scholarly journals Invasive pneumococcal disease and serotype emergence in the Auckland region during the vaccine era 2009–16

2019 ◽  
Vol 11 (1) ◽  
pp. 24 ◽  
Author(s):  
Nick Eichler ◽  
Edwin Reynolds ◽  
Catherine Jackson ◽  
Simon Thornley ◽  
Julia Peters
Keyword(s):  
New Zealand ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Pneumococcal Vaccination ◽  
The Elderly ◽  
District Health ◽  
Time Series Regression ◽  
Pacific People ◽  
Age Related ◽  
Auckland Region

ABSTRACT INTRODUCTIONThere is a deficit of knowledge in New Zealand as the epidemiology of invasive pneumococcal disease varies significantly between countries. AIMTime trends and sociodemographic characteristics of cases of invasive pneumococcal disease (IPD) in the Auckland region are reviewed after the introduction of a conjugate vaccination, to provide evidence for future vaccine policy and to ensure Auckland region analysis is representative of national trends for subsequent IPD analysis. METHODSData on all cases of IPD occurring in Waitemata, Auckland and Counties Manukau District Health Boards between 2009 and 2016 were extracted from EpiSurv. Denominator data were drawn from mid-year estimates supplied by Statistics New Zealand. Descriptive epidemiology and time-series regression was performed to analyse trends. RESULTSRates of IPD have fallen in the Auckland region over the past 8 years by 32%. While absolute rates in the elderly have reduced by 12%, they have the highest disease burden at 32/100,000. The ethnic disparity continues with Pacific people (33/100,000) and Māori (14/100,000) over represented compared to European (10/100,000). In the elderly, the 19A serotype has increased from an incidence of 0 in 2008 to 8.2/100,000. DISCUSSIONLarge ethnic and age-related disparities are observed in the Auckland region, consistent with the rest of the country, since the start of the pneumococcal vaccination era. Extending immunisation to the elderly may help close these gaps. As with other countries, there is 19A serotype replacement occurring following conjugate vaccine introduction.

scholarly journals Effects of PCV7 and PCV13 on invasive pneumococcal disease and carriage in Stockholm, Sweden

2016 ◽  
Vol 47 (4) ◽  
pp. 1208-1218 ◽  
Author(s):  
Ilias Galanis ◽  
Ann Lindstrand ◽  
Jessica Darenberg ◽  
Sarah Browall ◽  
Priyanka Nannapaneni ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Pneumococcal Vaccination ◽  
Clinical Information ◽  
Immunisation Programme ◽  
The Elderly ◽  
Older Children ◽  
Serotype Distribution ◽  
Vaccine Introduction ◽  
Herd Protection

The effects of pneumococcal conjugated vaccines (PCVs) need to be investigated. In Stockholm County, Sweden, PCV7 was introduced in the childhood immunisation programme in 2007 and changed to PCV13 in 2010.Over 90% of all invasive isolates during 2005–2014 (n=2336) and carriage isolates, 260 before and 647 after vaccine introduction, were characterised by serotyping, molecular typing and antibiotic susceptibility, and serotype diversity was calculated. Clinical information was collected for children and adults with invasive pneumococcal disease (IPD).The IPD incidence decreased post-PCV7, but not post-PCV13, in vaccinated children. Beneficial herd effects were seen in older children and adults, but not in the elderly. The herd protection was more pronounced post-PCV7 than post-PCV13. PCV7 serotypes decreased. IPD caused by PCV13 serotypes 3 and 19A increased post-PCV7. Post-PCV13, serotypes 6A and 19A, but not serotype 3, decreased. The serotype distribution changed in carriage and IPD to nonvaccine types, also in nonvaccinated populations. Expansion of non-PCV13 serotypes was largest following PCV13 introduction. Serotype diversity increased and nonvaccine clones emerged, such as CC433 (serotype 22F) in IPD and CC62 (serotype 11A) in carriage. In young children, meningitis, septicaemia and severe rhinosinusitis, but not bacteraemic pneumonia, decreased.Pneumococcal vaccination leads to expansion of new or minor serotypes/clones, also in nonvaccinated populations.

Neonatal invasive pneumococcal disease: New Zealand experience in the era of pneumococcal vaccination

2016 ◽  
Vol 57 (3) ◽  
pp. 280-285 ◽  
Author(s):  
Vicki Mount ◽  
Cameron Burton ◽  
Catherine Jackson ◽  
Helen Heffernan ◽  
Emma Best
Keyword(s):  
New Zealand ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Pneumococcal Vaccination

scholarly journals Coeliac disease and invasive pneumococcal disease: a population-based cohort study

2017 ◽  
Vol 145 (6) ◽  
pp. 1203-1209 ◽  
Author(s):  
A. RÖCKERT TJERNBERG ◽  
J. BONNEDAHL ◽  
M. INGHAMMAR ◽  
A. EGESTEN ◽  
G. KAHLMETER ◽  
...  
Keyword(s):  
Cohort Study ◽  
Coeliac Disease ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Cox Regression ◽  
Statistical Significance ◽  
Pneumococcal Vaccination ◽  
Population Based ◽  
Increased Risk ◽  
Severe Infections

SUMMARYSevere infections are recognized complications of coeliac disease (CD). In the present study we aimed to examine whether individuals with CD are at increased risk of invasive pneumococcal disease (IPD). To do so, we performed a population-based cohort study including 29 012 individuals with biopsy-proven CD identified through biopsy reports from all pathology departments in Sweden. Each individual with CD was matched with up to five controls (n = 144 257). IPD events were identified through regional and national microbiological databases, including the National Surveillance System for Infectious Diseases. We used Cox regression analyses to estimate hazard ratios (HRs) for diagnosed IPD. A total of 207 individuals had a record of IPD whereas 45/29 012 had CD (0·15%) and 162/144 257 were controls (0·11%). This corresponded to a 46% increased risk for IPD [HR 1·46, 95% confidence interval (CI) 1·05–2·03]. The risk estimate was similar after adjustment for socioeconomic status, educational level and comorbidities, but then failed to attain statistical significance (adjusted HR 1·40, 95% CI 0·99–1·97). Nonetheless, our study shows a trend towards an increased risk for IPD in CD patients. The findings support results seen in earlier research and taking that into consideration individuals with CD may be considered for pneumococcal vaccination.

scholarly journals 2701. The Impact of Infant 13-valent Conjugate Pneumococcal Vaccination Program on Invasive Pneumococcal Disease in Children in British Columbia, Canada

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S950-S950
Author(s):  
Nirma K Vadlamudi ◽  
David Patrick ◽  
Linda Hoang ◽  
Fawziah Marra
Keyword(s):  
British Columbia ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Pneumococcal Vaccination ◽  
Annual Incidence ◽  
Immunization Program ◽  
Incremental Change ◽  
Laboratory Surveillance ◽  
Rate Ratios ◽  
The Impact

Abstract Background A significant reduction in invasive pneumococcal disease (IPD) has been reported following implementation of the 7-valent pneumococcal conjugate vaccine (PCV7) infant immunization program, but not much has been reported after introduction of the 13-valent vaccine (PCV13). This study represents the effect of PCV13 on IPD in British Columbia, Canada over a 14 year period (2002–2015). Methods Using provincial IPD laboratory surveillance data, we calculated the annual incidence following implementation of PCV7 (September 2004), and PCV13 (September 2010) in children less than 17 years of age. We also compared incidence rate ratios (IRR) against pre-PCV13 (2004–2010) and pre-PCV7 (2002–2003) baselines for overall and age-specific IPD rates using Poisson regression. Results A total of 697 cases were reported over the 14 year period. The overall annual incidence decreased from 10.9 cases per 100,000 population in 2002 to 4.64 cases per 100,000 population in 2015. While overall decline of IPD was 59% (IRR 0.41; 95% CI: 0.35–0.51) compared with baseline, this reduction was greatest after introduction of PCV7 (IRR 0.44; 95% CI: 0.37–0.53); the incremental change after introduction of PCV13 was non-significant (IRR 0.94; 95% CI: 0.78–1.13). The greatest reduction in IPD was in children <2 years of age (PCV13 vs baseline: IRR 0.19; 95% CI: 0.14–0.25), followed by children 3–5 years of age (PCV13 vs baseline: IRR 0.34; 95% CI: 0.21–0.56); no significant change was observed in 6–17 year olds. Conclusion While IPD rates have been significantly reduced since the introduction of the PCV vaccines, the impact of the additional 6 serotypes in the PCV13 vaccine is non-significant. Disclosures All authors: No reported disclosures.

scholarly journals 1003. Clinical Implications of Emerging Nonvaccine-Serotype Invasive Pneumococcal Disease Among Adults in the Republic of Korea in the Era of Protein-Conjugated Pneumococcal Vaccine

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S298-S299
Author(s):  
Jong Hun Kim ◽  
Seung Hee Baik ◽  
Joon Young Song ◽  
In-Gyu Bae ◽  
Hyo Youl Kim ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Multiple Logistic Regression Analysis ◽  
Pneumococcal Vaccination ◽  
Case Fatality ◽  
Republic Of Korea ◽  
Surveillance Program ◽  
Clinical Implications ◽  
National Immunization ◽  
The Republic

Abstract Background In the Republic of Korea (ROK), protein conjugated vaccines (PCV13 and PCV10) in replacement of PCV7 have been used in children since 2010, and then included in the childhood national immunization program (NIP) in 2014. This study investigated indirect effect of PVCs on serotypes in PCV-naïve adult invasive pneumococcal disease (IPD) and its clinical implications. Methods A prospective observational cohort study was conducted, through the serotype surveillance program following the NIP implementation of 23-valent pneumococcal polysaccharide vaccine (PPV23) for elderly population (≥65 years) from 2013 to 2015. Clinical data and pneumococcal isolates from adult IPD patients (≥18 years) were collected from 20 hospitals. Clinical characteristics were compared between vaccine-serotype (VT) and nonvaccine-serotype (NVT) groups. Results Of a total of 319 IPD patients enrolled, 189 cases (59.2%) were available for serotypes. Among them, the proportion of PCV-naïve cases was 99.5% (188/189) and 189 patients consisted of NVT (n = 64, 33.9%) and VT group (n = 125, 66.1%). Compared with the previous study in the ROK (2004–2010), the proportion of PCV13 serotypes was decreased (61.4% vs. 37.0%, P &lt; 0.001) and PPV23 serotypes were stationary (71.5% vs. 65.6%), but NVT serotypes were increased (23.4% vs. 33.9%, P = 0.033) in our study. The most common serotype was 3 (20.8%) and 34 (23.4%) in VT and NVT group, respectively. VT group had more bacteremic pneumonia (72.0% vs. 48.4%, P = 0.002). There was no difference of the case fatality rate between NVT and VT groups (29.7% vs. 35.2%, P = 0.447). Multiple logistic regression analysis showed that chronic kidney disease (odds ratio [OR] 10.26, 95% confidence interval [CI] 1.94–54.44, P = 0.006), younger age of 18–49 years (OR 4.04, 95% CI 1.29–12.71, P = 0.017), deep-seated infection (OR 3.73, 95% CI 1.34–10.39, P = 0.012), meropenem resistance (OR 3.21, 95% CI 1.49–6.91, P = 0.003) were significantly associated with NVT-IPD cases. Conclusion Our study indicates that emerging and expanding NVT-IPD among adults, probably due to indirect herd effect of widespread use of pediatric PCV. Further changes of IPD serotypes might occur and IPD serotypes should be monitored for developing better pneumococcal vaccination policy. Disclosures All authors: No reported disclosures.

Incidence of Invasive Pneumococcal Disease Higher Among People Notified With Markers of Hepatitis C Virus Infection: Population-based Surveillance in Victoria, Australia, 2001–2017

2020 ◽  
Author(s):  
Katherine B Gibney ◽  
Jennifer MacLachlan ◽  
Rachel Coutts ◽  
Nasra Higgins ◽  
Janet Strachan
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
General Population ◽  
Virus Infection ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Pneumococcal Vaccination ◽  
Hepatitis C Virus Infection ◽  
Hepatitis C Infection ◽  
Vaccine Serotypes

Abstract Background Worse outcomes from invasive pneumococcal disease (IPD) have been reported among those coinfected with hepatitis C. We aimed to establish if IPD notification rates are higher among people notified with markers of hepatitis C virus infection than the general population. Methods IPD cases notified in Victoria, Australia, from July 2001–December 2017 were linked with hepatitis C cases (diagnosed by serology or PCR testing) notified from January 1991–December 2017. IPD incidence was calculated using population data and the estimated number of Victorians with hepatitis C. Results From July 2001–December 2017, 6407 IPD cases were notified. Hepatitis C infection was notified in 342 (5.3%) of IPD cases overall, and 24.4% among IPD cases aged 45–49 years. Among IPD cases also notified with hepatitis C, 55.3% were infected with 13-valent pneumococcal conjugate vaccine serotypes and 82.8% with 23-valent pneumococcal polysaccharide vaccine serotypes. Compared with IPD cases without hepatitis C, IPD cases also notified with hepatitis C were younger (mean age, 45.7 vs 49.4 years; P = .011) and more often male (65.5% vs 55.5%, P &lt; .001). Annual IPD notification incidence was 6.8/100 000 among people without hepatitis C and 39.4/100 000 among people with hepatitis C (IRR, 5.8; 95% CI, 5.2–6.4; P &lt; .001). Conclusions IPD notification incidence was 5 times higher among people notified with markers of hepatitis C than the general population. Pneumococcal vaccination should be offered to people with markers of hepatitis C virus infection. To facilitate appropriate treatment, young and middle-aged adults with IPD should be tested for hepatitis C.

Incidence of invasive pneumococcal disease in Scotland, 1988–99

2002 ◽  
Vol 128 (2) ◽  
pp. 139-147 ◽  
Author(s):  
M. H. KYAW ◽  
S. CLARKE ◽  
I. G. JONES ◽  
H. CAMPBELL
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Age Groups ◽  
The Elderly ◽  
Invasive Disease ◽  
Increased Risk ◽  
Influenza Activity ◽  
The Mean ◽  
Pneumococcal Bacteraemia ◽  
Using Data

A review of the epidemiology of invasive pneumococcal disease in Scotland was carried out using data from laboratory-based systems during the period 1988–99. This comprised 5456 (90·8%) isolates of Streptococcus pneumoniae from blood, 467 (7·8%) from cerebrospinal fluid (CSF) and 84 (1·4%) from other sterile sites. The mean annual incidence of invasive disease was 9·8/105 population (9·0/105 for bacteraemia and 0·8/105 for meningitis). Invasive disease was highest in children <2 years of age and in the elderly [ges ]65 years (44·9/105 and 28·4/105 population in these age groups respectively). The highest incidence of pneumococcal meningitis, 11·8/105 persons occurred in children <2 years of age. Males had a higher incidence of pneumococcal bacteraemia and meningitis than females (male[ratio ]female = 1·2[ratio ]1 for bacteraemia (RR = 1·17, 95% CI 1·11, 1·24) and 1·5[ratio ]1 for meningitis (RR = 1·41, 95% CI 1·18, 1·70)). Pneumococcal disease was highest in winter periods and coincided with influenza activity. The proportion of penicillin and erythromycin non-susceptible isolates increased from 4·2% in 1992 to 12·6% in 1999 and from 5·6% in 1994 to 16·3% in 1999 respectively. Our data confirm the substantial and increasing disease burden from pneumococcal disease and rise in prevalence of antibiotic non-susceptibility among pneumococci in Scotland. Continued surveillance of groups at increased risk for pneumococcal disease and the antibiotic susceptibility and serotype distribution of isolates are important to develop appropriate policies for the prevention of pneumococcal disease in Scotland.

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