Birger -. Trollfors, Sweden
Sahlgrenska University Hospital PediatricsPresenter of 1 Presentation
INVASIVE PNEUMOCOCCAL DISEASE IN SWEDEN DURING 45 YEARS BEFORE GENERAL INFANT VACCINATION (ID 583)
Abstract
Background
1. Pneumococci cause many deaths world-wide. In the area around Gothenburg in Sweden invasive pneumococcal disease (IPD) has been studied between 1964 and 2009, before any pneumococcal vaccines were used.
Methods
Information about isolations of pneumococci in blood, CSF, synovial, pleural, pericardial and peritoneal fluid was obtained from all bacteriological laboratories in the area.Data were obtained from individual presentation records
Results
1. Totally 4347 patients with IPD were identified. 69 had IPD more than once. The incidence rose continuously from 4.2 to 13.1 cases /100,000 inhabitants/year. The incidence was highest in individuals ≥65 years (45/100,000/year) followed by infants <2 years (23/100,000/year. The most common clinical presentation was sepsis with unknown focus, followed by pneumonia. Meningitis incidence remained unchanged; 1.1 – 1.2 cases/100 000/year. More than 70 % of adult patients had risk factors (high age, alcoholism, malignant or immunological diseases.
Conclusions
1. IPD is a common problem in Sweden mainly affecting the elderly, infants and patients with obvious risk factors.
Author Of 2 Presentations
INVASIVE PNEUMOCOCCAL DISEASE IN SWEDEN DURING 45 YEARS BEFORE GENERAL INFANT VACCINATION (ID 583)
Abstract
Background
1. Pneumococci cause many deaths world-wide. In the area around Gothenburg in Sweden invasive pneumococcal disease (IPD) has been studied between 1964 and 2009, before any pneumococcal vaccines were used.
Methods
Information about isolations of pneumococci in blood, CSF, synovial, pleural, pericardial and peritoneal fluid was obtained from all bacteriological laboratories in the area.Data were obtained from individual presentation records
Results
1. Totally 4347 patients with IPD were identified. 69 had IPD more than once. The incidence rose continuously from 4.2 to 13.1 cases /100,000 inhabitants/year. The incidence was highest in individuals ≥65 years (45/100,000/year) followed by infants <2 years (23/100,000/year. The most common clinical presentation was sepsis with unknown focus, followed by pneumonia. Meningitis incidence remained unchanged; 1.1 – 1.2 cases/100 000/year. More than 70 % of adult patients had risk factors (high age, alcoholism, malignant or immunological diseases.
Conclusions
1. IPD is a common problem in Sweden mainly affecting the elderly, infants and patients with obvious risk factors.
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.