Indirect effects of paediatric conjugate vaccines on invasive pneumococcal disease in older adults
Por:
Ciruela, P, Broner, S, Izquierdo, C, Pallares, R, Munoz-Almagro, C, Hernandez, S, Grau, I, Dominguez, A, Jane, M, Esteva, C, de Sevilla, MF, Henares, D, Ardanuy, C, Marco, F, Margall, N, Gonzalez-Cuevas, A, Diaz, A
Publicada:
1 sep 2019
Resumen:
Objectives: The aim of this study was to assess the indirect effect of paediatric 13-valent pneumococcal conjugate vaccine (PCV13) vaccination on people >= 65 years of age with invasive pneumococcal disease (IPD) in Catalonia and to determine factors predictive of mortality.
Methods: During 2014-2016, 1285 IPD cases were reported to the Public Health Agency of Catalonia. The indirect effect of paediatric PCV13 vaccination was calculated by comparing the incidence rate (IR) in 2016 (PCV13 year) with that in 2009 (pre-PCV13). Predictors of mortality were determined using multivariate logistic regression.
Results: Comparing 2016 and 2009, IPD decreased by 19% (IR 40.1 and 32.5 per 100 000 person-years, respectively). PCV13 serotypes decreased by 57% (IR 23.7 and 10.1), while non-PCV13 serotypes increased by 36% (IR 16.4 and 22.4). During 2014-2016, the mortality rate was 17.5%, and mortality was associated with age >= 85 years (adjusted odds ratio (aOR) 2.91, 95% confidence interval (CI) 1.89, 4.48), meningitis (aOR 2.29, 95% CI 1.25, 4.19), non-focal bacteraemia (aOR 3.73, 95% CI 2.00, 6.94), and >= 1 high-risk condition (aOR 1.89, 95% CI 1.08, 3.32). PPV23non13 serotypes were associated with lower mortality than PCV13 serotypes (aOR 0.54, 95% CI 0.34, 0.86).
Conclusions: The incidence of IPD in people >= 65 years of age decreased after the introduction of paediatric PCV13, and this was due to a reduction in PCV13 serotypes, although an increase in non-PCV13 serotypes was observed. Mortality was associated with age, meningitis, non-focal bacteraemia, >= 1 high-risk condition, and PCV13 serotypes. (C) 2019 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.
Filiaciones:
Ciruela, P:
Generalitat Catalunya, Agencia Salut Publ Catalunya, C Roc Boronat 81-95, Barcelona 08005, Spain
Inst Salud Carlos III, CIBER Epidemiol & Salud Publ CIBERESP, C Monforte de Lemos 3-5, Madrid 28029, Spain
Broner, S:
Generalitat Catalunya, Agencia Salut Publ Catalunya, C Roc Boronat 81-95, Barcelona 08005, Spain
Izquierdo, C:
Generalitat Catalunya, Agencia Salut Publ Catalunya, C Roc Boronat 81-95, Barcelona 08005, Spain
Pallares, R:
Univ Barcelona, Hosp Univ Bellvitge, C Feixa Llarga S-N 08907, Barcelona 08907, Spain
Inst Salud Carlos III, CIBER Enfermedades Resp, C Monforte de Lemos 3-5, Madrid 28029, Spain
Munoz-Almagro, C:
Inst Salud Carlos III, CIBER Epidemiol & Salud Publ CIBERESP, C Monforte de Lemos 3-5, Madrid 28029, Spain
Hosp Univ St Joan de Deu, Pg St Joan de Deu 2, Barcelona 08950, Spain
Univ Int Catalunya, Dept Med, C Josep Trueta S-N, Barcelona 08195, Spain
Hernandez, S:
Generalitat Catalunya, Agencia Salut Publ Catalunya, C Roc Boronat 81-95, Barcelona 08005, Spain
Grau, I:
Univ Barcelona, Hosp Univ Bellvitge, C Feixa Llarga S-N 08907, Barcelona 08907, Spain
Inst Salud Carlos III, CIBER Enfermedades Resp, C Monforte de Lemos 3-5, Madrid 28029, Spain
Dominguez, A:
Inst Salud Carlos III, CIBER Epidemiol & Salud Publ CIBERESP, C Monforte de Lemos 3-5, Madrid 28029, Spain
Univ Barcelona, Dept Med, C Casanova 143, E-08036 Barcelona, Spain
Jane, M:
Generalitat Catalunya, Agencia Salut Publ Catalunya, C Roc Boronat 81-95, Barcelona 08005, Spain
Inst Salud Carlos III, CIBER Epidemiol & Salud Publ CIBERESP, C Monforte de Lemos 3-5, Madrid 28029, Spain
Esteva, C:
Hosp Univ St Joan de Deu, Dept Microbiol Mol, Pg St Joan de Deu 2, Barcelona 08950, Spain
de Sevilla, MF:
Hosp Univ St Joan de Deu, Serv Pediat, Pg St Joan de Deu 2, Barcelona 08950, Spain
Henares, D:
Hosp Univ St Joan de Deu, Dept Microbiol Mol, Pg St Joan de Deu 2, Barcelona 08950, Spain
Ardanuy, C:
Univ Barcelona, Hosp Univ Bellvitge, C Feixa Llarga S-N, Barcelona 08907, Spain
Marco, F:
Hosp Clin Barcelona, Serv Microbiol, C Villarroel 170, Barcelona 08036, Spain
Margall, N:
Hosp Santa Creu & Sant Pau, Serv Microbiol, C de Sant Quinti 89, Barcelona 08041, Spain
Gonzalez-Cuevas, A:
Hosp Gen Parc Sanitari St Joan de Deu, Lab Microbiol, Cami Vell Colonia 25, Barcelona 08830, Spain
Diaz, A:
Fundacio Hosp Nens Barcelona, Serv Pediat & Recerca, C Consell Cent 437, Barcelona 08009, Spain
Green Published, gold
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