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[Serotypes of pneumococci isolated from children with pneumonia: implication of pneumococcal specific immunization]
N Hein1, B Ejzenberg, J P Lotufo
1Departamento de Pediatria, Faculdade de Medicina, Universidade de São Paulo.
Insights
Serologic typing of 124 pneumococcus isolates revealed that the 23-valent vaccine covers 89.3% of strains. However, reduced immunogenicity in children under two necessitates careful vaccine selection.
Area of Science:
- Pediatric infectious diseases
- Bacteriology
- Vaccinology
Context:
- Acute pneumonia in children is a significant health concern.
- Serologic typing of Streptococcus pneumoniae isolates was conducted over 15 years (1978-1992).
- Bacterial sources included pulmonary aspirates, pleural fluid, and blood.
Purpose:
- To serotype pneumococcus isolates from pediatric pneumonia cases.
- To assess the coverage of the 23-valent pneumococcal vaccine.
- To analyze pneumococcal serogroup distribution patterns.
Summary:
- 124 pneumococcus isolates were serotyped, identifying 122 capsular antigens.
- Serogroups 14, 1, and 6 were most prevalent, accounting for over 60% of cases.
- The 23-valent vaccine covers 89.3% of identified serogroups, but its efficacy is reduced in children under two.
Impact:
- Findings highlight the need for evaluating new conjugate vaccines for pediatric use.
- The study provides insights into pneumococcal serogroup distribution, bridging developed and developing country patterns.
- Understanding serogroup prevalence is crucial for effective vaccine strategies in different regions.
Abstract:
For the 15 years from 1978 to 1992 serologic typing was performed on 124 pneumococcus isolates from children with acute pneumonia. The source of bacteria was material obtained by aspirative pulmonary punction, pleural fluid or blood; 122 capsular antigens representing groups and types could be determined. Of the 122 isolates serogrouped 14, 1, 6, 5, 4, 7, 23, 19 and 4, accounted for 25.4%; 23.8%; 13.1%; 9.0%; 4.9%; 4.9%; 4.1%; 4.1%; 4.1%; respectively, of cases. The currently available 23-valent vaccine would provide protection against 89.3% of identified pneumococci in our study, but because of its poor immunogenicity in children less than 2 years old (73.0%) they would have received reduced protection by the use of this vaccine. The distribution of pneumococci serogroups found in our study has an intermediary pattern in relation to those found at develop countries (6, 14, 18, 19, 23) and developing ones (1, 2, 3, 5, 7, 12, 46). The new conjugate vaccines, with limited number of pneumococcal groups/types, should be analysed before the introduction in different geographic areas.