Invasive Pneumococcal Disease and Influenza Activity in a Pediatric Population: Impact of PCV13 Vaccination in Pandemic and Nonpandemic Influenza Periods.

Abstract

The objective of this study was to analyze the incidence, clinical presentation, and severity of invasive pneumococcal disease (IPD)-causing serotypes and the impact of the 13-valent pneumococcal conjugate vaccination during epidemic and nonepidemic influenza periods in Catalonia, Spain. This was a prospective study in persons aged <18 years diagnosed with IPD between 2012 and 2015 in three Catalan pediatric hospitals. IPD was defined as clinical infection together with isolation of Streptococcus pneumoniae by culture and/or detection by reverse transcription-PCR in a normally sterile sample. Incidence rate ratios (IRRs) and the fraction of IPD prevented associated with 13-valent pneumococcal conjugate vaccine (PCV13) were calculated. The bivariate analysis used the χ2 test and the multivariate analysis nonconditional logistic regression. A total of 229 cases of IPD were recorded. The incidence was higher during influenza epidemic periods (IRR, 2.7; 95% confidence interval [CI], 2.05 to 3.55; P < 0.001), especially for pneumonia (IRR, 3.25; 95% CI, 2.36 to 4.47; P < 0.001), with no differences in the distribution of pneumococcal serotypes. Complications during admission and sequel at discharge were greater during epidemic periods (adjusted odds ratio [aOR], 2.00; 95% CI, 1.06 to 3.77; P = 0.03) than at nonepidemic periods (aOR, 3.38; 95% CI, 1.37 to 8.29; P = 0.01). The prevented fraction for the population (PFp) of IPD in children aged 7 to 59 months was 48% to 49.4%. The PFp was higher in influenza epidemic than nonepidemic periods and increased when ≥2 doses of PCV13 or ≥1 after 24 months were administered. Influenza virus circulation increases the incidence of IPD in persons aged <18 years. In influenza epidemic periods, IPD cases were more severe. Increased PCV13 coverage might increase the fraction of IPD prevented in epidemic and nonepidemic periods.

• Authors: Sergi Hernández, Carmen Muñoz-Almagro, Pilar Ciruela, Núria Soldevila, Conchita Izquierdo, Maria Gemma Codina, Alvaro Díaz, Fernando Moraga-Llop, Juan José García-García, Ángela Domínguez
• Journal: Journal of clinical microbiology (J Clin Microbiol) Vol. 57 Issue 8 (08 2019) ISSN: 1098-660X [Electronic] United States
• PMID: 31189583 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2019 American Society for Microbiology.

Chemical References

• 13-valent pneumococcal vaccine
• Pneumococcal Vaccines

Topics

• Adolescent
• Child
• Child, Preschool
• Female
• Hospitalization
• Humans
• Incidence
• Infant
• Influenza, Human (epidemiology)
• Male
• Pandemics (statistics & numerical data)
• Pneumococcal Infections (epidemiology, microbiology, prevention & control)
• Pneumococcal Vaccines (administration & dosage)
• Prospective Studies
• Serogroup
• Severity of Illness Index
• Spain (epidemiology)
• Streptococcus pneumoniae (genetics)
• Vaccination Coverage (statistics & numerical data)