Increased Risk of Hospitalization for Acute Lower Respiratory Tract Infection among Australian Indigenous Infants 5–23 Months of Age Following Pneumococcal Vaccination: A Cohort Study

O'Grady, Kerry‐Ann F; Lee, Katherine J.; Carlin, John B.; Torzillo, Paul J.; Chang, Anne B.; Mulholland, E. Kim; Lambert, Stephen B.; Andrews, Ross M.

doi:10.1086/651079

Cited by 32 publications

(23 citation statements)

References 34 publications

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“…Additional analyses evaluating repeated episodes of WHOdefined radiologically diagnosed pneumonia and all-cause acute lower respiratory infection and pneumonia requiring hospitalization have been performed for children from 5 to 23 months of age and have not changed our findings substantially. 31 We were unable to demonstrate definitively that PCV7 had an effect in preventing a first episode of radiologically diagnosed pneumonia in a setting characterized by high rates occurring very early in infancy with delays in delivery of the primary vaccination series. This study highlights the importance of immunization timeliness to extrapolating the results of vaccine efficacy established in randomized controlled trials relative to vaccine effectiveness at the population level with vaccine delivery under routine field conditions.…”

Section: Résumémentioning

confidence: 77%

Effectiveness of 7-valent pneumococcal conjugate vaccine against radiologically diagnosed pneumonia in Indigenous infants in Australia

O'Grady

Carlin

Chang

et al. 2010

Bull World Health Org

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Section: Résumémentioning

confidence: 77%

Effectiveness of 7-valent pneumococcal conjugate vaccine against radiologically diagnosed pneumonia in Indigenous infants in Australia

O'Grady

Carlin

Chang

et al. 2010

Bull World Health Org

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“…Despite immune hyporesponsiveness being described in several studies, both in adults and infants, the clinical implications of these findings are yet to fully elucidated. In an observational study, receipt of PPS at 18 months of age following three infant PCV doses was associated with a significantly increased risk of hospitalizations for non-viral acute lower respiratory tract infections in indigenous Australians 5 to 23 months of age (hazard ratio, 1.39; P=0 .002) [33]. …”

Section: Discussionmentioning

confidence: 99%

Impaired serotype-specific immune function following pneumococcal vaccination in infants with prior carriage

Licciardi

Russell

Balloch

et al. 2014

Vaccine

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The impact of prior nasopharyngeal carriage on serotype-specific IgG responses following immunisation with pneumococcal conjugate vaccines (PCV) has recently been described. This report extends these findings to describe the attenuation of functional immune responses following 23-valent pneumococcal polysaccharide vaccination (PPS). We report the attenuation of immune responses following booster with the 23-valent pneumococcal polysaccharide vaccination (PPS) in infants with prior nasopharyngeal carriage of Streptococcus pneumoniae. Fijian infants who were part of a phase II randomized, controlled trial of reduced dose PCV7 schedules were the basis of this study. Pneumococcal carriage was determined at 6, 9 and 12 months of age, prior to PPS immunisation. Serum samples collected at 18 weeks (post-PCV7), 12 months (pre-PPS), 12.5 Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptVaccine. Author manuscript; available in PMC 2015 April 25. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript months and 17 months (post-PPS) of age were assessed for serotype-specific IgG and opsonophagocytic responses. The most frequently carried serotypes were 6B (N=11), 19F (N=14) and 23F (N=23). Significantly lower serotype-specific IgG for 19F, 23F but not 6B post-PPS were detected in infants with homologous serotype carriage prior to PPS compared with non-carriers (N=230). However, OPA levels for 6B and 23F were lower in infants that carried these serotypes. Pneumococcal carriage with 19F or 23F at any time prior to PPS immunisation in infants at 12 months of age who were previously primed with PCV resulted in serotype-specific hyporesponsiveness that persisted until 17 months of age. These results may have implications for the timing of infant vaccine schedules, particularly in high disease burden settings.

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“…In remote Indigenous communities of the Northern Territory, otitis media affects approximately 90% of children less than 2 years of age [15], and 20% of children are hospitalised with an acute lower respiratory infection in their first year of life [16]. In this population NTHi is a more dominant pathogen in terms of prevalence than either Streptococcus pneumoniae or Moraxella catarrhalis [17], [18] with nasopharyngeal isolation in up to 80% of Indigenous children 3–7 years of age [19], and ear discharge isolation in 21% of Indigenous children with chronic suppurative otitis media (mean age 8 years) [20].…”

Section: Introductionmentioning

confidence: 99%

Molecular Surveillance of True Nontypeable Haemophilus influenzae: An Evaluation of PCR Screening Assays

et al. 2012

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BackgroundUnambiguous identification of nontypeable Haemophilus influenzae (NTHi) is not possible by conventional microbiology. Molecular characterisation of phenotypically defined NTHi isolates suggests that up to 40% are Haemophilus haemolyticus (Hh); however, the genetic similarity of NTHi and Hh limits the power of simple molecular techniques such as PCR for species discrimination.Methodology/Principal FindingsHere we assess the ability of previously published and novel PCR-based assays to identify true NTHi. Sixty phenotypic NTHi isolates, classified by a dual 16S rRNA gene PCR algorithm as NTHi (n = 22), Hh (n = 27) or equivocal (n = 11), were further characterised by sequencing of the 16S rRNA and recA genes then interrogated by PCR-based assays targeting the omp P2, omp P6, lgtC, hpd, 16S rRNA, fucK and iga genes. The sequencing data and PCR results were used to define NTHi for this study. Two hpd real time PCR assays (hpd#1 and hpd#3) and the conventional iga PCR assay were equally efficient at differentiating study-defined NTHi from Hh, each with a receiver operator characteristic curve area of 0.90 [0.83; 0.98]. The hpd#1 and hpd#3 assays were completely specific against a panel of common respiratory bacteria, unlike the iga PCR, and the hpd#3 assay was able to detect below 10 copies per reaction.Conclusions/SignificanceOur data suggest an evolutionary continuum between NTHi and Hh and therefore no single gene target could completely differentiate NTHi from Hh. The hpd#3 real time PCR assay proved to be the superior method for discrimination of NTHi from closely related Haemophilus species with the added potential for quantification of H. influenzae directly from specimens. We suggest the hpd#3 assay would be suitable for routine NTHi surveillance and to assess the impact of antibiotics and vaccines, on H. influenzae carriage rates, carriage density, and disease.

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Increased Risk of Hospitalization for Acute Lower Respiratory Tract Infection among Australian Indigenous Infants 5–23 Months of Age Following Pneumococcal Vaccination: A Cohort Study

Abstract: Our results suggest an increased risk of ALRI requiring hospitalization after pneumococcal vaccination, particularly after receipt of the 23vPPV booster. The use of the 23vPPV booster should be reevaluated.

Cited by 32 publications

References 34 publications

Effectiveness of 7-valent pneumococcal conjugate vaccine against radiologically diagnosed pneumonia in Indigenous infants in Australia

Effectiveness of 7-valent pneumococcal conjugate vaccine against radiologically diagnosed pneumonia in Indigenous infants in Australia

Impaired serotype-specific immune function following pneumococcal vaccination in infants with prior carriage

Molecular Surveillance of True Nontypeable Haemophilus influenzae: An Evaluation of PCR Screening Assays

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