IMPACT OF 13-VALENT PNEUMOCOCCAL CONJUGATE VACCINE (PCV13) ON PEDIATRIC BACTEREMIC PNEUMOCOCCAL PNEUMONIA, 2010/2017 (ID 497)
- Inci Yildirim, United States of America
- Inci Yildirim, United States of America
- Hillary Johnson,
- Stephen I. Pelton, United States of America
Abstract
Background
Streptococcus pneumoniae (SPN) is a major cause of hospitalized community-acquired-pneumonia. We assessed the impact of PCV13 on the epidemiology of bacteremic pneumococcal pneumonia (BPP).
Methods
A population-based, enhanced surveillance for invasive pneumococcal disease among Massachusetts children is ongoing since 2001. SPN isolates from normally sterile body sites are sent to the Department of Public Health and serotyped using Quellung reaction. Parents/guardians/providers are interviewed to obtain demographic and clinical information.
Results
Three-hundred-ninety-one BPP cases were identified between 04/2002 and 03/2017. Incidence of BPP declined 79% in 2016/2017 compared to prePCV13 baseline (0.68/100,000 vs 3.35/100,000,rate ratio 0.19,95%CI 0.09-0.25)(Figure). One-hundred-six(26.0%) children had >1 comorbidity. Mortality rate was 2.6%. Serotypes 19A(37.5%), 7F(21.3%), 3(6.0%), 22F(3.7%) were the most frequent serotypes in the prePCV13-era; 19A(16.0%), 22F(11.7%),7F(11.7%),3(7.5%), and 33F(5.3%) were the most frequent serotypes in the postPCV13-era. Nonvaccine serotypes (NVST) were isolated in 42(19.4%) and 55(58.5%) of BPP cases in prePCV13 and postPCV13-eras, respectively. The incidence of NVST BPP increased from 0.36/100,000 to 0.56/100,000 annually in postPCV13 eras. Twenty-six(8.4%) isolates were penicillin-non-susceptible and 93(30.2%) were macrolide-non-susceptible.
Conclusions
In the post-PCV13 era, NVST are the most common cause of BPP, supporting a need for strategies to further reduce the burden of childhood pneumonia.