2197. Maternal Parasitic Infections Alter Infant Antibody Response to Pneumococcal Immunization
Session: Poster Abstract Session: Host-Pathogen Interactions
Saturday, October 29, 2016
Room: Poster Hall
Posters
  • IDSA poster noah mck 10-21.pdf (6.2 MB)
  • Background: Vaccine-preventable diseases remain a significant cause of early childhood mortality in developing countries, despite concerted efforts to improve vaccine coverage. One reason for this discrepancy may be the impact of prenatal exposure to parasitic antigens on the infant’s developing immune system. Our goal in this study was to investigate the effect of maternal parasitic infections on the infant immune response to early childhood vaccines.

    Methods: 580 pregnant Kenyan mothers were enrolled in the study and tested at prenatal visits for malaria, soil transmitted helminths, G. lamblia, S. stercoralis and S. haematobium infection. The infants received the 10-valent Streptococcus pneumonia conjugate vaccine (PCV), Haemophilus influenzae type B (Hib) and Diphtheria toxoid (DT) vaccines at 6, 10, and 14 weeks of age. Serum was collected from cord blood, 10 and 14-weeks, 6 months, and every 6 months following through the second year of life. A multiplex fluorescent bead assay determined IgG concentrations to HiB, DT, and the ten PCV serotypes: 1, 4, 5, 6B, 7F, 9V, 14, 18C, 19F and 23F.

    Results: Total parasitic infection incidence among mothers in the study is high, with 373 of 580 (64.2%) participants having at least one parasitic infection during pregnancy and 75 participants (13%) with 2 or more infections. The most common infections were hookworm (19.7%), P. falciparum (16.2%), S. haematobium (11%), and T. trichiura (10.5%). In preliminary analysis using a mixed linear model comparing infection status to log (antibody concentration), we are able to see a 37% higher concentration of PCV 9V antibody in children born to mothers with infections (p=0.016) compared to uninfected mother/child pairs. S. haematobiuminfection was associated with significantly higher concentrations in 4 PCV antigens: 1 (3.9 fold higher, p=0.0006), 7 (2.3 fold higher, p=0.004), 9V (2.3 fold higher, p=0.002), and 18C (6.8 fold higher, p<0.0001).

    Conclusion: Perinatal parasitic infections appear to have a significant impact on the developing fetal immune system resulting in an altered response to early childhood vaccinations.

    Noah Mckittrick, MD1, David Vu, MD2, Derek Boothroyd, PhD3, Indu Malhotra, PhD4, Charles H. King, MD5,6, Francis Mutuku, PhD7 and A. Desiree Labeaud, MD, MS2, (1)Infectious Diseases, Stanford, Stanford, CA, (2)Stanford University, Stanford, CA, (3)Stanford University, Palo Alto, CA, (4)Case Western Reserve University, Cleveland, OH, (5)Center for Global Health and Diseases, Case Western Reserve University, Cleveland, OH, (6)Pediatrics and Center for Global Health and Diseases, Case Western Reserve University, Cleveland, OH, (7)Environmental and Health Sciences, Technical University of Mombasa, Mombasa, Kenya

    Disclosures:

    N. Mckittrick, None

    D. Vu, None

    D. Boothroyd, None

    I. Malhotra, None

    C. H. King, None

    F. Mutuku, None

    A. D. Labeaud, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.