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 recommen...
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Published in | The Journal of infectious diseases Vol. 191; no. 7; pp. 1063 - 1067 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
Chicago, IL
The University of Chicago Press
01.04.2005
University of Chicago Press Oxford University Press |
Subjects | |
Online Access | Get full text |
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Summary: | 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 |
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Bibliography: | ark:/67375/HXZ-DP9WP6MX-1 istex:5BEC35AF801A11A6904E88E73233A8BC1888A9C8 ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Case Study-3 ObjectType-Article-1 ObjectType-Feature-4 ObjectType-Report-2 |
ISSN: | 0022-1899 1537-6613 |
DOI: | 10.1086/428135 |