Incidence of pneumococcal infections among children under 15 years in southern Catalonia throughout the heptavalent conjugate vaccine era, 2002–2009
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Updating epidemiological studies to document current incidences of pneumococcal diseases are greatly needed in the current era of new pneumococcal conjugate vaccines (PCVs). The aim of this study is to analyze the incidence and distribution of different serotypes causing pneumococcal infections among the pediatric population in southern Catalonia, Spain, throughout the 2002–2009 PCV7 eras.
A population-based surveillance study was conducted among children aged ≤14 years in the region of Tarragona (Catalonia, Spain) during the period 2002–2009. All cases of pneumococcal infections (invasive and non-invasive cases) were included in the study. Incidence rates (per 100,000 population-year) and prevalence of infections caused by serotypes included in different PCV formulations were calculated for the 2002–2005 and 2006–2009 periods.
Globally, across the total 2002–2009 period, the incidence of pneumococcal infections was 48.2 per 100,000 children-year (22.4 and 25.8 for invasive and non-invasive infections, respectively). Between 2002–2005 and 2006–2009, the incidence rates largely decreased among children aged <2 years (from 171 to 111 per 100,000 children-year; p = 0.059), but they did not substantially vary among children aged 2–14 years. The percentages of cases caused by serotypes included in PCV7 (60.0 vs. 16.7 %; p < 0.001), PCV10 (75.0 vs. 47.4 %; p = 0.028), and PCV13 (85.0 vs. 70.5 %; p = 0.190) decreased in both periods.
In this study, which was conducted in a setting with intermediate PCV7 uptakes, a considerable protective direct effect of vaccination occurred among young infants, but an indirect protective effect did not emerge in the rest of the pediatric population. Despite new PCVs with higher serotype coverage, an important proportion of pneumococcal infections is still not covered by these vaccines.
- Ortqvist, A, Hedlund, J, Kalin, M (2005) Streptococcus pneumoniae: epidemiology, risk factors, and clinical features. Semin Respir Crit Care Med 26: pp. 563-574 CrossRef
- Black, S, Shinefield, H, Fireman, B, Lewis, E, Ray, P, Hansen, JR (2000) Efficacy, safety and immunogenicity of heptavalent pneumococcal conjugate vaccine in children. Pediatr Infect Dis J 19: pp. 187-195 CrossRef
- Whitney, CG, Farley, MM, Hadler, J, Harrison, LH, Bennett, NM, Lynfield, R (2003) Decline in invasive pneumococcal disease after the introduction of protein–polysaccharide conjugate vaccine. N Engl J Med 348: pp. 1737-1746 CrossRef
- Direct and indirect effects of routine vaccination of children with 7-valent pneumococcal conjugate vaccine on incidence of invasive pneumococcal disease–united States, 1998–2003. Morb Mortal Wkly Rep 54: pp. 893-897
- Pilishvili, T, Lexau, C, Farley, MM, Hadler, J, Harrison, LH (2010) Sustained reductions in invasive pneumococcal disease in the era of conjugate vaccine. J Infect Dis 201: pp. 32-41 CrossRef
- Progress in introduction of pneumococcal conjugate vaccine worldwide, 2000–2008. Morb Mortal Wkly Rep 57: pp. 1148-1151
- Singleton, RJ, Hennessy, TW, Bulkow, LR, Hammitt, LL, Zulz, T, Hurlburt, DA (2007) Invasive pneumococcal disease caused by nonvaccine serotypes among Alaska native children with high levels of 7-valent pneumococcal conjugate vaccine coverage. JAMA 297: pp. 1784-1792 CrossRef
- Hicks, L, Harrison, L, Flannery, B, Hadler, JL, Schaffner, W, Craig, AS (2007) Incidence of pneumococcal disease due to non-pneumococcal conjugate vaccine (PCV7) serotypes in United States during the era of widespread PCV7 vaccination, 1998–2004. J Infect Dis 196: pp. 1346-1354 CrossRef
- Croxtall, JD, Keating, GM (2009) Pneumococcal polysaccharide protein D-conjugate vaccine (Synflorix; PHiD-CV). Paediatr Drugs 11: pp. 349-357 CrossRef
- Paradiso, PR (2011) Advances in pneumococcal disease prevention: 13-valent pneumococcal conjugate vaccine for infants and children. Clin Infect Dis 52: pp. 1241-1247 CrossRef
- Vila Córcoles, A, Diego Cabanes, C, Salsench Serrano, E, Saún Casas, N (2007) Cover with conjugated heptavalent pneumococcal vaccine in the child population of Tarragona-Valls, Spain. Aten Primaria 39: pp. 507 CrossRef
- Web de l’estadística oficial de Catalunya. Idescat. Available at: http://www.idescat.cat. Accessed 20 Feb 2011.
- Fenoll, A, Granizo, JJ, Aguilar, L, Giménez, MJ, Aragoneses-Fenoll, L, Hanquet, G (2009) Temporal trends of invasive Streptococcus pneumonia serotypes and antimicrobial resistance patterns in Spain from 1979 to 2007. J Clin Microbiol 47: pp. 1012-1020 CrossRef
- Hanquet, G, Kissling, E, Fenoll, A, George, R, Lepoutre, A, Lernout, T (2010) Pneumococcal serotypes in children in 4 European countries. Emerg Infect Dis 16: pp. 1428-1439 CrossRef
- Guevara, M, Barricarte, A, Gil-Setas, A, García-Irure, JJ, Beristain, X, Torroba, L (2009) Changing epidemiology of invasive pneumococcal disease following increased coverage with the heptavalent conjugate vaccine in Navarre, Spain. Clin Microbiol Infect. 15: pp. 1013-1019 CrossRef
- Barricarte, A, Gil-Setas, A, Torroba, L, Castilla, J, Petit, A, Polo, I (2007) Invasive pneumococcal disease in children younger than 5 years in Navarra, Spain (2000–2005). Impact of the conjugate vaccine. Med Clin (Barc). 129: pp. 41-45 CrossRef
- Salleras, L, Domínguez, A, Ciruela, P, Izquierdo, C (2009) Grupo de Trabajo del Sistema de Notificación Microbiológica de Cataluña. Impact of 7-valent pneumococcal conjugate vaccination in a population with low to intermediate vaccination levels. Enferm Infecc Microbiol Clin 27: pp. 275-277 CrossRef
- Aristegui, J, Bernaola, E, Pocheville, I, García, C, Arranz, L, Durán, G (2007) Reduction in pediatric invasive pneumococcal disease in the Basque Country and Navarre, Spain, after introduction of the heptavalent pneumococcal conjugate vaccine. Eur J Clin Microbiol Infect Dis 26: pp. 303-310 CrossRef
- Muñoz-Almagro, C, Jordan, I, Gene, A, Latorre, C, Garcia–Garcia, JJ, Pallares, R (2008) Emergence of invasive pneumococcal disease caused by nonvaccine serotypes in the era of 7-valent conjugate vaccine. Clin Infect Dis 46: pp. 174-182 CrossRef
- Picazo, J, Ruiz-Contreras, J, Casado-Flores, J, Giangaspro, E, Castillo, F, Hernández-Sampelayo, T (2011) Relationship between serotypes, age, and clinical presentation of invasive pneumococcal disease in Madrid, Spain, after introduction of the 7-valent pneumococcal conjugate vaccine into the vaccination calendar. Clin Vaccine Immunol 18: pp. 89-94 CrossRef
- Sevilla, MF, García-García, JJ, Esteva, C, Moraga, F, Hernández, S, Selva, L (2012) Clinical presentation of invasive pneumococcal disease in Spain in the era of heptavalent conjugate vaccine. Pediatr Infect Dis J. 31: pp. 124-128 CrossRef
- Johnson HL, Deloria-Knoll M, Levine OS, Stoszek SK, Freimanis Hance L, Reithinger R et al. Systematic evaluation of serotypes causing invasive pneumococcal disease among children under five: the pneumococcal global serotype project. PLoS Med. 2010; 7. pii:e1000348.
- Salleras, L, Domínguez, A, Ciruela, P, Izquierdo, C, Navas, E, Torner, N (2009) Changes in serotypes causing invasive pneumococcal disease (2005–2007 vs. 1997–1999) in children under 2 years of age in a population with intermediate coverage of the 7-valent pneumococcal conjugated vaccine. Clin Microbiol Infect 5: pp. 97-1001
- Imöhl, M, Reinert, RR, Linden, M (2010) Temporal variations among invasive pneumococcal disease serotypes in children and adults in Germany (1992–2008). Int J Microbiol. 2010: pp. 874189
- Park, IH, Pritchard, DG, Cartee, R, Brandao, A, Brandileone, MC, Nahm, MH (2007) Discovery of a new capsular serotype (6C) within serogroup 6 of Streptococcus pneumoniae. J Clin Microbiol 45: pp. 1225-1233 CrossRef
- Incidence of pneumococcal infections among children under 15 years in southern Catalonia throughout the heptavalent conjugate vaccine era, 2002–2009
Volume 41, Issue 2 , pp 439-446
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Streptococcus pneumoniae
- Pneumococcal infection
- Pneumococcal conjugate vaccine
- Serotype coverage
- Industry Sectors
- Author Affiliations
- 1. EPIVAC Study Group, Primary Care Service of Tarragona, Institut Catala de la Salut, Prat de la Riba 39, 43001, Tarragona, Spain
- 2. Department of Laboratory and Microbiology, Joan XXIII Hospital, Dr. Mallafré I Guasch, 4, 43007, Tarragona, Spain
- 3. Department of Otorhinolaryngology, Joan XXIII Hospital, Dr. Mallafré I Guasch, 4, 43007, Tarragona, Spain
- 4. Department of Laboratory and Microbiology, Santa Tecla Hospital, Rambla Vella, 14, 43003, Tarragona, Spain
- 5. IDIAP Jordi Gol Foundation, Gran Via Corts Catalanes, 587, 08007, Barcelona, Spain