Global serotype distribution among Streptococcus pneumoniae isolates causing otitis media in children: Potential implications for pneumococcal conjugate vaccines

Rodgers, Gail L.; Arguedas, Adriano; Cohen, Robert; Dagan, Ron

doi:10.1016/j.vaccine.2009.04.021

Cited by 109 publications

(74 citation statements)

References 73 publications

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“…Perhaps serotype 3 pneumococci are prone to causing pleural effusions because they can produce high and protective concentrations of capsular PS, overcome host immunity, and proliferate better than other pneumococcal serotypes. Interestingly, the prevalence of serotype 3 is disproportionately higher in otitis media than in IPD in many different geographic regions (20). Perhaps the pleural cavity and the middle ear are body cavities conducive for the high-capsule-producing serotypes.…”

Section: Discussionmentioning

confidence: 99%

Pneumococcal Serotypes Causing Pneumonia with Pleural Effusion in Pediatric Patients

Salamon

Marcon

et al. 2011

J Clin Microbiol

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To determine the prevalence of serotypes of Streptococcus pneumoniae responsible for pneumonia with pleural effusion, we determined the capsular polysaccharide (PS) type directly on 49 pleural fluid specimens collected from pediatric patients during 2007 to 2009 with laboratory-confirmed pneumococcal pneumonia by using monoclonal antibodies and a multiplex, bead array immunoassay. Because the fluids had to be heated to remove nonspecific reactivity before being tested in the immunoassay and type 19A PS is heat labile, the pleural fluid samples were also tested for serotype 19A capsule gene locus by PCR. Use of the multiplex immunoassay combined with type-specific 19A PCR allowed for serotype determination on 40 of 49 pleural fluids. Pneumococcal pneumonia with pleural effusion was associated with a limited number of serotypes, with types 1, 3, 7F/A, and 19A accounting for 75% of the typeable cases. The concentration of capsular PS in the pleural fluids was often greater than 1 g/ml and sufficient to inhibit the opsonic capacity of sera from individuals who had received the 23-valent pneumococcal PS vaccine. Based on the serotypes observed before and after introduction of the 7-valent pneumococcal conjugate vaccine, the recently licensed 13-valent pneumococcal conjugate vaccine may reduce the incidence of pneumonia with pleural effusions.Parapneumonic pleural effusions in children are most commonly associated with pneumococcal infections, and they may lead to the more serious complication of empyema (10). With the introduction of the 7-valent pneumococcal conjugate vaccine (PCV7) in 2000, there has been a dramatic decrease in the number of cases of invasive pneumococcal disease (IPD) in the United States; however, the incidence of empyema has actually increased by as much as 50% (6). To investigate the apparent failure of PCV7 in reducing the incidence of pneumonia with empyema, it is important to investigate pneumococcal serotypes associated with parapneumonic pleural effusions obtained after PCV7 became widely used.While pneumococcal serotypes associated with pleural effusions have been studied in the past (6), most studies used pneumococcal isolates obtained from blood or pleural fluid cultures of patients; however, this approach is insensitive and may preferentially recover antibiotic-resistant serotypes because most patients are treated with antibiotics and only a small percentage of cases yield positive cultures. To avoid these limitations, two reports investigated pleural fluids directly for the presence of pneumococcal capsular polysaccharide (PS) with monoclonal antibodies (10, 12); however, these studies were performed in England before PCV7 was widely used and they tested the fluids for only 13 capsular PS serotypes.Recently, we developed a multiplex immunoassay to detect capsular PS of 36 pneumococcal serotypes on cultured isolates (29). The method was modified to detect and quantify the concentration of capsular PS directly in clinical samples such as pleural fluids. We used this modified method to i...

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Section: Discussionmentioning

confidence: 99%

Pneumococcal Serotypes Causing Pneumonia with Pleural Effusion in Pediatric Patients

Salamon

Marcon

et al. 2011

J Clin Microbiol

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“…Not surprisingly figures are heavily skewed towards the developing world: 61% of the 735,000 victims (not co-infected with HIV) came from 10 African and Asian countries [62]. However, serious, life threatening infections are not the only problems associated with S. pneumoniae exhibiting increasing drug resistance: acute otitis media is the commonest disease following the colonization of the upper respiratory tract [63], and this pathogen is the most frequent isolate from the middle ear worldwide [64].…”

Section: Streptococcus Pneumoniaementioning

confidence: 99%

Update on Antibacterial Resistance in Low-Income Countries: Factors Favoring the Emergence of Resistance

Vilà

Pál

2010

TOIDJ

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Antimicrobial resistance has increased drastically in recent years in the developing countries, and it has rapidly become a leading public health concern. The prevalence of antimicrobial resistance varies greatly between and within countries and between different pathogens. However, overall a trend to the increase of the resistance to those antimicrobial agents more often used in these countries has been observed. Several factors can contribute to the rapid emergence and dissemination of antimicrobial resistance. In this paper, the current antimicrobial resistance in different microorganisms from different countries as well as the factors contributing to the emergence and spread of resistance in developing countries will be reviewed.

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“…However, the current 23-valent capsular polysaccharide vaccine is not able to elicit protective antibodies in infants who suffer the highest rates of pneumococcal carriages and infections (8). Although the current 7-valent pneumococcal conjugate vaccine is effective against invasive pneumococcal diseases and nasopharyngeal colonization (36,47), the protective effect is restricted to seven serotypes, which has been shown to increase the carriage of the nonvaccine serotype (38). Moreover, the high cost limits their extensive application in developing countries (26).…”

mentioning

confidence: 99%

Intranasal Vaccination with Chitosan-DNA Nanoparticles Expressing Pneumococcal Surface Antigen A Protects Mice against Nasopharyngeal Colonization by Streptococcus pneumoniae

Dai

Wang

et al. 2011

Clin Vaccine Immunol

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Streptococcus pneumoniae is a respiratory pathogen, and mucosal immune response plays a significant role in the defense against pneumococcal infections. Thus, intranasal vaccination may be an alternative approach to current immunization strategies, and effective delivery systems to mucosal organism are necessary. In this study, BALB/c mice were immunized intranasally with chitosan-DNA nanoparticles expressing pneumococcal surface antigen A (PsaA). Compared to levels in mice immunized with naked DNA or chitosan-pVAX1, anti-PsaA IgG antibody in serum and anti-IgA antibody in mucosal lavages were elevated significantly in mice immunized with chitosan-psaA. The balanced IgG1/IgG2a antibody ratio in serum, enhanced gamma interferon (IFN-␥) and IL-17A levels in spleen lymphocytes, and mucosal washes of mice immunized with chitosan-psaA suggested that cellular immune responses were induced. Furthermore, significantly fewer pneumococci were recovered from the nasopharynx of mice immunized with chitosan-psaA than for the control group following intranasal challenge with ATCC 6303 (serotype 3). These results demonstrated that mucosal immunization with chitosan-psaA may successfully generate mucosal and systemic immune responses and prevent pneumococcal nasopharyngeal colonization. Hence, a chitosan-DNA nanoparticle vaccine expressing pneumococcal major immunodominant antigens after intranasal administration could be developed to prevent pneumococcal infections.

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Global serotype distribution among Streptococcus pneumoniae isolates causing otitis media in children: Potential implications for pneumococcal conjugate vaccines

Cited by 109 publications

References 73 publications

Pneumococcal Serotypes Causing Pneumonia with Pleural Effusion in Pediatric Patients

Pneumococcal Serotypes Causing Pneumonia with Pleural Effusion in Pediatric Patients

Update on Antibacterial Resistance in Low-Income Countries: Factors Favoring the Emergence of Resistance

Intranasal Vaccination with Chitosan-DNA Nanoparticles Expressing Pneumococcal Surface Antigen A Protects Mice against Nasopharyngeal Colonization by Streptococcus pneumoniae

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