Alfredo Tagarro1, Andrea Benito2, Aida Sánchez3, Esteban Aznar3, Enrique Otheo4, David Sanz-Rosa5. 1. Pediatrics Department, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain; Clinical Department, School of Biomedicine, Universidad Europea, Madrid, Spain. Electronic address: alfredo.tagarro@salud.madrid.org. 2. Pediatrics, Tropical and Infectious Diseases Department, Hospital Universitario La Paz, Madrid, Spain. 3. Microbiology Department, Laboratory BR, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain. 4. Pediatrics Department, Hospital Universitario Ramón y Cajal, Madrid, Spain. 5. Clinical Department, School of Biomedicine, Universidad Europea, Madrid, Spain.
Abstract
OBJECTIVE: To compare the incidence and epidemiology of bacteremic community-acquired pneumonia (CAP) in the setting of changes in 13-valent pneumococcal conjugate vaccine (PCV13) coverage. STUDY DESIGN: In the region of Madrid, universal immunization with the PCV13 started in May 2010. In July 2012, public funding ceased. Vaccination coverage decreased from >95% to 82% in 2013 and to 67% in 2014. We performed a multicenter surveillance and case-control study from 2009-2014. Cases were hospitalized children with bacteremic CAP. Controls were children selected 1:1 from next-admitted with negative blood cultures and typical, presumed bacterial CAP. RESULTS: Annual incidence of bacteremic CAP declined from 7.9/100,000 children (95% CI 5.1-11.1) in 2009 to 2.1/100,000 children (95% CI 1.1-4.1) in 2012. In 2014, 2 years after PCV13 was withdrawn from the universal vaccination program, the incidence of bacteremic CAP increased to 5.4/100,000 children (95% CI 3.5-8.4). We enrolled 113 cases and 113 controls. Streptococcus pneumoniae caused most of bloodstream infections (78%). Empyema was associated with bacteremia (P = .003, OR 3.6; 95% CI 1.4-8.9). Simple parapneumonic effusion was not associated with bacteremia. Incomplete PCV immunization was not a risk factor for bacteremic pneumonia. CONCLUSIONS: High rate of PCV13 immunization was associated with decreased incidence of bacteremic CAP; this incidence increased when rate of immunization fell. Empyema (but not parapneumonic pleural effusion) was associated with bacteremia.
OBJECTIVE: To compare the incidence and epidemiology of bacteremic community-acquired pneumonia (CAP) in the setting of changes in 13-valent pneumococcal conjugate vaccine (PCV13) coverage. STUDY DESIGN: In the region of Madrid, universal immunization with the PCV13 started in May 2010. In July 2012, public funding ceased. Vaccination coverage decreased from >95% to 82% in 2013 and to 67% in 2014. We performed a multicenter surveillance and case-control study from 2009-2014. Cases were hospitalized children with bacteremic CAP. Controls were children selected 1:1 from next-admitted with negative blood cultures and typical, presumed bacterial CAP. RESULTS: Annual incidence of bacteremic CAP declined from 7.9/100,000 children (95% CI 5.1-11.1) in 2009 to 2.1/100,000 children (95% CI 1.1-4.1) in 2012. In 2014, 2 years after PCV13 was withdrawn from the universal vaccination program, the incidence of bacteremic CAP increased to 5.4/100,000 children (95% CI 3.5-8.4). We enrolled 113 cases and 113 controls. Streptococcus pneumoniae caused most of bloodstream infections (78%). Empyema was associated with bacteremia (P = .003, OR 3.6; 95% CI 1.4-8.9). Simple parapneumonic effusion was not associated with bacteremia. Incomplete PCV immunization was not a risk factor for bacteremic pneumonia. CONCLUSIONS: High rate of PCV13 immunization was associated with decreased incidence of bacteremic CAP; this incidence increased when rate of immunization fell. Empyema (but not parapneumonic pleural effusion) was associated with bacteremia.
Authors: Abel Abera Negash; Daniel Asrat; Workeabeba Abebe; Tewodros Hailemariam; Tsegaye Hailu; Abraham Aseffa; Mario Vaneechoutte Journal: Open Forum Infect Dis Date: 2019-01-23 Impact factor: 3.835
Authors: Sarah Pugh; Matt Wasserman; Margaret Moffatt; Susana Marques; Juan Manuel Reyes; Victor A Prieto; Davy Reijnders; Mark H Rozenbaum; Juha Laine; Heidi Åhman; Raymond Farkouh Journal: Infect Dis Ther Date: 2020-02-24