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PubMed2006

Role of tonsillar IgD+CD27+ memory B cells in humoral immunity against pneumococcal infection.

IgD+CD27+ memory B cells are a major compartment of circulating memory B cells. However, the characteristics of these cells in the tonsils have been unclear. In this study, IgD+CD27+ memory B cells residing in the tonsillar marginal zone were found to exhibit similar characteristics as IgD+CD27+ memory B cells in the periphery, namely large morphology, expression of surface molecules, and hypermutated Ig variable region genes. Furthermore, these IgD+CD27+ memory B cells predominantly produced IgM, including IgM specific against pneumococcal polysaccharides. Taken together, these results provide convincing evidence that tonsillar IgD+CD27+ memory B cells impart protective humoral immunity against pneumococcal infection by producing high-affinity IgM.

Adolescent↗
PubMed2004

[Dutch Health Council advice 'Vaccination against pneumococcal infections in elderly persons and immunocompromised adults'].

The Dutch Health Council recently reported on the scientific desirability of making pneumococcal vaccination available to elderly persons and immunocompromised adults. On the basis of an assessment of the scientific evidence undertaken by the Dutch Cochrane Centre, the Council has concluded that extension of the current indication for pneumococcal vaccination is not scientifically justified. Vaccination is definitely recommended only for patients suffering from asplenia, sickle-cell anaemia or cerebrospinal fluid leakage. Whereas vaccination should be considered in individuals with certain other illnesses, vaccination is not recommended for people of advanced age or those diagnosed with solid tumours, diabetes mellitus, chronic respiratory disease or chronic heart failure.

Aged↗
PubMed1990

Epidemiology of pneumococcal infection in Singapore (1977-1986).

Streptococcus pneumoniae was isolated from 43 children and 143 adults in a ten year period from 1977 through 1986. There was a high incidence in the males, in the extremes of ages and in the Indian and Others racial groups. The overall mortality rate was 29.5% with a higher rate associated in those with chronic obstructive lung disease, smoking, malignancy and alcoholism, 0.5% of the isolates were resistant to penicillin (of intermediate resistance only) and 16% resistant to tetracycline. Common serotypes isolated were types 1, 4, 14, 3 and 6B, all of which are covered by the pneumococcal vaccine. In children, the common serotypes associated with primary bacteraemia were types 14 and 20; with pneumonia, types 6B, 14, 19A and with meningitis, types 6B, 19F and 19A. In adults, the common serotypes associated with primary bacteraemia were types 20, 11A and 1; with pneumonia, types 3, 4, 7F, 14; with meningitis, types 1, 13, 34 and with endocarditis, type 13. Characteristics of pneumococcal infection, the organism's antibiogram and the serotype distribution are discussed in relation to the work of other investigators.

Age Factors↗
PubMed1988

[Epidemiologic problems of pneumococcal infection].

During the microbiological examination of 314 tentatively healthy donors, residents of Leningrad, Streptococcus pneumoniae was detected in the rhinopharynx of 94 donors (29.9%) in amounts ranging from a few individual microbial cells to 10(6) microbial cells with the mean geometric concentration equal to 3.58 lg. Antipneumococcal antibodies were detected in the blood of 147 donors (46.8%). The occurrence of antipneumococcal antibodies was approximately 2.5 times higher than the average level of carriership, but in most cases the dynamics of immunological reactions changed in the same direction. Considerable monthly and annual fluctuations in the occurrence of pneumococcal carriership and antipneumococcal antibodies, as well as their correlation with the epidemic rises of acute respiratory diseases, influenza and other acute respiratory viral diseases, were established. These data indicate that pneumococcal infection plays a definite role in the epidemic rises of acute respiratory diseases.

Antibodies, Bacterial↗
PubMed1972

Host factors and capsular typing of body fluid isolates in fulminant pneumococcal infections.

A 10-year retrospective study was made to determine the spectrum of underlying disease in, and the capsular types of pneumococci isolated from, blood and body fluids of 140 hospitalized patients. Fifteen serotypes were found among 82 typed isolates, 53% of which were types 8, 14, or 23. There was a predominance of males and a high incidence of underlying pneumonia, chronic liver disease, nephrotic syndrome, cerebrospinal fluid rhinorrhea, and malignancy. Mortality rates were higher among the very young and aged, and the immunologically comprised host at either extreme of life was more susceptible to disseminated pneumococcal infection. Pneumococci of the higher capsular types were prominent in children, and those of the lower types in adults, a finding in agreement with other recent studies.

Adolescent↗
PubMed1992

Unusual manifestations of pneumococcal infection in human immunodeficiency virus-infected individuals: the past revisited.

Although AIDS was largely recognized and defined because of the increased presence of diseases that reflect deficiencies in cell-mediated immunity, susceptibility to common extracellular bacterial pathogens has also been shown to be increased. To our knowledge, adults with concurrent infection due to human immunodeficiency virus (HIV) and Streptococcus pneumoniae whose cases have been described to date have all had pneumococcal pneumonia and/or bacteremia. We describe five cases of HIV-infected patients who had unusual manifestations of pneumococcal infection, which include recurrent exudative pleural effusion, pyopneumothorax, purpura fulminans, mediastinitis with chest wall abscess, and multiple brain abscesses. Such complications of pneumococcal infection occurred more or less commonly in the preantibiotic era, but on the basis of our experience and an exhaustive literature search, these complications have been exceedingly rare in the past few decades. In four of our five patients, the unusual, complicated pneumococcal disease preceded and prompted a search for HIV infection. Because concurrent HIV infection increases the susceptibility to pneumococcal disease, other such cases are likely to be seen.

Adult↗
PubMed2006

The cathepsin B inhibitor, z-FA-FMK, inhibits human T cell proliferation in vitro and modulates host response to pneumococcal infection in vivo.

The cathepsin B inhibitor, benzyloxycarbonyl-phenyl-alanyl-fluoromethylketone (z-FA-FMK) at nontoxic doses was found to be immunosuppressive and repressed human T cell proliferation induced by mitogens and IL-2 in vitro. We showed that z-FA-FMK suppresses the secretion of IL-2 and IFN-gamma as well as the expression of IL-2R alpha-chain (CD25) in activated T cells, whereas the expression of the early activated T cell marker, CD69, was unaffected. Furthermore, z-FA-FMK blocks NF-kappaB activation, inhibits T cell blast formation, and prevents cells from entering and leaving the cell cycle. z-FA-FMK inhibits the processing of caspase-8 and caspase-3 to their respective subunits in resting T cells stimulated through the Ag receptor, but has no effect on the activation of these caspases during Fas-induced apoptosis in proliferating T cells. When administered in vivo, z-FA-FMK significantly increased pneumococcal growth in both lungs and blood, compared with controls, in a mouse model of intranasal pneumococcal infection. Because host response to bronchopneumonia in mice is T cell dependent, our collective results demonstrated that z-FA-FMK is immunosuppressive in vitro and in vivo.

Animals↗
PubMed2002

Is household antibiotic use a risk factor for antibiotic-resistant pneumococcal infection?

We used microbiology and pharmacy data from health-maintenance organizations to determine whether antibiotic use by a household member increases the risk of penicillin-non-susceptible pneumococcal disease. Though it has been well established that an individual's antibiotic use increases one's risk of antibiotic-resistant infection, it is unclear whether the risk is increased if a member of one's household is exposed to antibiotics. We therefore conducted a case-control study of patients enrolled in health maintenance organizations in Western Washington and Northern California. Cases were defined as individuals with penicillin-non-susceptible pneumococcal infection; controls were individuals with penicillin-susceptible pneumococcal infection. Socioeconomic variables were obtained by linking addresses with 1997 census block group data. One-hundred and thirty-four cases were compared with 798 controls. Individual antibiotic use prior to diagnosis increased the odds of penicillin non-susceptibility, with the strongest effect seen for beta-lactam use within 2 months (OR 1.8, 95% CI 1.2, 2.8). When household antibiotic use by persons other than the patient were considered, at 4 months prior to diagnosis there was a trend towards an association between penicillin non-susceptibility and beta-lactam antibiotic use, and a possible association in a small subgroup of patients with eye and ear isolates. However, no significant overall pattern of association was seen. We conclude that though antibiotic use of any kind within 2 months prior to diagnosis is associated with an increased risk of penicillin-non-susceptible pneumococcal disease, there is no significant overall pattern of association between household antibiotic use and penicillin-non-susceptible pneumococcal infection.

Adult↗
PubMed1999

A randomized, crossover design study of the pharmacology of extended-spectrum fluoroquinolones for pneumococcal infections.

STUDY OBJECTIVES: The objectives of this study were to characterize the single-dose and steady-state plasma pharmacokinetics of IV levofloxacin and IV alatrofloxacin, and to compare the results to pneumococcal isolate sensitivities in order to estimate the clinical efficacy of current community-acquired pneumonia treatment regimens against pneumococcal infections. DESIGN: Two-way, open-label, randomized, crossover study. PARTICIPANTS: Each of 12 healthy volunteer subjects received IV levofloxacin, 500 mg qd for 7 days, and IV alatrofloxacin, 200 mg qd for 7 days. The two regimens were separated by a 2-week washout period. MEASUREMENTS AND RESULTS: Plasma concentration profiles were collected around the first and final doses of both regimens and were assayed for their respective quinolone concentrations. When the peak concentrations for both agents were compared to standard twofold dilution minimum inhibitory concentration (MIC) values for pneumococcal isolates, it was discovered that the breakpoint MIC value at which each compound would no longer achieve a peak plasma concentration/MIC ratio of at least 12:1 was 0.5 mg/L for levofloxacin and 0.25 mg/L for alatrofloxacin. CONCLUSIONS: Based on the MIC that inhibits 90% of isolates of Streptococcus pneumoniae for both of these agents (1.0 to 2.0 mg/L for levofloxacin and 0.125 to 0.25 mg/L for trovafloxacin), our results indicate that although the once-daily regimen of alatrofloxacin appears to be appropriate for this pathogen, a more aggressive regimen may need to be investigated to optimize the clinical and microbiological effects of levofloxacin.

Adult↗