Administration of protein-conjugate pneumococcal vaccine to patients who have invasive disease after splenectomy despite their having received 23-valent pneumococcal polysaccharide vaccine
Patients who undergo splenectomy are at greatly increased risk for overwhelming pneumococcal bacteremia and death. Twenty-three-valent pneumococcal polysaccharide vaccine (PPV-23), which contains capsular polysaccharides (PSs) from 23 common serotypes of Streptococcus pneumoniae, is strongly recommended for such patients. The capacity to respond to PPV-23 by producing immunoglobulin (Ig) G is genetically regulated. Some proportion of adults do not respond and, despite postsplenectomy administration of PPV-23, may remain susceptible to recurrent pneumococcal sepsis. Here, we describe 2 patients who had recurring pneumococcal bacteremia after undergoing splenectomy despite having received numerous doses of PPV-23. Heptavalent protein-conjugate pneumococcal vaccine (PCPV-7) was then administered, and it induced high levels of IgG to all 7 PSs; in one of the patients, functional activity against 5 of the 7 PSs was demonstrable, both in vitro and in vivo. Recurrent pneumococcal bacteremia in patients who have undergone splenectomy may indicate a genetically regulated failure to respond to PPV-23; PCPV-7 may stimulate production of IgG to PSs in such patients.
| Errataetall: |
CommentIn: J Infect Dis. 2006 Apr 15;193(8):1189-90. - PMID 16544264 |
|---|---|
| Medienart: |
Artikel |
| Erscheinungsjahr: |
2005 |
|---|---|
| Erschienen: |
2005 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:191 |
|---|---|
| Enthalten in: |
The Journal of infectious diseases - 191(2005), 7 vom: 01. Apr., Seite 1063-7 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Musher, Daniel M [VerfasserIn] |
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| Anmerkungen: |
Date Completed 06.05.2005 Date Revised 19.11.2015 published: Print-Electronic CommentIn: J Infect Dis. 2006 Apr 15;193(8):1189-90. - PMID 16544264 Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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NLM15402144X |
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| 100 | 1 | |a Musher, Daniel M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Administration of protein-conjugate pneumococcal vaccine to patients who have invasive disease after splenectomy despite their having received 23-valent pneumococcal polysaccharide vaccine |
| 264 | 1 | |c 2005 | |
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| 500 | |a Date Completed 06.05.2005 | ||
| 500 | |a Date Revised 19.11.2015 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: J Infect Dis. 2006 Apr 15;193(8):1189-90. - PMID 16544264 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Patients who undergo splenectomy are at greatly increased risk for overwhelming pneumococcal bacteremia and death. Twenty-three-valent pneumococcal polysaccharide vaccine (PPV-23), which contains capsular polysaccharides (PSs) from 23 common serotypes of Streptococcus pneumoniae, is strongly recommended for such patients. The capacity to respond to PPV-23 by producing immunoglobulin (Ig) G is genetically regulated. Some proportion of adults do not respond and, despite postsplenectomy administration of PPV-23, may remain susceptible to recurrent pneumococcal sepsis. Here, we describe 2 patients who had recurring pneumococcal bacteremia after undergoing splenectomy despite having received numerous doses of PPV-23. Heptavalent protein-conjugate pneumococcal vaccine (PCPV-7) was then administered, and it induced high levels of IgG to all 7 PSs; in one of the patients, functional activity against 5 of the 7 PSs was demonstrable, both in vitro and in vivo. Recurrent pneumococcal bacteremia in patients who have undergone splenectomy may indicate a genetically regulated failure to respond to PPV-23; PCPV-7 may stimulate production of IgG to PSs in such patients | ||
| 650 | 4 | |a Case Reports | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, U.S. Gov't, Non-P.H.S. | |
| 650 | 7 | |a 23-valent pneumococcal capsular polysaccharide vaccine |2 NLM | |
| 650 | 7 | |a Antibodies, Bacterial |2 NLM | |
| 650 | 7 | |a Heptavalent Pneumococcal Conjugate Vaccine |2 NLM | |
| 650 | 7 | |a Immunoglobulin G |2 NLM | |
| 650 | 7 | |a Meningococcal Vaccines |2 NLM | |
| 650 | 7 | |a Pneumococcal Vaccines |2 NLM | |
| 700 | 1 | |a Ceasar, Heather |e verfasserin |4 aut | |
| 700 | 1 | |a Kojic, Erna M |e verfasserin |4 aut | |
| 700 | 1 | |a Musher, Benjamin L |e verfasserin |4 aut | |
| 700 | 1 | |a Gathe, Joseph C |c Jr |e verfasserin |4 aut | |
| 700 | 1 | |a Romero-Steiner, Sandra |e verfasserin |4 aut | |
| 700 | 1 | |a White, A Clinton |c Jr |e verfasserin |4 aut | |
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