2013-08-012024-05-14https://scholars.lib.ntu.edu.tw/handle/123456789/657750摘要：器官移植患者因需長期使用免疫抑制劑和一般民眾相較，有數十倍以上的風險發生侵犯性肺炎鏈球菌(invasive pneumococcal diseases)感染。肺炎鏈球菌對於多種抗生素產生抗藥性，增加臨床治療的困難度。因此，在美國成人疫苗接種諮詢委員會(Advisory Committee on Immunization Practices)就針對預防器官移植患者發生肺炎鏈球菌(Streptococcus pneumoniae)感染提出肺炎鏈球菌疫苗接種的建議: 一劑 13 價蛋白接合型肺炎鏈球菌疫苗再於八周後追加接種一劑 23價多醣體肺炎鏈球菌疫苗血清抗體效價。13價蛋白接合型肺炎鏈球菌疫苗已證實可有效用於兒童(年寄由六周至五歲)及年紀大於 50歲的成人，但目前 13價蛋白接合型肺炎鏈球菌疫苗使用於器官移植患者並無臨床資料。故本研究欲評估器官移植患者施打 13價蛋白接合型肺炎鏈球菌疫苗後產生免疫功能(immunogenicity)的狀況及安全性。<br> Abstract: Because of long-term use of immunosuppressants, solid-organ transplant recipients had a significantly higher incidence rate (146 infections per 100000 persons per year) of invasive pneumococcal disease, including pneumonia, bacteremia, and meningitis, than the general population (11.5 per 100000 persons per year, p < 0.00001). The immunogenicity of pneumococcal vaccine (PPV23) in solid organ transplant recipients was generally suppressed. The 13-valent conjugate pneumococcal vaccines (PCV13) have been developed in order to enhance the immunogenicity of the polysaccharide vaccine, and has been proofed effective in children aged 6 weeks to 5 years and adults aged >50 years. The Advisory Committee on Immunization Practices (ACIP) recommended that solid organ transplant recipients should receive a dose of PCV13 first, followed by a dose of PPV23 at least 8 weeks later, but there are no clinical data regarding its use in solid organ transplant recipients. Thus the present study aims to evaluate the safety and immunogenicity of PCV13 use in solid organ transplant recipients.