Comparative incidence dynamics and serotypes of meningitis, bacteremic pneumonia and other-IPD in young children in the PCV era: Insights from Israeli surveillance studies

被引:31
作者
Ben-Shimol, Shalom [1 ,2 ]
Givon-Lavi, Noga [1 ,2 ]
Grisaru-Soen, Galia [3 ]
Megged, Orli [4 ,5 ]
Greenberg, David [1 ,2 ]
Dagan, Ron [1 ]
机构
[1] Soroka Univ Med Ctr, Pediat Infect Dis Unit, Beer Sheva, Israel
[2] Ben Gurion Univ Negev, Fac Hlth Sci, Beer Sheva, Israel
[3] Tel Aviv Sourasky Med Ctr, Dana Childrens Hosp, Pediat Infect Dis Unit, Tel Aviv, Israel
[4] Hebrew Univ Jerusalem, Hadassah Med Sch, Shaare Zedek Med Ctr, Pediat Dept, Jerusalem, Israel
[5] Hebrew Univ Jerusalem, Hadassah Med Sch, Shaare Zedek Med Ctr, Infect Dis Unit, Jerusalem, Israel
关键词
Pneumonia; IPD - invasive pneumococcal disease; PCV - pneumococcal conjugate vaccine; Dynamics; Children; Surveillance; INVASIVE PNEUMOCOCCAL DISEASE; CONJUGATE VACCINE; STREPTOCOCCUS-PNEUMONIAE; NASOPHARYNGEAL CARRIAGE; IMPACT; ENGLAND; INFECTIONS; BURDEN; ADULTS; WALES;
D O I
10.1016/j.vaccine.2017.05.059
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Introduction: Widespread introduction of pneumococcal conjugated vaccines (PCVs) impacted on invasive pneumococcal disease (IPD). However, IPD reduction may not be similar in all outcomes within IPD. We assessed PCV7/PCV13 impact on pneumococcal meningitis, bacteremic pneumonia (BP) and other (non-meningitis, non-pneumonia) IPD episodes in children <5 years in Israel. Methods: A prospective, population-based, active nationwide surveillance. All pneumococcal invasive episodes with positive blood/CSF cultures, July 2000 through June 2016, were included. Three sub-periods were defined: pre-PCV (2000-2008), PCV7 (2009-2011) and PCV13 (2014-2016). Incidence rate ratios (IRRs) were calculated. Results: Overall, 4321 episodes were recorded; 456 (10.6%) meningitis, 1478 (34.2%) pneumonia and 2387 (55.2%) other-IPD. In the pre-PCV period, proportion of serotypes in PCV13, but not in PCV7 (mainly serotypes 1, 5 and 19A) was higher in BP (43.3%) compared with other-IPD episodes (32.8%, p < 0.001) and similar to that of meningitis (37.6%, p = 0.1). The proportion of episodes in children <12 months was higher in meningitis (52.1%) compared with pneumonia (23.2%) and other-IPD episodes (39.5%; p < 0.001 for both). The declines of the 3 entities were not similar; Meningitis rate non-significantly declined by 24% (IRR = 0.76; 95% CI 0.57-1.01), while BP and other-IPD rates significantly declined by 57% and 70%, respectively. In contrast to other entities, BP did not decline significantly after PCV7 introduction but started to decline only after PCV13 introduction. Rates of meningitis, pneumonia and other-IPD caused by PCV13-serotypes (VT13) substantially declined by 88%, 95% and 97%, respectively, comparing PCV13 and the pre-PCV periods. However, diseases caused by non-VT13 increased by 256%, 302% in meningitis and pneumonia, respectively, but only 116% in other-IPD. Conclusions: Following PCV7/PCV13 introduction, rates of episodes caused by VT13 were substantially reduced in all 3 groups. However, differences in age distribution, serotype replacement and specific serotype decrease suggest different pathogenesis and host susceptibility between the 3 entities. (C) 2017 Elsevier Ltd. All rights reserved.
引用
收藏
页码:5477 / 5484
页数:8
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