T. Lahiri et Da. Waltz, Preimmunization anti-pneumococcal antibody levels are protective in a majority of patients with cystic fibrosis, PEDIATRICS, 108(4), 2001, pp. NIL_28-NIL_32
Objective. Although invasive pneumococcal disease is infrequent in cystic f
ibrosis (CF), it is recommended that all patients with CF receive pneumococ
cal 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 leve
ls of anti-pneumococcal antibody levels would be high, as they are exposed
to frequent antibiotic therapy that may eradicate organisms before generati
on 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 immunoso
rbent assay. Protective antibody levels were defined as >200 ng/mL.
Results. A majority of CF patients-61% to 100%, depending on age and seroty
pe-had protective levels of pneumococcal antibody. There was a significant
positive correlation between antibody level and age for 5 of the 6 serotype
s tested.
Conclusions. In contradistinction to our hypothesis, the majority of CF pat
ients have protective preimmunization anti-pneumococcal antibody levels. Ho
wever, a significant proportion-between 17% and 39%, depending on the serot
ype-did not exhibit adequate levels. Therefore, we concur with current reco
mmendations for pneumococcal immunization in CF.