Invasive pneumococcal disease among adults in Japan, April 2013 to March 2015: disease characteristics and serotype distribution

BMC Infectious Diseases

Research Article

Kei Kasahara¹  Bin Chang²  Tetsuya Kubota³  Kengo Oshima⁴  Hiroshi Watanabe⁵  Jiro Fujita⁶  Takaya Maruyama⁷  Junichiro Nishi⁸  Koji Kuronuma⁹  Hiroaki Takeda^1,10  Yoshinari Tanabe^1,11  Munehisa Fukusumi^1,12  Tamano Matsui^1,13  Kazunori Oishi^1,13  Tomimasa Sunagawa^1,13 

[1] Center for Infectious Diseases, Nara Medical University, Nara, Japan;Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan;Department of Hematology and Respiratory Medicine, Kochi Medical School, Kochi University, Kochi, Japan;Department of Infection Control and Laboratory Diagnostics, Internal Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan;Department of Infection Control and Prevention, Kurume University School of Medicine, Fukuoka, Japan;Department of Infectious Diseases, Respiratory and Digestive Medicine, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan;Department of Medicine, National Hospital Organization, Mie Hospital, Mie, Japan;Department of Microbiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan;Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Hokkaido, Japan;Department of Respiratory Medicine, Yamagata Saisei Hospital, Yamagata, Japan;Division of Infection Control and Prevention, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan;Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan;Department of Epidemiology for Infectious Diseases, Osaka University Graduate School of Medicine, Osaka, Japan;Infectious Diseases Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan;

关键词: Streptococcus pneumoniae;    Invasive pneumococcal disease;    Indirect effect;    Surveillance;   

DOI  :  10.1186/s12879-016-2113-y

 received in 2016-03-08, accepted in 2016-12-14,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundIn Japan, the clinical characteristics and recent serotype distribution among adult patients of invasive pneumococcal disease (IPD) have not been fully investigated since the introduction of the pneumococcal conjugate vaccine (PCV) in children. From November 2010, PCV7 was encouraged by an official program, funded by government, subsequently included in the routine schedule in April 2013, and replaced with a PCV13 in November 2013.MethodsBetween April 2013 and March 2015, patients with IPD older than 15 years were evaluated based on the enhanced national surveillance in ten prefectures of Japan. The serotype distribution of the isolates was analyzed in these patients.ResultsThe analysis included 291 patients: 107 patients (37%) were female and the median age was 70 years. Of 281 patients with available data, 202 (72%) had underlying diseases, including 107 patients (38%) with immunocompromised status. The case fatality proportion for all case was 20%. In subgroup analysis, the case fatality proportion (29%) in immunocompromised patients was much higher than that (0–16%) in each age group of nonimmunocompromised patients (15–39 years, 40–64 years, and ≥ 65 years). While the proportion of bacteremia without any focus (27%) was higher than that (8–10%) in nonimmunocompromised patients, the proportions of vaccine types (PCV13, 32%; PPSV23, 51%) of the causative isolates were lower than those in each age group of nonimmunocompromised patients. Among 291 isolates, the most frequent serotypes were 3 (17%), 19A (13%), and 22F (10%). Twelve percent of the isolates were PCV7 serotypes, 46% were PCV13 serotypes, and 66% were PPSV23 serotypes.ConclusionsThe majority of adult patients of IPD had underlying diseases, including immunocompromised conditions. A low proportion (12%) of PCV7-type IPD was observed in this population where PCV7 for children had been included in the routine immunization schedule.

【 授权许可】

CC BY   
© The Author(s). 2017