Skip to main content

Advertisement

SpringerLink
Log in

Reduction in pediatric invasive pneumococcal disease in the Basque Country and Navarre, Spain, after introduction of the heptavalent pneumococcal conjugate vaccine

  • Article
  • Published:
European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

This study evaluated the incidence of invasive pneumococcal disease, identified the causal serotypes, and tracked the evolution of the antibiotic susceptibility of Streptococcus pneumoniae isolates in the regions of the Basque Country and Navarre, Spain, before and after the introduction of the heptavalent pneumococcal conjugate vaccine. The study included all children aged between birth and 5 years diagnosed with bacteremia, meningitis, or bacteremic pneumonia caused by pneumococci. By the second year after introduction of the heptavalent pneumococcal conjugate vaccine, compared with the period 1998–2001, the incidence of invasive disease decreased by 64.3% in children less than 12 months of age, by 39.7% in children less than 24 months of age, and by 37.5% in children less than 60 months of age. The prevalence of clinical isolates of S. pneumoniae that lacked susceptibility to penicillin decreased by 58.2% among children less than 60 months of age. With an estimated coverage by four-dose heptavalent pneumococcal conjugate vaccine of 28–45% in 2003, the number of invasive pneumococcal infections in the Basque Country and in Navarre fell significantly after just 2 years of immunization, underscoring the importance of improving vaccination coverage under a universal childhood immunization program.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Black S, Shinefield H, Fireman B, Lewis E, Ray P, Hansen JR, Elvin, L, Ensor KM, Hackell J, Siber G, Malinoski F, Madore D, Chang I, Kohberger R, Watson W, Austrian R, Edwards K (2000) Efficacy, safety and immunogenicity of heptavalent pneumococcal conjugate vaccine in children. Northern California Kaiser Permanente Vaccine Study Center Group. Pediatr Infect Dis J 19:187–195

    Article  PubMed  CAS  Google Scholar 

  2. Lin PL, Michaels MG, Janosky J, Ortenzo M, Wald ER, Mason EO Jr (2003) Incidence of invasive pneumococcal disease in children 3 to 36 months of age at a tertiary care pediatric center 2 years after licensure of the pneumococcal conjugate vaccine. Pediatrics 111(4 Pt 1):896–899

    Article  PubMed  Google Scholar 

  3. Black S, Shinefield H, Baxter R, Austrian R, Bracken L, Hansen J, Lewis E, Fireman B (2004) Postlicensure surveillance for pneumococcal invasive disease after use of heptavalent pneumococcal conjugate vaccine in Northern California Kaiser Permanente. Pediatr Infect Dis J 23:485–489

    Article  PubMed  Google Scholar 

  4. Talbot TR, Poehling KA, Hartert TV, Arbogast PG, Halasa NB, Mitchel E, Schaffner W, Craig AS, Edwards KM, Griffin MR (2004) Reduction in high rates of antibiotic-nonsusceptible invasive pneumococcal disease in Tennessee after introduction of the pneumococcal conjugate vaccine. Clin Infect Dis 39:641–648

    Article  PubMed  Google Scholar 

  5. Kaplan SL, Mason EO Jr, Wald ER, Schutze GE, Bradley JS, Tan TQ, Hoffman JA, Givner LB, Yogev R, Barson WJ (2004) Decrease of invasive pneumococcal infections in children among 8 children’s hospitals in the United States after the introduction of the 7-valent pneumococcal conjugate vaccine. Pediatrics 113(3 Pt 1):443–449

    Article  PubMed  Google Scholar 

  6. Whitney CG, Farley MM, Hadler J, Harrison LH, Bennett NM, Lynfield R, Reingold A, Cieslak PR, Pilishvili T, Jackson D, Facklam RR, Jorgensen JH, Schuchat A, and the Active Bacterial Core Surveillance of the Emerging Infections Program Network (2003) Decline in invasive pneumococcal disease after the introduction of protein-polysaccharide conjugate vaccine. N Engl J Med 348:1737–1746

    Article  PubMed  Google Scholar 

  7. Pérez Mendez C, Solís Sanchez G, Miguel Martínez D, La Iglesia Martínez P, Viejo de la Guerra G, Martín Mardomingo MA (2002) Factores predictivos de enfermedad neumocócica invasora: estudio de casos y controles. An Esp Pediatr 57:310–316

    PubMed  Google Scholar 

  8. Arístegui J, Bernaola Iturbe E, Pocheville Gurutzeta I, Perez-Yarza E, Arranz I, Durán G (2002) Incidence of invasive pneumococcal disease (IPD) in children from 0 to 23 months old in the Basque Country and Navarre (Spain). 20th Annual Meeting of the European Society for Paedriatic Infectious Diseases, Vilnius, Lithuania

  9. Casado Flores J, Fenoll A, Arístegui Fernandez J, Rodrigo De Liria C, Martinon Sanchez JM, Berron S, Fernandez Perez C, and the Grupo para el Estudio de la Meningitis Neumococica (2002) Meningitis neumocócica en niños españoles: incidencia, serotipos y resistencia antibiótica. Estudio prospectivo multicéntrico. An Esp Pediatr 57:295–300

    PubMed  CAS  Google Scholar 

  10. Casado-Flores J, Arístegui J, Rodrigo de Liria C, Martinon J, Fernández C (2002) Prevalencia de meningitis neumocócica en niños españoles. An Esp Pediatr 56:5–9

    PubMed  CAS  Google Scholar 

  11. Hsu K, Pelton S, Karumuri S, Heisey-Grove D, Klein J, and the Massachusetts Department of Public Health Epidemiologists (2005) Population-based surveillance for childhood invasive pneumococcal disease in the era of conjugate vaccine. Pediatr Infect Dis J 24:17–23

    Article  PubMed  Google Scholar 

  12. Eskola J, Takala AK, Kela E, Pekkanen E, Kalliokoski R, Leinonen M (1992) Epidemiology of invasive pneumococcal infections in children in Finland. JAMA 268:3323–3327

    Article  PubMed  CAS  Google Scholar 

  13. Bjornson G, Scheifele D, Binder F, Talling D (2000) Population-based incidence rate of invasive pneumococcal infection in children: Vancouver, 1994–1998. Can Commun Dis Rep 26:149–151

    PubMed  CAS  Google Scholar 

  14. Anonymous (1997) Prevention of pneumococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 46(RR-8):1–24

    Google Scholar 

  15. Blanco Quiros A, Gimenez Sanchez F, Asensi Botet F, Bernaola Iturbe E, Martin Fde J, Garcia Perez J, Garces Sanchez M, Gomez Campdera JA, Picazo JJ, Pineda Solas V, and the Comite Asesor de Vacunas de la Asociacion Espanola de Pediatria (2002) Incidencia de la infeccion neumococica invasora en ninos menores de dos anos. Vacuna neumococica conjugada heptavalente. Situacion en Espana. An Esp Pediatr 57:287–289

    PubMed  CAS  Google Scholar 

  16. Bernaola Iturbe E, de Aristegui Fernandez J, Herranz Aguirre M, Garcia Calvo C, Fernandez Perez C, and the Grupo de Estudio de Enfermedad Invasora Neumococica en el Pais, Vasco-Navarra (2002) Estudio de la incidencia de enfermedad neumocócica invasora entre 0–5 años en el País Vasco y Navarra. An Esp Pediatr 57:301–309

    PubMed  CAS  Google Scholar 

  17. National Committee for Clinical Laboratory Standards (2000) Methods for dilution antimicrobial susceptibility testing for bacteria that grow aerobically. Approved standard M7-A5. NCCLS, Wayne, PA

    Google Scholar 

  18. Casal J (1982) Antimicrobial susceptibility of Streptococcus pneumoniae: serotype distribution of penicillin-resistant strains in Spain. Antimicrob Agents Chemother 22:222–225

    PubMed  CAS  Google Scholar 

  19. Fenoll A, Casal J (2000) Estudio de los serotipos de Streptococcus pneumoniae en España. In: Campins Martí M, Moraga Llop F (eds) Vacunas 2000. Prous Science, Barcelona, pp 55–67

    Google Scholar 

  20. Thornsberry C, Ogilvie P, Kahn J, Mauriz Y (1997) Surveillance of antimicrobial resistance in Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis in the United States in 1996–1997 respiratory season. The Laboratory Investigator Group. Diagn Microbiol Infect Dis 29:249–257

    Article  PubMed  CAS  Google Scholar 

  21. Tomasz A (1997) Antibiotic resistance in Streptococcus pneumoniae. Clin Infect Dis 24(Suppl 1):S85–S88

    PubMed  CAS  Google Scholar 

  22. Oteo J, Lazaro E, de Abajo FJ, Baquero F, Campos J, and the Spanish members of the European Antimicrobial Resistance Surveillance System (2004) Trends in antimicrobial resistance in 1,968 invasive Streptococcus pneumoniae strains isolated in Spanish Hospitals (2001 to 2003): decreasing penicillin resistance in children’s isolates. J Clin Microbiol 42:5571–5577

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgement

This study was conducted with assistance in sample collection from the microbiological departments of Basurto Hospital, Virgen del Camino Hospital, Cruces Hospital, Complejo Hospitalario Donostia, Zumárraga Hospital, García Orcoyen Hospital, Txgorritxu Hospital, Santiago Apostol Hospital, and Alto Deba Hospital. We thank Cristina Fernández for technical support.

This study was funded in part by an unrestricted educational grant from Wyeth Lederle Vaccines.

Author information

Authors and Affiliations

  1. Pediatric Department, Basurto Hospital, Avenida Montevideo 16-18, 48013, Bilbao, Spain

    J. Aristegui & E. Garrote

  2. Pediatric Department, Virgen del Camino Hospital, Irunlarrea 4, 48013, Pamplona, Navarra, Spain

    E. Bernaola & M. Herranz Aguirre

  3. Pediatric Department, Cruces Hospital, Plaza Cruces s/n, 48903, Barakalodo, Vizcaya, Spain

    I. Pocheville

  4. Pediatric Department, Complejo Hospitalario Donostia, Paseo Dr. Beguiristain 109, 20014, San Sebastian, Guipuzcoa, Spain

    C. García

  5. Pediatric Department, Zumárraga Hospital, Barrio Argixao s/n, 20700, Zumárraga, Guipuzcoa, Spain

    L. Arranz

  6. Pediatric Department, García Orcoyen Hospital, Santa Soria 22, 31200, Estella Navarra, Spain

    G. Durán

  7. Pediatric Department, Txagorritxu Hospital, José Atxotegui s/n, 01009, Vitoria, Spain

    L. Pérez

  8. Pediatric Department, Santiago Apostol Hospital, Olaguibel 29, 01004, Vitoria, Spain

    M. Bastida

  9. Pediatric Department, Alto Deba Hospital, Zaldispe s/n, 20500, Mondragón, Guipuzcoa, Spain

    C. Canduela

  10. Wyeth Vaccines Research, Coeur Défense-Tour A-La Défense 4, 92931, Paris, France

    M. A. Fletcher

  11. Wyeth Farma, Crta, N-I Km 23, Desvío Algete Km 1, 28700, San Sebastián de los Reyes, Madrid, Spain

    C. Pérez

Authors
  1. J. Aristegui
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E. Bernaola
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. I. Pocheville
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. García
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. L. Arranz
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. G. Durán
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. L. Pérez
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. M. Bastida
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. C. Canduela
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. M. Herranz Aguirre
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. E. Garrote
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. M. A. Fletcher
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. C. Pérez
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Aristegui.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Aristegui, J., Bernaola, E., Pocheville, I. et al. 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, 303–310 (2007). https://doi.org/10.1007/s10096-007-0294-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-007-0294-4

Keywords

Search

Navigation