Impact of the Pneumococcal Conjugate Vaccine in the Management of Highly Febrile Children Aged 6 to 24 Months in an Emergency Department

Mintegi, Santiago; Benito, Javier; González, María; Astobiza, Eider; Sanchez, Jesus; Santiago, Mikel

doi:10.1097/01.pec.0000230550.79046.68

Cited by 17 publications

(10 citation statements)

References 19 publications

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“…In well‐appearing children 3–36 months of age with FWS, overall OB rates <0.5% were found in studies with general population PCV‐7 coverage of approximately 80% (10,12), while rates between 0.7% and 0.9% were found in the studies carried out in the Basque Country in Spain (13–15), where PCV‐7 coverage in the general population was lower (50–70%) and patients included in the study were mostly unvaccinated (study subjects who received at least 1 PCV‐7 dose represented 27% and 11%, respectively, in two of these studies) (14,15). In the Spanish PED, PCV‐7 introduction was associated with an important reduction in blood tests performance for vaccinated children (19). The study including only infants younger than 3 months of age showed an overall bacteremia rate of 2.2% with no SP cases; bacteremia was found more frequently in patients considered ‘not well appearing’ and in those with leukocyturia and/or nitrituria (16).…”

Section: Resultsmentioning

confidence: 99%

Bacteremia in feverish children presenting to the emergency department: a retrospective study and literature review

et al. 2011

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Section: Resultsmentioning

confidence: 99%

Bacteremia in feverish children presenting to the emergency department: a retrospective study and literature review

et al. 2011

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“…The PCV7 has not been included in the official vaccination schedule of the public health system of the Basque Country, and was only dispensed in private practice. Its use had progressively increased from 2002, with a vaccine coverage rate in children under 2 years of age estimated to be close to 50% before 2006 [10]) and 60% in 2009, based on the number of doses sold in Gipuzkoa.…”

Section: Methodsmentioning

confidence: 99%

Dynamics of Streptococcus pneumoniae Serotypes Causing Acute Otitis Media Isolated from Children with Spontaneous Middle-Ear Drainage over a 12-Year Period (1999–2010) in a Region of Northern Spain

et al. 2013

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The aim of this study was to determine the serotype and clonal distribution of pneumococci causing acute otitis media (AOM) and their relationship with recurrences and mixed infections with other microorganisms under the influence of the 7-valent pneumococcal conjugate vaccine (PCV7). To do this, all pneumococcal isolates collected from the spontaneous middle-ear drainage of children <5 years old diagnosed of AOM by their pediatrician or their general practitioner from 1999 to 2010 were phenotypically characterized and the most frequent serotypes were genotyped. In the 12-year study, 818 episodes of pneumococcal AOM were detected, mostly (70.5%) in children younger than 2 years old. In 262 episodes (32%), the pneumococci were isolated with another bacterium, mainly (n = 214) Haemophilus influenzae. Mixed infections were similar in children under or over 2 years old. The most frequent serotypes were 19A (n = 227, 27.8%), 3 (n = 92, 11.2%) and 19F (n = 74, 9%). Serotypes included in the PCV7 sharply decreased from 62.4% in the pre-vaccination (1999–2001) to 2.2% in the late post-vaccination period (2008–2010). Serotype diversity steadily increased after the introduction of the PCV7 but decreased from 2008–2010 due to the predominant role of serotype 19A isolates, mostly ST276 and ST320. The prevalence of serotype 3 doubled from 6.1% (20/326) in 1999–2004 to 14.6% (72/492) in 2005–2010. Relapses mainly occurred in male infants infected with isolates with diminished antimicrobial susceptibility. Reinfections caused by isolates with the same serotype but different genotype were frequent, highlighting the need for genetic studies to differentiate among similar strains. In conclusion, the main change in pneumococcal AOM observed after the introduction of the PCV7 was the sharp decrease in vaccine serotypes. Also notable was the high burden of serotype 19A in total pneumococcal AOM before and especially after the introduction of the PCV7, as well as in relapses and reinfections.

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“…Population data were based on the official censuses for 1991, 1996, 2001 and 2006 (Eustat, http://www.eustat.es). The PCV7 was introduced in Spain in June 2001 and approximately 50% of children aged <2 years have been vaccinated in the study region [6].…”

Section: Temporal Distribution Of Streptococcus Pneumoniae Serotype mentioning

confidence: 99%

Clonal structure and 21-year evolution of Streptococcus pneumoniae serotype 1 isolates in northern Spain

Marimón

Ercibengoa

Alonso

et al. 2009

Clinical Microbiology and Infection

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This study of 135 serotype 1 pneumococcal isolates (88 invasive and 47 non-invasive), collected between 1987 and 2007, gave eight sequence types (217, 227, 228, 304, 305, 306, 3860 and 3861) that group, using eBurst, into three different lineages and one singleton. The annual incidence of serotype 1 invasive episodes per million inhabitants increased from 1.8 in 1987-1993 to 4.0 in 1994-2000, and to 25.6 in 2001-2007. ST228 was the predominant clone until 1998. ST306 first appeared in 1998 and became the most prevalent sequence type (>80%) after the introduction, in June 2001, of the heptavalent pneumococcal conjugate vaccine.

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Impact of the Pneumococcal Conjugate Vaccine in the Management of Highly Febrile Children Aged 6 to 24 Months in an Emergency Department

Abstract: Inclusion of PCV-7 vaccinal status in the management of highly febrile children aged 6 to 24 months significantly reduces CBC and blood cultures practiced in the ED and the administration of ceftriaxone.

Cited by 17 publications

References 19 publications

Bacteremia in feverish children presenting to the emergency department: a retrospective study and literature review

Bacteremia in feverish children presenting to the emergency department: a retrospective study and literature review

Dynamics of Streptococcus pneumoniae Serotypes Causing Acute Otitis Media Isolated from Children with Spontaneous Middle-Ear Drainage over a 12-Year Period (1999–2010) in a Region of Northern Spain

Clonal structure and 21-year evolution of Streptococcus pneumoniae serotype 1 isolates in northern Spain

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