Regarding background characteristics, the percentages of patients with dementia and liver disease were significantly higher in patients in the VT group than in those in the NVT group (p = 0.048 and p = 0.012, respectively). There were no significant differences in the severity of pneumonia and mortality rate between patients with the VT and NVT isolates. This study first demonstrated that NVT isolates included those with reduced susceptibility to antibiotics in adult pneumonia in Japan. The data of the present study can be useful in optimizing treatment strategies for pneumococcal pneumonia because of the increasing number of NVT cases in Japan., Competing Interests: Declarations of competing interest None., (Copyright © 2023 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.)- Published
- 2023
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14. Streptococcus pneumoniae: estudo das cepas isoladas de liquor Streptococcus pneumoniae: a study of strains isolated from cerebrospinal fluid
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Ataiza C. Vieira, Marizoneide C. Gomes, Maurício Rolo Filho, João Eudes Filho, Edson José M. Bello, and Rosane B. de Figueiredo
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Meningite pneumocócica ,resistência bacteriana a drogas ,sorotipagem ,vacina pneumocócica ,Pneumococcal meningitis ,bacterial resistance to drugs ,serotyping ,pneumococcal vaccine ,Pediatrics ,RJ1-570 - Abstract
OBJETIVO: Determinar a freqüência dos sorotipos capsulares e a susceptibilidade antimicrobiana de cepas de Streptococcus pneumoniae, assim como dar suporte à indicação de vacinas disponíveis e ao uso de antimicrobianos. MÉTODOS: Neste estudo retrospectivo, foram adotadas metodologias padronizadas para identificar, sorotipar e determinar a susceptibilidade à penicilina, cefotaxima e vancomicina. O estudo foi realizado com cepas de pneumococo isoladas de liquor em pacientes atendidos nos hospitais públicos e em três hospitais particulares do Distrito Federal no período de janeiro de 1995 a dezembro de 2004. A identificação e a determinação de susceptibilidade a antimicrobianos foi realizada no Laboratório Central de Saúde Pública no Distrito Federal. A sorotipagem foi realizada no Instituto Adolfo Lutz. RESULTADOS: Foram isoladas 232 cepas de pneumococo, compreendendo 126 cepas (54,31%) de pacientes do sexo masculino. A idade dos pacientes variou de 0 a 62 anos, sendo agrupados em faixas etárias de 0 a 5, 6 a 17, 18 a 50 e acima de 50 anos. Identificaram-se 36 sorotipos distintos. Desses destacaram-se oito: 14, 6B, 18C, 5, 19F, 23F, 9V e 6A. O teste de oxacilina caracterizou 67 cepas resistentes à penicilina; dessas, 47 foram confirmadas pelo E teste com resistência de nível intermediário. Nenhuma cepa apresentou resistência de alto nível. CONCLUSÃO: A resistência do pneumococo à penicilina apresentou um aumento gradativo nos últimos 10 anos no Distrito Federal. Os sorotipos mais isolados na faixa etária de 0 a 5 anos foram também os mais envolvidos na resistência à penicilina, e estão incluídos na vacina 7-valente.OBJECTIVE: To determine the frequency of capsular serotypes and the antimicrobial susceptibility of strains of Streptococcus pneumoniae, as well as to provide recommendations on the use of available vaccines and antimicrobial drugs. METHODS: In this retrospective study, standard procedures were followed to identify, serotype, and determine bacterial susceptibility to penicillin, cefotaxime, and vancomycin. Pneumococcal strains were isolated from the cerebrospinal fluid (CSF) of patients admitted to nine public and three private hospitals in Distrito Federal, Brazil, between January 1995 and December 2004. Identification and antimicrobial susceptibility tests were carried out at the Central Laboratory of Public Health (Laboratório Central de Saúde Pública). Serotyping was performed at Instituto Adolfo Lutz. RESULTS: A total of 232 pneumococcal strains were isolated, including 126 (54.31%) strains from male patients. Patients had an age range of 0 to 62 years and were distributed into four age groups: 0 to 5, 6 to 17, 18 to 50, and above 50. From the 36 distinct serotypes identified, eight were more prevalent: 14, 6B, 18C, 5, 19F, 23F, 9V, and 6A. The oxacillin test identified 67 penicillin-resistant strains, out of which 47 were confirmed by the E test as having intermediate level of resistance. None of the strains exhibited high-level resistance. CONCLUSIONS: Pneumococcal resistance to penicillin has gradually increased over the last 10 years in Distrito Federal. Serotypes more frequently isolated in the 0 to 5 years age group were the same involved in penicillin-resistance, all of which are covered by the 7-valent vaccine.
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- 2007
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15. A feasibility study of controlled human infection with Streptococcus pneumoniae in Malawi
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Marc Henrion, Ben Morton, Daniela M. Ferreira, Sarah Burr, Stephen B. Gordon, Tarsizio Chikaonda, Edna Nsomba, Lucinda Manda-Taylor, Jamie Rylance, Ndaziona Peter Banda, and Kondwani C. Jambo
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Serotype ,Adult ,Male ,qw_563 ,Malawi ,Mucosal inflammation ,Medicine (General) ,Microbiological culture ,Population ,Vaccine Efficacy ,wa_395 ,medicine.disease_cause ,Serogroup ,Human infection model ,General Biochemistry, Genetics and Molecular Biology ,Pneumococcal Infections ,Pneumococcal Vaccines ,Young Adult ,R5-920 ,Nasopharynx ,Streptococcus pneumoniae ,Medicine ,Humans ,education ,education.field_of_study ,business.industry ,Nasal ,Vaccination ,General Medicine ,Vaccine efficacy ,Antibodies, Bacterial ,Nasal Mucosa ,Carriage ,Pneumococcal vaccine ,Immunology ,Carrier State ,Feasibility Studies ,Female ,business ,qw_142 ,Research Paper - Abstract
Background Persistent carriage of pneumococcal vaccine serotypes has occurred after introduction of PCV13 vaccination in Africa but the mechanisms are unclear. We tested the feasibility of using a human pneumococcal challenge model in Malawi to understand immune correlates of protection against carriage and to trial alternative vaccine candidates. We aimed to identify a dose of Streptococcus pneumoniae serotype 6B sufficient to establish nasopharyngeal carriage in 40% of those nasally inoculated and evaluate nasal mucosal immunity before and after experimental inoculation. Methods Healthy student volunteers were recruited and inoculated with saline, 20,000 CFU/naris or 80,000 CFU/naris of Streptococcus pneumoniae serotype 6B Post inoculation carriage was determined by nasal sampling for bacterial culture and lytA PCR. Immunological responses were measured in serum and nasal mucosal biopsies before and after bacterial inoculation. Findings Twenty-four subjects completed the feasibility protocol with minimal side effects. pneumococcal carriage was established in 0/6, 3/9 and 4/9 subjects in the saline, 20,000 CFU/naris and 80,000 CFU/naris groups, respectively. Incidental (natural) serotype carriage was common (7/24 participants carried non-6B strains, 29.2%. Experimentally induced type 6B pneumococcal carriage was associated with pro-inflammatory nasal mucosal responses prior to inoculation and altered mucosal recruitment of immune cells post bacterial challenge. There was no association with serum anti-capsular antibody. Interpretation The serotype 6B experimental human pneumococcal carriage model is feasible in Malawi and can now be used to determine the immunological correlates of protection against carriage and vaccine efficacy in this population.
- Published
- 2021
16. Serotype distribution and antibiotic resistance among invasive Streptococcus pneumoniae from Oman post 13-valent vaccine introduction
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Mohamed Al Bulushi, Seif Al-Abri, Rajesh Kumar, Sara Al Mahrouqi, Azza Al Rashdi, Amina Al-Jardani, Aisha Al Jaaidi, and Amal Al-Maani
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Adult ,Male ,0301 basic medicine ,Microbiology (medical) ,Serotype ,Adolescent ,Oman ,medicine.drug_class ,030106 microbiology ,Antibiotics ,Serogroup ,medicine.disease_cause ,Pneumococcal Infections ,Microbiology ,lcsh:Infectious and parasitic diseases ,Pneumococcal Vaccines ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Antibiotic resistance ,Drug Resistance, Bacterial ,Case fatality rate ,Streptococcus pneumoniae ,medicine ,Humans ,Antimicrobial stewardship ,lcsh:RC109-216 ,030212 general & internal medicine ,Child ,Aged ,Aged, 80 and over ,Vaccines, Conjugate ,business.industry ,Infant, Newborn ,Infant ,General Medicine ,Middle Aged ,Vaccination ,Infectious Diseases ,Pneumococcal vaccine ,Child, Preschool ,Female ,business - Abstract
Objective: This study was undertaken to determine the serotype distribution and drug susceptibility patterns in pneumococcal isolates recovered from patients with invasive pneumococcal disease (IPD). Methods: All invasive pneumococcal isolates received between June 2014 and June 2016 were included in the study as part of a national laboratory-based IPD surveillance program. Isolates recovered from clinical specimens of normally sterile body sites were included. Results: A total of 41 different serotypes were identified among the 132 pneumococcal isolates included in this study. The most prevalent serotypes/serogroups were 12 (8.3%), 15 (8.3%), 19 F (7.6%), 3 (6.1%), and 19A (6.1%);. It was observed that overall vaccine coverage rates for pneumococcal conjugate vaccines (PCV), PCV7, PCV10 and PCV13 were 15.9%, 24.2% and 37.1% respectively. 56.8% (n = 75) of the isolates were non-susceptible to at least one antibiotic and 40.9% (n = 54) of the isolates were resistant to PEN (M). 18.9% (n = 25) of the isolates were multi-drug resistant (MDR).The case fatality rate was 15.9%. Conclusion: Our study results call for broader vaccine coverage, emphasizes the need to introduce the conjugate pneumococcal vaccine for the high risk adult population and stress the importance of continuous surveillance of serotypes and antimicrobial resistance to guide vaccine development and antimicrobial stewardship activities. Keywords: Streptococcus pneumoniae, IPD, Serotype, Antibiotic resistance, Oman, Vaccination
- Published
- 2019
17. Carriage of penicillin-non-susceptible pneumococci among children in northern Tanzania in the 13-valent pneumococcal vaccine era
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Susann Skovbjerg, Fredrika Sahlgren, Josefine Blomqvist, Victor Mosha, Shadi Geravandi, Balthazar M. Nyombi, Rune Andersson, Sia E. Msuya, Dominic Mosha, Matilda Emgård, Lucia Gonzales-Siles, Sofie Franzén, and Rickard Nordén
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Male ,0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,medicine.drug_class ,030106 microbiology ,Antibiotics ,Penicillins ,medicine.disease_cause ,Tanzania ,Pneumococcal Infections ,Pneumococcal conjugate vaccine ,lcsh:Infectious and parasitic diseases ,Pneumococcal Vaccines ,03 medical and health sciences ,0302 clinical medicine ,Antibiotic resistance ,Internal medicine ,Ampicillin ,Streptococcus pneumoniae ,Humans ,Medicine ,lcsh:RC109-216 ,030212 general & internal medicine ,business.industry ,Infant, Newborn ,Infant ,General Medicine ,Amoxicillin ,Anti-Bacterial Agents ,Penicillin ,Cross-Sectional Studies ,Infectious Diseases ,Pneumococcal vaccine ,Carrier State ,Female ,business ,medicine.drug - Abstract
Objectives: To determine the antibiotic susceptibility and serotype distribution of colonizing Streptococcus pneumoniae in Tanzanian children. Serial cross-sectional surveys were performed following the national introduction of the 13-valent pneumococcal conjugate vaccine (PCV13) in December 2012. Methods: A total of 775 children less than 2 years of age were recruited at primary health centres in Moshi, Tanzania between 2013 and 2015, and samples were obtained from the nasopharynx. S. pneumoniae were isolated by culture and tested for antibiotic susceptibility by disc diffusion and E-test methods; molecular testing was used to determine serotype/group. Results: Penicillin non-susceptibility in the isolated pneumococci increased significantly from 31% (36/116) in 2013, to 47% (30/64) in 2014 and 53% (32/60) in 2015. Non-susceptibility to amoxicillin/ampicillin and ceftriaxone was low (n = 8 and n = 9, respectively), while 97% (236/244) of the isolates were non-susceptible to trimethoprim–sulfamethoxazole. The majority of the children (54%, n = 418) had been treated with antibiotics in the past 3 months, and amoxicillin/ampicillin were overall the most commonly used antibiotics. Carriage of penicillin-non-susceptible pneumococci was more common in children with many siblings. The prevalence of PCV13 serotypes among the detected serotypes/groups decreased from 56% (40/71) in 2013 to 23% (13/56) in 2015. Conclusions: Penicillin non-susceptibility in S. pneumoniae colonizing Tanzanian children increased during an observation period shortly after the introduction of PCV13. Measures to ensure rational use of antibiotics and more effective systems for surveillance of antibiotic resistance and serotype distribution are needed to assure continued effective treatment of pneumococcal disease. Keywords: Streptococcus pneumoniae, Drug resistance, Bacterial, Air pollution, Pneumococcal vaccines, Nasopharyngeal colonization
- Published
- 2019
18. Pneumococcal vaccine uptake and vaccine effectiveness in older adults with invasive pneumococcal disease in Germany: A retrospective cohort study
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Mark van der Linden and Stephanie Perniciaro
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Serotype ,Pediatrics ,medicine.medical_specialty ,Pneumococcal disease ,Pneumococcal vaccination ,business.industry ,Health Policy ,Retrospective cohort study ,PCV13 ,bacterial infections and mycoses ,Confidence interval ,Oncology ,Vaccination status ,Pneumococcal vaccine ,PPV23 ,Cohort ,Internal Medicine ,medicine ,Public aspects of medicine ,RA1-1270 ,business ,Research Paper - Abstract
Background Invasive pneumococcal disease (IPD) in people ≥60 years old is on the rise in Germany. There has been a recommendation for pneumococcal vaccination in this age group since 1998. Methods We determined the vaccination status of people ≥60 years old with IPD in Germany. We assessed vaccine effectiveness (VE) of the recommended 23-valent polysaccharide vaccine (PPV23) against IPD using the indirect cohort method. Results The rate of pneumococcal vaccination in older adults with IPD is low, 26%, with only 16% of people receiving a pneumococcal vaccine within five years of the IPD episode. Age- and gender- adjusted vaccine effectiveness (VE) for PPV23 was 37% (95% confidence interval 12% - 55%). For people vaccinated with PPV23 less than two years prior to IPD, VE was -20% (-131% - 34%), between two and four years prior to IPD, VE was 56% (20% - 76%), and 47% (17% - 63%) for those vaccinated ≥5 five years ago. Excluding serotype 3, overall VE for the remaining serotypes in PPV23 was 63% (49% - 74%). For people receiving PPV23 within the past two years, VE against all serotypes except 3 was 49% (12% - 71%); for people vaccinated between two and four years prior to IPD 66% (37% - 82%); for those vaccinated ≥five years ago, 69% (50% - 81%). VE of PPV23 against serotype 3 IPD only was -110% (-198% - -47%). Conclusions To reduce IPD in older adults in Germany, we must increase the rate of pneumococcal vaccine uptake. For 22/23 serotypes, PPV23 was effective. Serotype 3 remains a major problem. Funding This work was supported by an investigator-initiated research grant from Pfizer.
- Published
- 2021
19. Immunogenicity of three versus four doses of 13-valent pneumococcal conjugate vaccine followed by 23-valent pneumococcal polysaccharide vaccine in allogeneic haematopoietic stem cell transplantation recipients: a multicentre, randomized controlled trial.
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Okinaka K, Akeda Y, Inamoto Y, Fuji S, Ito A, Tanaka T, Kurosawa S, Kim SW, Tanosaki R, Yamashita T, Ohwada C, Kurata K, Mori T, Onozawa M, Takano K, Yokoyama H, Koh K, Nagafuji K, Nakayama K, Sakura T, Takahashi T, Oishi K, and Fukuda T
- Subjects
- Humans, Middle Aged, Streptococcus pneumoniae, Vaccines, Conjugate, Double-Blind Method, Antibodies, Bacterial, Pneumococcal Vaccines, Immunoglobulin G, Hematopoietic Stem Cell Transplantation adverse effects, Pneumococcal Infections prevention & control
- Abstract
Objective: This multicentre, phase 2, randomized, controlled study of allogeneic haematopoietic stem cell transplantation (allo-HSCT) recipients compared the immunogenicity of two anti-pneumococcal vaccine regimens: four doses of 13-valent pneumococcal conjugate vaccine (PCV13) followed by 23-valent pneumococcal polysaccharide vaccine (PPSV23) (3+1+1 experimental group), and three doses of PCV13 followed by PPSV23 (3+0+1 group)., Methods: Allo-HSCT recipients without active graft-versus-host disease at enrolment were eligible. The primary endpoint was the IgG response rate (≥0.20 mg/mL) for all eight measured serotypes at 5 months after the PPSV23 booster., Results: Seventy-two recipients were randomized, and seventy recipients who received over one PCV13 dose were analysed. The mean ages were 47.2 years (standard deviation, 14.4) in the 3+1+1 group (n = 35) and 49.0 years (standard deviation, 14.3) in the 3+0+1 group (n = 35). There was no significant difference in the overall IgG response rate at 5 months after the PPSV23 booster between the 3+1+1 and 3+0+1 groups (100% (26/26) vs. 93% (27/29), respectively, relative risk (RR): 1.07; 95% confidence interval (CI): 0.97-1.19). This rate was high immediately before the PPSV23 booster in the 3+1+1 group (100% (26/26) compared with 81% (21/26), respectively, RR: 1.24; 95% CI: 1.03-1.49), but this difference disappeared 1 month after the PPSV23 booster (100% (26/26) vs. 97% (28/29), respectively, RR: 1.04; 95% CI; 0.97-1.11). No serious adverse events leading to study dropout occurred., Discussion: We were not able to determine the efficacy of the experimental arm based on the IgG response rate at 5 months after the PPSV23 booster in allo-HSCT recipients., (Copyright © 2022 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)
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- 2023
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20. Methods for estimating the direct and indirect effect of 10 valent pneumococcal vaccine on nasopharyngeal carriage in children under 2 years in Matiari, Pakistan
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Sheraz Ahmed, Anita K. M. Zaidi, Sahrish Muneer, Furqan Kabir, Saad B. Omer, Shahira Shahid, Muhammad Imran Nisar, Sadia Shakoor, Fyezah Jehan, Najeeha Talat Iqbal, Aneeta Hotwani, Cynthia G. Whitney, and Asad Ali
- Subjects
medicine.medical_specialty ,Pediatrics ,Science ,Clinical Biochemistry ,010501 environmental sciences ,medicine.disease_cause ,01 natural sciences ,Herd immunity ,03 medical and health sciences ,Epidemiology ,Streptococcus pneumoniae ,medicine ,Nasopharyngeal carriage ,Pakistan ,030304 developmental biology ,0105 earth and related environmental sciences ,0303 health sciences ,Surveillance ,Transmission (medicine) ,business.industry ,Pneumococcal vaccines ,Method Article ,medicine.disease ,Medical Laboratory Technology ,Pneumonia ,Carriage ,Immunization ,Pneumococcal vaccine ,business - Abstract
Pneumonia is the leading cause of morbidity and mortality in children worldwide. The ten valent pneumococcal vaccine (PCV10) was introduced in Pakistan's Expanded Program on Immunization (EPI) in 2012 as a 3 + 0 schedule without catchup immunization. Nasopharyngeal carriage is taken as a surrogate marker to measure the impact of pneumococcal vaccine on populations. Carriage surveys are necessary to monitor the persistence of Vaccine Type (VT) serotypes, the emergence of Non-Vaccine Type (NVT) serotypes, and their role in both transmission and disease. This article describes various troubleshooting measures which we undertook to adopt the protocol to our setting. We also used an innovative approach to describe various epidemiological parameters of vaccine effectiveness against carriage. It is important to publish these methods to allow for valid regional and temporal comparisons of results in different settings. Thus, in this article, we describe the following methods for isolating upper airway pneumococcal carriage:•Methods for the collection, transport, and storage of nasopharyngeal samples.•Methods for identification and serotyping of pneumococci.•Methods for estimation of the direct and indirect effects of pneumococcal vaccines on nasopharyngeal carriage., Graphical abstract Image, graphical abstract
- Published
- 2021
21. Are younger COPD patients adequately vaccinated for influenza and pneumococcus?
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Gogou E, Hatzoglou C, Zarogiannis SG, Siachpazidou D, Gerogianni I, Kotsiou OS, Varsamas C, and Gourgoulianis KI
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- Aged, Male, Humans, Adult, Middle Aged, Female, Streptococcus pneumoniae, Pneumococcal Vaccines therapeutic use, Vaccination, Influenza, Human epidemiology, Influenza, Human prevention & control, Influenza Vaccines therapeutic use, Pulmonary Disease, Chronic Obstructive epidemiology
- Abstract
Influenza and pneumococcal pneumonia are major causes of increased morbidity and mortality among elderly and COPD patients. Vaccines against influenza and pneumococcus are recommended for COPD patients according to GOLD 2020 guidelines to prevent serious illnesses. Despite their high morbidity and mortality burden, the vaccination coverage rates remain far below the WHO's recommended targets. In Greece, there are insufficient data on influenza and pneumococcal immunization rates among younger COPD patients. This study investigated whether COPD patients under the age of 65 are adequately vaccinated against influenza and pneumococcus and the factors that influence vaccination rates. 1100 individuals at 22 Primary Health Centers in Central Greece participated in a two-year spirometry monitoring program. Face-to-face interviews were used to collect information regarding demographics, smoking status, comorbidities, respiratory illnesses in the previous two years, and influenza and pneumococcal vaccination coverage from all COPD patients. 117 patients aged 40-65 years old were diagnosed with COPD and 80.3% were males. Only 40.2% of them had received influenza and 32.5% pneumococcus vaccinations. Age, advanced stage of COPD, years on COPD diagnosis, respiratory infection within the previous two years, comorbidity, and smoking cessation are all positively connected with influenza and pneumococcus vaccine coverage in younger COPD patients. Gender, education level, and marital status did not affect influenza and pneumococcus vaccination rates. These vaccination rates among younger COPD patients demonstrate the need for increased awareness and knowledge about the advantages of immunizations in lowering morbidity and mortality., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)
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- 2022
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22. Bacteriological testing and recurrence prevention efforts in the diagnosis and treatment of nursing- and healthcare-associated pneumonia and aspiration pneumonia: A questionnaire survey of hospitals across Japan
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Daisuke Ninomiya, Shinsuke Yahata, Ayako Noda, Tsuneaki Kenzaka, Koki Kosami, Yasufumi Matsuoka, Kensuke Minami, and Ayako Kumabe
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Pulmonary and Respiratory Medicine ,Aspiration pneumonia ,Hospital-acquired pneumonia ,Pneumonia, Aspiration ,Bacteriological testing ,law.invention ,Sputum culture ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,Community-acquired pneumonia ,Japan ,law ,Recurrence ,Surveys and Questionnaires ,medicine ,Pneumonia, Bacterial ,Secondary Prevention ,Humans ,Blood culture ,030212 general & internal medicine ,Recurrence prevention ,Nursing- and healthcare-associated pneumonia ,Skilled Nursing Facilities ,Bacteriological Techniques ,medicine.diagnostic_test ,business.industry ,Sputum ,Pneumococcal vaccine ,medicine.disease ,Hospitals ,respiratory tract diseases ,Nursing Homes ,Pneumonia ,Gram staining ,Cross-Sectional Studies ,Practice Guidelines as Topic ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Background Clinical practice guidelines for nursing- and healthcare-associated pneumonia (NHCAP) were developed for pneumonia caused by drug-resistant bacteria and pneumonia in elderly patients, particularly aspiration pneumonia. The identification of pathogenic bacteria and implementation of efforts to prevent the recurrence of aspiration pneumonia are very important in clinical practice. This study examined the extent to which clinicians have established bacteriological testing and recurrence prevention efforts for NHCAP and aspiration pneumonia. Methods Questionnaire surveys were mailed to the heads of internal medicine and respiratory medicine departments at 2490 Japanese hospitals. The questionnaire evaluated bacteriological testing for NHCAP or aspiration pneumonia and prevention of the recurrence of aspiration pneumonia. Results A total of 350 hospitals responded. These hospitals were grouped on the basis of whether a pulmonologist provided medical care for aspiration pneumonia and whether the hospital employed an infectious disease specialist. For hospitals in which pulmonologists treated aspiration pneumonia, the response rates for "is done in nearly all cases" were 70.0%, 84.7%, 31.6%, and 48.9% for sputum gram staining, sputum culture tests, blood culture tests, and pneumococcal vaccination, respectively. In hospitals that employed an infectious disease specialist, the response rates for "is done in nearly all cases" were 72.8% and 41.3% for sputum gram staining and blood culture tests, respectively. Recurrence prevention for aspiration pneumonia (other than pneumococcal vaccination) was not actively implemented. Conclusions Sputum gram staining, sputum culture tests, and other bacteriological tests were implemented quite actively. However, physicians who treat aspiration pneumonia should implement efforts to prevent pneumonia recurrence more actively.
- Published
- 2018
23. Type II mixed cryoglobulinemia following influenza and pneumococcal vaccine administration
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Jeffrey P. Callen and Sabine Eid
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mixed cryoglobulinemia ,business.industry ,Hepatitis C virus ,Case Report ,Dermatology ,medicine.disease_cause ,medicine.disease ,vaccination ,Virology ,vasculitis ,Vaccination ,Hcv hepatitis c virus ,Pneumococcal vaccine ,HCV, hepatitis C virus ,Mixed cryoglobulinemia ,Medicine ,business ,Vasculitis - Published
- 2019
24. A prospective observational cohort study to assess the incidence of acute otitis media among children 0–5 years of age in Southern Brazil
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Clovis Arns da Cunha, Raghavendra Devadiga, D. Fermin Arguello, Eduardo Ortega Barria, Rejane B. Cunha, Tatiana M. Lanzieri, and Nervo Sanchez
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Male ,Quality of life ,Microbiology (medical) ,Pediatrics ,medicine.medical_specialty ,Acute otitis media ,lcsh:QR1-502 ,lcsh:Microbiology ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Humans ,Medicine ,lcsh:RC109-216 ,Prospective Studies ,030212 general & internal medicine ,Prospective cohort study ,Children ,Pediatric practice ,business.industry ,Incidence ,Incidence (epidemiology) ,Infant, Newborn ,Infant ,Confidence interval ,Otitis Media ,Infectious Diseases ,Caregivers ,Pneumococcal vaccine ,Child, Preschool ,Acute Disease ,Quality of Life ,Female ,business ,Brazil ,Cohort study - Abstract
Objectives: To estimate acute otitis media incidence among young children and impact on quality of life of parents/caregivers in a southern Brazilian city. Methods: Prospective cohort study including children 0–5 years of age registered at a private pediatric practice. Acute otitis media episodes diagnosed by a pediatrician and impact on quality of life of parents/caregivers were assessed during a 12-month follow-up. Results: During September 2008–March 2010, of 1,136 children enrolled in the study, 1074 (95%) were followed: 55.0% were ≤2 years of age, 52.3% males, 94.7% white, and 69.2% had previously received pneumococcal vaccine in private clinics. Acute otitis media incidence per 1000 person-years was 95.7 (95% confidence interval: 77.2–117.4) overall, 105.5 (95% confidence interval: 78.3–139.0) in children ≤2 years of age and 63.6 (95% confidence interval: 43.2–90.3) in children 3–5 years of age. Acute otitis media incidence per 1000 person-years was 86.3 (95% confidence interval: 65.5–111.5) and 117.1 (95% confidence interval: 80.1–165.3) among vaccinated and unvaccinated children, respectively. Nearly 68.9% of parents reported worsening of their overall quality of life. Conclusion: Acute otitis media incidence among unvaccinated children in our study may be useful as baseline data to assess impact of pneumococcal vaccine introduction in the Brazilian National Immunization Program in April 2010. Keywords: Acute otitis media, Children, Incidence, Quality of life
- Published
- 2017
25. Vacunación frente al neumococo en adultos mayores de 65 años
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M. Gobernado, Alberto Pérez-Rubio, and José María Eiros Bouza
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Male ,Risk ,Adult ,Vaccination Coverage ,Carta al Editor ,Urban Population ,Anciano ,MEDLINE ,medicine.disease_cause ,Infecciones neumocócicas ,Pneumococcal Infections ,Pneumococcal Vaccines ,Pulmonary Disease, Chronic Obstructive ,Streptococcus pneumoniae ,Medicine ,Humans ,Aged ,lcsh:R5-920 ,business.industry ,Incidence ,Vaccination ,Vacunación ,Pneumococcal pneumonia ,General Medicine ,Originales ,Neumonía neumocócica ,Cross-Sectional Studies ,Pneumococcal vaccine ,Spain ,Chronic Disease ,Immunology ,Regression Analysis ,Female ,Family Practice ,business ,lcsh:Medicine (General) - Abstract
Resumen Objetivos Conocer la cobertura vacunal antineumocócica en pacientes ≥ 65 años, así como el riesgo de enfermedad neumocócica según hayan o no recibido dicha vacunación. Diseño Estudio transversal, seguido de cohorte histórica. Emplazamiento Ámbito urbano. Participantes Se seleccionaron por muestreo sistemático 2.805 personas ≥ 65 años de la ciudad de Albacete. Mediciones principales Variable dependiente: diagnóstico de enfermedad neumocócica y fecha. Variables independientes: edad, sexo, enfermedades crónicas, medicación, vacunación antineumocócica y fecha. Se revisaron las historias clínicas informatizadas, de 1-1-2009 a octubre-diciembre de 2015. Se ha realizado un análisis descriptivo, se ha calculado el riesgo relativo de aparición de enfermedad neumocócica según la vacunación y se ha realizado un análisis de supervivencia con el programa estadístico SPSS 17.0. Resultados La mediana de edad era de 71 años; el 57,2% eran mujeres. Recibieron vacuna polisacárida el 46,0% (IC 95% 44,1-47,8). Solo 10 recibieron la conjugada. Fueron diagnosticadas de enfermedad neumocócica invasiva 22 personas, y de no invasiva, 153. El riesgo relativo de enfermedad neumocócica en vacunados frente a no vacunados, respectivamente para invasiva y no invasiva, era 1,59 (IC 95% 0,69-3,68) y 1,84 (IC 95% 1,33-2,54). Por regresión de Cox se demostró un mayor riesgo de enfermedad no invasiva para EPOC (1,95; IC 95% 1,32-2,89), tabaquismo (1,87; IC 95% 1,28-2,73), corticoterapia (1,73; IC 95% 1,08-2,79), vacunación polisacárida (141,41; IC 95% 5,92-3.378,49) y edad (1,11; IC 95% 1,08-1,14), con interacción entre estas 2 (0,94; IC 95% 0,91-0,98). Conclusiones Existe un mayor riesgo de presentar enfermedad neumocócica en pacientes ≥ 65 años vacunados con la polisacárida, si bien habría que considerar un efecto protector en los vacunados de mayor edad.
- Published
- 2020
26. Mucosal Vaccines for Streptococcus pneumoniae
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Larry S. McDaniel and Edwin Swiatlo
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Serotype ,biology ,business.industry ,medicine.disease_cause ,medicine.disease ,Pneumococcal infections ,medicine.anatomical_structure ,Immune system ,Antigen ,Pneumococcal vaccine ,Streptococcus pneumoniae ,Immunology ,medicine ,biology.protein ,Antibody ,business ,Respiratory tract - Abstract
Infections with Streptococcus pneumoniae (pneumococcus) are a major public health problem worldwide and cause significant morbidity and mortality. Despite their pathogenic potential, pneumococci are usually commensal inhabitants of the upper respiratory tract and colonize mucosal surfaces without symptoms. Infection of divergent sites follows colonization and is a function of both host and bacterial factors. The historical focus of vaccine development against pneumococcal infection has been serum antibody responses to polysaccharide capsule in an effort primarily to prevent invasive disease. Currently available vaccines are based on capsular polysaccharides and include only a small subset of the more than 90 serotypes identified. Because of the usual anatomical location of pneumococci in a host and the large diversity of capsular serotypes, pneumococcal vaccine efforts have been shifting to serotype-independent antigens delivered to mucosal surfaces to prevent the first essential step in pneumococcal infections. In this chapter, we review immune responses at the respiratory mucosa in response to both natural infection and experimental vaccines. Both antibody and Th17-biased CD4+ T cell responses appear to be involved in clearing pneumococci from mucosal surfaces. However, it is still not known what the optimal immune response induced by a mucosal vaccine would look like.
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- 2020
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27. Risk factors for modified vaccine effectiveness of the live attenuated zoster vaccine among the elderly in England
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Thomas Verstraeten, Kaatje Bollaerts, and Maria Alexandridou
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lcsh:Immunologic diseases. Allergy ,medicine.medical_specialty ,Herpes zoster ,Effectiveness ,Shingles ,Internal medicine ,medicine ,Vaccine failure ,General Veterinary ,General Immunology and Microbiology ,business.industry ,Incidence (epidemiology) ,Public Health, Environmental and Occupational Health ,Retrospective cohort study ,medicine.disease ,Infectious Diseases ,Pneumococcal vaccine ,Regular paper ,Cohort ,Molecular Medicine ,Zoster vaccine ,business ,lcsh:RC581-607 ,Body mass index ,Vaccine ,medicine.drug - Abstract
Highlights • Diabetes or prior herpes zoster result in 22–23% lower vaccine effectiveness (VE). • These groups represent 28.5% of the population for whom the vaccine is recommended. • Key to study VE by risk groups for vaccine recommendations and development., Background The United Kingdom introduced routine vaccination with the live-attenuated zoster vaccine for 70 year-olds in 2013, with the vaccine also offered to 79 year-olds as part of a catch-up campaign. In the subsequent years, the catch-up campaign was extended to also include adults aged 78 years. We investigated 14 pre-identified potential risk factors for potential modified vaccine effectiveness. Methods This retrospective cohort study in England included subjects born in 1943–1946 (the routine cohort) and in 1934–1937 (the catch-up cohort). We used the Clinical Practice Research Datalink (CPRD) to identify herpes zoster (HZ) cases and the risk factors: age, gender, ethnicity, socio-economic status, asthma, type 2 diabetes, chronic obstructive pulmonary disease, smoking, body mass index, immunosuppression, history of HZ, co-administration with influenza or pneumococcal vaccine. We derived HZ incidence by risk groups, overall vaccine effectiveness (VE) and modified VE expressed as relative differences in VE from Poisson regression models. Results Overall VE was 66.8% [95% CI: 62.2; 71.0]. Two out of the 14 investigated risk factors modified the HZ VE. Notably, lower VE was observed in diabetics and in persons with a history of HZ with relative differences in VE of –22·2%, [95% CI: −39·6, −4·5] and –22·5%, [95% CI: −44·9, −0·1]. Conclusions Live-attenuated zoster vaccine protection against HZ was lower in type 2 diabetics and in subjects with a history of HZ. Contrary to clinical trial results, age did not affect the observed VE. Further study is required to gain insights into why certain risk groups are less protected. Identifying and understanding the effect modifiers of VE is important for future vaccine development as well as vaccine recommendations.
- Published
- 2019
28. Rapid progressive destruction of the cochleae in an infant due to pneumococcal meningitis.
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Kusama Y, Maruyama M, Fukui S, Hatsukawa H, Ito Y, Kamimura K, and Maihara T
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- Female, Humans, Infant, Pneumococcal Vaccines, Serogroup, Serotyping, Streptococcus pneumoniae genetics, Vaccines, Conjugate therapeutic use, Vancomycin therapeutic use, Meningitis, Pneumococcal complications, Meningitis, Pneumococcal diagnosis, Meningitis, Pneumococcal drug therapy, Pneumococcal Infections prevention & control
- Abstract
The widespread adoption of pneumococcal conjugate vaccines has reduced the incidence of Streptococcus pneumoniae infections, but has also led to the emergence of infections due to non-vaccine serotypes. A 15-month-old girl was referred to our hospital with suspected meningitis. S. pneumoniae was isolated from her cerebrospinal fluid. She was initially treated with a combination of cefotaxime and vancomycin, followed by ampicillin and vancomycin. After 7 days, the patient's condition improved and she was transferred to the general ward; however, her mother noted signs of hearing difficulties. On the 16th day of admission, we performed an auditory brainstem response test, which suggested severe bilateral hearing impairment. This was confirmed using an auditory steady-state response test after consulting with otolaryngologists. Magnetic resonance imaging revealed fibrosis of both cochleae with labyrinthitis. The patient underwent emergency cochlear implantation at a different hospital. The S. pneumoniae isolate was later identified to be serotype 10A with a PBP2x mutation, which is not covered by the conjugate vaccine and has reduced cephalosporin susceptibility. This case was characterized by highly rapid cochlear destruction, and an earlier otolaryngologist consultation may have provided a more well-organized surgery plan. Pediatricians are urged to promptly consult with otolaryngologists for patients with similar indications., (Copyright © 2022 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)
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- 2022
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29. Generation of cardio-protective antibodies after pneumococcal polysaccharide vaccine: Early results from a randomised controlled trial.
- Author
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Ren S, Hansbro PM, Srikusalanukul W, Horvat JC, Hunter T, Brown AC, Peel R, Faulkner J, Evans TJ, Li SC, Newby D, Hure A, Abhayaratna WP, Tsimikas S, Gonen A, Witztum JL, and Attia J
- Subjects
- Australia, Biomarkers, Humans, Immunoglobulin G, Immunoglobulin M, Streptococcus pneumoniae, Atherosclerosis prevention & control, Pneumococcal Vaccines
- Abstract
Background and Aims: Observational studies have demonstrated that the pneumococcal polysaccharide vaccine (PPV) is associated with reduced risk of cardiovascular events. This may be mediated through IgM antibodies to OxLDL, which have previously been associated with cardioprotective effects. The Australian Study for the Prevention through Immunisation of Cardiovascular Events (AUSPICE) is a double-blind, randomised controlled trial (RCT) of PPV in preventing ischaemic events. Participants received PPV or placebo once at baseline and are being followed-up for incident fatal and non-fatal myocardial infarction or stroke over 6 years., Methods: A subgroup of participants at one centre (Canberra; n = 1,001) were evaluated at 1 month and 2 years post immunisation for changes in surrogate markers of atherosclerosis, as pre-specified secondary outcomes: high-sensitive C-reactive protein (CRP), pulse wave velocity (PWV), and carotid intima-media thickness (CIMT). In addition, 100 participants were randomly selected in each of the intervention and control groups for measurement of anti-pneumococcal antibodies (IgG, IgG2, IgM) as well as anti-OxLDL antibodies (IgG and IgM to CuOxLDL, MDA-LDL, and PC-KLH)., Results: Concentrations of anti-pneumococcal IgG and IgG2 increased and remained high at 2 years in the PPV group compared to the placebo group, while IgM increased and then declined, but remained detectable, at 2 years. There were statistically significant increases in all anti-OxLDL IgM antibodies at 1 month, which were no longer detectable at 2 years; there was no increase in anti-OxLDL IgG antibodies. There were no significant changes in CRP, PWV or CIMT between the treatment groups at the 2-year follow-up., Conclusions: PPV engenders a long-lasting increase in anti-pneumococcal IgG, and to a lesser extent, IgM titres, as well as a transient increase in anti-OxLDL IgM antibodies. However, there were no detectable changes in surrogate markers of atherosclerosis at the 2-year follow-up. Long-term, prospective follow-up of clinical outcomes is continuing to assess if PPV reduces CVD events., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)
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- 2022
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30. Comparative characteristics of the background and blood test findings in adults with pneumococcal pneumonia and invasive pneumococcal disease: A retrospective study.
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Tsuchiya M, Miyazaki H, Takata M, Shibuya R, Chang B, Ubukata K, Matsumoto T, and Nakamura S
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- Hematologic Tests, Humans, Infant, Pneumococcal Vaccines, Retrospective Studies, Serogroup, Pneumococcal Infections diagnosis, Pneumococcal Infections drug therapy, Pneumonia, Pneumococcal diagnosis, Pneumonia, Pneumococcal drug therapy
- Abstract
Introduction: Invasive pneumococcal disease (IPD) is often fatal, requiring prompt diagnosis and treatment. To evaluate the factors associated with IPD in adults, we retrospectively investigated its characteristics compared to pneumococcal pneumonia without confirmation of invasion (PP)., Methods: Patients >18 years with PP (n = 79) and IPD (n = 53) from whom Streptococcus pneumoniae was isolated were enrolled from two hospitals between 2011 and 2017. Clinical backgrounds, blood test results at admission, initial antimicrobials administered, isolate serotypes, and outcomes were compared between the PP and IPD groups., Results: Patients with IPD exhibited higher mortality (28.3%) than those with PP (2.5%) (p<0.001), regardless of the type of antimicrobials first administered. The majority (80.0%) of fatal cases of IPD were due to vaccine serotypes. Almost all patients with PP (97.4%) and IPD (88.7%) had underlying disease. C-reactive protein (CRP) ≥17.0 mg/dL (odds ratio [OR], 7.1; 95% CI, 2.7-19.0; p<0.001), white blood cell counts <11.0 × 10
3 /μL (OR, 3.2; 95% CI, 1.3-8.4; p = 0.016), and platelet (PLT) counts <16.2 × 104 /μL (OR, 2.8; 95% CI, 1.1-7.4; p = 0.036) were significantly more common in IPD. Moreover, 89.5% of cases with both CRP ≥23.8 mg/dL and PLT <18.5 × 104 /μL were diagnosed with IPD., Conclusion: Laboratory blood test findings at admission, particularly high CRP and low PLT values, are useful early indicators of IPD in adults. These results could be used to initiate rapid and intensive treatment and improve prognosis., (Copyright © 2021 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)- Published
- 2022
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31. Pneumococcal vaccination prevented severe LRTIs in adults: a causal inference framework applied in registry data.
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Mamouris P, Henrard S, Molenberghs G, Verhaegen J, Lin G, and Vaes B
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- Adult, Humans, Pneumococcal Vaccines therapeutic use, Propensity Score, Registries, Risk Factors, Vaccination, Pneumococcal Infections prevention & control, Respiratory Tract Infections
- Abstract
Objectives: We estimated the effect of pneumococcal vaccination (PV) on acute lower respiratory tract infections (LRTIs) in various age and risk groups using different methods within a causal inference methodological framework., Study Design and Setting: We used data from a general practitioners' morbidity registry for the year 2019. Both traditional statistical methods (regression-based and propensity score methods) and machine learning techniques were deployed. Multiple imputation was used to account for missing data. Relative risks (RRs) with 95% confidence intervals were estimated. Sensitivity analyses were performed to account for the severity of LRTIs and differences in vaccination registration., Results: All methods showed a standardized mean difference below 0.1 for each covariate. No method was found to be superior to another. PV (combination of conjugate and polysaccharide vaccine) had an overall protective effect for severe LRTIs. PV was protective in different age and risk groups, especially in people aged 50-84 years with an intermediate risk group., Conclusion: Using several techniques, PV was found to prevent severe LRTIs and confirmed the recommendations of the Belgian Superior Health Council., (Copyright © 2021 Elsevier Inc. All rights reserved.)
- Published
- 2022
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32. Bacterial etiology of acute otitis media in Spain in the post-pneumococcal conjugate vaccine era
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Pilar García-Corbeira, Sara Cardelús, Raghavendra Devadiga, Justo Ramón Gómez Martínez, Ignacio Salamanca de la Cueva, Fernando A. Moraga-Llop, Cynthia McCoig, Rosa Rosell Ferrer, Jesús Iniesta Turpin, Felix Pumarola, and Alessandra Sistiaga-Hernando
- Subjects
Male ,0301 basic medicine ,Serotype ,Pediatrics ,medicine.medical_specialty ,Otitis media aguda ,Acute otitis media ,030106 microbiology ,España ,medicine.disease_cause ,Pneumococcal conjugate vaccine ,RJ1-570 ,Haemophilus influenzae ,Pneumococcal Vaccines ,03 medical and health sciences ,0302 clinical medicine ,Management of Technology and Innovation ,Streptococcus pneumoniae ,otorhinolaryngologic diseases ,Humans ,Medicine ,Tympanocentesis ,Prospective Studies ,030212 general & internal medicine ,Niños ,business.industry ,Infant ,Bacterial Infections ,Epidemiologic Studies ,Otitis Media ,Pneumococcal vaccine ,Spain ,Child, Preschool ,Vacuna neumocócica conjugada ,Acute Disease ,Etiology ,Female ,business ,medicine.drug - Abstract
Introduction: Acute otitis media (AOM) is common in children aged
- Published
- 2016
33. Enfermedad neumocócica en el adulto: niveles de riesgo y recomendaciones de vacunación
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Olga Ochoa-Gondar and Angel Vila-Corcoles
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0301 basic medicine ,Adult ,Pediatrics ,medicine.medical_specialty ,Asplenia ,Heart disease ,Adolescent ,030106 microbiology ,Pneumococcal disease ,Recommendations ,Risk Assessment ,Pneumococcal conjugate vaccine ,Pneumococcal Infections ,Pneumococcal Vaccines ,03 medical and health sciences ,Artículo Especial ,Young Adult ,0302 clinical medicine ,Diabetes mellitus ,medicine ,Adults ,Humans ,030212 general & internal medicine ,Adultos ,Enfermedad neumocócica ,Aged ,Medicine(all) ,lcsh:R5-920 ,business.industry ,Immunogenicity ,General Medicine ,Middle Aged ,medicine.disease ,Anti-pneumococcal vaccine ,Vaccination ,Increased risk ,Pneumococcal vaccine ,Practice Guidelines as Topic ,Recomendaciones ,lcsh:Medicine (General) ,Family Practice ,business ,Vacunación antineumocócica ,medicine.drug - Abstract
ResumenActualmente 2 vacunas antineumocócicas están disponibles para uso en adultos: la «clásica» vacuna neumocócica polisacárida tricosavalente (VNP23) y la «nueva» vacuna neumocócica conjugada tridecavalente (VNC13). La principal ventaja de la VNC13 sería su potencial mejor inmunogenicidad, siendo sus principales inconvenientes el elevado coste y la baja cobertura de serotipos en comparación con la VNP23. Las evidencias actualmente disponibles apoyan las siguientes recomendaciones básicas: a)en los adultos con más alto riesgo (básicamente inmunocompromiso y/o asplenia) se recomienda la vacunación dual con ambas vacunas; b)en los sujetos con riesgo elevado (básicamente personas >65 años y pacientes de 15-64años con enfermedad pulmonar o cardiaca crónica, diabetes y/o alcoholismo) se recomienda la vacunación simple con VNP23 (dosis única en primovacunados ≥65años; revacunación a los 5-10años en el caso de primovacunados antes de los 65años), y c)en el resto de adultos (riesgo normal/bajo) no se recomienda la vacunación.AbstractThere are currently two anti-pneumococcal vaccines available for use in adults: the classical 23-valent polysaccharide pneumococcal vaccine (PPV23) and the new 13-valent pneumococcal conjugate vaccine (PCV13). The main advantage of the PCV13 is the potentially better immunogenicity, with its major disadvantages being the higher cost and the lower serotype-coverage than the PPV23. The currently available scientific evidence supports the following basic recommendations: (i)among adults with greatest risk (basically asplenia and immunocompromised), a dual vaccination (PCV13+PPV23) is recommended; (ii)among adults with increased risk (basically persons >65years-old and patients 15-64years with chronic pulmonary or heart disease, diabetes and/or alcoholism), a single vaccination with PPV23 is recommended (single dose in primo-vaccinated >65years; re-vaccination at 5-10years in those primo-vaccinated
- Published
- 2016
34. Bias with respect to socioeconomic status: A closer look at zip code matching in a pneumococcal vaccine effectiveness study
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Meghan Barnes, Bernard Beall, Ann Thomas, Arthur Reingold, Karen Scherzinger, Matthew R. Moore, Allison E. Aiello, Corinne Holtzman, Daniel Westreich, Jennifer B. Rosen, William Schaffner, Cynthia G. Whitney, Christine Wigen, Susan Petit, Jeffrey Eason, Ola Thomas, Ruth Link-Gelles, Monica M. Farley, Nong Shang, Shelley M. Zansky, Lee H. Harrison, and David J. Weber
- Subjects
Matching (statistics) ,Pediatrics ,medicine.medical_specialty ,Health (social science) ,Context (language use) ,PCV13 ,Pneumococcal conjugate vaccine ,Article ,Vaccine Related ,03 medical and health sciences ,0302 clinical medicine ,Clinical Research ,030225 pediatrics ,Behavioral and Social Science ,Medicine ,030212 general & internal medicine ,lcsh:Social sciences (General) ,Socioeconomic status ,Lung ,Vaccine effectiveness ,business.industry ,Health Policy ,Prevention ,lcsh:Public aspects of medicine ,Confounding ,Public Health, Environmental and Occupational Health ,lcsh:RA1-1270 ,Pneumococcal vaccine ,Odds ratio ,social sciences ,Pneumococcus ,Good Health and Well Being ,Public Health and Health Services ,population characteristics ,Observational study ,Immunization ,lcsh:H1-99 ,Matched case-control ,business ,Demography ,medicine.drug - Abstract
In 2010, 13-valent pneumococcal conjugate vaccine (PCV13) was introduced in the US for prevention of invasive pneumococcal disease in children. Individual-level socioeconomic status (SES) is a potential confounder of the estimated effectiveness of PCV13 and is often controlled for in observational studies using zip code as a proxy. We assessed the utility of zip code matching for control of SES in a post-licensure evaluation of the effectiveness of PCV13 (calculated as [1-matched odds ratio]*100). We used a directed acyclic graph to identify subsets of confounders and collected SES variables from birth certificates, geocoding, a parent interview, and follow-up with medical providers. Cases tended to be more affluent than eligible controls (for example, 48.3% of cases had private insurance vs. 44.6% of eligible controls), but less affluent than enrolled controls (52.9% of whom had private insurance). Control of confounding subsets, however, did not result in a meaningful change in estimated vaccine effectiveness (original estimate: 85.1%, 95% CI 74.8–91.9%; adjusted estimate: 82.5%, 95% CI 65.6–91.1%). In the context of a post-licensure vaccine effectiveness study, zip code appears to be an adequate, though not perfect, proxy for individual SES., Highlights • Socioeconomic status (SES) may impact enrollment in vaccine effectiveness studies. • We assessed zip code matching as a proxy for SES in a pneumococcal vaccine study. • After zip code matching, we found differences in SES between cases and controls. • Differences did not appear to substantially bias estimated vaccine effectiveness.
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- 2016
35. Pneumococcal Vaccines in Adults
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Srinivas Nanduri, Nancy M. Bennett, and Tamara Pilishvili
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medicine.medical_specialty ,Pediatrics ,Pneumococcal disease ,business.industry ,Advisory committee ,Pneumococcal polysaccharide vaccine ,Pneumococcal conjugate vaccine ,Immunization ,Pneumococcal vaccine ,Immunity ,Epidemiology ,Medicine ,business ,medicine.drug - Abstract
This chapter summarizes the epidemiology of pneumococcal disease among adults in the United States, available pneumococcal vaccines, and current recommendations regarding their use among adults. Although there has been a decline in vaccine-type invasive pneumococcal disease among adults due to indirect “herd” protection from the use of pneumococcal conjugate vaccines in children, there is still a significant burden. Pneumococcal disease is more common and more severe among adults with underlying conditions that lead to decreased immunity. The Advisory Committee on Immunization Practices currently recommends use of both the 13-valent pneumococcal conjugate vaccine and the 23-valent pneumococcal polysaccharide vaccine in all adults aged >65 years and in adults aged >19 years with certain medical conditions. However, overall pneumococcal vaccine coverage among adults remains low and has not yet met the Healthy People 2020 target.
- Published
- 2019
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36. Rare but not forgotten: A case of meningitis due to ceftriaxone-resistant Streptococcus pneumoniae
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Miguel E. Cervera-Hernandez, Najam Zaidi, John R. Lonks, and Naomi Hauser
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Pediatrics ,medicine.medical_specialty ,Pneumococcal disease ,Disease ,Infectious and parasitic diseases ,RC109-216 ,030204 cardiovascular system & hematology ,medicine.disease_cause ,Article ,03 medical and health sciences ,0302 clinical medicine ,Streptococcus pneumoniae ,medicine ,Meningitis ,030212 general & internal medicine ,Ceftriaxone resistance ,business.industry ,medicine.disease ,Infectious Diseases ,Pneumococcal vaccine ,Ceftriaxone ,business ,Empiric treatment ,medicine.drug - Abstract
Despite the dramatic decrease in invasive pneumococcal disease since the widespread use of the first pneumococcal vaccine, invasive and resistant disease still occurs. We present a case of ceftriaxone-resistant pneumococcal meningitis suggesting that continued vigilance is warranted for empiric treatment of meningitis when Streptococcus pneumoniae is a concern.
- Published
- 2018
37. Efficacy of a novel, protein-based pneumococcal vaccine against nasopharyngeal carriage of Streptococcus pneumoniae in infants: A phase 2, randomized, controlled, observer-blind study
- Author
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Mark R. Alderson, Kurt Dobbelaere, Magali Traskine, Ezra O. Ogundare, Yauba Saidu, Brian Greenwood, Isatou Drammeh, Abdoulie Bojang, Sonia Schoonbroodt, Kristien Swinnen, Archibald Worwui, Beate Kampmann, Olumuyiwa Owolabi, Vincent Verlant, Martin Antonio, Nathalie Devos, Fatima Ceesay, Sheikh Jarju, Martin O. C. Ota, Ebenezer Foster-Nyarko, Dorota Borys, Aderonke Odutola, Olubukola T. Idoko, and Patrick K. Owiafe
- Subjects
0301 basic medicine ,Male ,Dose-Response Relationship, Immunologic ,medicine.disease_cause ,Pneumococcal conjugate vaccine ,Pneumococcal Infections ,Pneumococcal Vaccines ,03 medical and health sciences ,0302 clinical medicine ,Bacterial Proteins ,Nasopharynx ,Streptococcus pneumoniae ,medicine ,Humans ,Single-Blind Method ,030212 general & internal medicine ,Reactogenicity ,Pneumolysin ,General Veterinary ,General Immunology and Microbiology ,business.industry ,Public Health, Environmental and Occupational Health ,Toxoid ,Infant ,Vaccine efficacy ,Bacterial Load ,030104 developmental biology ,Infectious Diseases ,Carriage ,Treatment Outcome ,Pneumococcal vaccine ,Immunology ,Carrier State ,Molecular Medicine ,Female ,Gambia ,business ,medicine.drug - Abstract
Background Conserved pneumococcal proteins are potential candidates for inclusion in vaccines against pneumococcal diseases. In the first part of a two-part study, an investigational vaccine (PHiD-CV/dPly/PhtD-30) containing 10 pneumococcal serotype-specific polysaccharide conjugates (10VT) combined with pneumolysin toxoid and pneumococcal histidine triad protein D (30 μg each) was well tolerated by Gambian children. Part two, presented here, assessed the efficacy of two PHiD-CV/dPly/PhtD formulations against pneumococcal nasopharyngeal carriage (NPC) prevalence in infants. Methods In this phase 2, randomized, controlled, observer-blind trial, healthy infants aged 8–10 weeks, recruited from a peri-urban health center, were randomized (1:1:1:1:1:1) into six groups. Four groups received PHiD-CV/dPly/PhtD (10 or 30 μg of each protein), PHiD-CV, or 13-valent pneumococcal conjugate vaccine at ages 2–3–4 months (3 + 0 infant schedule) and two groups PHiD-CV/dPly/PhtD-30 or PHiD-CV at 2–4–9 months (2 + 1 infant schedule). The primary objective was impact on non-10VT NPC at ages 5–9–12 months. Secondary objectives included confirmatory analysis of protein dose superiority and safety/reactogenicity. Impact on pneumococcal NPC acquisition, bacterial load, and ply and phtD gene sequencing were explored. Results 1200 infants were enrolled between June 2011 and May 2012. Prevalences of pneumococcal (60–67%) and non-10VT (55–61%) NPC were high at baseline. Across all post-vaccination time points, efficacy of PHiD-CV/dPly/PhtD-10 and PHiD-CV/dPly/PhtD-30 against non-10VT NPC (3 + 0 schedule) was 1.1% (95% CI −21.5, 19.5) and 2.1% (−20.3, 20.3), respectively; efficacy of PHiD-CV/dPly/PhtD-30 (2 + 1 schedule) was 0.5% (−22.1, 18.9) versus PHiD-CV. No differences were observed in pneumococcal NPC acquisition, clearance, or bacterial load. Both protein-based vaccines elicited immune responses to pneumococcal proteins. Conclusions In this high carriage prevalence setting, inclusion of pneumococcal proteins in the PHiD-CV/dPly/PhtD investigational vaccine had no impact on pneumococcal NPC in infants, regardless of protein dose or schedule. Future evaluations will assess its impact against pneumococcal disease endpoints. Funding: PATH, GlaxoSmithKline Biologicals SA. ClinicalTrials.gov identifier NCT01262872 .
- Published
- 2017
38. Lower vaccine uptake amongst older individuals living alone: A systematic review and meta-analysis of social determinants of vaccine uptake
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Sara L. Thomas, A.J. van Hoek, Delia Boccia, and Anu Jain
- Subjects
Gerontology ,Vaccination Coverage ,Herpes Zoster Vaccine ,Social Determinants of Health ,030231 tropical medicine ,Social class ,03 medical and health sciences ,0302 clinical medicine ,Immunology and Microbiology(all) ,Environmental health ,Humans ,Medicine ,030212 general & internal medicine ,Social determinants of health ,Healthcare Disparities ,Aged ,Aged, 80 and over ,Vaccines ,General Veterinary ,General Immunology and Microbiology ,business.industry ,Public Health, Environmental and Occupational Health ,Odds ratio ,veterinary(all) ,Europe ,Vaccination ,Infectious Diseases ,Pneumococcal vaccine ,Meta-analysis ,Molecular Medicine ,Marital status ,business - Abstract
INTRODUCTION: Vaccination is a key intervention to reduce infectious disease mortality and morbidity amongst older individuals. Identifying social factors for vaccine uptake enables targeted interventions to reduce health inequalities. OBJECTIVE: To systematically appraise and quantify social factors associated with vaccine uptake amongst individuals aged ≥60years from Europe. METHODS: We searched Medline and Embase from inception to 24/02/2016. The association of vaccine uptake was examined for social factors relevant at an individual level, to provide insight into individuals' environment and enable development of targeted interventions by healthcare providers to deliver equitable healthcare. Factors included: living alone, marital status, education, income, vaccination costs, area-level deprivation, social class, urban versus rural residence, immigration status and religion. Between-study heterogeneity for each factor was identified using I2-statistics and Q-statistics, and investigated by stratification and meta-regression analysis. Meta-analysis was conducted, when appropriate, using fixed- or random-effects models. RESULTS: From 11,754 titles, 35 eligible studies were identified (uptake of: seasonal influenza vaccine (SIV) only (n=27) or including pneumococcal vaccine (PV) (n=5); herpes zoster vaccine (n=1); pandemic influenza vaccine (n=1); PV only (n=1)). Higher SIV uptake was reported for individuals not living alone (summary odds ratios (OR)=1.39 (95% confidence interval (CI): 1.16-1.68). Lower SIV uptake was observed in immigrants and in more deprived areas: summary OR=0.57 (95%CI: 0.47-0.68) and risk ratio=0.93 (95%CI: 0.92-0.94) respectively. Higher SIV uptake was associated with higher income (OR=1.26 (95%CI: 1.08-1.47)) and higher education (OR=1.05 (95%CI: 1-1.11)) in adequately adjusted studies. Between-study heterogeneity did not appear to result from variation in categorisation of social factors, but for education was partly explained by varying vaccination costs (meta-regression analysis p=
- Published
- 2017
39. Methotrexate reduces vaccine-specific immunoglobulin levels but not numbers of circulating antibody-producing B cells in rheumatoid arthritis after vaccination with a conjugate pneumococcal vaccine
- Author
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Johanna Nagel, Inger Nordström, Meliha C Kapetanovic, Pierre Geborek, Anna Rudin, and Tore Saxne
- Subjects
Male ,0301 basic medicine ,Enzyme-Linked Immunospot Assay ,Pneumococcal conjugate vaccine ,Arthritis, Rheumatoid ,Pneumococcal Vaccines ,0302 clinical medicine ,B-Lymphocytes ,biology ,ELISPOT ,Middle Aged ,Antibodies, Bacterial ,Vaccination ,Streptococcus pneumoniae ,Infectious Diseases ,Antirheumatic Agents ,Rheumatoid arthritis ,Molecular Medicine ,Female ,Antibody ,medicine.drug ,Adult ,musculoskeletal diseases ,Pneumococcal vaccination ,Serogroup ,Circulating B cells ,03 medical and health sciences ,Conjugate vaccine ,medicine ,Humans ,Lymphocyte Count ,Aged ,Rheumatology and Autoimmunity ,030203 arthritis & rheumatology ,Vaccines, Conjugate ,General Veterinary ,General Immunology and Microbiology ,business.industry ,Public Health, Environmental and Occupational Health ,Pneumonia, Pneumococcal ,medicine.disease ,Immunoglobulin A ,030104 developmental biology ,Methotrexate ,Pneumococcal vaccine ,Immunoglobulin G ,Immunology ,biology.protein ,Antibody responses ,business - Abstract
Background: Treatment with methotrexate (MTX) in patients with rheumatoid arthritis (RA) leads to decreased total immunoglobulin (Ig) levels and impairs vaccine-specific IgG antibody levels following pneumococcal vaccination. The mechanisms by which MTX exerts these effects in RA are unknown. We aimed to evaluate whether MTX reduces vaccine-specific serum Ig levels and their functionality in RA patients following vaccination with pneumococcal conjugate vaccine, and if numbers of antigen-specific circulating plasmablasts are affected. Methods: Ten patients with RA on MTX and 10 RA patients without disease modifying anti-rheumatic drug (DMARD) were immunized with a dose 13-valent pneumococcal conjugate vaccine (Prevenar13). Circulating plasmablasts producing total IgG and IgA as well as specific IgG and IgA against two pneumococcal capsular serotypes (6B and 23F) were enumerated using ELISPOT 6. days after vaccination. IgG levels against both these serotypes were determined with ELISA before and 4-6. weeks after vaccination. Positive antibody response was defined as ≥2-fold increase of pre-vaccination antibody levels. The functionality of vaccine specific antibodies to serotype 23F was evaluated by measuring their ability to opsonize bacteria using opsonophagocytic assay (OPA) in 4 randomly chosen RA patients on MTX and 4 RA patients without DMARD. Results: After vaccination, RA patients on MTX showed significant increase in pre- to postvaccination antibody levels for 6B (p.
- Published
- 2017
40. Effect of N-terminal poly histidine-tag on immunogenicity of Streptococcus pneumoniae surface protein SP0845.
- Author
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Singh M, Sori H, Ahuja R, Meena J, Sehgal D, and Panda AK
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- Animals, Escherichia coli metabolism, Female, Mice, Mice, Inbred BALB C, Protein Structure, Secondary, Antibodies metabolism, Antibody Formation physiology, Bacterial Proteins metabolism, Histidine metabolism, Membrane Proteins metabolism, Streptococcus pneumoniae metabolism
- Abstract
SP0845, a pneumococcal surface protein and a potential candidate vaccine for Streptococcus pneumoniae infection, was used to evaluate the role of histidine affinity tag on its biophysical properties and immunogenicity. The protein was expressed in E. coli with and without histidine affinity tag and purified to homogeneity. Size exclusion chromatographic studies revealed that tag free SP0845 was mainly monomeric in solution whereas, histidine tagged SP0845 stayed predominantly in an oligomeric form. Histidine-tagged SP0845 have higher β sheet content than the tag free protein. Removal of histidine tag increased the α-helical content of SP0845 from 35% to 46%. Histidine tagged SP0845 elicited higher serum antibody titer in comparison to the tag free SP0845 in mice. Effect of alum in improving the immunogenicity of tagged SP0845 was low in comparison to that observed with tag free protein. Immunogenicity of tag free SP0845 was enhanced by delivering it using polylactide polymeric particles. The presence of histidine tag thus influences the secondary structure and immunogenicity of protein and need careful consideration before use., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)
- Published
- 2020
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41. The estimated impact of the 5-year national vaccination program on the trend of 23-valent pneumococcal polysaccharide vaccine vaccination rates in the elderly in Japan, 2009-2018.
- Author
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Naito T, Suzuki M, Fujibayashi K, Kanazawa A, Takahashi H, Yokokawa H, and Watanabe A
- Subjects
- Aged, Aged, 80 and over, Female, Humans, Immunization Programs economics, Japan, Male, Pneumococcal Vaccines administration & dosage, Pneumococcal Vaccines immunology, Immunization Programs statistics & numerical data, Pneumococcal Infections prevention & control, Vaccination Coverage statistics & numerical data
- Abstract
Pneumonia is the third most common cause of death in Japan. Low vaccination rates are thought to be related to low levels of public subsidy. Since 2014, the Japanese government has offered subsidies through a 5-year national routine vaccination program of the 23-valent pneumococcal polysaccharide vaccine (PPV23) for older adults at age ≥65 years with 5-year age intervals. We previously reported that, 2 years into the 5-year program, the estimated vaccination rate was 40.6% at the end of 2015, a significant increase compared with periods before the program introduced. Here, we present an update on the estimated vaccination coverage of the 5-year national routine vaccination program at the end of 2018. The PPV23 vaccination rates were calculated by dividing the cumulative amount shipped to each municipality by the population aged ≥65 years. At the end of 2018, the completion of the 5-year national immunization program, the estimated cumulative vaccination rate was 74%. Stepwise regression analysis revealed that the annual PPV23 vaccination rate significantly increased after 2014 (from 2 to 5% prior to 2014, to 10-11% after 2014), and remained steady for 2014-2018. Our findings suggest that the 5-year national routine vaccination subsidy program was successful in achieving a steady and higher vaccination rate of PPV23 in Japan., Competing Interests: Declaration of Competing Interest T.N. has received a grant from Pfizer Inc. and honoraria for lectures from MSD K.K. A.W. have received honoraria for lectures from MSD K.K., (Copyright © 2019 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2020
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42. ¿Por qué hay más empiemas pediátricos en España?
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F. de Juan Martín, M. Garcés Sánchez, M. Baca Cots, Federico Martinón-Torres, F. Giménez Sánchez, J.A. Gómez Campderá, E. Bernaola Iturbe, J. Díez Domingo, Juan J. Picazo, and V. Pineda Solas
- Subjects
medicine.medical_specialty ,business.industry ,media_common.quotation_subject ,Incidence (epidemiology) ,MEDLINE ,Meningococcal vaccine ,Pneumococcal vaccines ,medicine.disease ,Pediatrics ,Empyema ,RJ1-570 ,Surgery ,Vaccination ,Scarcity ,Streptococcus pneumoniae ,Pneumococcal vaccine ,Parapneumonic pleural effusion ,Pediatrics, Perinatology and Child Health ,medicine ,Heptavalent Pneumococcal Conjugate Vaccine ,Intensive care medicine ,business ,media_common - Abstract
Existe la percepción entre los pediatras españoles de que el número de casos de empiema pediátrico ha aumentado significativamente en los últimos años; sin embargo, la información objetiva disponible es limitada, y además es una patología de libre declaración para la que no existen sistemas específicos de vigilancia epidemiológica activa. En este trabajo se revisa la situación del empiema pediátrico en España, y se discute las principales hipótesis que se han planteado en la bibliografía internacional para explicar este incremento, así como las limitaciones de las fuentes disponibles. Se concluye que, aunque la información disponible es limitada: a) la incidencia de empiema pediátrico está aumentando en nuestro país, tanto globalmente como la específicamente ocasionada por neumococo; b) la causa de este incremento es desconocida, y hasta la fecha no existen datos que permitan vincularlo a la vacuna antineumocócica conjugada heptavalente, y c) esta situación justifica la puesta en marcha de sistemas prospectivos de vigilancia y control del empiema y, una vezmás, pone de relieve la importancia de implantar y desarrollar sistemas de vigilancia activa de la enfermedad neumocócica. : There is a widespread perception among Spanish pediatricians that the incidence of empyema has significantly increased in the last few years, even though the objective information available is limited, and there is no specific active epidemiological surveillance system for this condition. In the present article, we review the situation of empyema in Spain, and discuss the main hypotheses put forward in the international literature to explain this increase, as well as the limitations of the sources available. Despite the scarcity of information, we draw the following conclusions: 1) the incidence of pediatric empyema is increasing in Spain, both generally and when caused by pneumococcus in particular; 2) the reason for this increase remains unknown, and to date no firm link has been established between this phenomenon and the heptavalent conjugate pneumococcal vaccine; and 3) this situation justifies the establishment of prospective systems for the surveillance and control of empyema and, once again, highlights the importance of developing active surveillance systems for pneumococcal disease.
- Published
- 2008
43. Vaccines
- Author
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C.M. Jung and K.M. Damer
- Subjects
Poliomyelitis vaccine ,Measles-Mumps-Rubella Vaccine ,Influenza vaccine ,business.industry ,viruses ,virus diseases ,Meningococcal vaccine ,Virology ,Vaccination ,Pneumococcal vaccine ,medicine ,Japanese encephalitis vaccine ,business ,Duck embryo vaccine ,medicine.drug - Abstract
The Side Effects of Drugs Annuals forms a series of volumes in which the adverse effects of drugs and vaccines and the associated reactions are reviewed. The series supplements the contents of Meyler's Side Effects of Drugs: The International Encyclopedia of Adverse Drug Reactions and Interactions. This review of the January 2015 to December 2015 publications on vaccines covers diphtheria–tetanus–pertussis vaccines, hepatitis B vaccine, herpes zoster virus vaccine, human papillomavirus vaccines, influenza vaccines, Japanese encephalitis vaccine, measles–mumps–rubella vaccine, measles–mumps–rubella–varicella, meningococcal vaccines, pneumococcal vaccines, poliomyelitis vaccines, yellow fever vaccine, and varicella zoster virus vaccine.
- Published
- 2016
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44. Vaccines
- Author
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K.M. Damer, C.M. Maffeo, and C.M. Jung
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Measles-Mumps-Rubella Vaccine ,business.industry ,viruses ,virus diseases ,Meningococcal vaccine ,Rotavirus vaccine ,Virology ,Vaccination ,Pneumococcal vaccine ,Live attenuated influenza vaccine ,Medicine ,Japanese encephalitis vaccine ,business ,Duck embryo vaccine ,medicine.drug - Abstract
The Side Effects of Drugs Annuals forms a series of volumes in which the adverse effects of drugs and vaccines and the associated reactions are reviewed. The series supplements the contents of Meyler's Side Effects of Drugs: The International Encyclopedia of Adverse Drug Reactions and Interactions. This review of the July 2013 to December 2014 publications on vaccines covers diphtheria–tetanus–pertussis vaccine, hepatitis B vaccine, herpes zoster virus vaccine, human papillomavirus vaccine, influenza vaccine, Japanese encephalitis vaccine, measles–mumps–rubella vaccine, measles–mumps–rubella–varicella, meningococcal vaccine, pneumococcal vaccine rotavirus vaccine, yellow fever vaccine, and varicella zoster virus vaccine.
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- 2015
- Full Text
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45. Racial Disparities in Adult Pneumococcal Vaccination Indications and Pneumococcal Hospitalizations in the U.S.
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Nowalk MP, Wateska AR, Lin CJ, Schaffner W, Harrison LH, Zimmerman RK, and Smith KJ
- Subjects
- Age Factors, Aged, Aged, 80 and over, Female, Health Care Costs, Health Surveys, Humans, Immunocompromised Host, Length of Stay economics, Male, Middle Aged, Patient Discharge statistics & numerical data, Pneumococcal Infections economics, Risk Factors, Smoking ethnology, United States epidemiology, Black or African American statistics & numerical data, Healthcare Disparities ethnology, Length of Stay statistics & numerical data, Pneumococcal Infections epidemiology, Pneumococcal Vaccines, Vaccination statistics & numerical data
- Abstract
Background: Racial disparities in U.S. adult pneumococcal vaccination rates persist despite reduced barriers to access. Consequently, racial and ethnic minorities experience pneumococcal disease at higher rates than whites. This study examined prevalence of high-risk conditions and pneumococcal hospitalizations among U.S. black and non-black populations aged ≥50 years., Methods: National Health Interview Survey, National Center for Health Statistics and National Inpatient Sample data were used to create black and non-black population cohorts, determine risk factors for pneumococcal disease (pneumococcal vaccine indications) and assess the impact of pneumococcal hospitalization. Each racial cohort was segmented into groups based on the presence of immunocompromising or other pneumococcal high-risk conditions. Persons without those conditions were separated into smokers (also a pneumococcal vaccine indication) and nonsmokers. Mortality was estimated from NCHS life table data. NIS data provided length of stay and costs (calculated from cost to charge ratios) for admissions related to pneumococcal disease including bacteremia, meningitis and nonbacteremic pneumonia., Results: There were similar proportions of immunocompromised (<5%) and smokers (14%) in both racial cohorts. Likelihood of non-immunocompromising pneumococcal high-risk conditions was higher for blacks than non-blacks at age 65, but higher for non-blacks than blacks at age 80 years (P < 0.001). Age-specific relative likelihood of mortality was 1.1%-12% higher in blacks than non-blacks (P < 0.001). Length of stay was significantly longer for blacks than non-blacks in all age and discharge status groups for non-bacteremic pneumonia and for blacks discharged alive with invasive pneumococcal disease. Costs were higher for blacks 65 years or older with invasive pneumococcal disease., Conclusion: Marked differences exist between U.S. black and non-black populations in likelihood of conditions conferring a high-risk of pneumococcal disease, and for length of stay and costs of pneumococcal disease hospitalizations. Further research is recommended to identify cost-effective policies or interventions to increase vaccine uptake in higher risk populations., (Copyright © 2019 National Medical Association. Published by Elsevier Inc. All rights reserved.)
- Published
- 2019
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46. Genetic diversity and antigenicity analysis of Streptococcus pneumoniae pneumolysin isolated from children with pneumococcal infection.
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Han C and Zhang M
- Subjects
- Alleles, Amino Acid Sequence, Antigenic Variation, Bacterial Proteins chemistry, Bacterial Proteins genetics, Bacterial Proteins immunology, Child, Preschool, Genetic Variation, Humans, Infant, Phylogeny, Pneumococcal Infections prevention & control, Pneumococcal Vaccines, Serogroup, Streptococcus pneumoniae classification, Streptococcus pneumoniae isolation & purification, Streptolysins chemistry, Virulence Factors genetics, Virulence Factors immunology, Pneumococcal Infections microbiology, Streptolysins genetics, Streptolysins immunology
- Abstract
Background: Pneumolysin (Ply), as a major virulence factor of Streptococcus pneumoniae, has attracted increased attention for its potential value in the development of next-generation protein-based pneumococcal vaccines. This study aimed to analyze the genetic and antigenic diversity that can influence the immunogenicity of vaccines., Methods: A total of 96 pneumococcal isolate samples were obtained from children of 1-35 months old with invasive pneumococcal diseases in Shanghai Children's Medical Center (Shanghai, China). After DNA amplification by PCR and Sanger sequencing, Ply DNA sequences were analyzed by bioinformatics tools, including ClustalX, BioEdit and MEGA7., Results: Two alleles, allele 1 and 2, and 10 subtypes, of which were 6 novel subtypes, were identified. Nucleotide and amino acid sequence identity among these pneumococcal isolates were >99%. Subtypes with the same amino acid sequence were more closely evolutionarily related in the phylogenetic tree. Only minor differences in the B-cell epitopes were identified in the antigenicity plots of alleles 1 and 2. The most common serotype was serotype 19A., Conclusions: The sequence diversity of Ply is limited although some allelic variations are detected. Different alleles exhibit similar antigenic patterns. Development of Ply-based vaccines may be a promising method to combat pneumococcal infection in the future., (Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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- 2019
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47. Cost-Effectiveness Comparison of Pneumococcal Conjugate Vaccines in Turkish Children.
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Marijam A, Olbrecht J, Ozakay A, Eken V, and Meszaros K
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- Child, Child, Preschool, Haemophilus influenzae drug effects, Humans, Infant, Pneumococcal Infections economics, Pneumococcal Infections immunology, Pneumococcal Vaccines economics, Quality-Adjusted Life Years, Turkey, Vaccination, Vaccines, Conjugate therapeutic use, Cost-Benefit Analysis, Otitis Media prevention & control, Pneumococcal Infections prevention & control, Pneumococcal Vaccines therapeutic use, Vaccines, Conjugate economics
- Abstract
Background: The 13-valent pneumococcal conjugate vaccine (PCV13) is used for universal infant vaccination in Turkey., Objectives: To assess the cost effectiveness of replacing PCV13 with pneumococcal nontypeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV)., Methods: A Markov cohort model with monthly cycles following 1 cohort of infants over a 10-year time horizon was used. Local input parameters were obtained from published sources and expert consultation whenever possible. The model was adapted to estimate the health benefits and economic impact of each vaccine on invasive pneumococcal disease, pneumonia, and acute otitis media (AOM). An annual discount rate of 3% was used for benefits and costs (2016 euros)., Results: Under base-case assumptions, vaccinating 1 birth cohort of 1 325 783 infants with PHiD-CV instead of PCV13 was predicted to have the same impact on meningitis and pneumonia, a similar impact on bacteremia (+30 cases), but greater reductions in AOM-related general practitioner visits (-34 955) and hospitalizations (-624). Assuming equal vaccine prices, PHiD-CV was predicted to be dominant over PCV13 (176 additional quality-adjusted life-years while saving €635 330 [discounted]). One-way sensitivity analysis indicated that varying the vaccine price differential had the largest effect on the incremental cost-effectiveness ratio, and then AOM parameters. Probabilistic sensitivity analysis predicted PHiD-CV to be dominant over PCV13 in 92.4% of simulations., Conclusions: Any difference in price between PHiD-CV and PCV13 is expected to be the key driver of vaccine choice for preventing childhood pneumococcal disease in Turkey. At price parity, PHiD-CV use is likely to be a dominant strategy over the use of PCV13., (Copyright © 2019 ISPOR–The professional society for health economics and outcomes research. Published by Elsevier Inc. All rights reserved.)
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- 2019
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48. Fatal overwhelming postsplenectomy infection due to Streptococcus pneumoniae serotype 10A with atypical polysaccharide capsule in a patient with chromosome 22q11.2 deletion syndrome: A case report.
- Author
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Matsuoka K, Yanagihara I, Kawazu Y, Sato M, Nakayama M, Nakura Y, Kanagawa N, Akeda Y, Fujiwara F, Itoh K, Kawata H, and Takeuchi M
- Subjects
- Adolescent, Fatal Outcome, Humans, Male, Pneumococcal Vaccines, DiGeorge Syndrome, Pneumococcal Infections, Postoperative Complications, Splenectomy adverse effects, Streptococcus pneumoniae
- Abstract
We report the first case of a teenage patient with chromosome 22q11.2 deletion syndrome who died of overwhelming postsplenectomy infection (OPSI) by Streptococcus pneumoniae despite appropriate prevention by pneumococcal vaccine. He had congenital heart disease and underwent several surgeries. Immunodeficiency had not been noticed clinically. Two years prior to death, splenectomy was performed for a drug-resistant idiopathic thrombocytopenic purpura and he was immunized with 23-valent pneumococcal polysaccharide vaccine (PPV23) 4 months after splenectomy. He died suddenly after a mild flu-like symptom. Autopsy was performed and OPSI was diagnosed. Blood culture was positive for S. pneumoniae. This isolated S. pneumoniae strain was serotypically un-typable by polyvalent serum agglutination test. On the contrary, multilocus sequence typing followed by DNA sequencing indicated the molecular serotype as 10A. Additional testing using monovalent and factor-specific sera confirmed the strain as serotype 10A. Ultrastructural observation of this S. pneumoniae strain showed that the polysaccharide capsule was thin and sparse. We speculate that the abnormal morphology of the capsule may have accounted for the polyvalent serum agglutination failure and may possibly be associated with severity of OPSI observed in this case. Chromosome 22q11.2 deletion syndrome is associated with certain immunodeficiency, especially susceptible to S. pneumoniae infections; however, fatal OPSI has not been reported. In addition to vaccination, prophylactic antibiotics may be necessary for these patients who are at risk of immunodeficiency., (Copyright © 2018 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)
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- 2019
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49. Specific Antibody Deficiency with Normal Immunoglobulins
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Ricardo U. Sorensen and Lily E. Leiva
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Pathogenesis ,Immune system ,Pneumococcal vaccine ,Antigen ,biology ,Tetanus ,Immunology ,medicine ,Toxoid ,biology.protein ,Antibody ,medicine.disease ,Immunodeficiency - Abstract
Specific antibody deficiency (SAD) is a common antibody immunodeficiency defined as a poor antibody response to unconjugated pneumococcal polysccharides present in the 23-valent pneumococcal vaccine (PPV23). All immunoglobulin concentrations, including IgG subclasses, are normal, and antibody responses to protein antigens (e.g., tetanus toxoid, diphtheria toxoid) are also normal in most patients. In some patients with SAD, the response to the pneumococcal conjugate vaccines is also normal. The clinical manifestations of specific antibody deficiency include recurrent otitis media; sinopulmonary infections such as sinusitis; bronchitis; and pneumonia. In SAD patients these infections are more frequent or severe than infections observed in normal children or adults. There is not a single pathogenic mechanism for specific anti-polysaccharide antibody deficiencies. The variable conditions in which an inability to respond to polysaccharides is found suggest that many different immunologic phenotypes may lead to the same clinical phenotypic antibody deficiency. The interpretation of anti-pneumococcal antibody concentration results is based on increased post-immunization antibody concentrations over pre-immunization concentrations (immune response) and on the final post-immunization antibody concentrations, regardless of increase from pre-immunization concentrations (antibody concentration). The management of SAD, including prevention and treatment of recurrent infections, can be classified into the following broad categories: additional immunization, antibiotic prophylaxis and treatment, and immune serum globulin therapy. The immunologic phenotypes of SAD may be transient or permanent. Even in permanent phenotypes, the natural history of SAD is usually benign with proper management of these patients. Further insights into the pathogenesis of this immunodeficiency will allow further understanding of the correlation between immunologic and clinical phenotypes of SAD.
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- 2014
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50. Vaccines
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A.Y. Elliott
- Subjects
Trivalent influenza vaccine ,medicine.medical_specialty ,business.industry ,Influenza vaccine ,Hepatitis A ,medicine.disease ,Rubella ,Measles ,Vaccination ,Pneumococcal vaccine ,Family medicine ,Medicine ,Smallpox ,business - Abstract
Vaccination has been described as a deliberate attempt to protect humans against disease. Vaccination has a long history of successes, and during the twentieth century the practice matured into routine vaccination of large populations. During the recent campaign to immunize persons against the H1N1 strain of influenza, approximately 62 million subjects were vaccinated in the United States with a monovalent influenza vaccine produced in embryonated chicken eggs. During the past 200 years, since the time of Edward Jenner and his smallpox vaccination procedure, vaccination has controlled or contained epidemics for many infectious diseases in many parts of the world. Diseases such as diphtheria, tetanus, pertussis, smallpox, yellow fever, polio, measles, mumps, rubella, hepatitis A, and hepatitis B are rare in the United States due in large part to the vaccination procedures implemented by state and local health departments in cooperation with practicing physicians and their professional organizations. Yearly vaccinations with the trivalent influenza vaccine have helped to decrease the incidence of serious cases of influenza while vaccination of both children (conjugated pneumococcal vaccine from Wyeth Pharmaceutical Laboratories Philadelphia, PA) and the elderly (23-valent pneumococcal from Merck & Co. Inc., Whitehouse Station, NJ) has helped to diminish pneumonia in the United States and developing countries. The importance of vaccines cannot be overstated and millions of people are alive today due to the vaccinations that they and the people around them received either as children or as adults.
- Published
- 2011
- Full Text
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