Are risk factors associated with invasive pneumococcal disease according to different serotypes?
Por:
Ciruela Navas P, Soldevila N, Selva L, Hernández S, García-García JJ, Fernando Moraga Llop, Fernández de Sevilla-Estrach M, Codina MG, Ana Maria Planes Reig, Esteva-Afonso C, Coll F, Cardeñosa N, Jordán-García I, Batalla J, Salleras L, Munoz-Almagro C and Domínguez A
Publicada:
1 mar 2013
Resumen:
The aim of this study was to investigate risk factors for the most
common serotypes of invasive pneumococcal disease (IPD). A total of 293
IPD cases were analyzed in children aged 3-59 mo in a community with
intermediate vaccination coverage with the 7-valent pneumococcal vaccine
(PCV7). IPD cases were reviewed during 2007-2009 in two pediatric
hospitals in Catalonia (Spain). A multivariate analysis using
unconditional logistic regression was performed to estimate the adjusted
odds ratio. PCV7 coverage was 45.4%. Pneumonia with empyema (64.5%) was
the most frequent clinical manifestation. The most common serotypes
were: serotype 1 (21.2%), 19A (16.0%), 3 (12.6%) and 7F/A (6.8%). 70.0%
of serotypes found were included in the 13-valent conjugate vaccine
(PCV13), 39.2% in the 10-valent conjugate vaccine and 8.1% in the PCV7.
PCV7 was protective in IPD cases due to PCV7-serotypes (aOR: 0.15, 95%
CI: 0.04-0.55). Serotype 1 was positively associated with attending day
care or school (aOR: 3.55, 95% CI: 1.21-10.38) and age 24-59 mo (aOR:
7.70, 95% CI: 2.70-21.98). Serotype 19A was positively associated with
respiratory infection in the previous month (aOR: 2.26, 95% CI:
1.03-4.94), non-penicillin susceptible IPD (aOR: 1.89, 95% CI:
1.13-3.16) and negatively associated with age 24-59 mo (aOR: 0.19, 95%
CI: 0.09-0.41). Serotype 3 was positively associated with vaccination
(aOR: 4.87, 95% CI: 2.05-11.59). No factors were associated with
serotype 7F/A. Vaccination with pneumococcal vaccines including more
serotypes may reduce the risk of disease in our setting.
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