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Blood stream infection is associated with altered heptavalent pneumococcal conjugate vaccine immune responses in very low birth weight infants

Journal of Perinatology volume 33, pages 613–618 (2013)Cite this article

Subjects

Abstract

OBJECTIVE:

Sepsis in older children and adults modifies immune system function. We compared serotype-specific antibody responses to heptavalent pneumococcal conjugate vaccine (PCV7) in very low birth weight infants (<1500 g,VLBWs) with and without blood stream infection (BSI) during their birth hospitalization.

STUDY DESIGN:

Retrospective analysis of prospectively collected data for the Neonatal Research Network study of PCV7 responses among VLBWs. Infants received PCV7 at 2, 4 and 6 months after birth with blood drawn 4 to 6 weeks after third dose. Serotype antibodies were compared between infants with or without a history of BSI. Regression models were constructed with BW groups and other confounding factors identified in the primary study.

RESULT:

In all, 244 infants completed the vaccine series and had serum antibody available; 82 had BSI. After adjustment, BSI was not associated with reduced odds of serum antibody ⩾0.35 μg ml−1.

CONCLUSION:

BSI was not associated with reduced odds of World Health Organization-defined protective PCV7 responses in VLBWs.

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Acknowledgements

The National Institutes of Health, the NICHD, the National Center for Research Resources and the National Center for Advancing Translational Sciences provided grant support for the Neonatal Research Network’s PCV7 and Generic Database Studies. Data collected at participating sites of the NICHD NRN were transmitted to RTI International, the data coordinating center (DCC) for the network, which stored, managed and analyzed the data for this study. One behalf of the NRN, Dr A Das (DCC Principal Investigator) and Dr L Li (DCC Statistician) had full access to all of the data in the study, and with the NRN Center Principal Investigators, take responsibility for the integrity of the data and accuracy of the data analysis. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. We are indebted to our medical and nursing colleagues and the infants and their parents who agreed to take part in this study.

Author contributions

Dr JL Wynn, MD, conceptualized and designed the study, drafted the initial manuscript and approved the final manuscript as submitted. Dr L Li, PhD, performed the analyses, drafted the initial manuscript and approved the final manuscript as submitted. Dr CM Cotten, MD MHS, conceptualized and designed the study, drafted the initial manuscript and approved the final manuscript as submitted. Dr DL Phelps, MD, drafted the initial manuscript and approved the final manuscript as submitted. Dr S Shankaran, MD, drafted the initial manuscript and approved the final manuscript as submitted. Dr RN Goldberg, MD, drafted the initial manuscript and approved the final manuscript as submitted. Dr WA Carlo, MD, drafted the initial manuscript and approved the final manuscript as submitted. Dr K Van Meurs, MD, drafted the initial manuscript and approved the final manuscript as submitted. Dr A Das, PhD, performed the analyses, drafted the initial manuscript, and approved the final manuscript as submitted. Dr BR Vohr, MD, drafted the initial manuscript and approved the final manuscript as submitted. Dr RD Higgins, MD, drafted the initial manuscript and approved the final manuscript as submitted. Dr BJ Stoll, MD, conceptualized and designed the study, drafted the initial manuscript and approved the final manuscript as submitted. Dr CT D’Angio, MD, conceptualized and designed the study, drafted the initial manuscript and approved the final manuscript as submitted.

Author information

Authors and Affiliations

  1. Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Pediatrics/Neonatology, Nashville, TN, USA

    J L Wynn & C M Cotten

  2. Statistics and Epidemiology Unit, RTI International, Research Triangle Park, NC, USA

    L Li

  3. Department of Pediatrics, Duke University, Durham, NC, USA

    C M Cotten & R N Goldberg

  4. Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA

    D L Phelps & C T D'Angio

  5. Department of Pediatrics, Wayne State University, Detroit, MI, USA

    S Shankaran

  6. Department of Pediatrics, Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL, USA

    W A Carlo

  7. Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA, USA

    K Van Meurs

  8. Statistics and Epidemiology Unit, RTI International, Rockville, MD, USA

    A Das

  9. Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, RI, USA

    B R Vohr

  10. Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA

    R D Higgins

  11. Department of Pediatrics, Emory University School of Medicine, Children’s Healthcare of Atlanta, Atlanta, GA, USA

    B J Stoll

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  1. J L Wynn
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  2. L Li
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  7. W A Carlo
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Corresponding author

Correspondence to J L Wynn.

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Additional information

Supplementary Information accompanies the paper on the Journal of Perinatology website

Supplementary information

APPENDIX

APPENDIX

The following investigators, in addition to those listed as authors, participated in this study:

NRN Steering Committee Chairs: AH Jobe, MD PhD, University of Cincinnati (2003 to 2006); MS Caplan, MD, University of Chicago, Pritzker School of Medicine (2006 to 2011).

Duke University School of Medicine, University Hospital, Alamance Regional Medical Center and Durham Regional Hospital (U10 HD40492, UL1 RR24128, M01 RR30): RF Goldstein, MD; KJ Auten, MSHS; MB Lohmeyer, RN MSN.

Emory University Children’s Healthcare of Atlanta, Grady Memorial Hospital and Emory Crawford Long Hospital (GCRC M01 RR39, U10 HD27851): EC Hale, RN BS CCRC.

Eunice Kennedy Shriver National Institute of Child Health and Human Development: LL Wright, MD.

RTI International (U10 HD36790): W Kenneth Poole, PhD; S Emrich, MS; BK Hastings; Elizabeth McClure, MEd; JE Newman, PhD MPH; J O’Donnell Auman, BS; RL Perritt, MS; CP Huitema, MS; SE Schaefer, BS MS; K Zaterka-Baxter, RN.

Stanford University and Lucile Packard Children's Hospital (U10 HD27880, M01 RR70): SR Hintz, MD MS; ME DeAnda, PhD; MB Ball, BS CCRC.

University of Alabama at Birmingham Health System and Children’s Hospital of Alabama (U10 HD34216, M01 RR32): RL Schelonka, MD; M Peralta-Carcelen, MD MPH; MV Collins, RN BSN; SS Cosby, RN BSN; VA Phillips, RN BSN.

University of Miami, Holtz Children's Hospital (U10 HD21397, M01 RR16587): S Duara, MD; CR Bauer, MD; R Everett-Thomas, RN BSN.

University of Rochester Medical Center, Golisano Children's Hospital (U10 HD40521, M01 RR44): GJ Myers, MD; CA Horihan, MS; RL Jensen; DL Hust, RN PNP.

University of Texas Southwestern Medical Center at Dallas Parkland Health and Hospital System and Children's Medical Center Dallas (U10 HD40689, M01 RR633): CR Rosenfeld, MD; WA Salhab, MD; PJ Sánchez, MD; RJ Heyne, MD; A Guzman; G Hensley, RN; JF Hickman, RN; NA Miller, RN; JS Morgan, RN; SS Adams, MS, RN, CPNP; L Madden, BSN, RN, CPNP; E Heyne, PA-C, PsyD.

Wake Forest University Baptist Medical Center, Brenner Children’s Hospital and Forsyth Medical Center (U10 HD40498, M01 RR7122): TM O’Shea, MD MPH; LK Washburn, MD; RG Dillard, MD; NJ Peters, RN CCRP; BG Jackson, RN BSN.

Wayne State University, Hutzel Women’s Hospital and Children’s Hospital of Michigan (U10 HD21385): YR Johnson, MD MPH; A Pappas, MD; R Bara, RN BSN; G Muran, RN BSN; D Kennedy, RN BSN.

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Wynn, J., Li, L., Cotten, C. et al. Blood stream infection is associated with altered heptavalent pneumococcal conjugate vaccine immune responses in very low birth weight infants. J Perinatol 33, 613–618 (2013). https://doi.org/10.1038/jp.2013.5

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