Evaluating Clinical Effectiveness of Pneumococcal Vaccination in Preventing Stroke: The CAPAMIS Study, 3-Year Follow-up

Vila-Córcoles, Ángel; Ochoa-Gondar, Olga; Rodríguez-Blanco, Teresa; Diego-Cabanes, Cinta de; Satué-Gracia, Eva; Vila-Rovira, Ángel; Fraga, Cristina Torrente

doi:10.1016/j.jstrokecerebrovasdis.2013.12.047

Cited by 19 publications

(17 citation statements)

References 23 publications

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“… 2009 ; 2011 ), while antipneumococcal vaccination has shown efficacy in preventing stroke (Vila-Corcoles et al. 2014 ). Of course, events such as heart attacks and strokes (and see Table 4 ) may also be seen as sudden increases in severity of an underlying condition, and in some cases (such as the much increased likelihood of strokes after subarachnoid haemorrhages; McMahon et al.…”

Section: Concluding Remarks and Prospective Experimentsmentioning

confidence: 99%

The dormant blood microbiome in chronic, inflammatory diseases

Potgieter

Bester

Kell

et al. 2015

FEMS Microbiology Reviews

334

344

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Blood in healthy organisms is seen as a ‘sterile’ environment: it lacks proliferating microbes. Dormant or not-immediately-culturable forms are not absent, however, as intracellular dormancy is well established. We highlight here that a great many pathogens can survive in blood and inside erythrocytes. ‘Non-culturability’, reflected by discrepancies between plate counts and total counts, is commonplace in environmental microbiology. It is overcome by improved culturing methods, and we asked how common this would be in blood. A number of recent, sequence-based and ultramicroscopic studies have uncovered an authentic blood microbiome in a number of non-communicable diseases. The chief origin of these microbes is the gut microbiome (especially when it shifts composition to a pathogenic state, known as ‘dysbiosis’). Another source is microbes translocated from the oral cavity. ‘Dysbiosis’ is also used to describe translocation of cells into blood or other tissues. To avoid ambiguity, we here use the term ‘atopobiosis’ for microbes that appear in places other than their normal location. Atopobiosis may contribute to the dynamics of a variety of inflammatory diseases. Overall, it seems that many more chronic, non-communicable, inflammatory diseases may have a microbial component than are presently considered, and may be treatable using bactericidal antibiotics or vaccines.

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Section: Concluding Remarks and Prospective Experimentsmentioning

confidence: 99%

The dormant blood microbiome in chronic, inflammatory diseases

Potgieter

Bester

Kell

et al. 2015

FEMS Microbiology Reviews

334

344

View full text Add to dashboard Cite

show abstract

“…8,[26][27][28][29] The only prior pediatric study to assess vaccination and stroke risk was a retrospective cohort study that examined the electronic records from 8 medical care organizations, and found no increased risk of AIS after varicella vaccination. 30 However, this study assessed no other pediatric vaccines, and stroke diagnoses were based purely on billing codes, which have ,40% sensitivity for pediatric AIS.…”

Section: Major Infection Major Infection Included Diagnoses Of Menin-mentioning

confidence: 99%

Infection, vaccination, and childhood arterial ischemic stroke

et al. 2015

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Objectives: Minor infection can trigger adult arterial ischemic stroke (AIS) and is common in childhood. We tested the hypotheses that infection transiently increases risk of AIS in children, regardless of stroke subtype, while vaccination against infection is protective. Methods:The Vascular Effects of Infection in Pediatric Stroke study is an international casecontrol study that prospectively enrolled 355 centrally confirmed cases of AIS (29 days-18 years old) and 354 stroke-free controls. To determine prior exposure to infections and vaccines, we conducted parental interviews and chart review.Results: Median (interquartile range) age was 7.6 years for cases and 9.3 for controls (p 5 0.44).Infection in the week prior to stroke, or interview date for controls, was reported in 18% of cases, vs 3% of controls, conferring a 6.3-fold increased risk of AIS (p , 0.0001); upper respiratory infections were most common. Prevalence of preceding infection was similar across stroke subtypes: arteriopathic, cardioembolic, and idiopathic. Use of vasoactive cold medications was similarly low in both groups. Children with some/few/no routine vaccinations were at higher stroke risk than those receiving all or most (odds ratio [OR] 7.3, p 5 0.0002). In an age-adjusted multivariate logistic regression model, independent risk factors for AIS included infection in the prior week (OR 6.3, p , 0.0001), undervaccination (OR 8.2, p 5 0.0004), black race (compared to white; OR 1.9, p 5 0.009), and rural residence (compared to urban; OR 3.0, p 5 0.0003).Conclusions: Infection may act as a trigger for childhood AIS, while routine vaccinations appear protective. Hence, efforts to reduce the spread of common infections might help prevent stroke in children. Neurology ® 2015;85:1459-1466 GLOSSARY AIS 5 arterial ischemic stroke; CI 5 confidence interval; IQR 5 interquartile range; OR 5 odds ratio; PFO 5 patent foramen ovale; SES 5 socioeconomic status; VIPS 5 Vascular Effects of Infection in Pediatric Stroke.

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“…These apparently protective effects of PPV23 in the prevention of CVEs have, however, been challenged by the findings of a number of large case-control and population-based cohort studies which failed to confirm protection against AMI, ischaemic stroke, transient ischaemic events and all-cause mortality [66, 67, 72, 73]. In another population-based cohort study of adults presenting with CAP, PPV23 immunisation was associated with a 58 % reduction in acute coronary syndrome events occurring within 90 days of pneumonia [73].…”

Section: Treatment And/or Prevention Of Cap-associated Cvesmentioning

confidence: 99%

Prevalence, pathogenesis, therapy, and prevention of cardiovascular events in patients with community-acquired pneumonia

Feldman

Anderson

2016

pneumonia

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It is now well recognised that cardiac events occur relatively commonly in patients with acute community-acquired pneumonia. While these events are more frequent in patients with underlying risk factors—such as those with underlying chronic cardiovascular and respiratory comorbidities, the elderly, and in nursing home residents—they also occur in patients with no underlying risks other than severe pneumonia. Recent research elucidating the underlying pathogenic mechanisms related to these cardiac events has indicated a probable role for platelet activation, which is possibly exacerbated by pneumolysin in the case of pneumococcal infections. This, in turn, has resulted in the identification of possible therapeutic strategies targeting platelet activation, as well as the cardio-toxic activity of pneumolysin. These issues represent the primary focus of the current review.

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Evaluating Clinical Effectiveness of Pneumococcal Vaccination in Preventing Stroke: The CAPAMIS Study, 3-Year Follow-up

Cited by 19 publications

References 23 publications

The dormant blood microbiome in chronic, inflammatory diseases

The dormant blood microbiome in chronic, inflammatory diseases

Infection, vaccination, and childhood arterial ischemic stroke

Prevalence, pathogenesis, therapy, and prevention of cardiovascular events in patients with community-acquired pneumonia

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