Lucy J. Hathaway, Switzerland
University of Bern Institute for Infectious DiseasesAuthor Of 2 Presentations
PNEUMOCOCCAL SEROTYPES ASSOCIATED WITH MORTALITY AMONG CHILDREN LESS THAN 5 YEARS IN SOUTH AFRICA IN THE POST-VACCINATION ERA (ID 163)
Abstract
Background
Mortality due to S. pneumoniae is particularly high amongst children. We assessed the association of serotype with mortality in ages below 5 years in invasive pneumococcal disease (IPD) in the post-vaccine era in South Africa (SA).
Methods
We conducted surveillance for laboratory-confirmed IPD at 28 hospitals in SA during 2012-2018. We used multivariable logistic regression to compare the association of serotype with in-hospital outcome.
Results
Of 825 IPD cases with pneumococcal serotype, age and outcome data, 212(26%) died (31%(79/254) with meningitis, 21% (109/513) with bacteremia and 41%(24/58) from other invasive disease). Overall among IPD, compared to patients infected with serotype 8 (the most common serotype identified) and after adjusting for age, HIV status and specimen type, those with serotypes 15A (OR:5.0, 95%CI:2.0-12.1), 6A (OR:4.8, 95%CI:1.8-12.9), 19F (OR:3.3, 95%CI:1.3-8.6), 22F (OR:6.8, 95%CI:1.5-31.7), 17F (OR:3.8, 95%CI:1.2-12.2), 11A (OR:6.0, 95%CI:1.2-28.7), 13 (OR:4.1, 95%CI:1.2-14.7) and 35B (OR:2.6, 95%CI:1.1-6.2) were more likely to die. In meningitis cases, those with serotype 6A (OR:13.1, 95%CI:1.2-139.5) were more likely to die compared to serotype 8.
Conclusions
In the vaccine era in children aged <5 years, of the serotypes associated with increased mortality, the majority (15A, 22F, 17F, 11A, 13, 35B) are not included in the current conjugate vaccines.
PNEUMOCOCCAL SEROTYPES ASSOCIATED WITH MORTALITY IN PERSONS AGED 5 YEARS AND ABOVE IN SOUTH AFRICA DURING THE POST-VACCINATION ERA (ID 328)
Abstract
Background
Pneumococcal serotypes 19F and 1 were associated with mortality amongst adults and adolescents in the pre-vaccine era in South Africa (SA). We assessed the association of serotype with mortality in individuals aged ≥5 years with invasive pneumococcal disease (IPD) during the vaccine era.
Methods
We conducted surveillance for laboratory-confirmed IPD at 28 hospitals in SA during 2012-2018. We used multivariable logistic regression to compare the association of serotype with in-hospital outcome.
Results
Of 3453 IPD cases with available serotype, age and outcome information, 1158 (34%) died (47% (458/970) with meningitis, 29% (643/2219) with bacteremia and 22% (57/264) with other invasive disease). Overall among IPD, compared to patients infected with serotype 8 (the most common serotype identified) and after adjusting for age, HIV status and specimen type, those with serotype 15B/C (OR:2.01, 95%CI: 1.16-3.48) were more likely to die. When restricting to meningitis cases, patients with serotype 23A (OR:0.31, 95%CI:0.10-0.95) were less likely to die compared to patients with serotype 8.
Conclusions
In the post-vaccine era, in ages ≥5 years, serotype 15B/C is associated with increased mortality, however this serotype is not included in the currently available conjugate vaccines.