Laboratory for Clinical Research on Infectious Disease, International Research Center for Infectious Diseases, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan; Department of Respiratory Medicine, Allergy and Rheumatic Disease, Graduate School of Medicine, Osaka University, Osaka, Japan.
Department of Pediatrics, Nishi-Kobe Medical Center, Kobe, Japan.
Vaccine. 2014 Mar 14;32(13):1444-50. doi: 10.1016/j.vaccine.2014.01.031. Epub 2014 Jan 29.
Antibody responses to the infecting serotype in children who are vaccinated with pneumococcal conjugate vaccine (PCV) after having invasive pneumococcal diseases (IPD) have not been fully investigated. Of 56 children diagnosed with IPD between October 2009 and April 2013 in whom the infecting serotype was confirmed, 17 who were vaccinated with PCV7 following IPD were tested to determine the geometric mean concentration of serotype-specific immunoglobulin G (IgG) and the geometric mean titers of opsonization indices (OIs) using paired sera obtained at the onset of IPD and after PCV doses following the resolution of IPD. The geometric mean concentrations of serotype-specific IgG for all PCV7 serotypes other than serotype 6B were significantly increased after the last PCV7 dose compared with those at the time of IPD onset (P<0.01), as were the geometric mean titers of OIs for all PCV7 serotypes. In 14 children with IPD caused by PCV7 serotypes for whom both IgG and OI results were available, the OIs for the infecting serotype at the time of IPD onset were <8, although the IgG levels varied between from <0.2 to >5.0μg/ml. After the last PCV7 dose, the OIs for the infecting serotype remained <8 for six (43%) of 14 children. In these six children, hyporesponsiveness to PCV7 was specific for the infecting serotype. Hyporesponsiveness was found for serotypes 6B (n=5) and 23F (n=1). No difference was found between the responders (n=8) and the hyporesponders (n=6) with regard to any clinical characteristics. Our data suggest that hyporesponsiveness to the infecting serotype may occur in children vaccinated with PCV7 following IPD.
在患有侵袭性肺炎球菌病（IPD）后接种肺炎球菌结合疫苗（PCV）的儿童中，针对感染血清型的抗体反应尚未得到充分研究。在 2009 年 10 月至 2013 年 4 月期间诊断出的 56 名患有 IPD 的儿童中，有 17 名在患有 IPD 后接种了 PCV7，对其进行了检测，以确定在 IPD 发病时和 IPD 缓解后接种 PCV 剂量后获得的配对血清中针对各型特异性免疫球蛋白 G（IgG）的几何平均浓度和调理指数（OI）的几何平均滴度。与 IPD 发病时相比，所有除 6B 型以外的 PCV7 血清型的针对所有 PCV7 血清型的 IgG 浓度在最后一次 PCV7 剂量后均显著增加（P<0.01），所有 PCV7 血清型的 OI 几何平均滴度也是如此。在 14 名因 PCV7 血清型而患有 IPD 的儿童中，有 14 名同时获得了 IgG 和 OI 结果，在 IPD 发病时，感染血清型的 OI 低于 8，尽管 IgG 水平在 0.2 至 5.0μg/ml 之间变化。在最后一次 PCV7 剂量后，在 14 名儿童中，有 6 名（43%）的感染血清型的 OI 仍低于 8。在这 6 名儿童中，PCV7 的低反应性针对感染血清型。6B 型（n=5）和 23F 型（n=1）发现低反应性。在反应者（n=8）和低反应者（n=6）之间，在任何临床特征方面均未发现差异。我们的数据表明，在患有 IPD 后接种 PCV7 的儿童中，针对感染血清型可能会出现低反应性。
