Pneumococcal pneumonia

Induction of active immunity against pneumococcal disease caused by the pneumococcal antigen types included in the vaccine (the vaccine protects against pneumococcal pneumonia. pneumococcal bacteremia, and other pncuiiiiK iK Cal infections)... 

Pneumococcal vaccine is a bacterial vaccine that induces antibodies against 23 capsular types of Streptococcus pneumoniae. The type-specific antibody facilitates bacterial destruction by complement-mediated lysis. It is indicated in protection against pneumococcal pneumonia, pneumococcal bacteremia, and other pneumococcal infections. This bacterial vaccine is used for pneumococcal immunization. 

Vaccines for special populations are Hsted in Table 2. Two vaccines that are in fairly widespread use in the adult population are vaccines that prevent viral influenza and pneumococcal pneumonia. 

Immunization against pneumococcal pneumonia and bacteremia caused by the types of pneumococci included in the vaccine Active immunization against Streptococcus pneumoniae for infants and toddlers... 

In general, it is suggested that patients remain up to date on standard immunizations. Patients with HF should be counseled to receive yearly influenza vaccinations. Additionally, a pneumococcal vaccine is recommended. Usually only one pneumonia vaccination is necessary unless a patient is vaccinated before age 65. In that case, a booster vaccination is suggested 5 years after the initial vaccination. 

Complicated exacerbation FEV, less than 50% predicted Comorbid cardiac disease Greater than or equal to 3 exacerbations per year Antibiotic therapy in the previous 3 months Above organisms plus drug-resistant pneumococci, P-lactamase-producing H. influenzae and M. catarrhalis, Escherichia coli, Proteus spp., Enterobacter spp., Klebsiella pneumoniae Oral P-Lactam/P-Iactamase inhibitor (amoxicil 1 i n-clavulanate) Fluoroquinolone with enhanced pneumococcal activity (levofloxacin, gemifloxacin, moxifloxacin) Intravenous P-Iactam/P-Iactamase inhibitor (ampicillin-sulbactam) Second- or third-generation cephalosporin (cefuroxime, ceftriaxone) Fluoroquinolone with enhanced pneumococcal activity (levofloxacin, moxifloxacin)... 

Vaccination against hepatitis A and B is recommended in patients with underlying cirrhosis to prevent additional liver damage from an acute viral infection.35 Pneumococcal and influenza vaccination may also be appropriate and can reduce hospitalizations due to influenza or pneumonia. 

Influenza and pneumonia are common preventable infectious diseases that increase mortality and morbidity in persons with chronic diseases including DM.5 Yearly influenza vaccinations, commonly called flu shots, are recommended for patients with DM. Pneumococcal vaccination also is recommended for patients with DM as a one-time vaccination for most patients. 

Because patient with SCD have impaired splenic function, they are less adequately protected against encapsulated organisms such as S. pneumoniae, Hemophilus influenzae, and Salmonella. The use of pneumococcal vaccine in SCD patients has decreased the rates of morbidity and mortality dramatically. However, there are still groups of SCD children who continue to have high rates of invasive pneumococcal infections.17 Two pneumococcal vaccines are available. The 7-valent conjugate... 

Prevention of pneumococcal disease by use of vaccination is a national goal Vaccination is used to prevent or minimize the severity of pneumonia caused by S. pneumoniae or the influenza virus. 

Dowell SF, Butler JC, Giebink GS, et al. Acute otitis media Management and surveillance in an era of pneumococcal resistance—A report from the Drug-resistant Streptococcus pneumoniae Therapeutic Working Group. Pediatr Infect Dis J 1999 18(l) l-9. 

Herd immunity refers to high levels of immunization in one population resulting in protection of another unvaccinated population. For example, concentrated vaccination of children with the 7-valent pneumococcal conjugate vaccine resulted in decreased invasive Streptococcus pneumoniae infection not only in the vaccinated children, but also in elderly persons within the same community. 

Streptococcus pneumoniae is the most common bacterial cause of community-acquired respiratory tract infections. S. pneumoniae causes approximately 3000 cases of meningitis, 50,000 cases of bacteremia, 500,000 cases of pneumonia, and over 1 million cases of otitis media each year. The increasing prevalence of drug-resistant S. pneumoniae has highlighted the need to prevent infection through vaccination. Both licensed pneumococcal vaccines are highly effective in preventing disease from the common S. pneumoniae serotypes that cause human disease. 

The 23-valent pneumococcal polysaccharide vaccine contains 23 serotypes that are responsible for causing more than 80% of invasive S. pneumoniae infections in adults. The vaccine includes those serotypes that are associated with drug resistance. Use of the vaccine will not prevent the development of antibiotic-resistant S. pneumoniae, but is likely to prevent infection from drug-resistant strains. The 23-valent pneumococcal polysaccharide vaccine has demonstrated good immunogenicity in adults, but an individual will not develop immunity to all 23 serotypes following vaccination.10... 

The 23-valent pneumococcal polysaccharide vaccine is recommended for use in all adults 65 years of age or older and adults less than 65 years who have medical comorbidities that increase the risk for serious complications from S. pneumoniae infection, such as chronic pulmonary disorders, cardiovascular disease, diabetes mellitus, chronic liver disease, chronic renal failure, functional or anatomic asplenia, and immunosuppressive disorders. Alaskan natives and certain Native American populations are also at increased risk. Children over the age of 2 years may be vaccinated with the 23-valent pneumococcal polysaccharide vaccine if they are at increased risk for invasive S. pneumoniae infections, such as children with sickle cell anemia or those receiving cochlear implants. 

The Centers for Medicare and Medicaid Services has incorporated pneumococcal and influenza immunization rates into some of their quality standards. Patients admitted to a hospital for community-acquired pneumonia should be screened for, offered, and vaccinated with pneumococcal and influenza vaccines prior to discharge if not previously administered. In physicians office practice, all persons over 65 years of age who have been hospitalized in the past year should be screened for, offered, and vaccinated with pneumococcal and influenza vaccines if not previously administered. Both of these standards will affect payment if the standard is not met. The Joint Commission on Accreditation of Healthcare Organizations has also incorporated these standards into their accreditation reviews of health care facilities. 

Continued/increased emphasis upon the implementation of such immunization programmes is likely. This is true not only of poorer world regions, but also amongst the most affluent nations. An estimated 500 000 adults die annually in the USA from conditions that could have been prevented by vaccination. These include pneumococcal pneumonia, influenza and hepatitis B. 

S. pneumoniae is the leading cause of meningitis in adults. Pneumococcal meningitis occurs in the very young (less than 2 years of age) and the very old. 

Virtually all serotypes of S. pneumoniae exhibiting intermediate or complete resistance to penicillin are found in the current 23 serotype pneumococcal vaccine. A heptavalent conjugate vaccine is available for use in infants between 2 months and 9 years of age. Current recommendations are for all healthy infants younger than 2 years of age to be immunized with the heptavalent vaccine at 2, 4, 6, and 12 to 15 months. 

Pneumococcal vaccine is a mixture of capsular polysaccharides from 23 of the 83 most prevalent types of Streptococcus pneumoniae seen in the United States. 

Takashima, K. et al., Role of tumor necrosis factor alpha in pathogenesis of pneumococcal pneumonia in mice, Infect. Immun., 65, 257, 1997. 

Arredouani, M., et al., The scavenger receptor MARCO is required for lung defense against pneumococcal pneumonia and inhaled particles, J. Exp. Med. 200, 2, 267, 2004. 

Glaser, R. et al., Chronic stress modulates the immune response to a pneumococcal pneumonia vaccine, Psychosomat. Med., 804, 2000. 

The Gram-positive bacterium Streptococcus pneumoniae is an important cause of respiratory tract infections, bacteremia, and meningitis. In this strain, the cell wall anchored pneumococcal surface protein A (PspA) has been demonstrated to bind lactoferrin [181]. PspA and closely related proteins in a variety of pneumococcal isolates are most likely involved in the sequestration of iron from lactoferrins, and finally contribute to the virulence of these bacteria. However, the means by which the pneumococcus acquires iron at the mucosal surface during invasive infection is not well understood at the molecular level [182],... 

Hammerschmidt, S., Bethe, G., Remane, P. H. and Chhatwal, G. S. (1999). Identification of pneumococcal surface protein A as a lactoferrin-binding protein of Streptococcus pneumoniae, Infect. Immun., 67, 1683-1687. 

Pneumococcal Disease In October 2002, the FDA approved the use of Prevnar for immunization of infants and toddlers against otitis media— middle ear infection. Prevnar is a pneumococcal seven-valent conjugate vaccine. It is formulated with a sterile solution of saccharides conjugated to the antigen, Streptococcus pneumoniae. 

Olsen, K.M., Gentry-Nielsen, M., Yue, M., Snitily, M.U. and Preheim, L.C. (2006) Effect of ethanol on fluoroquinolone efficacy in a rat model of pneumococcal pneumonia. Antimicrobial Agents and Chemotherapy, 50, 210-219. 

It has been suggested that lactoferrin may only confer beneficial immune effects when consumed in the form of breast milk (Lonnerdal, 2003). When added to infant formula, lactoferrin may be affected by its prior bioactivity how it was added (blended or dissolved) and extent of heat treatment of the formula (Lonnerdal, 2003). There is evidence that lactoferrin can be inactivated by invading pathogens or even enhance microbial pathogenicity. For example, the pneumococcal surface protein A of Streptococcus pneumoniae was reported to bind to lactoferrin and protect the bacteria from the killing action of lactoferrin (Ward et ah, 2005). 

Pneumococcal vaccines Mixture of purified surface polysaccharide antigens obtained from differing serotypes of Streptococcus pneumoniae Active immunization against Streptococcus pneumoniae... 

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