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Comparative incidence dynamics and serotypes of meningitis, bacteremic pneumonia and other-IPD in young children in the PCV era: Insights from Israeli surveillance studies.
Vaccine. 2018 08 28; 36(36):5477-5484.V

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.

Authors+Show Affiliations

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.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.Pediatric Infectious Disease Unit, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.Pediatric Department and Infectious Diseases Unit, Shaare Zedek Medical Center Affiliated with Hebrew University-Hadassah School of Medicine, Jerusalem, Israel.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.The Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel. Electronic address: rdagan@bgu.ac.il.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28579230

Citation

Ben-Shimol, Shalom, et al. "Comparative Incidence Dynamics and Serotypes of Meningitis, Bacteremic Pneumonia and other-IPD in Young Children in the PCV Era: Insights From Israeli Surveillance Studies." Vaccine, vol. 36, no. 36, 2018, pp. 5477-5484.
Ben-Shimol S, Givon-Lavi N, Grisaru-Soen G, et al. Comparative incidence dynamics and serotypes of meningitis, bacteremic pneumonia and other-IPD in young children in the PCV era: Insights from Israeli surveillance studies. Vaccine. 2018;36(36):5477-5484.
Ben-Shimol, S., Givon-Lavi, N., Grisaru-Soen, G., Megged, O., Greenberg, D., & Dagan, R. (2018). Comparative incidence dynamics and serotypes of meningitis, bacteremic pneumonia and other-IPD in young children in the PCV era: Insights from Israeli surveillance studies. Vaccine, 36(36), 5477-5484. https://doi.org/10.1016/j.vaccine.2017.05.059
Ben-Shimol S, et al. Comparative Incidence Dynamics and Serotypes of Meningitis, Bacteremic Pneumonia and other-IPD in Young Children in the PCV Era: Insights From Israeli Surveillance Studies. Vaccine. 2018 08 28;36(36):5477-5484. PubMed PMID: 28579230.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative incidence dynamics and serotypes of meningitis, bacteremic pneumonia and other-IPD in young children in the PCV era: Insights from Israeli surveillance studies. AU - Ben-Shimol,Shalom, AU - Givon-Lavi,Noga, AU - Grisaru-Soen,Galia, AU - Megged,Orli, AU - Greenberg,David, AU - Dagan,Ron, AU - ,, Y1 - 2017/06/01/ PY - 2017/02/07/received PY - 2017/05/08/revised PY - 2017/05/22/accepted PY - 2017/6/6/pubmed PY - 2018/11/6/medline PY - 2017/6/6/entrez KW - Children KW - Dynamics KW - IPD – invasive pneumococcal disease KW - PCV – pneumococcal conjugate vaccine KW - Pneumonia KW - Surveillance SP - 5477 EP - 5484 JF - Vaccine JO - Vaccine VL - 36 IS - 36 N2 - 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. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/28579230/Comparative_incidence_dynamics_and_serotypes_of_meningitis_bacteremic_pneumonia_and_other_IPD_in_young_children_in_the_PCV_era:_Insights_from_Israeli_surveillance_studies_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(17)30707-7 DB - PRIME DP - Unbound Medicine ER -