Jurka Meichtry1, Rita Born2, Marianne Küffer3, Marcel Zwahlen4, Werner C Albrich5, Silvio D Brugger3, Kathrin Mühlemann1, Markus Hilty6. 1. Department of Infectious Diseases, Inselspital, Bern University Hospital and University of Bern, Switzerland; Institute for Infectious Diseases, University of Bern, Switzerland. 2. Federal Office of Public Health, Bern, Switzerland. 3. Institute for Infectious Diseases, University of Bern, Switzerland. 4. Institute of Social and Preventive Medicine, University of Bern, Switzerland. 5. Department of Infectious Diseases and Hospital Hygiene, Cantonal Hospital of St. Gallen, Switzerland. 6. Department of Infectious Diseases, Inselspital, Bern University Hospital and University of Bern, Switzerland; Institute for Infectious Diseases, University of Bern, Switzerland. Electronic address: Markus.Hilty@ifik.unibe.ch.
Abstract
BACKGROUND: In Switzerland, the heptavalent (PCV7) and 13-valent pneumococcal conjugate vaccine (PCV13) were recommended for all infants aged <2 years in 2007 and 2011, respectively. Due to herd effects, a protective impact on the invasive pneumococcal disease (IPD) rates in adults had been expected. METHODS: Within this study, data from the nationwide mandatory surveillance was analyzed for all adult patients ≥16 years with IPD of known serotype/serogroup during 2003-2012. Trend (for IPD cases from 2003 to 2012) and logistic regression analyses (2007-2010) were performed to identify changes in serotype distribution and to identify the association of serotypes with age, clinical manifestations, comorbidities and case fatality, respectively. FINDINGS: The proportion of PCV7 serotypes among all IPD cases (n=7678) significantly declined in adults from 44.7% (2003) before to 16.7% (2012) after the recommendation of PCV7 (P<0.001). In contrast, the proportion of non-PCV7 serogroup/serotypes increased for non-PCV13 but also PCV13 serotypes (not included in PCV7) at the same time. Serotype distribution varied significantly across ages, clinical manifestations and comorbidities. Serotype was furthermore associated with case fatality (P=0.001). In a multivariable logistic regression model, analyzing single serotypes showed that case-fatality was increased for the serotypes 3 (P=0.008), 19A (P=0.03) and 19F (P=0.005), compared to serotype 1 and 7F. CONCLUSION: There was a significant decline in PCV7 serotypes among adults with IPD in Switzerland after introduction of childhood vaccination with PCV7. Pneumococcal serotypes were associated with case fatality, age, clinical manifestation and comorbidities of IPD in adults. These results may prove useful for future vaccine recommendations for adults in Switzerland.
BACKGROUND: In Switzerland, the heptavalent (PCV7) and 13-valent pneumococcal conjugate vaccine (PCV13) were recommended for all infants aged <2 years in 2007 and 2011, respectively. Due to herd effects, a protective impact on the invasive pneumococcal disease (IPD) rates in adults had been expected. METHODS: Within this study, data from the nationwide mandatory surveillance was analyzed for all adult patients ≥16 years with IPD of known serotype/serogroup during 2003-2012. Trend (for IPD cases from 2003 to 2012) and logistic regression analyses (2007-2010) were performed to identify changes in serotype distribution and to identify the association of serotypes with age, clinical manifestations, comorbidities and case fatality, respectively. FINDINGS: The proportion of PCV7 serotypes among all IPD cases (n=7678) significantly declined in adults from 44.7% (2003) before to 16.7% (2012) after the recommendation of PCV7 (P<0.001). In contrast, the proportion of non-PCV7 serogroup/serotypes increased for non-PCV13 but also PCV13 serotypes (not included in PCV7) at the same time. Serotype distribution varied significantly across ages, clinical manifestations and comorbidities. Serotype was furthermore associated with case fatality (P=0.001). In a multivariable logistic regression model, analyzing single serotypes showed that case-fatality was increased for the serotypes 3 (P=0.008), 19A (P=0.03) and 19F (P=0.005), compared to serotype 1 and 7F. CONCLUSION: There was a significant decline in PCV7 serotypes among adults with IPD in Switzerland after introduction of childhood vaccination with PCV7. Pneumococcal serotypes were associated with case fatality, age, clinical manifestation and comorbidities of IPD in adults. These results may prove useful for future vaccine recommendations for adults in Switzerland.
Authors: Joel P Werren; Lukas J Troxler; Oluwaseun Rume-Abiola Oyewole; Alban Ramette; Silvio D Brugger; Rémy Bruggmann; Mark van der Linden; Moon H Nahm; Ilche Gjuroski; Carlo Casanova; Julien Furrer; Markus Hilty Journal: Int J Mol Sci Date: 2021-04-27 Impact factor: 5.923
Authors: Oluwaseun Rume-Abiola Oyewole; Phung Lang; Werner C Albrich; Kerstin Wissel; Stephen L Leib; Carlo Casanova; Markus Hilty Journal: Microorganisms Date: 2021-05-18
Authors: Rosa Prato; Francesca Fortunato; Maria Giovanna Cappelli; Maria Chironna; Domenico Martinelli Journal: BMJ Open Date: 2018-03-25 Impact factor: 2.692