Reduction in pediatric invasive pneumococcal disease in the Basque Country and Navarre, Spain, after introduction of the heptavalent pneumococcal conjugate vaccine

Abstract

This study evaluated the incidence of invasive pneumococcal disease, identified the causal serotypes, and tracked the evolution of the antibiotic susceptibility of Streptococcus pneumoniae isolates in the regions of the Basque Country and Navarre, Spain, before and after the introduction of the heptavalent pneumococcal conjugate vaccine. The study included all children aged between birth and 5 years diagnosed with bacteremia, meningitis, or bacteremic pneumonia caused by pneumococci. By the second year after introduction of the heptavalent pneumococcal conjugate vaccine, compared with the period 1998-2001, the incidence of invasive disease decreased by 64.3% in children less than 12 months of age, by 39.7% in children less than 24 months of age, and by 37.5% in children less than 60 months of age. The prevalence of clinical isolates of S. pneumoniae that lacked susceptibility to penicillin decreased by 58.2% among children less than 60 months of age. With an estimated coverage by four-dose heptavalent pneumococcal conjugate vaccine of 28-45% in 2003, the number of invasive pneumococcal infections in the Basque Country and in Navarre fell significantly after just 2 years of immunization, underscoring the importance of improving vaccination coverage under a universal childhood immunization program.

Serotype and Genotype Replacement among Macrolide-Resistant Invasive Pneumococci in Adults: Mechanisms of Resistance and Association with Different Transposons

“…In spite of this low uptake, a significant decrease of IPD due to serotypes included in the PCV7 was observed in children (3,24,25) and adults (2) The present study demonstrates that the incidence of IPD due to MR pneumococci among adults remained stable throughout the 1999 to 2007 period in southern Barcelona. This stabilization was the result of a combination of a significant decrease in IPD due to MR serotypes included in PCV7 and a significant increase in IPD caused by MR serotypes not included in PCV7, such as 15A, 16F, 19A, 23A, 24F, and 33F.…”

Expansion of Serotype Coverage in the Universal Pediatric Vaccination Calendar: Short-Term Effects on Age- and Serotype-Dependent Incidence of Invasive Pneumococcal Clinical Presentations in Madrid, Spain

“…The incidence rates of IPDs in children aged Ͻ2 years were reduced in the Basque Country and Navarre from 93.5 (1998 to 2001) to 56. 3 (2003), with a vaccine uptake of 28% and 45%, respectively, with significant reductions in pneumococcal meningitis and pneumococcal bacteremia, and also in children aged Ͻ5 years (19). In Barcelona, the incidence rates of IPDs in children decreased from 96.9 in 1999 to 90.6 in 2004, with onethird of children having received PCV7, and with significant reductions in meningitis and bacteremia but increases in empyema (20).…”

Polymorphisms at Position 245 of HIV Reverse Transcriptase Do Not Accurately Predict the Presence of Human Leukocyte Antigen B*5701

“…Arístegui et al [5] analyzed cases from several hospitals in the Basque County and Navarre. Theirs was a hospital-based study that was independent of the active population-based surveillance in Navarre.…”