Impact of PCV10 on pediatric pneumococcal disease burden in Brazil: time for new recommendations?

Jarovsky, Daniel; Berezin, Eitan Naaman

doi:10.1016/j.jped.2022.11.003

Cited by 7 publications

(6 citation statements)

References 75 publications

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“…Due to the serotype replacement phenomenon, some of the main serotypes circulating in Brazil are currently 19A in invasive diseases with high resistance to different classes of antimicrobial agents and 6C in colonization isolates [21,36,40,44]. In this context, a replacement by PCV13, PCV15, PCV20, and even Pneumosil ® , which also protects against 10 vaccine serotypes, would be appropriate to replace PCV10 in the Brazilian National Immunization Program [6,[9][10][11]19]. However, this phenomenon may continue due to the varied range of capsular serotypes and their distribution among populations.…”

Section: Discussionmentioning

confidence: 99%

“…In 2010, the 13-valent PCV (PCV13; PCV10 serotypes + 3, 6A, and 19A) replaced PCV7 in private clinics, and it was made available via SUS in 2019 for individuals aged 5 years or older who are at the highest risk for IPD, including patients living with HIV/AIDS, patients with cancer, and those who underwent solid organ or bone marrow transplantations. In 2023, the PCV15 (PCV13 serotypes + 22F and 33F) was approved for use in Brazil [13][14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

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Antimicrobial Resistance in Streptococcus pneumoniae before and after the Introduction of Pneumococcal Conjugate Vaccines in Brazil: A Systematic Review

Knupp-Pereira,

Cabral,

Dolores

et al. 2024

Antibiotics

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Streptococcus pneumoniae causes serious illnesses, such as pneumonia, bacteremia, and meningitis, mainly in immunocompromised individuals and those of extreme ages. Currently, pneumococcal conjugate vaccines (PCVs) are the best allies against pneumococcal diseases. In Brazil, the 10-valent and 13-valent PCVs have been available since 2010, but the threat of antimicrobial resistance persists and has been changing over time. We conducted a systematic review of the literature with works published since 2000, generating a parallel between susceptibility data on isolates recovered from colonization and invasive diseases before and after the implementation of PCVs for routine childhood use in Brazil. This systematic review was based on the Cochrane Handbook for Systematic Reviews of Interventions and Preferred Reporting Items for Systematic Literature Reviews and Meta-Analyses (PRISMA) guidelines. Despite the inclusion of PCVs at a large scale in the national territory, high frequencies of non-susceptibility to important drugs used in pneumococcal diseases are still observed, especially penicillin, as well as increasing resistance to macrolides. However, there are still drugs for which pneumococci have a comprehensive sensitivity profile.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Antimicrobial Resistance in Streptococcus pneumoniae before and after the Introduction of Pneumococcal Conjugate Vaccines in Brazil: A Systematic Review

Knupp-Pereira,

Cabral,

Dolores

et al. 2024

Antibiotics

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“…Brazilian studies conducted on PCV10’s impact showed a great effect of this vaccine in the reduction in IPD and nasopharyngeal colonization by PCV10 types, in addition to the increase in non-PCV10 types [ 14 , 25 , 26 , 27 , 28 ]. A high diversity of non-PCV10 types was found in IPD, mainly by serotypes 3, 19A, 6C, 8, and 23A, the most prevalent in Brazil in the 2017–2019 period [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…In Brazil, studies evaluating the long-term impact of the use of PCV10 on antimicrobial resistance have demonstrated that the benefit of controlling antimicrobial resistance has impacted by pneumococcal infections caused by non-PCV10 serotypes associated with antimicrobial resistance, mainly serotypes 19A and 6C [ 25 , 30 , 31 , 39 , 40 , 42 ].…”

Section: Discussionmentioning

confidence: 99%

Serotype Distribution and Antimicrobial Susceptibility Pattern of Streptococcus pneumoniae in COVID-19 Pandemic Era in Brazil

Almeida,

Lemos,

Bierrenbach

et al. 2024

Microorganisms

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Despite the introduction of the pneumococcal vaccine, Streptococcus pneumoniae remains a cause of invasive diseases in Brazil. This study provides the distribution of serotypes and antimicrobial susceptibility patterns for pneumococcal isolates before and during the years of the COVID-19 pandemic in two age groups, <5 and ≥50 years. This is a national laboratory-based surveillance study that uses data from the Brazilian national laboratory for invasive S. pneumoniae from the pre-COVID-19 (January 2016 to January 2020) and COVID-19 (February 2020 to May 2022) periods. Antimicrobial resistance was evaluated by disk diffusion and minimum inhibitory concentration. The year 2020 was marked by a 44.6% reduction in isolates received and was followed by an upward trend from 2021 onwards, which became evident in 2022. No differences were observed in serotypes distribution between the studied periods. The COVID-19 period was marked by the high prevalence of serotypes 19A, 3, and 6C in both age groups. Serotypes 19A and 6C were related to non-antimicrobial susceptibility. We observed a reduction in S. pneumoniae, without changes in serotypes distribution and epidemiological capsular switch during the COVID-19 period. We observed elevated resistance rates, mainly to penicillin and ceftriaxone for non-meningitis cases in children under 5 years of age.

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“…Some options may be PPSV-23 alone or a sequential regimen with PCV13/PCV15. Moreover, a broader spectrum of PCVs containing the most frequent serotypes causing pneumococcal disease in infants has the potential to increase the coverage against these serotypes for this population and provide additional protection through herd immunity for older ages [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

Trends in Pneumococcal and Bacterial Meningitis in Brazil from 2007 to 2019

Parellada

Abreu²,

Birck³

et al. 2023

Vaccines

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The pneumococcal conjugate vaccination (PCV) was introduced into the Brazilian Childhood National Immunization Program in 2010; however, universal pneumococcal vaccination for older adults has not been implemented yet. Our aim is to evaluate the trends in pneumococcal meningitis incidence and case fatality rate (CFR) across all age groups from 2007 to 2019 using data from the National Surveillance System. The pre-PCV (2007–2009) and post-PCV (2011–2019) periods were compared; changes in incidence and CFR were assessed by joinpoint regression. Additional analyses of bacterial meningitis were performed to compare the patterns and trends. Over the 13-year period, 81,203 and 13,837 cases were classified as bacterial and pneumococcal meningitis, respectively. S. pneumoniae was the main etiological agent of bacterial meningitis in adults aged ≥50 years and the most lethal in all age groups. In the post-PCV period, a 56.5% reduction in the average incidence was seen in pneumococcal meningitis in the pediatric population. In contrast, there was an increasing trend among adults. The CFR for pneumococcal and bacterial meningitis remained stable in most age groups during the study period. These findings highlight the value of expanding pneumococcal vaccination policies, including vaccines that provide better indirect protection from children to adults and broadening vaccination to older adults.

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Impact of PCV10 on pediatric pneumococcal disease burden in Brazil: time for new recommendations?

Cited by 7 publications

References 75 publications

Antimicrobial Resistance in Streptococcus pneumoniae before and after the Introduction of Pneumococcal Conjugate Vaccines in Brazil: A Systematic Review

Antimicrobial Resistance in Streptococcus pneumoniae before and after the Introduction of Pneumococcal Conjugate Vaccines in Brazil: A Systematic Review

Serotype Distribution and Antimicrobial Susceptibility Pattern of Streptococcus pneumoniae in COVID-19 Pandemic Era in Brazil

Trends in Pneumococcal and Bacterial Meningitis in Brazil from 2007 to 2019

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