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      Polysaccharide conjugate vaccine against pneumococcal pneumonia in adults.

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          Abstract

          Pneumococcal polysaccharide conjugate vaccines prevent pneumococcal disease in infants, but their efficacy against pneumococcal community-acquired pneumonia in adults 65 years of age or older is unknown.

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          THE USE OF CONFIDENCE OR FIDUCIAL LIMITS ILLUSTRATED IN THE CASE OF THE BINOMIAL

          C. J. CLOPPER, E. PEARSON (1934)
          Article 0 comments Cited 772 times – based on 0 reviews     Review now
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            Clinical and economic burden of community-acquired pneumonia among adults in Europe.

            T. Welte, A. Torres, D Nathwani (2012)
            It is difficult to determine the impact of community-acquired pneumonia (CAP) in Europe, because precise data are scarce. Mortality attributable to CAP varies widely between European countries and with the site of patient management. This review analysed the clinical and economic burden, aetiology and resistance patterns of CAP in European adults. All primary articles reporting studies in Europe published from January 1990 to December 2007 addressing the clinical and economic burden of CAP in adults were included. A total of 2606 records were used to identify primary studies. CAP incidence varied by country, age and gender, and was higher in individuals aged ≥65 years and in men. Streptococcus pneumoniae was the most common agent isolated. Mortality varied from <1% to 48% and was associated with advanced age, co-morbid conditions and CAP severity. Antibiotic resistance was seen in all pathogens associated with CAP. There was an increase in antibiotic-resistant strains, but resistance was not related to mortality. CAP was associated with high rates of hospitalisation and length of hospital stay. The review showed that the clinical and economic burden of CAP in Europe is high. CAP has considerable long-term effects on quality of life, and long-term prognosis is worse in patients with pneumococcal pneumonia.
            Article 0 comments Cited 347 times – based on 0 reviews     Review now
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              Efficacy of a pneumococcal conjugate vaccine against acute otitis media.

              J Eskola, T Kilpi, A. Palmu … (2001)
              Ear infections are a common cause of illness during the first two years of life. New conjugate vaccines may be able to prevent a substantial portion of cases of acute otitis media caused by Streptococcus pneumoniae. We enrolled 1662 infants in a randomized, double-blind efficacy trial of a heptavalent pneumococcal polysaccharide conjugate vaccine in which the carrier protein is the nontoxic diphtheria-toxin analogue CRM197. The children received either the study vaccine or a hepatitis B vaccine as a control at 2, 4, 6, and 12 months of age. The clinical diagnosis of acute otitis media was based on predefined criteria, and the bacteriologic diagnosis was based on a culture of middle-ear fluid obtained by myringotomy. Of the children who were enrolled, 95.1 percent completed the trial. With the pneumococcal vaccine, there were more local reactions than with the hepatitis B vaccine but fewer than with the combined whole-cell diphtheria-tetanus-pertussis and Haemophilus influenzae type b vaccine that was administered simultaneously. There were 2596 episodes of acute otitis media during the follow-up period between 6.5 and 24 months of age. The vaccine reduced the number of episodes of acute otitis media from any cause by 6 percent (95 percent confidence interval, -4 to 16 percent [the negative number indicates a possible increase in the number of episodes]), culture-confirmed pneumococcal episodes by 34 percent (95 percent confidence interval, 21 to 45 percent), and the number of episodes due to the serotypes contained in the vaccine by 57 percent (95 percent confidence interval, 44 to 67 percent). The number of episodes attributed to serotypes that are cross-reactive with those in the vaccine was reduced by 51 percent, whereas the number of episodes due to all other serotypes increased by 33 percent. The heptavalent pneumococcal polysaccharide-CRM197 conjugate vaccine is safe and efficacious in the prevention of acute otitis media caused by the serotypes included in the vaccine.
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                Author and article information

                Journal
                Journal ID (iso-abbrev): N. Engl. J. Med.
                Title: The New England journal of medicine
                ISSN (Electronic): 1533-4406
                ISSN (Print): 0028-4793
                Publication date (Electronic): Mar 19 2015
                Volume: 372
                Issue: 12
                Affiliations
                [1 ] From the Julius Center for Health Sciences and Primary Care (M.J.M.B., S.M.H., M.B., C.H.W., A.M.M.D., T.J.M.V.) and the Department of Medical Microbiology (M.J.M.B., S.M.H., M.B., C.H.W., A.M.M.D., T.J.M.V.), University Medical Center (UMC) Utrecht, and the Department of Immunology and Infectious Diseases, Wilhelmina Children's Hospital, UMC Utrecht (A.M.M.D., E.A.M.S.), Utrecht, Research Center Linnaeus Institute, Spaarne Hospital, Hoofddorp (A.M.M.D.), and Julius Clinical, Zeist (R.L., B.O., N.V., E.C., A.S., D.E.G.) - all in the Netherlands; Pfizer Vaccine Clinical Research, Maidenhead, United Kingdom (C.W., S.G., M.P., A.M., A.M.-H., H.S., T.M., G.C.); Pfizer Vaccine Clinical Research, Collegeville, PA (S.P., E.A.E.); Pfizer Vaccine Research and Early Development (M.W.P., K.U.J.) and Pfizer Vaccine Clinical Research (D.A.S., E.A.E., W.C.G.), Pearl River, NY; and Pfizer Vaccine Clinical Research, Berlin (B.S.-T.).
                Article
                DOI: 10.1056/NEJMoa1408544
                PubMed ID: 25785969
                SO-VID: 56a0e4ce-6341-4879-ace4-6ff6d43f8e2c
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