Erik Backhaus, Sweden
Skaraborg Hospital, Skövde, Sweden Department of Infectious DiseasesAuthor Of 1 Presentation
SEROTYPE DISTRIBUTION AND CLINICAL PICTURE OF INVASIVE PNEUMOCOCCAL DISEASE IN THE POST- CONJUGATE VACCINE ERA OF SOUTHWESTERN SWEDEN (ID 573)
Abstract
Background
The pneumococcal conjugate vaccines (PCVs) were introduced in southwestern Sweden in 2009. Here we assessed associations between pneumococcal serotype distribution, age, predisposing factors, clinical manifestations and case-fatality-rate in patients with invasive pneumococcal disease (IPD).
Methods
Data from 1,278 patients with 1,304 episodes of IPD between January 2009 and December 2015 in southwestern Sweden, were collected from medical records. Pneumococcal isolates were serotyped by gel diffusion and/or Quellung reactions at the Public Health Agency, Sweden.
Results
Except for serotype 3, the prevalence of PCV13 serotypes decreased from 76 % in 2009 to 25 % in 2015, while non-PCV13 serotypes increased, mainly among the elderly and in patients with predisposing factors. Non-PCV13 serotypes were associated with bacteremia with unknown focus, and PCV13 serotypes with invasive pneumonia. Serotype 3 and 4 were associated with intensive care unit admission, whilst serotype 1 and 7F caused IPD among healthier and younger patients. The case-fatality rate was lower for 7F caused IPD (4%) than for all other serotypes (13%).
Conclusions
Non-PCV13 serotypes now dominate among IPD cases in southwestern Sweden, and more often caused disease in patients with predisposing factors as compared to PCV13 types. Serotype 3 is still prevalent and often cause severe IPD.