Shalom Ben-Shimol1, Noga Givon-Lavi1, Galia Grisaru-Soen2, Orli Megged3, David Greenberg1, Ron Dagan4. 1. The Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel; Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. 2. Pediatric Infectious Disease Unit, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. 3. Pediatric Department and Infectious Diseases Unit, Shaare Zedek Medical Center Affiliated with Hebrew University-Hadassah School of Medicine, Jerusalem, Israel. 4. The Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel. Electronic address: rdagan@bgu.ac.il.
Abstract
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 <5years 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 <12months 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.
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 <5years 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 <12months 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.
Authors: Feroze Ganaie; Karsten Maruhn; Chengxin Li; Richard J Porambo; Pernille L Elverdal; Chitrananda Abeygunwardana; Mark van der Linden; Jens Ø Duus; Carmen L Sheppard; Moon H Nahm Journal: J Clin Microbiol Date: 2021-06-18 Impact factor: 5.948
Authors: Laura L Hammitt; Anthony O Etyang; Susan C Morpeth; John Ojal; Alex Mutuku; Neema Mturi; Jennifer C Moisi; Ifedayo M Adetifa; Angela Karani; Donald O Akech; Mark Otiende; Tahreni Bwanaali; Jackline Wafula; Christine Mataza; Edward Mumbo; Collins Tabu; Maria Deloria Knoll; Evasius Bauni; Kevin Marsh; Thomas N Williams; Tatu Kamau; Shahnaaz K Sharif; Orin S Levine; J Anthony G Scott Journal: Lancet Date: 2019-04-15 Impact factor: 79.321
Authors: Godwin Oligbu; Sarah Collins; Abdelmajid Djennad; Carmen L Sheppard; Norman K Fry; Nick J Andrews; Ray Borrow; Mary E Ramsay; Shamez N Ladhani Journal: Emerg Infect Dis Date: 2019-09 Impact factor: 6.883
Authors: Stephanie W Lo; Rebecca A Gladstone; Andries J van Tonder; John A Lees; Mignon du Plessis; Rachel Benisty; Noga Givon-Lavi; Paulina A Hawkins; Jennifer E Cornick; Brenda Kwambana-Adams; Pierra Y Law; Pak Leung Ho; Martin Antonio; Dean B Everett; Ron Dagan; Anne von Gottberg; Keith P Klugman; Lesley McGee; Robert F Breiman; Stephen D Bentley Journal: Lancet Infect Dis Date: 2019-06-10 Impact factor: 71.421
Authors: Shalom Ben-Shimol; Noga Givon-Lavi; David Greenberg; Michal Stein; Orli Megged; Avihu Bar-Yochai; Shahar Negari; Ron Dagan Journal: Euro Surveill Date: 2018-11