RELATION OF THE PNEUMOCOCCAL POLYSACCHARIDE VACCINE (PPSV23) IN THE PROGNOSTIC OUTCOME OF PATIENTS WITH NON-CYSTIC FIBROSIS BRONCHIECTASIS

ABSTRACT Considered a complex and heterogeneous disease that was previously underdiagnosed due to its distinct etiology, non-cystic bronchiectasis has a significant socioeconomic impact worldwide. The objective of this study was to evaluate the effect of the pneumococcal polysaccharide vaccine (PPSV23) on the prognosis of patients with bronchiectasis, using epidemiological and sociodemographic data and respiratory specimens evaluated by Gram staining and identification of Pseudomonas aeruginosa. The severity of bronchiectasis was classified using the FACED prognostic score. Of the 70 selected patients, 64.3% were women, with a mean age of 59 years and a history of smoking (80%). Among them, 65.7% reported not having received the pneumococcal polysaccharide vaccine, and 68.57% were not registered in the immunization database (P < 0.000). Substance use was higher in the unvaccinated group (p = 0.0174), as was the frequency of hospitalization among unvaccinated individuals (9/48) compared with vaccinated individuals (4/22). Furthermore, 55.7% were colonized by Gram-positive cocci, with a higher frequency of Gram-positive bacteria (35.71%) among unvaccinated individuals. Of the samples identified as Gram-negative, 90.9% (10/11) were confirmed as P. aeruginosa, and, 41.4% of patients with bronchiectasis were classified as having “mild” disease; the vaccinated group (22/70) was predominantly classified as having “mild” to “moderate” disease (63.6%; 14/22). Unvaccinated patients used antimicrobials more frequently (42.85%), and only those who reported using antimicrobials were classified as having “severe” disease. Given the significance of the association between self-reported use and respiratory infections, as well as between antibiotic use and the need for hospitalization, we emphasize the recommendation for Pneumococcal Polysaccharide Vaccine (PPSV23) immunization in patients with bronchiectasis as a highly important complementary alternative in the treatment of the disease, which may help control exacerbations and lead to a favorable prognosis. Keywords: Respiratory infection; Immunization; FACED Prognostic Score; Colonization.