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Impact of pneumococcal conjugate vaccine (PCV7 and PCV13) on pneumococcal invasive diseases in Italian children and insight into evolution of pneumococcal population structure.
Vaccine. 2017 08 16; 35(35 Pt B):4587-4593.V

Abstract

BACKGROUND

The use of PCV7 for children immunization was gradually implemented in the Italian regions starting from 2006 and was replaced by PCV13 in 2010-2011. In this study we aimed to assess the PCV impact on invasive pneumococcal diseases (IPD) incidence, serotype distribution and antibiotic resistance in Italian children under 5years old.

METHODS

All IPD cases in children from 5 Italian regions (Emilia-Romagna, Lombardia, A. P. Bolzano, A. P. Trento, and Piemonte) reported through the nationwide surveillance system during 2008-2014 were included in this study. Pneumococcal isolates were subjected to serotyping, antibiotic susceptibility testing, and clonal analysis according to standard methods.

RESULTS

During the study period overall IPD incidence decreased from 7.8 cases/100,000 inhabitants in 2008 to 3.0 cases/100,000 in 2014 (61% decrease, P<0.001). In particular, from 2008 to 2014, PCV7-type IPD decreased from 2.92 to 0.13 cases/100,000 inhabitants (95% decrease, P<0.001) while PCV13-non-PCV7 type IPD decreased from 3.2 to 0.89 cases/100,000 inhabitants (72% decrease, P=0.008). Conversely, non-vaccine serotype (NVS) IPD increased overtime, becoming more common than PCV13 serotype IPD in 2013-2014. Emergent NVS 24F and 12F were the most prevalent in 2014. Antibiotic resistance testing revealed an overall increasing trend in penicillin resistance, from 14% in 2008 to 23% in 2014. Erythromycin resistance showed a downward trend, from 38% in 2008 to 27% in 2014. While in 2008 PCV13 serotypes were the major responsible for antibiotic resistance, during the following years antimicrobial resistance due to NVS increased, mainly as a result of expansion of pre-existing clones.

CONCLUSIONS

Both PCVs led to a substantial decrease in vaccine-related IPD incidence in the children population. However NVS-related IPD increased, becoming the most prevalent in the last two-years period. Continuous surveillance is an essential tool to monitor evolution of pneumococcal population causing IPD in children.

Authors+Show Affiliations

Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy. Electronic address: romina.camilli@iss.it.Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.Department of Medicine, Campus Biomedico University, Rome, Italy.Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28716556

Citation

Camilli, Romina, et al. "Impact of Pneumococcal Conjugate Vaccine (PCV7 and PCV13) On Pneumococcal Invasive Diseases in Italian Children and Insight Into Evolution of Pneumococcal Population Structure." Vaccine, vol. 35, no. 35 Pt B, 2017, pp. 4587-4593.
Camilli R, D'Ambrosio F, Del Grosso M, et al. Impact of pneumococcal conjugate vaccine (PCV7 and PCV13) on pneumococcal invasive diseases in Italian children and insight into evolution of pneumococcal population structure. Vaccine. 2017;35(35 Pt B):4587-4593.
Camilli, R., D'Ambrosio, F., Del Grosso, M., Pimentel de Araujo, F., Caporali, M. G., Del Manso, M., Gherardi, G., D'Ancona, F., & Pantosti, A. (2017). Impact of pneumococcal conjugate vaccine (PCV7 and PCV13) on pneumococcal invasive diseases in Italian children and insight into evolution of pneumococcal population structure. Vaccine, 35(35 Pt B), 4587-4593. https://doi.org/10.1016/j.vaccine.2017.07.010
Camilli R, et al. Impact of Pneumococcal Conjugate Vaccine (PCV7 and PCV13) On Pneumococcal Invasive Diseases in Italian Children and Insight Into Evolution of Pneumococcal Population Structure. Vaccine. 2017 08 16;35(35 Pt B):4587-4593. PubMed PMID: 28716556.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of pneumococcal conjugate vaccine (PCV7 and PCV13) on pneumococcal invasive diseases in Italian children and insight into evolution of pneumococcal population structure. AU - Camilli,Romina, AU - D'Ambrosio,Fabio, AU - Del Grosso,Maria, AU - Pimentel de Araujo,Fernanda, AU - Caporali,Maria Grazia, AU - Del Manso,Martina, AU - Gherardi,Giovanni, AU - D'Ancona,Fortunato, AU - Pantosti,Annalisa, AU - ,, Y1 - 2017/07/14/ PY - 2017/03/09/received PY - 2017/05/29/revised PY - 2017/07/03/accepted PY - 2017/7/19/pubmed PY - 2018/4/18/medline PY - 2017/7/19/entrez KW - Antibiotic resistance KW - Children KW - IPD KW - PCV13 KW - PCV7 KW - Pneumococcal clones KW - Streptococcus pneumoniae SP - 4587 EP - 4593 JF - Vaccine JO - Vaccine VL - 35 IS - 35 Pt B N2 - BACKGROUND: The use of PCV7 for children immunization was gradually implemented in the Italian regions starting from 2006 and was replaced by PCV13 in 2010-2011. In this study we aimed to assess the PCV impact on invasive pneumococcal diseases (IPD) incidence, serotype distribution and antibiotic resistance in Italian children under 5years old. METHODS: All IPD cases in children from 5 Italian regions (Emilia-Romagna, Lombardia, A. P. Bolzano, A. P. Trento, and Piemonte) reported through the nationwide surveillance system during 2008-2014 were included in this study. Pneumococcal isolates were subjected to serotyping, antibiotic susceptibility testing, and clonal analysis according to standard methods. RESULTS: During the study period overall IPD incidence decreased from 7.8 cases/100,000 inhabitants in 2008 to 3.0 cases/100,000 in 2014 (61% decrease, P<0.001). In particular, from 2008 to 2014, PCV7-type IPD decreased from 2.92 to 0.13 cases/100,000 inhabitants (95% decrease, P<0.001) while PCV13-non-PCV7 type IPD decreased from 3.2 to 0.89 cases/100,000 inhabitants (72% decrease, P=0.008). Conversely, non-vaccine serotype (NVS) IPD increased overtime, becoming more common than PCV13 serotype IPD in 2013-2014. Emergent NVS 24F and 12F were the most prevalent in 2014. Antibiotic resistance testing revealed an overall increasing trend in penicillin resistance, from 14% in 2008 to 23% in 2014. Erythromycin resistance showed a downward trend, from 38% in 2008 to 27% in 2014. While in 2008 PCV13 serotypes were the major responsible for antibiotic resistance, during the following years antimicrobial resistance due to NVS increased, mainly as a result of expansion of pre-existing clones. CONCLUSIONS: Both PCVs led to a substantial decrease in vaccine-related IPD incidence in the children population. However NVS-related IPD increased, becoming the most prevalent in the last two-years period. Continuous surveillance is an essential tool to monitor evolution of pneumococcal population causing IPD in children. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/28716556/Impact_of_pneumococcal_conjugate_vaccine__PCV7_and_PCV13__on_pneumococcal_invasive_diseases_in_Italian_children_and_insight_into_evolution_of_pneumococcal_population_structure_ DB - PRIME DP - Unbound Medicine ER -