Pneumococcal infection and immunologic response to pneumococcal vaccine in XXXX . A pilot study.

@entity1 @entity55 @entity1729 @entity1030 @entity204 @entity328
We assessed the importance of @entity328 and immunologic response to 14-valent pneumococcal vaccine in a randomized (saline placebo or vaccine) double-blind pilot study involving 103 @entity1 with @entity1030 ( @entity1030 ). Antibody titers, the flora of the sputum, @entity1729 or @entity55 , and @entity204 were monitored. The patients' antibody titers before immunization were higher than healthy control subjects. Titers rose normally in those vaccinated but declined more rapidly. Differences between the group receiving placebo and vaccine were not significant at 12 and 24 months. The incidence of @entity55 was high before and after vaccine (47/1,000 vs 41/1,000 @entity1 -years). Nonpneumococcal causes predominated (73 percent of @entity55 ; 83.4 percent of @entity55 ). Isolates from sputum were predominantly nonvaccine types (50 to 62.5 percent). Twenty-seven @entity1 died; @entity55 occurred in six (one pneumococcal in a vaccinated @entity1 ) as a terminal complication of other diseases. Thus, although @entity55 occurred frequently in these @entity1 with @entity1030 and contributed to mortality in 22 percent (six) of the 27 @entity204 , the predominance of nonpneumococcal causes and the data on antibodies and sputum suggest that pneumococcal vaccine may not be as beneficial for @entity1 with @entity1030 as was hoped. More observations are needed.
