-
Vaccine Oct 2013The Advisory Committee on Immunization Practices (ACIP) recommended the inclusion of asthma as a high-risk condition that should warrant pneumococcal vaccination, but... (Review)
Review
BACKGROUND
The Advisory Committee on Immunization Practices (ACIP) recommended the inclusion of asthma as a high-risk condition that should warrant pneumococcal vaccination, but the National Advisory Committee on Immunization (NACI) in Canada has not yet done so. We aimed to determine the risk of invasive pneumococcal disease (IPD) in patients with asthma.
METHODS
We searched Ovid Medline, EMBASE, Classic EMBASE, PubMEd and Cochrane for articles published between January 1990 and February 2013, using the MeSH terms pneumococcal infections/or invasive pneumococcal disease and asthma. Google Scholar was used to retrieve articles citing the seminal article by Talbot et al. Articles were included if they were population-based studies that evaluated the relationship between IPD and asthma. Two authors independently assessed all titles and abstracts. All potentially relevant articles were retrieved as full text and assessed for inclusion.
RESULTS
The combined searches yielded 376 articles, which were reviewed by title and abstract. At this stage, 330 articles were excluded; 40 articles were excluded at the full article review stage - leaving 6 articles. Two additional articles were found through Google Scholar. The evidence reviewed consistently showed a positive association between asthma and risk of IPD. However, the magnitude of this effect was heterogeneous with adjusted odds ratios ranging from 6.7 (95% CI 1.6-27.3) in adults >18 years to 1.7 (95% CI 0.99-3.0) in individuals aged 2-49 with low-risk asthma.
CONCLUSION
The positive association between asthma and risk of IPD supports the addition of asthma as a high-risk condition warranting pneumococcal vaccination. Data on vaccine effectiveness in this population is needed.
Topics: Asthma; Bacteremia; Canada; Female; Humans; Male; Meningitis, Bacterial; Pneumococcal Infections; Risk Factors
PubMed: 23965221
DOI: 10.1016/j.vaccine.2013.07.079 -
Clinical Infectious Diseases : An... Aug 2022Pneumococcal serotypes differ in antimicrobial susceptibility. However, patterns and causes of this variation are not comprehensively understood. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Pneumococcal serotypes differ in antimicrobial susceptibility. However, patterns and causes of this variation are not comprehensively understood.
METHODS
We undertook a systematic review of epidemiologic studies of pneumococci isolated from carriage or invasive disease among children globally from 2000-2019. We evaluated associations of each serotype with nonsusceptibility to penicillin, macrolides, and trimethoprim/sulfamethoxazole. We evaluated differences in the prevalence of nonsusceptibility to major antibiotic classes across serotypes using random-effects meta-regression models and assessed changes in prevalence of nonsusceptibility after implementation of pneumococcal conjugate vaccines (PCVs). We also evaluated associations between biological characteristics of serotypes and their likelihood of nonsusceptibility to each drug.
RESULTS
We included data from 129 studies representing 32 187 isolates across 52 countries. Within serotypes, the proportion of nonsusceptible isolates varied geographically and over time, in settings using and those not using PCVs. Factors predicting enhanced fitness of serotypes in colonization as well as enhanced pathogenicity were each associated with higher likelihood of nonsusceptibility to penicillin, macrolides, and trimethoprim/sulfamethoxazole. Increases in prevalence of nonsusceptibility following PCV implementation were evident among non-PCV serotypes, including 6A, 6C, 15A, 15B/C, 19A, and 35B; however, this pattern was not universally evident among non-PCV serotypes. Postvaccination increases in nonsusceptibility for serotypes 6A and 19A were attenuated in settings that implemented PCV13.
CONCLUSIONS
In pneumococci, nonsusceptibility to penicillin, macrolides, and trimethoprim/sulfamethoxazole is associated with more frequent opportunities for antibiotic exposure during both prolonged carriage episodes and when serotypes cause disease. These findings suggest multiple pathways leading to resistance selection in pneumococci.
Topics: Anti-Bacterial Agents; Child; Humans; Infant; Macrolides; Nasopharynx; Penicillins; Pneumococcal Infections; Pneumococcal Vaccines; Serogroup; Streptococcus pneumoniae; Trimethoprim, Sulfamethoxazole Drug Combination; Vaccines, Conjugate
PubMed: 34599811
DOI: 10.1093/cid/ciab852 -
Otolaryngology--head and Neck Surgery :... Mar 2023To review the literature on pneumococcal vaccination compliance rates among cochlear implant (CI) patients and to examine the utility of intervention programs on... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To review the literature on pneumococcal vaccination compliance rates among cochlear implant (CI) patients and to examine the utility of intervention programs on increasing vaccination rates.
DATA SOURCES
PubMed, Scopus, and CINAHL.
REVIEW METHODS
A systematic review was performed following PRISMA guidelines. Studies of pneumococcal vaccination rates at baseline and before and after the implementation of a quality improvement (QI) intervention were included. A total of 641 studies were screened, and 13 studies met inclusion criteria. Meta-analyses of pneumococcal vaccination rates pre- and post-QI intervention in CI patients were performed.
RESULTS
A total of 12,973 children and adults were included. The baseline PCV13 and PPSV23 vaccination rates were 53.45% (95% CI, 37.02%-69.51%) and 42.53% (95% CI, 31.94%-53.48%), respectively. Comparing children and adults, PCV13 and PPSV23 baseline vaccination rates were not statistically significant. The PPSV23 vaccine rate after QI initiatives was significantly higher than the baseline rate at 83.52% (95% CI, 57.36%-98.46%). After these interventions, patients had a 15.71 (95% CI, 4.32-57.20, P < .001) increased odds of receiving PPSV23 vaccination compared to before QI implementation.
CONCLUSIONS
The baseline rates of PCV13 and PPSV23 are highly variable and lower than expected, given current vaccination recommendations for CI patients. QI programs appear successful in increasing compliance rates with the PPSV23 vaccination; however, they are still far from full compliance. Further intervention programs with stricter surveillance, monitoring, and follow-up systems are needed to achieve improved compliance with the PCV13 and PPSV23 vaccination in CI recipients.
Topics: Adult; Child; Humans; Cochlear Implants; Vaccines, Conjugate; Vaccination; Cochlear Implantation; Pneumococcal Vaccines; Quality Improvement; Pneumococcal Infections
PubMed: 35852861
DOI: 10.1177/01945998221113310 -
Pathogens (Basel, Switzerland) Apr 2020Adult vaccination is high on the agenda in many countries. Two different vaccines are available for the prevention of pneumococcal disease in adults: a 23-valent... (Review)
Review
A Systematic Review of Studies Published between 2016 and 2019 on the Effectiveness and Efficacy of Pneumococcal Vaccination on Pneumonia and Invasive Pneumococcal Disease in an Elderly Population.
Adult vaccination is high on the agenda in many countries. Two different vaccines are available for the prevention of pneumococcal disease in adults: a 23-valent polysaccharide vaccine (PPV23), and a 13-valent conjugated vaccine (PCV13). The objective of this review is to update the evidence base for vaccine efficacy and effectiveness of PPV23 and PCV13 against invasive pneumococcal disease and pneumonia among an unselected elderly population. We systematically searched for clinical trials and observational studies published between January 1 2016 and April 17 2019 in Pubmed, Embase, Cinahl, Web of Science, Epistemonikos and Cochrane databases. Risk of bias was assessed using Cochrane Risk of Bias tool for and the Newcastle-Ottawa Scale. Results were stratified by vaccine type and outcome. We identified nine studies on PCV13 and six on PPV23. No new randomized clinical trials were identified. Due to different outcomes, it was not possible to do a meta-analysis. New high-quality observational studies indicate protective vaccine effectiveness for both vaccines against vaccine type pneumonia. Our estimates for the protective vaccine efficacy and effectiveness (VE) of PPV23 on pneumonia and pneumococcal pneumonia overlap with results from previously published reviews. Some of the results indicate that the effectiveness of the PPV23 is best in younger age groups, and that it decreases over time.
PubMed: 32260132
DOI: 10.3390/pathogens9040259 -
Expert Review of Vaccines Feb 2017Pneumococcal infection is a public health concern that disproportionately affects the young, the elderly, and the immunocompromised. There is an open debate on the... (Review)
Review
Pneumococcal infection is a public health concern that disproportionately affects the young, the elderly, and the immunocompromised. There is an open debate on the implementation of polysaccharide and/or conjugate vaccines for pneumococcal diseases in adults and the elderly in many countries. The aim of this paper is to systematically review the economic profile of pneumococcal vaccines in adults in terms of costs and benefits. Areas covered: The search for economic studies on pneumococcal vaccination was carried out in Pubmed, Embase, Scopus, and the HTA and NHS EED databases and through a manual search in journals dealing with economic evaluations. We included original articles and reviews with economic evaluation of polysaccharide 23-valent (PPV23) and/or conjugate pneumococcal vaccine 13-valent (PCV13) use in adults, the elderly, and at-risk groups to provide a systematic review of economical evaluation. Expert commentary: Pneumococcal vaccination is strongly recommended for all adults, especially subjects at risk and the elderly. Pneumococcal vaccination with PCV13 or PPV23 in adults is good value for money and should be a priority for the decision-makers. The main issue is how vaccination could be offered.
Topics: Adult; Aged; Aged, 80 and over; Cost-Benefit Analysis; Humans; Middle Aged; Pneumococcal Infections; Pneumococcal Vaccines; Vaccination
PubMed: 27680425
DOI: 10.1080/14760584.2017.1242419 -
Public Health Oct 2007Despite strong national and international recommendations on immunization practices, rates for influenza (IV) and pneumococcal vaccinations (PV) are low. We aimed to... (Review)
Review
OBJECTIVES
Despite strong national and international recommendations on immunization practices, rates for influenza (IV) and pneumococcal vaccinations (PV) are low. We aimed to review international immunization rates and to analyze attitudes and beliefs regarding IV and PV.
STUDY DESIGN
Systematic review.
METHOD
The MEDLINE database search comprised articles from 1966 to October 2005. Fourteen surveys evaluating a total number of 49292 participants in nine different countries were included into the analysis.
RESULTS
Vaccination rates among risk groups do vary significantly between different countries, reaching highest rates in the USA (IV, 82%; PV, 71%) and lowest in former West-Germany for IV (37%) and in Israel for PV (20%). Recommendations by doctors play a central role in promoting IV and PV. The main reason for not being vaccinated was lack of information.
CONCLUSION
Specific strategies targeted at groups are needed to increase the knowledge of IV and PV, and thereby decrease incidences of acute lung diseases.
Topics: Aged; Germany; Humans; Influenza, Human; Pneumococcal Infections; Vaccination
PubMed: 17572457
DOI: 10.1016/j.puhe.2007.02.011 -
PloS One 2017S. pneumoniae can cause a wide spectrum of diseases, including invasive pneumococcal disease and pneumonia. Two types of pneumococcal vaccines are indicated for use in... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
S. pneumoniae can cause a wide spectrum of diseases, including invasive pneumococcal disease and pneumonia. Two types of pneumococcal vaccines are indicated for use in adults: 23-valent pneumococcal polysaccharide vaccines (PPV23) and a 13-valent pneumococcal conjugate vaccine (PCV13).
OBJECTIVE
To systematically review the literature assessing pneumococcal vaccine effectiveness (VE) against community-acquired pneumonia (CAP) in adults among the general population, the immunocompromised and subjects with underlying risk factors in real-world settings.
METHODS
We searched for peer-reviewed observational studies published between 1980 and 2015 in Pubmed, SciELO or LILACS, with pneumococcal VE estimates against CAP, pneumococcal CAP or nonbacteremic pneumococcal CAP. Meta-analyses and meta-regression for VE against CAP requiring hospitalization in the general population was performed.
RESULTS
1159 unique articles were retrieved of which 33 were included. No studies evaluating PCV13 effectiveness were found. Wide ranges in PPV23 effectiveness estimates for any-CAP were observed among adults ≥65 years (-143% to 60%). The meta-analyzed VE estimate for any-CAP requiring hospitalization in the general population was 10.2% (95%CI: -12.6; 33.0). The meta-regression indicates that VE against any-CAP requiring hospitalization is significantly lower in studies with a maximum time since vaccination ≥60 months vs. <60 months and in countries with the pediatric PCV vaccine available on the private market. However, these results should be interpreted cautiously due to the high influence of two studies. The VE estimates for pneumococcal CAP hospitalization ranged from 32% (95%CI: -18; 61) to 51% (95%CI: 16; 71) in the general population.
CONCLUSIONS
Wide ranges in PPV23 effectiveness estimates for any-CAP were observed, likely due to a great diversity of study populations, circulation of S. pneumoniae serotypes, coverage of pediatric pneumococcal vaccination, case definition and time since vaccination. Despite some evidence for short-term protection, effectiveness of PPV23 against CAP was not consistent in the general population, the immunocompromised and subjects with underlying risk factors.
Topics: Aged; Humans; Observational Studies as Topic; Pneumococcal Vaccines; Pneumonia, Pneumococcal
PubMed: 28542347
DOI: 10.1371/journal.pone.0177985 -
The Lancet. Infectious Diseases Jan 2009Streptococcus pneumoniae and Neisseria meningitidis can cause sepsis and meningitis. Several risk factors for pneumococcal and meningococcal disease have been... (Meta-Analysis)
Meta-Analysis Review
Streptococcus pneumoniae and Neisseria meningitidis can cause sepsis and meningitis. Several risk factors for pneumococcal and meningococcal disease have been identified, but the cause of basic differences in susceptibility between individuals and populations is unknown. Single-nucleotide polymorphisms are thought to explain interindividual differences in susceptibility. New technologies provide the opportunity to study the genetic basis of susceptibility to these diseases. In recent years, several studies have been published on these polymorphisms in pneumococcal and meningococcal disease, many with apparently conflicting results. Herein we provide a systematic overview of all polymorphisms studied for a relation with susceptibility to pneumococcal and meningococcal disease. We also propose an initiative to pool genetic data on pneumococcal and meningococcal meningitis in one biobank.
Topics: Genetic Predisposition to Disease; Humans; Meningococcal Infections; Pneumococcal Infections; Polymorphism, Genetic
PubMed: 19036641
DOI: 10.1016/S1473-3099(08)70261-5 -
The Pediatric Infectious Disease Journal Sep 2014Pneumococcal meningitis and bacteremia pose a significant disease burden in Latin America and the Caribbean (LAC). (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Pneumococcal meningitis and bacteremia pose a significant disease burden in Latin America and the Caribbean (LAC).
METHODS
To perform a systematic review of studies of pediatric pneumococcal meningitis and non-pneumonia, non-meningitis pneumococcal bacteremia in LAC, we conducted an exhaustive search from 2000 to 2010 in electronic databases and grey literature. Pairs of independently selected reviewers assessed the quality and extracted the studies' data. A STROBE-based checklist was used to assess the risk of bias in observational studies. Meta-analyses were performed.
RESULTS
Of 1218 retrieved studies, 39 were included. In children <5 years, the pooled 95% confidence interval (CI) percentage of pneumococcal etiology out of cases studied with cerebrospinal fluid/blood cultures was 6.0% (95% CI: 3.3-9.5) for meningitis and 8.0% (95% CI: 5.3-12.4) for bacteremia. The incidences per 100,000 children were 4.7 (95% CI: 3.2-6.1) and 3.9 (95% CI: 2.0-5.9) for pneumococcal meningitis and non-pneumonia, non-meningitis bacteremia, respectively. The mortality was 8.3 (95% CI: 0.0-21.0) and 0.5 (95% CI: 0.3.0-0.6)/100,000 for meningitis and sepsis, respectively. The case fatality ratio was 33.2% (95% CI: 21.3-46.2) for meningitis and 29.0% (95% CI: 21.9-36.8) for sepsis. The pooled serotype distribution from SIREVA surveillance data showed that 14, 5, 6B (for meningitis) and 14, 6B, 19F (for bacteremia) were the most frequent serotypes, all included in licensed vaccines.
CONCLUSION
Pneumococcal meningitis and bacteremia are important causes of morbidity and mortality in LAC children <5 years of age. This systematic review provided evidence about the burden of pneumococcal disease and the serotype distribution to assess the impact the pneumococcal vaccines and to assist decision makers in the region.
Topics: Age Factors; Bacteremia; Caribbean Region; Child, Preschool; Humans; Incidence; Infant; Infant, Newborn; Latin America; Meningitis, Pneumococcal; Serogroup; Streptococcus pneumoniae
PubMed: 24830699
DOI: 10.1097/INF.0000000000000363 -
The Pediatric Infectious Disease Journal Feb 2016This study aimed to estimate the global burden of invasive pneumococcal disease (IPD) incidence among neonates during the pre-pneumococcal conjugate vaccine era. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
This study aimed to estimate the global burden of invasive pneumococcal disease (IPD) incidence among neonates during the pre-pneumococcal conjugate vaccine era.
METHODS
A systematic search of published and unpublished data was undertaken. Bias assessment and qualitative synthesis of the included studies were carried out. Random effects models using the method of DerSimonian and Laird were constructed. Subgroup analyses, sensitivity analyses and meta-influence analysis were undertaken. Sources of heterogeneity were investigated.
RESULTS
From 26 neonatal IPD data points in the pre-pneumococcal conjugate vaccine era, the overall pooled neonatal IPD incidence, in the general population, combining all 3 United Nations (UN) country strata was estimated to be 36.0 per 100,000 live births [95% confidence interval (CI): 20.0-64.7 per 100,000]. The pooled neonatal IPD incidence in the general population in the less-developed UN country strata was estimated to be 16.0 per 100,000 live births (95% CI: 3.9-65.6 per 100,000) and in the more-developed stratum was 41.1 per 100,000 live births (95% CI: 29.1-58.1 per 100,000). This counter-intuitive finding is likely to have been affected by data quantity and confounding by time. A pooled estimate for the least-developed stratum was not computable as there was only 1 study in this stratum-a study from The Gambia with an unweighted IPD incidence of 369.5 per 100,000 (95% CI: 119.2-1138.5 per 100,000).
CONCLUSIONS
Pneumococcus was a recognized pathogen among neonates in all development regions of the world. The burden of neonatal IPD, particularly in the least-developed UN country stratum, requires substantial further evaluation.
Topics: Female; Global Health; Humans; Incidence; Infant; Infant, Newborn; Male; Pneumococcal Infections; Socioeconomic Factors
PubMed: 26517330
DOI: 10.1097/INF.0000000000000955