Studies on Clinical Application of Pneumococcal Vaccine

Streptococcus pneumoniae isolated in various parts of Japan from a total of 590 patients with identified or putative pneumococcal infections were typed using type-specific antisera during the three years from April, 1980 to March, 1983.The results obtained were as follows:1) The 590 identified isolates belonged to 43 Danish types and the rank order of isolates was: Type 3 (12.7%), 19 F (9.3%), 23 F (6.8%), 6 B (5.9%), 6 A (5.9%), 14 (4.9%), 11 A (4.1%), 19 A (3.7%), 9 V (3.6%), 22 F (3.1%) and others.2) A total of 430 isolates (72.9%) belonged to one of the 23 pneumococcal types to be included in the commercial 23-valent pneumococcal polysaccharide vaccine and 160 isolates (27.1%) were types not be included in the vaccine. The rates of isolation of vaccine-type pneumococci were 76.2% for blood, CSF, transtracheal aspirate (TTA) and others, 66.9% for sputum and throat swabs, 90.5% for middle ear effusions, 79.1% for meningitis and septicemia, 66.9% for respiratory tract infections, and 89.3% for otitis media.When the nonvaccine-type 6 A which is known to cross-react with type 6 B antibody in humans is included, the total number of vaccine-type pneumococcal isolates was 465 (78.8%), and the rates of isolation of vaccine-type pneumococci were 83.3% for blood, CSF, TTA and others, 73.3% for sputum and throat swabs, 91.9% for middle ear effusions, 87.0% for meningitis and septicemia, 71.9% for respiratory tract infections, and 92.0% for otitis media.It seems that there is no variation depending on the distribution by type of the pneumococcal isolates according to age and region.