| 摘要: | Streptococcus pneumoniae, an important pathogen causing
sepsis, sinusitis, otitis media, bacterial meningitis and bacterial
pneumonia, results in global morbidity and mortality each
year. The burden of pneumococcal disease is highest in children
and the elderly. Treatment of pneumococcal infection has
been hampered by the complexity of the host immune
response. In recent decades, the increase of S. pneumoniae
strains’ resistance to -lactam antibiotics and other classes of
antimicrobials has made treatment even more complicated.
Fortunately, the advent of heptavalent conjugate vaccine confers
a high degree of protection against pneumococcal disease
and colonization caused by vaccine serotype strains. After the
introduction of conjugate pneumococcal vaccine, invasive
pneumococcal disease caused by vaccine serotypes and antibiotic-
resistant isolates has been reduced. However, naturally
transformable pneumococci may escape vaccine-induced immunity by switching their capsular
genes to non-vaccine serotypes. Development of cheaper, serotype-independent vaccines
based on a combination of protein antigens should be pursued. (Chang Gung Med J
2008;31:117-24)
肺炎雙球菌是造成敗血症Streptococcus pneumoniae, an important pathogen causing
sepsis, sinusitis, otitis media, bacterial meningitis and bacterial
pneumonia, results in global morbidity and mortality each
year. The burden of pneumococcal disease is highest in children
and the elderly. Treatment of pneumococcal infection has
been hampered by the complexity of the host immune
response. In recent decades, the increase of S. pneumoniae
strains’ resistance to -lactam antibiotics and other classes of
antimicrobials has made treatment even more complicated.
Fortunately, the advent of heptavalent conjugate vaccine confers
a high degree of protection against pneumococcal disease
and colonization caused by vaccine serotype strains. After the
introduction of conjugate pneumococcal vaccine, invasive
pneumococcal disease caused by vaccine serotypes and antibiotic-
resistant isolates has been reduced. However, naturally
transformable pneumococci may escape vaccine-induced immunity by switching their capsular
genes to non-vaccine serotypes. Development of cheaper, serotype-independent vaccines
based on a combination of protein antigens should be pursued. (Chang Gung Med J
2008;31:117-24)
肺炎雙球菌是造成敗血症Streptococcus pneumoniae, an important pathogen causing
sepsis, sinusitis, otitis media, bacterial meningitis and bacterial
pneumonia, results in global morbidity and mortality each
year. The burden of pneumococcal disease is highest in children
and the elderly. Treatment of pneumococcal infection has
been hampered by the complexity of the host immune
response. In recent decades, the increase of S. pneumoniae
strains’ resistance to -lactam antibiotics and other classes of
antimicrobials has made treatment even more complicated.
Fortunately, the advent of heptavalent conjugate vaccine confers
a high degree of protection against pneumococcal disease
and colonization caused by vaccine serotype strains. After the
introduction of conjugate pneumococcal vaccine, invasive
pneumococcal disease caused by vaccine serotypes and antibiotic-
resistant isolates has been reduced. However, naturally
transformable pneumococci may escape vaccine-induced immunity by switching their capsular
genes to non-vaccine serotypes. Development of cheaper, serotype-independent vaccines
based on a combination of protein antigens should be pursued. (Chang Gung Med J
2008;31:117-24)
肺炎雙球菌是造成敗血症、鼻竇炎、中耳炎、細菌性腦膜炎的重要病菌之一，每年都造成相當大的發病率及死亡率。這個疾病特別容易發生在兒童及老年人身上。當宿主受肺炎雙球菌感染時，複雜的免疫反應使得治療效果受限。近幾年來，抗藥性肺炎雙球菌的產生使得肺炎雙球菌的治療更為困難。幸運的是，由於7價結合型肺炎雙球菌疫苗的使用，成功的降低了疫苗型侵襲性肺炎雙球菌疾病的發生，也減少了抗藥性肺炎雙球菌的散播。雖然如此，由於肺炎雙球菌具有自然勝任能力，能夠將原本的疫苗型莢膜轉換成非疫苗型莢膜。宿主由於疫苗的保護，不會被疫苗型肺炎雙球菌感染，但有可能會受到非疫苗型肺炎雙球菌的侵襲。在未來，發展一個更經濟實惠，不受莢膜型限制的蛋白疫苗，將是努力的目標。(長庚醫誌2008;31:117-24) |
