Role of vaccination in preventing pneumococcal disease in adults.
ABSTRACT Pneumococcal infections, including pneumonia and invasive disease (IPD), are major sources of morbidity and mortality worldwide. Prevention of first acquisition of S. pneumoniae with the use of vaccines represents an effective method to reduce the burden of the disease in both children and adults. Two vaccines are currently available in adults: a pneumococcal polysaccharide vaccine (PPV23) that includes 23 purified capsular polysaccharide antigens and a pneumococcal protein-conjugate vaccine (PCV13) that includes capsular polysaccharide antigens covalently linked to a non-toxic protein. The PPV23 induces a humoral immune response and since it has been licensed, it has been the subject of debates and controversies. Numerous studies and meta-analyses have shown that PPV23 protects against IPD, although there are conflicting data regarding its efficacy for the prevention of pneumonia. Vaccination with PCV13 stimulates good antibody responses as well as mucosal antibody and suppresses colonization. A conjugate vaccine can be expected to have benefits over a polysaccharide vaccine, due to the characteristics of a T-cell dependent response in terms of affinity, maturation of antibodies with repeated exposure, induction of immunological memory and long lasting immunity. The PCV13 has demonstrated all these characteristics in children and fundamental differences in adults are not expected. The efficacy in adults is currently being investigated and results will be available soon. This article is protected by copyright. All rights reserved.
[Show abstract] [Hide abstract]
ABSTRACT: Chronic pulmonary diseases describe chronic diseases that affect the airways and lung parenchyma. Examples of common chronic pulmonary diseases include asthma, bronchiectasis, chronic obstructive lung disease, lung fibrosis, sarcoidosis, pulmonary hypertension and cor pulmonale. Pulmonary infection is considered a significant cause of mortality in patients with chronic pulmonary diseases. Streptococcus pneumoniae is the leading isolated bacteria from adult patients with community-acquired pneumonia, the most common pulmonary infection. Vaccination against S. pneumoniae can reduce the risk of mortality especially from more serious infections in both immunocompetent and immunocompromised patients. Patients with chronic pulmonary diseases who take steroids or immunomodulating therapy (e.g., methotrexate, anti-TNF inhibitors), having concurrent sickle cell disease or other hemoglobinopathies, primary immunodeficiency disorders, human immunodeficiency virus infection / acquired immunodeficiency syndrome (HIV/AIDS), nephrotic syndrome, and hematologic or solid malignancies should be vaccinated with both 13-valent pneumococcal conjugate vaccine (PCV13) and the pneumococcal polysaccharide vaccine 23-valent (PPSV23).The American Journal of Medicine 09/2014; 127(9). DOI:10.1016/j.amjmed.2014.05.010 · 5.30 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: The Italian Committee of medical residents in Hygiene, Preventive Medicine and Public Health is a member of the Italian Society of Hygiene, Preventive Medicine and Public Health with the aim of developing a network among Italian resident in public health and promoting the educational path improvement through comparisons and debates between postgraduate medical schools. In this perspective, during last years account has been taken of some essential topics concerning education of public health medical residents, which represent future health-care and public health experts. Cross-sectional researches were conducted among Italian public health medical residents (PHMRs) through self-administered and web-based questionnaires. Each questionnaire was previously validated by pilot studies conducted during the 46th National Conference of the Italian Society of Hygiene, Preventive Medicine and Public Health. Seventy percent of Italian PHMRs considered the actual length of Public Health postgraduate medical school excessively long, with regard to predetermined educational goals. Confirming this statement, 90% of respondents were inclined to a reduction from 5 to 4 years of postgraduate medical school length, established by Law Decree 104/2013. Seventy seven percent of surveyed PHMRs stand up for a rearrangement on a national setting of the access contest to postgraduate medical schools. Moreover 1/3 of Italian schools performed less than 75%of learning and qualifying activities specified in Ministerial Decree of August 2005. In particular, data analysis showed considerable differences among Italian postgraduate schools. Finally, in 2015 only four Italian Universities (Napoli Federico II, Palermo, Pavia, Roma Tor Vergata) provide for the Second Level Master qualify for the functions of occupational doctor. This offer makes available 60 positions against a request of over 200 future Public Health medical doctors who have shown interest in the Master. In Italy, after the introduction of Ministerial Decree 285/2005, the educational course of PHMRs was significantly improved. The standardization of learning and qualifying activities allowed for the first time the attendance at medical directions or Local Health Units. Nevertheless, the excessive lenght of postgradute schools and the differences about training among Italian Universities are critical and actual issue. Moreover, the remarkable interest shown by PHMRs in the Master could suggest a poor job replacement prospect for young medical specialist in Hygiene, Preventive Medicine and Public Health.Epidemiologia e prevenzione 11/2014; 38(6 Suppl 2):115-9. · 1.46 Impact Factor
Clinical Microbiology and Infection 06/2014; 20(s6). DOI:10.1111/1469-0691.12642 · 4.58 Impact Factor