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Pneumococcal vaccines Review

Yıl 2007, Cilt: 42 Sayı: 11, 43 - 50, 01.05.2007

Öz

Diseases caused by Streptococcus pneumoniae pneumococcus are major public health problems worldwide Serious diseases that are often caused by pneumococci include pneumonia meningitis and bacteraemia; otitis media and sinusitis are more common but less serious manifestations of infection 23 valent pneumococcal polysaccharide vaccine PPV23 is not effective in children younger than 2 years of age in whom 80 of childhood invasive pneumococcal diseases occur The 7 valent pneumococcal conjugate vaccine PCV7 contains 4 6B 9V 14 18C 19F and 23F serotypes Serotypes included in PCV7 and potentially cross reactive serotypes 6A 9A 9L 18B and 18F accounted for 86 of bacteremia 83 of meningitis and 65 of AOM among children aged lt;6 years PCV7 is administered intramusculary at ages of 2 4 6 and 12 15 months After three doses of PCV7 a preventing level of type specific antibody against the vaccine serotypes is achieved in approximately 90 of children Clinical studies suggest that PCV7 is safe and highly effective in preventing invasive pneumococcal disease in healthy children aged lt;2 years and has nbsp; a significant impact on pneumonia and acute otitis media Therefore it is recommended that all children aged lt;2 years should be vaccinated with PCV7 Heptavalent conjugate vaccine has advantages over PPV23 which include induction of immune system memory possibly resulting in longer duration of protection reduction in carriage probable higher efficacy against serotypes causing most invasive disease and probable effectiveness against noninvasive syndromes pneumonia and acute otitis media A 7 valent pneumococcal conjugate vaccine has been licensed since 2000 in USA The introduction of PCV7 in the US has resulted in substantial decline in IPD in the target population despite supply shortages including high risk children A herd effect in unvaccinated children and adults especially in the elderly has been observed A decline in antibiotic resistance has been observed since introduction of PCV7 Serotype replacement has been observed for carriage isolates of SP and for IPD nbsp; Serotypes 19A 15 22F 33F 35 are increasing in frequency in both children and in those agedabove 65 Today PCV7 is licensed in more than 70 countries and is used routinely in several developed countries Vaccines with 10 and 13 serotypes might be licensed between 2008 and 2010 Turk Arch Ped 2007; 42 Suppl: 43 50 Key words: nbsp; İnvazive pneumococcal disease pneumococcal conjugate vaccıne

Kaynakça

  • CDC. Preventing pneumoccal disease among infants and young children: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 2000; 49 (No. RR-9): 1-38.
  • American Academy of Pediatrics. Immunization in special cli- nical circumstances. In: Peter G (ed). 1997 Red Book: Report of the Committee on Infectious Diseases. 24th ed. Elk Grove Village, IL: American Academy of Pediatrics; 1997: 48-80.
  • Schuchat A, Robinson K, Wenger JD, et al. Bacterial meningitis in the United States in 1995. N Engl J Med 1997; 337: 970-6.
  • CDC. Geographic variation in penicillin resistance in Strepto- coccus pneumoniae-selected sites, United States, 1997. MMWR 1999;48:656--61.
  • Gaudelus J, Cohen R, Reinert P. Epidemiology of pneumoccal infections in French children. Acta Ped 2000; Suppl 435: 27-30.
  • Dagan R, Abramson O, Leibovitz E, et al. Impaired bacteriologic response to oral cephalosporins in acute otitis media caused by pneumococci with intermediate resistance to penicillin. Pediatr Infect Dis J 1996; 15: 980-5.
  • Mao C, Harper M, McIntosh K, et al. Invasive pneumococcal infections in human immunodeficiency virus-infected children. J Infect Dis 1996; 173: 870-6.
  • Levine OS, Farley M, Harrison LH, et al. Risk factors for invasive pneumococcal disease in children: a population-based case-control study in North America. Pediatrics 1999; 103: 28.
  • Nafstad P, Hagen JA, Oie L, Magnus P, Jaakkola JJK. Day care centers and respiratory health. Pediatrics 1999; 103: 753-8.
  • Fleming DW, Cochi SL, Hightower AW, Broome CV. Childhood upper respiratory tract infections: to what degree is incidence affected by day-care attendance? Pediatrics 1987 ;79: 55-60.
  • Henrichsen J. Six newly recognized types of Streptococcus pneumoniae. J Clin Microbiol 1995; 33: 2759-62.
  • Kalin M. Pneumococcal serotypes and their clinical relevance. Thorax 1998; 53: 159-62.
  • Butler JC, Breiman RF, Lipman HB, Hofmann J, Facklam RR. Serotype distribution of Streptococcus pneumoniae infections among preschool children in the United States, 1978-1994: implications for development of a conjugate vaccine. J Infect Dis 1995; 171 :885-9.
  • Eskola J, Kilpi T, Palmu A, et al. Efficacy of a pneumococcal conjugate vaccine against acute otitis media. N Engl J Med 2001; 344; 403-9.
  • Arnold KE, Leggiadro RJ, Breiman RF, et al. Risk factors for carriage of drug-resistant Streptococcus pneumoniae among children in Memphis, Tennessee. J Pediatr 1996; 128: 757-64.
  • Black S, Shinefield H, Fireman B, et al. Efficacy, safety and immunogenicity of heptavalent pneumococcal conjugate vaccine in children. Pediatr Infect Dis J 2000; 19: 187-95.
  • Food and Drug Administration. Product approval information- licensing action. Hyattsville, MD: US Department of Health and Human Services, Food and Drug Administration, Center for Biologics Evaluation and Research, 2000.
  • Vernacchio L, Neufeld EJ, MacDonald K, et al. Combined schedule of 7-valent pneumococcal conjugate vaccine followed by 23-valent pneumococcal vaccine in children and young adults with orak hücre disease. J Pediatr 1998; 133: 275-8.
  • Rennels MB, Edwards KM, Keyserling HL, et al. Safety and immunogenicity of heptavalent pneumococcal vaccine conjugated to CRM197 in United States infants. Pediatrics 1998; 101: 604-11.
  • Sorensen RU, Leiva LE, Giangrosso PA, et al. Response to a heptavalent conjugate Streptococcus pneumoniae vaccine in children with recurrent infections who are unresponsive to the polysaccharide vaccine. Pediatr Infect Dis J 1998; 17: 685-91.
  • Powers DC, Anderson EL, Lottenbach K, Mink CM. Reactogenicity and immunogenicity of a protein-conjugated pneumococcal oligosaccharide vaccine in older adults. J In- fect Dis 1996; 173: 1014-18.
  • Ahmed F, Steinhoff MC, Rodriquez-Barradas MC, Hamilton RG, immunodeficiency virus type 1 infection on the antibody response to a glycoprotein conjugate pneumococcal vaccine: results from a randomized trial. J Infect Dis 1996; 173: 83-90.
  • Levine OS, O'Brien KL, Knoll M, et al. Pneumococcal vaccination in developing countries. Lancet 2006; 367: 9526.
  • Devlet İstatistik Enstitüsü, Ölüm İstatistikleri, 1996.
  • Goldblatt D, Southern J, Ashton L, et al. Immunogenicity and boosting after a reduced number of doses of a pneumococcal conjugate vaccine in infants and toddlers. Pediatr Infect Dis J. 2006; 25:312-9.
  • Orin SL, O’Brien KL, Knoll M, et al. Pneumococcal vaccination in developing countries. Lancet. 2006; 367: 1880-2.
  • Kanra G, Akan O, Ecevit Z, Ceyhan M, Seçmeeer G. Microorganisms involved in acute bacterial meningitis in children and the role of Haemophilus influenzae. Turkish J Ped 1996; 38: 407-12.
  • Ceyhan M. Konjuge pnömokok aşısı. Katkı Pediatri Dergisi 2006; 668-81.
  • Gür D, Güciz B, Hasçelik G, et al. Streptococcus pneumoniae penicillin resistance in Turkey. J Chemother 2001; 13: 541-5.
  • Yenişehirli G, Şener B. Antibiotic resistance and serotype distribution of Streptococcus pneumoniae strains isolated from patients at Hacettepe University Medical Faculty. Mikrobiyol Bul 2003; 37: 1-11.
  • Öncü S, Erdem A, Paşa A. Therapeutic options for pneumococ- cal pneumonia in Turkey. Clin Ther 2005; 27:674-83.
  • Cutts FT, Zaman SM, Enwere G, et al. Efficacy of nine-valent pneumococcal conjugate vaccine against pneumonia and invasive pneumococcal disease in The Gambia: randomised, double-blind, placebo-controlled trial. Lancet 2005; 365: 1139-46.
  • Klugman KP, Madhi SA, Hueber RE, et al. A trial of a 9-valent pneumococcal conjugate vaccine in children with and those without HIV infection. N Engl J Med 2003; 349: 1341-8.
  • Yalcın I, Gürler N, Alhan E, et al. Serotype distribution and antibiotic susceptibility of invasive Streptococcus pneumoniae disease isolates from children in Turkey, 2001-2004. Eur J Pediatr 2006; 165: 654-7.
  • Bakır M, Yağcı A, Akbenlioğlu C, et al. Epidemiology of Strep- tococcus pneumoniae pharyngeal carriage among healthy Turkish infants and children. Eur J Pediatr 2002; 161: 165-6.
  • World Health Organization. Pneumococcal conjugate vaccine for childhood immunization–WHO position paper. Weekly Epidemi- ological Record 2007; 82: 93-104. (http://www.who.int/wer).

Pnömokok aşıları Derleme

Yıl 2007, Cilt: 42 Sayı: 11, 43 - 50, 01.05.2007

Öz

Streptococcus pneumoniae pnömokok tüm dünyada önemli bir halk sağlığı sorunudur Pnömokoklar menenjit pnömoni ve bakteriyemi gibi invazif hastalıklara neden olduğu gibi otitis mediya ve sinüzit gibi sık görülen mukozal enfeksiyonlara da neden olur Pnömokokların neden olduğu hastalıklar her yaşta görülmekle birlikte invazif pnömokok hastalığı IPH küçük çocuklarda özellikle iki yaş altı çocuklarda sık görülür Hastalığın sık görülmesinin yanı sıra etkeni olduğu invazif enfeksiyonlar ölüme de neden olmaktadır Dünya genelinde aşı ile korunabilir hastalıklar arasında pnömokok hastalığı yılda 1 609 000 ölümle birinci sırayı almaktadır Pnömokok enfeksiyonlarında kaynak genellikle bulgu vermeyen taşıyıcılardır Pnömokokların penisilin direnci son yıllarda tüm dünyada artmıştır Bazı ülkelerde orta veya yüksek düzeyde penisilin direnci 50’lere ulaşmıştır Tüm bu nedenlerle pnömokok enfeksiyonlarından korunmak gereklidir Korunma 23 valanlı pnömokok polisakkarid aşısı PPV23 ve 7 valanlı konjüge pnömokok aşısı PCV7 ile sağlanır PPV23 1977’den beri uygulanmaktadır Ancak PPV23 kısa süreli immünite oluşturması antijenle tekrar karşılaşılınca “anemnestik” yanıt oluşmaması ve iki yaşından küçüklerde yeterli antikor yanıtı koruyuculuk oluşturmaması nedeniyle normal aşılamada kullanılamaz Sadece iki yaş üstü risk grubu çocuklara uygulanabilir PCV7 ilk kez 1999 yılında ABD’de ruhsat almış ve aşı şemasına dahil edilmiştir ABD’de gerek ruhsat öncesi yapılan “Kaiser Permanente” çalışması gerekse normal uygulamadan sonra yapılan gözlem çalışmaları PCV7’nin IPH ve mukozal enfeksiyona karşı etkili olduğunu dolaylı olarak immünite sağladığını taşıyıcılığı penisilin direncini ve antibiyotik kullanımını azalttığını göstermiştir Aşı serotipleri olan enfeksiyon ve taşıyıcılıkta azalma olmasına karşın aşı içeriğinde yer almayan pnömokok serotiplerinde 19A 15 22F 33F ve 35 gibi artış vardır Ancak aşı ile korunulamayan serotiplerdeki bu artış şimdilik IPH’ye neden olmamaktadır Üretimin de artması ile son yıllarda PCV7 ülkemizin de içinde olduğu 70’den fazla ülkede ruhsat almış ve birçok gelişmiş ülkede aşı şemasına dahil edilmiştir 10 ve 13 valanlı aşıların da 2008 2010 yılları arasında ruhsat almaları beklenmektedir Ayrıca 20’den fazla aday pmönokok aşısı protein aşılar dahil ile ilgili çalışmalar umut vericidir Türk Ped Arş 2007; 42 Özel Sayı: 43 50 Anahtar kelimeler: Konjüge pnömokok aşısı invazif pnömokok hastalığı

Kaynakça

  • CDC. Preventing pneumoccal disease among infants and young children: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 2000; 49 (No. RR-9): 1-38.
  • American Academy of Pediatrics. Immunization in special cli- nical circumstances. In: Peter G (ed). 1997 Red Book: Report of the Committee on Infectious Diseases. 24th ed. Elk Grove Village, IL: American Academy of Pediatrics; 1997: 48-80.
  • Schuchat A, Robinson K, Wenger JD, et al. Bacterial meningitis in the United States in 1995. N Engl J Med 1997; 337: 970-6.
  • CDC. Geographic variation in penicillin resistance in Strepto- coccus pneumoniae-selected sites, United States, 1997. MMWR 1999;48:656--61.
  • Gaudelus J, Cohen R, Reinert P. Epidemiology of pneumoccal infections in French children. Acta Ped 2000; Suppl 435: 27-30.
  • Dagan R, Abramson O, Leibovitz E, et al. Impaired bacteriologic response to oral cephalosporins in acute otitis media caused by pneumococci with intermediate resistance to penicillin. Pediatr Infect Dis J 1996; 15: 980-5.
  • Mao C, Harper M, McIntosh K, et al. Invasive pneumococcal infections in human immunodeficiency virus-infected children. J Infect Dis 1996; 173: 870-6.
  • Levine OS, Farley M, Harrison LH, et al. Risk factors for invasive pneumococcal disease in children: a population-based case-control study in North America. Pediatrics 1999; 103: 28.
  • Nafstad P, Hagen JA, Oie L, Magnus P, Jaakkola JJK. Day care centers and respiratory health. Pediatrics 1999; 103: 753-8.
  • Fleming DW, Cochi SL, Hightower AW, Broome CV. Childhood upper respiratory tract infections: to what degree is incidence affected by day-care attendance? Pediatrics 1987 ;79: 55-60.
  • Henrichsen J. Six newly recognized types of Streptococcus pneumoniae. J Clin Microbiol 1995; 33: 2759-62.
  • Kalin M. Pneumococcal serotypes and their clinical relevance. Thorax 1998; 53: 159-62.
  • Butler JC, Breiman RF, Lipman HB, Hofmann J, Facklam RR. Serotype distribution of Streptococcus pneumoniae infections among preschool children in the United States, 1978-1994: implications for development of a conjugate vaccine. J Infect Dis 1995; 171 :885-9.
  • Eskola J, Kilpi T, Palmu A, et al. Efficacy of a pneumococcal conjugate vaccine against acute otitis media. N Engl J Med 2001; 344; 403-9.
  • Arnold KE, Leggiadro RJ, Breiman RF, et al. Risk factors for carriage of drug-resistant Streptococcus pneumoniae among children in Memphis, Tennessee. J Pediatr 1996; 128: 757-64.
  • Black S, Shinefield H, Fireman B, et al. Efficacy, safety and immunogenicity of heptavalent pneumococcal conjugate vaccine in children. Pediatr Infect Dis J 2000; 19: 187-95.
  • Food and Drug Administration. Product approval information- licensing action. Hyattsville, MD: US Department of Health and Human Services, Food and Drug Administration, Center for Biologics Evaluation and Research, 2000.
  • Vernacchio L, Neufeld EJ, MacDonald K, et al. Combined schedule of 7-valent pneumococcal conjugate vaccine followed by 23-valent pneumococcal vaccine in children and young adults with orak hücre disease. J Pediatr 1998; 133: 275-8.
  • Rennels MB, Edwards KM, Keyserling HL, et al. Safety and immunogenicity of heptavalent pneumococcal vaccine conjugated to CRM197 in United States infants. Pediatrics 1998; 101: 604-11.
  • Sorensen RU, Leiva LE, Giangrosso PA, et al. Response to a heptavalent conjugate Streptococcus pneumoniae vaccine in children with recurrent infections who are unresponsive to the polysaccharide vaccine. Pediatr Infect Dis J 1998; 17: 685-91.
  • Powers DC, Anderson EL, Lottenbach K, Mink CM. Reactogenicity and immunogenicity of a protein-conjugated pneumococcal oligosaccharide vaccine in older adults. J In- fect Dis 1996; 173: 1014-18.
  • Ahmed F, Steinhoff MC, Rodriquez-Barradas MC, Hamilton RG, immunodeficiency virus type 1 infection on the antibody response to a glycoprotein conjugate pneumococcal vaccine: results from a randomized trial. J Infect Dis 1996; 173: 83-90.
  • Levine OS, O'Brien KL, Knoll M, et al. Pneumococcal vaccination in developing countries. Lancet 2006; 367: 9526.
  • Devlet İstatistik Enstitüsü, Ölüm İstatistikleri, 1996.
  • Goldblatt D, Southern J, Ashton L, et al. Immunogenicity and boosting after a reduced number of doses of a pneumococcal conjugate vaccine in infants and toddlers. Pediatr Infect Dis J. 2006; 25:312-9.
  • Orin SL, O’Brien KL, Knoll M, et al. Pneumococcal vaccination in developing countries. Lancet. 2006; 367: 1880-2.
  • Kanra G, Akan O, Ecevit Z, Ceyhan M, Seçmeeer G. Microorganisms involved in acute bacterial meningitis in children and the role of Haemophilus influenzae. Turkish J Ped 1996; 38: 407-12.
  • Ceyhan M. Konjuge pnömokok aşısı. Katkı Pediatri Dergisi 2006; 668-81.
  • Gür D, Güciz B, Hasçelik G, et al. Streptococcus pneumoniae penicillin resistance in Turkey. J Chemother 2001; 13: 541-5.
  • Yenişehirli G, Şener B. Antibiotic resistance and serotype distribution of Streptococcus pneumoniae strains isolated from patients at Hacettepe University Medical Faculty. Mikrobiyol Bul 2003; 37: 1-11.
  • Öncü S, Erdem A, Paşa A. Therapeutic options for pneumococ- cal pneumonia in Turkey. Clin Ther 2005; 27:674-83.
  • Cutts FT, Zaman SM, Enwere G, et al. Efficacy of nine-valent pneumococcal conjugate vaccine against pneumonia and invasive pneumococcal disease in The Gambia: randomised, double-blind, placebo-controlled trial. Lancet 2005; 365: 1139-46.
  • Klugman KP, Madhi SA, Hueber RE, et al. A trial of a 9-valent pneumococcal conjugate vaccine in children with and those without HIV infection. N Engl J Med 2003; 349: 1341-8.
  • Yalcın I, Gürler N, Alhan E, et al. Serotype distribution and antibiotic susceptibility of invasive Streptococcus pneumoniae disease isolates from children in Turkey, 2001-2004. Eur J Pediatr 2006; 165: 654-7.
  • Bakır M, Yağcı A, Akbenlioğlu C, et al. Epidemiology of Strep- tococcus pneumoniae pharyngeal carriage among healthy Turkish infants and children. Eur J Pediatr 2002; 161: 165-6.
  • World Health Organization. Pneumococcal conjugate vaccine for childhood immunization–WHO position paper. Weekly Epidemi- ological Record 2007; 82: 93-104. (http://www.who.int/wer).
Toplam 36 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Derleme
Yazarlar

Zafer Kurugöl Bu kişi benim

Yayımlanma Tarihi 1 Mayıs 2007
Yayımlandığı Sayı Yıl 2007 Cilt: 42 Sayı: 11

Kaynak Göster

APA Kurugöl, Z. (2007). Pnömokok aşıları Derleme. Türk Pediatri Arşivi, 42(11), 43-50.
AMA Kurugöl Z. Pnömokok aşıları Derleme. Türk Pediatri Arşivi. Mayıs 2007;42(11):43-50.
Chicago Kurugöl, Zafer. “Pnömokok aşıları Derleme”. Türk Pediatri Arşivi 42, sy. 11 (Mayıs 2007): 43-50.
EndNote Kurugöl Z (01 Mayıs 2007) Pnömokok aşıları Derleme. Türk Pediatri Arşivi 42 11 43–50.
IEEE Z. Kurugöl, “Pnömokok aşıları Derleme”, Türk Pediatri Arşivi, c. 42, sy. 11, ss. 43–50, 2007.
ISNAD Kurugöl, Zafer. “Pnömokok aşıları Derleme”. Türk Pediatri Arşivi 42/11 (Mayıs 2007), 43-50.
JAMA Kurugöl Z. Pnömokok aşıları Derleme. Türk Pediatri Arşivi. 2007;42:43–50.
MLA Kurugöl, Zafer. “Pnömokok aşıları Derleme”. Türk Pediatri Arşivi, c. 42, sy. 11, 2007, ss. 43-50.
Vancouver Kurugöl Z. Pnömokok aşıları Derleme. Türk Pediatri Arşivi. 2007;42(11):43-50.