Published online Feb 25, 2015. doi: 10.5495/wjcid.v5.i1.1
Peer-review started: July 24, 2014
First decision: August 14, 2014
Revised: August 26, 2014
Accepted: November 7, 2014
Article in press: November 10, 2014
Published online: February 25, 2015
Processing time: 196 Days and 11.7 Hours
In solid organ transplant (SOT) recipients, Streptococcus pneumoniae can cause substantial morbidity and mortality ranging from non-invasive to invasive diseases, including pneumonia, bacteremia, and meningitis, with a risk of invasive pneumococcal disease 12 times higher than that observed in non-immunocompromised patients. Moreover, pneumococcal infection has been related to graft dysfunction. Several factors have been involved in the risk of pneumococcal disease in SOT recipients, such as type of transplant, time since transplantation, influenza activity, and nasopharyngeal colonization. Pneumococcal vaccination is recommended for all SOT recipients with 23-valent pneumococcal polysaccharides vaccine. Although immunological rate response is appropriate, it is lower than in the rest of the population, decreases with time, and its clinical efficacy is variable. Booster strategy with 7-valent pneumococcal conjugate vaccine has not shown benefit in this population. Despite its relevance, there are few studies focused on invasive pneumococcal disease in SOT recipients. Further studies addressing clinical, microbiological, and epidemiological data of pneumococcal disease in the transplant setting as well as new strategies for improving the protection of SOT recipients are warranted.
Core tip: Streptococcus pneumoniae causes substantial morbidity and mortality in solid organ transplant (SOT) recipients, ranging from non-invasive to invasive diseases, with a 12-fold risk of invasive pneumococcal disease higher than in non-immunocompromised patients. Pneumococcal vaccination is recommended for all SOT recipients with 23-valent pneumococcal polysaccharides vaccine. Although immunological rate response is appropriate, it is lower than in the rest of the population, decreases with time, and its clinical efficacy is variable. Booster strategy with 7-valent pneumococcal conjugate vaccine has not shown benefit in this population. Despite its relevance, robust evidence on pneumococcal disease in organ transplant recipients is lacking. New strategies for improving the protection of SOT recipients are warranted.