Pneumococcal Infections and Vaccines - Think Globally, Act Locally -

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Table of Contents

Ⅰ. Introduction

1. Prologue

1) Potency of one penicillin ampule

2) Pneumonia that follows a rapid clinical course in the elderly

3) Social background of the shift from antimicrobial agents to vaccines

2. Emergence of penicillin-resistant S. pneumoniae

1) EU and US

2) Japan

3. Organization of “Penicillin-resistant Streptococcus pneumoniae Study Group

1) Aiming at world-level surveillance studies

2) Accurate association between serotypes and resistant bacteria

Ⅱ. Nature of S. pneumoniae

1.Capsules and ß-lactams target, PBPs

1) Diversity of capsules

2) Characteristics of pbp gene mutations

3) Relationship between pbp mutations and susceptibility

4) Rapid identification of serotypes and resistant genes

2. Development of vaccines targeting capsules

1) Capsule as a vaccine target

2) Differences in the production method between PCV13 and PPSV23

3) Differences in the induction of antibody production between PCV13 and PPSV23

Ⅲ.Epidemiology of pneumococcal isolates

1. Introduction of pneumococcal vaccines
2. Invasive pneumococcal disease (IPD)

1) Medical institutions and departments from which strains were sent

2) Age distribution

3) Age and disease

4) Age and prognosis

3. Changes in capsular types and resistance genotypes

1) Introduction of conjugate vaccines (PCVs) and changes in capsular types

  • a) Strains from children (A)
  • b) Strains from adults (B)

2) Introduction of PCVs and changes of resistance genotypes

  • a) Strains from children (A)
  • b) Strains from adults (B)

3) Relationship between capsular types and resistance genotypes

  • a) Strains from children
  • b) Strains from adults

4) Capsular type 3 S. pneumoniae

Ⅳ. Characteristics of Cases Based on Epidemiological Analysis


1) Invasive pneumococcal disease (IPD)

2) Acute otitis media (AOM)

3) Summary

2. Adults

1) Relationship between age and IPD

2) Relationship between underlying diseases and IPD

3) Risk factor analysis in cases with pneumonia

4) Relationship between WBC at admission and outcome

5) Onset of IPD in those who received PPSV23

6) Differences in rate of poor prognosis by capsular types

7) Summary

Ⅴ. Evolution of S. pneumoniae revealed by Genomic Analysis

  1. Genomic feature
  2. MLST analysis
  3. Genetic recombination as a means of survival tool

Ⅵ. Conclusions

♦ Our Literature on S. pneumoniae

♦ Complementary Materials

  1. Changes in IPD after the introduction of PCV13 in the US
  2. A randomized, double-blind, controlled study of PCV13 and placebo
  3. OPA activity
  4. Recommendation of pneumococcal vaccination for adults in the US
  5. Proportion of S. pneumoniae in adult respiratory diseases in Japan
  6. Antimicrobial susceptibility

♦ Our article published in Emerging Infectious Diseases

♦ Biographies of Authors