MD Conference Express ICAAC 2011 - (Page 17)
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Hot Topics in Vaccines
Written by Eric Butterman
The following is a summary of several presentations which discussed recent publications that covered important advances in vaccinology. Kathryn M. Edwards, MD, Vanderbilt University, Nashville, Tennessee, USA, opened the session with a discussion of a publication that analyzed bacterial meningitis trends in the United States between 1998 and 2007 [Thigpen MC et al. N Engl J Med 2011]. Using data from eight surveillance areas, consisting of approximately 17.4 million persons, the authors identified 3188 cases of meningitis. During the study period, there was a 31% decrease in the incidence of meningitis and an increase in the median age of patients from 30.3 to 41.9 years. There was no change in case fatality rate (15.7% to 14.3%) or in the rate of disease in children aged <2 months. Dr. Edwards noted the marked reduction, by as much as 50% to 60%, in cases among children aged 2 to 10 years, which she attributed to the introduction of the conjugate pneumococcal vaccine in 2000. The study showed a much greater change in children than in adults, which raises a question as to whether herd immunity is going to be good enough to allow children to be immunized, without having adults immunized. In concluding, Dr. Edwards noted that while the rates of meningitis have decreased since 1998, largely due to effective immunization programs among children, the burden of disease is now being borne by adults, for whom new vaccine approaches are needed. In addition, there remains an enormous burden of Group B Streptococcus (GBS) disease in children aged <2 months that still needs to be addressed (Figure 1). Figure 1. Proportion of the 1670 Cases of Bacterial Meningitis Reported in 2003 to 2007 Caused by Each Pathogen, According to Age Group.
60 50 40 30 20 10 0
18.1% 13.9% 6.7% 58.0%
Percent of Overall Cases
Peer-Reviewed Highlights from the
3.4% Listeria monocytogenes
Streptococcus Pneumoniae
GBS
Neisseria meningitidis
Reproduced with permission from KM Edwards, MD.
GBS=Group B Streptococcus.
Causes
Haemophilus influenzae
51st ICAAC
Dr. Edwards also discussed an animal study that provided a new method of identifying protective antigens of Staphylococcus aureus [Kim HK et al. FASEB J 2011]. Staphylococcal sepsis and skin and soft tissue infections are major problems. Antibiotic resistance is increasing, there are no vaccines to prevent staphylococcal infections, and staphylococcal infection does not confer immunity from repeat infection. This study hoped to address
Official Peer-Reviewed Highlights from the 51st ICAAC
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Table of Contents for the Digital Edition of MD Conference Express ICAAC 2011
MD Conference Express ICAAC 2011
Contents
Infectious Disease Genomics
Emerging Resistance Among Gram-Negative Pathogens
Procalcitonin-Guided Antibiotic Therapy In Patients with Lower Respiratory Tract Infections
Combination Therapy with Flucytosine Improves Survival in AIDS-Related Cryptococcal Meningitis
CXA-201 Effective Against Common ICU Pathogens
Tigecycline Plus Standard Therapy Is More Effective For Treating Infections in Febrile Neutropenic Cancer Patients
Interventions Aimed at Reducing MRSA BSIs Led to Decreased Rates of Nosocomial MSSA BSIs
Is the Effectiveness of aP Vaccine in Pre-Adolescents Insufficient?
TMC435 Effective in the Treatment of HCV Genotype 1 Infection
HIV
Vaccines
Antibiotic Resistance
Drug Discovery
The Conundrum of MDR TB and Combination Therapy
New Drugs to Treat MDR Pathogens
Immunizations in Reproductive Health
Why Can’t Microbes Just Get Along?
The Role of Adjunctive Steroids in the Treatment of Bacterial Meningitis
Human and Animal Viruses Share “One World” and Emerging Zoonotic Infections Continue to Threaten
MD Conference Express ICAAC 2011
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