Sorotipos de Streptococcus pneumoniae isolados de líquido cefalorraquidiano no período de 1977-1988 na cidade de São Paulo, Brasil

Taunay, Augusto de E; Austrian, Robert; Landgraf, Ilka Maria; Vieira, M.F.P.; Melles, Carmo Elias Andrade

doi:10.1590/s0036-46651990000100003

Cited by 13 publications

(8 citation statements)

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“…All serotypes included in this study can cause invasive disease in infants (11,23,44,48). Four of these serotypes are included in the new experimental conjugate vaccines proposed for different areas of the world (47).…”

Section: Discussionmentioning

confidence: 99%

“…However, these vaccines are still experimental and the small number of serotype polysaccharides included in the vaccines may limit the coverage they offer. A 10-year study of 308 cases of meningitis in children under 2 years of age in São Paulo, Brazil (48), reveals that vaccine formula B, which includes serotypes 1, 5, 6B, 14, 18C, 19F, and 23F (47), would cover only 68% of the infections caused by 42 different strains, even taking into account the cross-reactivity of vaccine and nonvaccine serotypes (41). Two recent studies in Brazil estimate that the 23-valent polysaccharide vaccine offers protection against 85.7 and 89.6% of these infections, respectively, if vaccine-related crossreactive serotypes are taken into account (11,44).…”

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confidence: 99%

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862 Transplacental transmission of serotype-specific pneumococcal antibodies in a Brazilian population

Calvalho¹,

Sampaio²,

Solé³

et al. 1996

Journal of Allergy and Clinical Immunology

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The highest incidence of severe pneumococcal infections in children occurs in the first 6 months of life; however, immunization of infants with the existing polysaccharide vaccines is ineffective. We wished to determine the prevalence of immunoglobulin G (IgG) pneumococcal antibodies in unimmunized Brazilian mothers and their transplacental transmission to term and preterm infants. Total IgG, IgG1 and -2 subclass levels, and IgG antibodies against Streptococcus pneumoniae serotypes 1, 3, 6B, 9V, and 14 were determined in 15 pairs of mothers and term newborns (gestational age, >37 weeks) and in 18 pairs of mothers and preterm newborns (gestational age, 32 to 36 weeks). Serotype-specific anti-pneumococcal antibodies were detected by a recently standardized enzyme-linked immunosorbent assay calibrated with the 89-SF reference serum. Varying percentages of the mothers had antibody concentrations below arbitrarily defined protective levels: 33% for serotype 1, 67% for serotype 3, 30% for serotype 6B, 52% for serotype 9V, and 22% for serotype 14. In term newborns, IgG1 concentrations were slightly higher than maternal concentrations; in preterm newborns, the concentrations were much lower. Concentrations of IgG2 in term and preterm infants were significantly lower than in the mothers. Transplacental transmission of antibodies to serotypes 3 and 14 was clearly different from that of antibodies to serotypes 1, 6B, and 9V. Concentrations of IgG antibodies against serotypes 3 and 14 were similar to or higher than those of the mothers; against serotypes 1, 6B, and 9V they ranged from 77 to 83% of maternal concentrations in term newborns and also in preterm infants, although transplacental transmission of antibodies was proportionally lower for each specific serotype in preterm than in term infants. These data are relevant for developing strategies to protect infants against pneumococcal infections in the first months of life. Our findings and a review of existing information stress the importance of understanding the relationships among pneumococcal immunization, IgG subclass antibodies to individual serotypes, transplacental transport, half-life, and antibody function and their protective values against infection.Pneumococcal infections cause high morbidity and mortality in children during the first 2 years of life, with the highest incidence of severe, systemic pneumococcal infections occurring in the first year of life (15,18). Immunization of infants with the existing polysaccharide vaccines, however, becomes effective only after 2 years of age.Conjugate pneumococcal vaccines containing five or seven polysaccharides have been found to be immunogenic in the first year of life in several studies (1,3,31). However, these vaccines are still experimental and the small number of serotype polysaccharides included in the vaccines may limit the coverage they offer. A 10-year study of 308 cases of meningitis in children under 2 years of age in São Paulo, Brazil (48), reveals that vaccine formula B, which includes serotypes 1, 5,...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

862 Transplacental transmission of serotype-specific pneumococcal antibodies in a Brazilian population

Calvalho¹,

Sampaio²,

Solé³

et al. 1996

Journal of Allergy and Clinical Immunology

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“…, Santa Fé (42), Córdoba (32),Mendoza (30),Tucumán (13), Neuquén(12), Misiones(10), and Rosario(6). Complete data was available for 443 children.…”

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confidence: 99%

Distribution of Capsular Types and Penicillin-Resistance of Strains ofStreptococcus pneumoniaeCausing Systemic Infections in Argentinian Children Under 5 Years of Age

Rossi

Ruvinsky²,

Regueira³

et al. 1997

Microbial Drug Resistance

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Streptococcus pneumoniae (SPN) is the most common cause of invasive infections in children, with high levels of mortality in developing countries. An increase in frequency of penicillin-resistant strains is reported in most parts of the world. A study was undertaken in Argentina and 5 other countries of the region, to determine the type distribution and penicillin resistance rate of SPN isolated from invasive infections in children less than 5 years old. Between June 1994 and March 1996, a total of 505 SPN isolated from sterile sites were collected from 15 hospitals located in 9 cities of different geographic areas. Clinical and epidemiological data from 443 children were analyzed. Sixty five percent SPN were isolated from children less than 2 years old. Pneumonia was the clinical diagnosis in 58% of the cases, meningitis in 22%, and sepsis in 10.6%. Isolates were recovered from blood (51.2%), pleural fluid (22.7%), CSF (20.7%), and other sterile sites (5.4%). Thirty different pneumococcal capsular types were identified and the 10 most frequent in descending order were: 14, 5, 1, 6A/6B, 7F, 9V, 19F, 19A, 16F y 23F, representing 89.3% of the total. Overall, 13.1% of isolates showed intermediate resistance to penicillin while 11.3% showed high resistance. Lethality was 8.8%, without correlation with penicillin-resistance and/or type. These result should be used in selecting the optimal combination of specific types for a conjugate vaccine, useful in children less than 2 years old and for considering therapeutic strategies for invasive pneumococcal infections.

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“…22 identificaram 60 sorotipos de pneumococos entre 1.000 exames de líquido cefalorraquidiano positivos para esse patógeno. Os sorotipos mais identificados, em ordem decrescente de freqüência, foram 1; 6B; 18C; 14; 5; 3; 6A; 23F; 19F e 38.…”

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Pneumococcal Vaccine: overview about the protective efficacy in different high risk groups and new progress in the development of a conjugate Pneumococcal Vaccine

Bricks¹

1994

J Pediatr (Rio J)

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ResumoA autora apresenta uma revisão da literatura mais recente a respeito das vacinas polissacarídicas contra o pneumococo, enfatizando as controvérsias a respeito da eficácia vacinal em diferentes grupos de risco e as dificuldades para o desenvolvimento de novas vacinas conjugadas com maior imunogenicidade e capacidade de estimular a produção de anticorpos em lactentes. J. Pediatr. (Rio). 1994; 70(2):75-81: vacina antipneumocó-cica, Streptococcus pneumoniae, imunização. AbstractThe author presents a review about the protective efficacy of polyvalent pneumococcal polysaccharide vaccines in different groups at high risk for severe pneumococcal infection and the difficulties in the development of a conjugate pneumococcal vaccine capable of offering protection to younger children. O pneumococo (Streptococcus pneumoniae) é o microrganismo mais freqüentemente identificado em pneumonias de etiologia bacteriana e otite média aguda e é a 3 a causa mais freqüente de meningite bacteriana. É um diplococo gram-positivo encontrado freqüentemente no trato respiratório superior que só causa doença quando consegue crescer e se multiplicar fora das células fagocitárias, pois, uma vez fagocitado, é rapidamente destruído por macrófagos e neutrófilos. J. Pediatr. (RioMuitos pneumococos são revestidos por uma cápsula polissacarídica que impede ou retarda a fagocitose e somente as cepas encapsuladas são patogênicas para o homem. A virulência dos pneumococos é maior nas cepas totalmente encapsuladas, e o uso de antisoros contra os antígenos polissacarídicos da cápsula permite, atualmente, a identificação de 84 sorotipos de S. pneumoniae. 1,2,3,4,5 A fagocitose dos pneumococos é facilitada quando essas bactérias são opsonizadas e a opsonização adequada dos pneumococos requer a ativação do complemento, que pode se dar tanto pela via clássica como pela via alternativa, através da properdina. A recuperação das doenças pneumocócicas depende da produção de anticorpos que agem como opsoninas, aumentando a fagocitose e determinando a morte das bactérias.A maior parte das infecções graves por pneumococos é observada em crianças com menos de dois anos de idade, em indivíduos com asplenia anatômica ou funcional, em idosos ou imunodeprimidos. Pacientes com doenças cardíacas ou pulmonares crônicas, diabetes mellitus e cirrose, embora geralmente imunocompetentes, também apresentam maior risco 1,6,7,8,9 .Os indivíduos com anemia falciforme têm episódios repetitivos de vaso oclusão e infarto, que determinam a chamada "auto esplenectomia", ou asplenia funcional. Esse problema determina um aumento da suscetibilidade às infecções, especialmente por S. pneumoniae e H. influenzae, pois o baço exerce importante papel tanto na produção de anticorpos contra esses germes, como na retirada dos mesmos da circulação sanguínea. O problema da produção de anticorpos é mais freqüentemente identificado em crianças com menos de 5 anos, pois, com o aumento da idade e a maior exposição às bactérias, o fígado passa a suprir essa função. No entanto, o papel de retirar as...

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Sorotipos de Streptococcus pneumoniae isolados de líquido cefalorraquidiano no período de 1977-1988 na cidade de São Paulo, Brasil

Cited by 13 publications

References 8 publications

862 Transplacental transmission of serotype-specific pneumococcal antibodies in a Brazilian population

862 Transplacental transmission of serotype-specific pneumococcal antibodies in a Brazilian population

Distribution of Capsular Types and Penicillin-Resistance of Strains ofStreptococcus pneumoniaeCausing Systemic Infections in Argentinian Children Under 5 Years of Age

Pneumococcal Vaccine: overview about the protective efficacy in different high risk groups and new progress in the development of a conjugate Pneumococcal Vaccine

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