Longitudinal Anlalysis of Pneumoccal, meningococcal ... - Planet xMap

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Longitudinal Anlalysis of Pneumoccal, meningococcal ... - Planet xMap

Pneumococcal Disease


1

2

3

4

5

6A,6B

7A,7B,7C,7F

8

9A,9L,9N,9V

10A,10B,10C,10F

11A,11B,11C,11D,11F

12A,12B,12F

13

14

15A,15B,15C,15F

16A,16F

17A,17F

18A,18B,18C,18F

Pneumococcal serotypes

19A,19B,19C,19F

20

21

22A,22F

23A,23B,23F

24A,24B

25A,25F

27

28A,28F

29

31

32A,32F

33A,33B,33C,33D,33F

34

35A,35B,35C,35F

36

37

38

39

40

41A,41F

42

43

44

45

46

47A,47F

48


23V Pneumovax ®

1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19A, 19F, 20, 22F, 23F, 33F


xMAP

Pneumo 14


Antibody response to

Pneumovax® vaccination


Community acquired pneumonia


8

Community acquired pneumonia

S. pneumoniae 27%

Coxiella burnetti 5%

Haemophilus influenzae 2%

Legionella spp. 4%

Mycoplasma pneumoniae 3%

Other (incl. viral) 10%

Unknown cause 48%


Streptococcus pneumoniae

pneumonia: diagnostics

Sputum culture +ve 22 (35%)

Urine antigen 15 (25%)

Blood culture 5 (8%)

Combined (blood 12) 18 (30%)

60 (100%)

27 Patients serotyped, covered by 14-plex, sufficient data points


Streptococcus pneumoniae pneumonia:

antibody response

Serotype specific antibody response (14 plex

pneumopanel) during course of disease

2-fold increase in antibody titer; 0.35 g/ml

And: other serotypes no (i.e. > 2 fold lower)

response


Streptococcus pneumoniae serotype 19F

pneumonia

serotype specific IgG (g/ml)

10

0.1

1

1 2 3 5 10 >30

19A

19F


Other cause community acquired

serotype specific IgG (g/ml)

10

1

0.1

pneumonia

2 3 5 >30


Culture negative community acquired

serotype specific IgG (g/ml)

10

1

0.1

pneumonia

2 3 5 >30

Serotype 7F


van Mens S P et al. Clin. Vaccine Immunol. 2011;18:796-

801


17

Community acquired pneumonia

Triple P + Ovidus study: specific response

S. pneumoniae (27%)

Coxiella burnetti (5%)

H. influenzae (2%)

Legionella spp. (4%)

Mycopl. Pneumoniae (3%)

Other (incl. viral) (10%)

Unknown cause (48%)

Contribution of S. pneumoniae to CAP: 54%

45%

“0”%

28%


Conclusions

•Multiplex antibody determination (Luminex) is a valuable tool

for monitoring CAP patients and for measuring response to

vaccination.

•The estimated involvement of S. pneumoniae in 190 of all 349

(54%) CAP cases in our study: 94 patients identified by

conventional methods and 96 patients estimated by a positive

antibody response .

• (Insufficient response: indication for gammaglobulin

substitution therapy).

• 14-plex 23-plex 90-plex?

• Cell wall polysaccharide antibodies: all pneumococci?


Streptococcus pneumoniae reservoir

Kadioglu et al., Nature Reviews Microbiol 6 (2008) 288-301


Proportion of pediatric pneumococcal disease

prevented by PCV-7

86%

60%

62%

Assumes cross protection within serogroup 6

71%

38%

73%


Nieuwegein

The Netherlands

Capetown

South Africa

Dhaka

Bangla Desh


Acknowledgements

Suzan van Mens, Ben de Jong, Bart Vlamincks, Sabine Meijvis, Hilde Remmelts,

Simone Spoorenberg, Hendrik Endeman, Paul Voorn, Heleen van Velzen-Blad,

Willem Jan Bos, Jan Grutters, Douwe Biesma, Hubert Endtz, Ger Rijkers

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