Corinne Levy1,2,3,4, Emmanuelle Varon5, Naim Ouldali1,2,6,7, Stéphane Béchet1,3,4, Stéphane Bonacorsi8,9, Robert Cohen1,2,3,4,10. 1. Association Clinique et Thérapeutique Infantile du Val-de-Marne, Saint Maur-des-Fossés. 2. Groupe de Pathologie Infectieuse Pédiatrique, Paris. 3. Université Paris Est, Institut Mondor de Recherche Biomédicale - Groupe de Recherche Clinique, Groupe d'Etude des Maladies Infectieuses Néonatales et Infantiles, Créteil. 4. Clinical Research Center, Créteil. 5. National Reference Center for Pneumococci, Centre Hospitalier Intercommunal de Créteil. 6. Unité d'épidémiologie clinique, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Robert Debré, Epidémiologie Clinique et Evaluation Economique Appliquée aux Populations Vulnérables Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche, Paris. 7. Urgences pédiatriques, Hôpital Necker Enfants Malades, Université Paris Descartes. 8. Université Paris Diderot, Sorbonne Paris Citépital Robert-Debré, Paris. 9. Service de Microbiologie, AP-HP, Hôpital Robert-Debré, Paris. 10. Unité Court Séjour, Petits nourrissons, Service de Néonatalogie, Centre Hospitalier Intercommunal de Créteil, France.
Abstract
BACKGROUND: Pneumococcal conjugate vaccine (PCV) implementation has led to a sharp decrease in invasive pneumococcal disease (IPD) due to the reduction in PCV serotypes. We aimed to describe the changes in the spectrum of IPD and its clinical presentations after 13-valent PCV (PCV13) implementation. METHODS: This prospective, hospital-based, active surveillance involved 130 pediatric wards and microbiology departments throughout France. We analyzed IPD cases from 2011 to 2016 for which a pneumococcal isolate was sent to the National Reference Center for Pneumococci for serotyping. Clinical data recorded were medical history, vaccination status, type of IPD, clinical features, and short-term evolution. RESULTS: Among 1082 IPD cases, we observed a 35.3% decrease (95% confidence interval, 29.2%-41.8%]) and the median age shifted from 38.3 months to 23.7 months (P = .007). The change in IPD type was mostly due to a reduction in bacteremic pneumonia frequency (from 42.1% to 19.1%; P < .001). Among the emerging non-PCV13 types (NVTs), those known to have the highest disease potential (8, 12F, 24F, and 33F) were isolated more frequently in patients without underlying conditions and were able to induce all IPD clinical presentations including bacteremic pneumonia. Conversely, serotypes with lower disease potential (15A, 15BC, 16F, and 23B) were rarely isolated from bacteremic pneumonia cases and were particularly involved in IPD in patients with underlying conditions (35.8%). CONCLUSIONS: Besides the decrease in IPD after 7-valent, then 13-valent PCV implementation, the spectrum of the remaining IPD cases showed significant changes, with substantial discrepancies across NVTs implicated in terms of clinical features and underlying conditions.
BACKGROUND:Pneumococcal conjugate vaccine (PCV) implementation has led to a sharp decrease in invasive pneumococcal disease (IPD) due to the reduction in PCV serotypes. We aimed to describe the changes in the spectrum of IPD and its clinical presentations after 13-valent PCV (PCV13) implementation. METHODS: This prospective, hospital-based, active surveillance involved 130 pediatric wards and microbiology departments throughout France. We analyzed IPD cases from 2011 to 2016 for which a pneumococcal isolate was sent to the National Reference Center for Pneumococci for serotyping. Clinical data recorded were medical history, vaccination status, type of IPD, clinical features, and short-term evolution. RESULTS: Among 1082 IPD cases, we observed a 35.3% decrease (95% confidence interval, 29.2%-41.8%]) and the median age shifted from 38.3 months to 23.7 months (P = .007). The change in IPD type was mostly due to a reduction in bacteremic pneumonia frequency (from 42.1% to 19.1%; P < .001). Among the emerging non-PCV13 types (NVTs), those known to have the highest disease potential (8, 12F, 24F, and 33F) were isolated more frequently in patients without underlying conditions and were able to induce all IPD clinical presentations including bacteremic pneumonia. Conversely, serotypes with lower disease potential (15A, 15BC, 16F, and 23B) were rarely isolated from bacteremic pneumonia cases and were particularly involved in IPD in patients with underlying conditions (35.8%). CONCLUSIONS: Besides the decrease in IPD after 7-valent, then 13-valent PCV implementation, the spectrum of the remaining IPD cases showed significant changes, with substantial discrepancies across NVTs implicated in terms of clinical features and underlying conditions.
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: Irene Rivero-Calle; Jose Gómez-Rial; Louis Bont; Bradford D Gessner; Melvin Kohn; Ron Dagan; Daniel C Payne; Laia Bruni; Andrew J Pollard; Adolfo García-Sastre; Denise L Faustman; Albert Osterhaus; Robb Butler; Francisco Giménez Sánchez; Francisco Álvarez; Myrsini Kaforou; Xabier Bello; Federico Martinón-Torres Journal: Hum Vaccin Immunother Date: 2020-08-05 Impact factor: 3.452