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Capsular Serotyping of Streptococcus pneumoniae Using the Quellung Reaction
Published on: February 24, 2014
Optimizing seroprotection against pneumococcus in children with nephrotic syndrome using the 13-valent pneumococcal
Laure F Pittet1, Klara M Posfay-Barbe2, Hassib Chehade3
1Department of Pediatrics, Children's Hospital of Geneva, University Hospitals of Geneva, Geneva, Switzerland; Platform of Clinical Research in Pediatrics, Department of Pediatrics, University Hospitals of Geneva, Geneva, Switzerland.
Insights
This study shows that the 13-valent pneumococcal conjugate vaccine (PCV13) effectively protects children with nephrotic syndrome (NS) against Streptococcus pneumoniae infections. High antibody levels were maintained for a year, with no serious side effects observed.
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
- Immunology
Background:
- Nephrotic syndrome (NS) patients face life-threatening infections, primarily from Streptococcus pneumoniae.
- Streptococcus pneumoniae is the leading cause of bacterial peritonitis and sepsis in NS patients.
Purpose of the Study:
- To assess baseline seroprotection against S. pneumoniae in NS patients.
- To evaluate the immunogenicity and safety of the 13-valent pneumococcal conjugate vaccine (PCV13) in NS patients.
- To determine the impact of NS treatment on vaccine responses.
Main Methods:
- A multicentre prospective interventional study involving 42 children with NS.
- PCV13 vaccination administered at study inclusion.
- Serotype-specific S. pneumoniae IgG titers measured at baseline, post-vaccination, and 1-year follow-up.
- Clinical and urinary tests used for vaccine safety evaluation.
Main Results:
- PCV13 vaccination induced high, sustained serotype-specific IgG titers for one year.
- Vaccine effectiveness was observed even in previously immunized children.
- No serious adverse events were reported, and relapse frequency remained unchanged.
Conclusions:
- High IgG titers achieved and maintained post-PCV13 vaccination in NS patients.
- Re-vaccination with PCV13 is recommended for all NS patients, regardless of immunization history, treatment, or disease activity.
- PCV13 vaccination is a safe and effective strategy to mitigate S. pneumoniae morbidity in NS patients.
Background:
Infections are among the main life-threatening complications in patients with nephrotic syndrome (NS), in particular with Streptococcus pneumoniae, the first cause of bacterial peritonitis and sepsis in these patients. This study aims to evaluate the baseline seroprotection of NS patients against S. pneumoniae, and immunize them with the 13-valent pneumococcal conjugate vaccine (PCV13) regardless of disease activity and previous immunization history, in order to evaluate the immunogenicity, safety profile, and effect of NS treatment on vaccine responses.
Methods:
This multicentre prospective interventional study enrolled 42 children with NS at disease onset or during a regular follow-up appointment. PCV13 was administered at inclusion. Serotype-specific S. pneumoniae IgG titer were assessed at baseline, after immunization, and at 1year follow-up. Vaccine safety was evaluated clinically and by urinary tests.
Results:
PCV13 induced high serotype-specific IgG titers that were maintained at high levels one year after vaccination, even in children previously immunized. No serious adverse event occurred and relapse frequency was unchanged.
Conclusion:
Given that high IgG titers were achieved and maintained after PCV13 vaccination, and considering the high morbidity related to S. pneumoniae, we propose PCV13 (re-)vaccination for all NS patients, irrespective of their previous immunization history, treatment and disease activity.
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