Pneumococcal infections: association with asthma and COPD

Med Mal Infect. 2012 May;42(5):188-92. doi: 10.1016/j.medmal.2012.02.003. Epub 2012 Mar 22.

Abstract

Pneumococci are responsible for lower respiratory tract infections (bronchitis and pneumonia) and invasive infections (bacteremia and meningitis). Pneumococcal vaccination is recommended for adults at high risk of pneumococcal infection. Asthma is not currently considered as an indication for pneumococcal vaccination and this vaccination is indicated only in case of respiratory insufficiency. Indeed, asthma is not usually considered as a risk factor for pneumococcal infection and pneumococcal polysaccharide vaccine does not decrease mortality in patients presenting with COPD. According to several recent epidemiological studies, asthma is associated with a doubled risk of pneumonia and invasive infections. This epidemiological association is supported by biological data suggesting increased susceptibility to pneumococcal infection in asthmatic patients. Pneumococci are responsible for 10 to 15% of acute exacerbations and onset of often-severe pneumonia in patients presenting with COPD. The recent availability of pneumococcal conjugate vaccines could be interesting for these patients, but their clinical and cost effectiveness will have to be demonstrated before they can be recommended for these conditions.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / adverse effects
  • Adrenal Cortex Hormones / therapeutic use
  • Airway Obstruction / etiology
  • Anti-Inflammatory Agents / adverse effects
  • Anti-Inflammatory Agents / therapeutic use
  • Asthma / epidemiology*
  • Asthma / immunology
  • Asthma / physiopathology
  • Bronchi / microbiology
  • Bronchi / pathology
  • Carrier State / epidemiology
  • Carrier State / microbiology
  • Disease Susceptibility
  • Epithelium / microbiology
  • Epithelium / pathology
  • Humans
  • Hypersensitivity, Immediate / complications
  • Hypersensitivity, Immediate / immunology
  • Pneumococcal Infections / complications
  • Pneumococcal Infections / epidemiology*
  • Pneumococcal Infections / prevention & control
  • Pneumococcal Vaccines
  • Pneumonia, Pneumococcal / complications
  • Pneumonia, Pneumococcal / epidemiology
  • Pneumonia, Pneumococcal / prevention & control
  • Pulmonary Disease, Chronic Obstructive / drug therapy
  • Pulmonary Disease, Chronic Obstructive / epidemiology*
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Respiratory Tract Infections / epidemiology*
  • Respiratory Tract Infections / microbiology
  • Risk Factors
  • Smoking / epidemiology

Substances

  • Adrenal Cortex Hormones
  • Anti-Inflammatory Agents
  • Pneumococcal Vaccines