Anti-pneumococci vaccination:: role and indications in the prevention of community acquired infections of the lower respiratory tract.

被引:8
作者
Léophonte, P [1 ]
Neukirch, F [1 ]
机构
[1] Hop Rangueil, Serv Pneumol, F-31403 Toulouse 04, France
来源
MEDECINE ET MALADIES INFECTIEUSES | 2001年 / 31卷 / 04期
关键词
pneumococcus; pneumonia; Streptococcus pneumoniae; vaccine;
D O I
10.1016/S0399-077X(01)00183-4
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Objective - The authors had for aim to evaluate the effectiveness and clinical indications of the anti pneumococcal vaccine. Methods - Seventy one articles were selected after a computerized research including the most recent studies on immunogenicity, all the prospective double blind randomized trials, and retrospective studies (case-control and indirect cohort studies). The evaluation concerned exclusively non conjugated vaccine. Results - The immune response was significant among vaccinated patients including elderly ones; antibody response was reduced or absent among immune-compromised patients. Only one study among 11 randomized trials concerned the 23-valent vaccine. According to the results of these trials and of 2 meta-analyses, efficacy in preventing pneumococcal bacteremia and pneumococcal pneumonia is clearly established in young adults (with a response rate reaching around 80% for vaccine serotypes). Clinical studies in older adults, adults with risk factors, or immune-compromised adults are inconclusive, usually because the number of patients was too small. Retrospective case-control and indirect cohort studies confirmed the clinical efficiency of pneumococcal vaccination. They showed that pneumococcal vaccination was efficient in 50-80% of the patients to prevent invasive pneumococcal diseases, including in older patients and those with associated diseases, particularly with COPD or cardiovascular diseases. Efficiency was not demonstrated in immune-compromised patients. The vaccine proved safe with a good tolerance. Vaccination is recommended by the WHO and various advisory national committees in North America and Europe for elderly patients and those with associated diseases. (C) 2001 Editions scientifiques et medicales Elsevier SAS.
引用
收藏
页码:181 / 194
页数:14
相关论文
共 71 条
  • [1] AN IMMUNODEFICIENCY CHARACTERIZED BY IMPAIRED ANTIBODY-RESPONSES TO POLYSACCHARIDES
    AMBROSINO, DM
    SIBER, GR
    CHILMONCZYK, BA
    JERNBERG, JB
    FINBERG, RW
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1987, 316 (13) : 790 - 793
  • [2] [Anonymous], 1997, MMWR Recomm Rep, V46, P1
  • [3] [Anonymous], J RES PHARM EC
  • [4] PNEUMOCOCCAL BACTEREMIA WITH ESPECIAL REFERENCE TO BACTEREMIC PNEUMOCOCCAL PNEUMONIA
    AUSTRIAN, R
    GOLD, J
    [J]. ANNALS OF INTERNAL MEDICINE, 1964, 60 (05) : 759 - +
  • [5] Austrian R, 1976, Trans Assoc Am Physicians, V89, P184
  • [6] Austrian R, 1996, VACCINIA, VACCINATION, VACCINOLOGY, P127
  • [7] AUSTRIAN R, 1980, SURVEILLANCE PNEUMOC, P1
  • [8] *AV CONS SUP HYG P, 1999, BEH, V22, P87
  • [9] Cost-effectiveness of vaccination against pneumococcal pneumonia in the Netherlands
    Baltussen, RMPM
    Ament, AJHA
    Leidl, RM
    VanFurth, R
    [J]. EUROPEAN JOURNAL OF PUBLIC HEALTH, 1997, 7 (02) : 153 - 161
  • [10] PNEUMOCOCCAL VACCINE EFFICACY IN SELECTED POPULATIONS IN THE UNITED-STATES
    BOLAN, G
    BROOME, CV
    FACKLAM, RR
    PLIKAYTIS, BD
    FRASER, DW
    SCHLECH, WF
    [J]. ANNALS OF INTERNAL MEDICINE, 1986, 104 (01) : 1 - 6