Efficacy of 23-valent Pneumococcal Polysaccharide Vaccine in Steroid Responsive Nephrotic Syndrome

ABSTRACT

PURPOSE: Streptococcus pneumoniae is a major pathogen in both adults and children, causing significant morbidity and mortality. In patients with nephrotic syndrome, Streptococcus pneumoniae is a major cause of spontaneous peritonitis, and the increasing incidence of penicillin-resistance strain facilitates the development of effective vaccine. The limitation of current pneumococcal polysaccharide vaccine prompted development of polysaccharide-protein conjugate vaccine. METHODS: We reviewed the medical record of total 225 steroid responsive nephrotic patients to ascertain the effectiveness of 23-valent pneumococcal polysaccharide vaccine. RESULTS: Twenty-eight patients have developed peritonitis during the courses, and 7 of those have recurrent peritonitis. Fifty-five patients were vaccinated and followed-up for 1-108 months (mean 38.5 months), and during the follow-up period, pneumococcus related peritonitis was not detected. Vaccine-related relapse of nephrotic syndrome was absent. CONCLUSION: In spite of the non-consensus about the efficacy of PPV23, clinically it benefits, and until the clinical trial of PCV7 is completed, PPV23 will be recommended.