Invasive Pneumococcal Disease and Influenza Activity in a Pediatric Population: Impact of PCV13 Vaccination in Pandemic and Nonpandemic Influenza Periods
Por:
Hernández S, Munoz-Almagro C, Ciruela Navas P, Soldevila N, Izquierdo C, Codina MG, Díaz A, Moraga-Llop F, García-García JJ and Domínguez Á
Publicada:
1 ago 2019
Ahead of Print:
26 jul 2019
Categoría:
Microbiology (medical)
Resumen:
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 chi(2) 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 non-epidemic 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 non-epidemic 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.
Filiaciones:
Hernández S:
Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
Munoz-Almagro C:
CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
Malalties Prevenibles amb vacunes, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
Hospital Sant Joan de Déu Barcelona, Universitat de Barcelona, Barcelona, Spain
Departament de Medicina, Universitat Internacional de Catalunya, Barcelona, Spain
Ciruela Navas P:
CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
Soldevila N:
CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
Codina MG:
Hospital Universitari Vall d'Hebron, Barcelona, Spain
Díaz A:
Hospital de Nens, Barcelona, Spain
Moraga-Llop F:
Hospital Universitari Vall d'Hebron, Barcelona, Spain
García-García JJ:
CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
Malalties Prevenibles amb vacunes, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
Hospital Sant Joan de Déu Barcelona, Universitat de Barcelona, Barcelona, Spain
Domínguez Á:
Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
Green Published, Bronze
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