Incidence of pediatric invasive pneumococcal disease in the Island of Majorca (2008-2010), an area with non-universal vaccination, and estimations of serotype & children population coverage by available conjugate vaccines

BMC Infectious Diseases

Cristina Mendez³  Cesar Balseiro³  Esther Culebras⁸  Carmen Gallegos⁶  Susana Herrero⁴  Emma Padilla¹  Andres-Ricardo Perez⁵  Antonio Ramirez²  Joaquin Dueñas⁷  Juan Picazo⁸ 

[1] Microbiology Department, Hospital de Manacor, Ctra. Manacor- Alcúdia km. 1, 07500 Manacor, Mallorca, Spain;Microbiology Department, Hospital Son Dureta, c/ Andrea Doria 55, 07014 Palma de Mallorca, Spain;Medical Department, Pfizer SA, Avda. Europa 20B, 28108 Alcobendas, Madrid, Spain;Pediatric Department, Hospital Son Llatzer, Ctra. Manacor km. 4, 07198 Palma de Mallorca, Spain;Pediatric Department, Hospital de Manacor, Ctra. Manacor- Alcúdia km. 1, 07500 Manacor, Mallorca, Spain;Microbiology Department, Hospital Son Llatzer, Ctra. Manacor km. 4, 07198 Palma de Mallorca, Spain;Pediatric Department, Hospital Son Dureta, c/ Andrea Doria 55, 07014 Palma de Mallorca, Spain;Microbiology Deparment, Hospital Clínico San Carlos, c/ Martín Lagos s/n, 28040 Madrid, Spain

关键词: Incidence rate;    Invasive pneumococcal disease;    PCV13;    PCV10;    PCV7;    Majorca;   

Others  :  1145670
DOI  :  10.1186/1471-2334-13-503

 received in 2012-11-27, accepted in 2013-10-22,  发布年份 2013

【 摘 要 】

Background

The World Health Organization reported in 2007 that inclusion of PCV7 in national immunization programs should be seen as a priority, also encouraging countries to conduct appropriate surveillances for monitoring the impact of vaccination. These analyses should be conducted in specific geographical areas and should be aimed to evolution of invasive pneumococcal disease (IPD), by age groups, clinical presentation, and vaccine serotypes (and non-vaccine serotypes to detect possible replacement). This study aimed to monitor the evolution of IPD incidence in children <15 years requiring hospitalization in the Island of Majorca.

Methods

A prospective clinical surveillance of all culture and/or PCR-confirmed IPD in children <15 years was performed in all hospitals in the Island of Majorca (approximately 900,000 inhabitants) from January 2008 to December 2010. Incidence rate (IR) was calculated as cases/100000 inhabitants using children population data.

Results

66 IPDs were identified: 39 (59.1%) parapneumonic pneumococcal empyema (PPE), 16 (24.2%) bacteremic pneumonia (BP), 7 (10.6%) primary bacteremia, 3 (4.5%) meningitis, and 1 (1.5%) osteomyelitis. IRs in the three-year study period were: 64.22 for children 12- < 24 months, 37.21 for those 24-59 months, 22.62 for those <12 months, and 3.98 for children >59 months. By study year, IRs were 21.25 in 2008, 19.89 in 2009 and 9.80 in 2010. The reduction found in 2010 was significant and due to significant reductions in IRs of IPDs caused by serotypes included in PCV10 and PCV13. Overall, estimated serotype coverage by conjugate vaccines was 12.1% for PCV7, 37.9% for PCV10 and 65.2% for PCV13. Of the 66 hospitalized children with IPD, 20 had received at least one dose of PCV7 (13 cases with identified serotype). None of these 13 cases was caused by PCV7 serotypes, all were caused by PCV13 serotypes and only 53.8% by PCV10 serotypes.

Conclusions

The results of the present study evidence the importance of expanding the number of serotypes covered by PCV, and the added value of PCV13 with respect to PCV10 and PCV7, even in an area of low prevalence of 19A as the Island of Majorca.

【 授权许可】

   
2013 Picazo et al.; licensee BioMed Central Ltd.

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