Preimmunization anti-pneumococcal antibody levels are protective in a majority of patients with cystic fibrosis

Pediatrics. 2001 Oct;108(4):E62. doi: 10.1542/peds.108.4.e62.


Objective: Although invasive pneumococcal disease is infrequent in cystic fibrosis (CF), it is recommended that all patients with CF receive pneumococcal immunization. As part of a comprehensive program to immunize our clinic population, we obtained preimmunization anti-pneumococcal antibody levels. We hypothesized that the percentage of CF patients without protective levels of anti-pneumococcal antibody levels would be high, as they are exposed to frequent antibiotic therapy that may eradicate organisms before generation of an antibody response.

Methods: An observational study of 100 patients with CF, aged 1 to 39 years, was conducted in a regional CF center. Preimmunization anti-pneumococcal antibody levels against 6 serotypes were measured by enzyme-linked immunosorbent assay. Protective antibody levels were defined as >200 ng/mL.

Results: A majority of CF patients-61% to 100%, depending on age and serotype-had protective levels of pneumococcal antibody. There was a significant positive correlation between antibody level and age for 5 of the 6 serotypes tested.

Conclusions: In contradistinction to our hypothesis, the majority of CF patients have protective preimmunization anti-pneumococcal antibody levels. However, a significant proportion-between 17% and 39%, depending on the serotype-did not exhibit adequate levels. Therefore, we concur with current recommendations for pneumococcal immunization in CF.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Antibodies, Bacterial / blood*
  • Child
  • Child, Preschool
  • Cystic Fibrosis / blood
  • Cystic Fibrosis / diagnosis
  • Cystic Fibrosis / immunology*
  • Enzyme-Linked Immunosorbent Assay / statistics & numerical data
  • Female
  • Humans
  • Immunization Schedule
  • Infant
  • Male
  • Pneumococcal Infections / immunology
  • Pneumococcal Infections / prevention & control*
  • Pneumococcal Vaccines / therapeutic use*
  • Serotyping
  • Streptococcus pneumoniae / classification
  • Streptococcus pneumoniae / immunology*


  • Antibodies, Bacterial
  • Pneumococcal Vaccines