Declining mortality from adult pneumococcal infections linked to children's vaccination

Grau, Inmaculada; Ardanuy, Carmen; Cubero, Meritxell; Benítez, Miguel Ángel; Liñares, Josefina; Pallarés, Román

doi:10.1016/j.jinf.2016.01.011

Cited by 32 publications

(28 citation statements)

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“…During 2014-2016, mortality due to IPD was 17.5%, which is lower than observed in other countries (24-30%) (Harboe et al, 2009;Grau et al, 2016;van Hoek et al, 2012). The difference in mortality may be due, in part, to the characteristics of the population, the type of analysis, and differing serotype distributions.…”

Section: Discussionmentioning

confidence: 82%

Indirect effects of paediatric conjugate vaccines on invasive pneumococcal disease in older adults

Domı́nguez

Ciruela

Izquierdo

et al. 2019

International Journal of Infectious Diseases

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The aim of this study was to assess the indirect effect of paediatric 13-valent pneumococcal conjugate vaccine (PCV13) vaccination on people !65 years of age with invasive pneumococcal disease (IPD) in Catalonia and to determine factors predictive of mortality. Methods: During 2014-2016, 1285 IPD cases were reported to the Public Health Agency of Catalonia. The indirect effect of paediatric PCV13 vaccination was calculated by comparing the incidence rate (IR) in 2016 (PCV13 year) with that in 2009 (pre-PCV13). Predictors of mortality were determined using multivariate logistic regression. Results: Comparing 2016 and 2009, IPD decreased by 19% (IR 40.1 and 32.5 per 100 000 person-years, respectively). PCV13 serotypes decreased by 57% (IR 23.7 and 10.1), while non-PCV13 serotypes increased by 36% (IR 16.4 and 22.4). During 2014-2016, the mortality rate was 17.5%, and mortality was associated with age !85 years (adjusted odds ratio (aOR) 2.91, 95% confidence interval (CI) 1.89, 4.48), meningitis (aOR 2.29, 95% CI 1.25, 4.19), non-focal bacteraemia (aOR 3.73, 95% CI 2.00, 6.94), and !1 high-risk condition (aOR 1.89, 95% CI 1.08, 3.32). PPV23non13 serotypes were associated with lower mortality than PCV13 serotypes (aOR 0.54, 95% CI 0.34, 0.86). Conclusions: The incidence of IPD in people !65 years of age decreased after the introduction of paediatric PCV13, and this was due to a reduction in PCV13 serotypes, although an increase in non-PCV13 serotypes was observed. Mortality was associated with age, meningitis, non-focal bacteraemia, !1 high-risk condition, and PCV13 serotypes.

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Section: Discussionmentioning

confidence: 82%

Indirect effects of paediatric conjugate vaccines on invasive pneumococcal disease in older adults

Domı́nguez

Ciruela

Izquierdo

et al. 2019

International Journal of Infectious Diseases

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“…In this case, in Lombardy, only patients with particular pathologies, such as defects of the immune system, chronic illnesses, and diabetes, are recommended to receive PCV vaccination. As recently demonstrated, PCV13 vaccination of children seems to produce a small impact in the reduction of pneumococcal infections in adults (11, 27). In fact, in our study, the most common serotypes found, e.g., 3 and 19A, although they are included in PCV13, caused diseases in adults.…”

Section: Discussionmentioning

confidence: 77%

Serotype Distribution and Antimicrobial Resistance of Streptococcus pneumoniae Invasive Isolates Collected at the Italian Hospital of Desio, Lombardy, from 2008 to 2016

Intra

Besana

Savarino

et al. 2017

Front. Public Health

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“…In the UK, on the other hand, CAP declined in adults after introduction of PCV7 (2008) and PCV13 (2010) indicating the establishment of a potential herd immunity [143]. In Spain, the vaccination of children reduced the mortality due to IPD in adults but the case fatality rate in over 65 years old patients remained unchanged [144]. In elderly, non-PCV serotypes were the main cause of death.…”

Section: Herd Immunitymentioning

confidence: 99%

From Immunologically Archaic to Neoteric Glycovaccines

Cavallari

Libero

2017

Vaccines

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Polysaccharides (PS) are present in the outermost surface of bacteria and readily come in contact with immune cells. They interact with specific antibodies, which in turn confer protection from infections. Vaccines with PS from pneumococci, meningococci, Haemophilus influenzae type b, and Salmonella typhi may be protective, although with the important constraint of failing to generate permanent immunological memory. This limitation has in part been circumvented by conjugating glycovaccines to proteins that stimulate T helper cells and facilitate the establishment of immunological memory. Currently, protection evoked by conjugated PS vaccines lasts for a few years. The same approach failed with PS from staphylococci, Streptococcus agalactiae, and Klebsiella. All those germs cause severe infections in humans and often develop resistance to antibiotic therapy. Thereby, prevention is of increasing importance to better control outbreaks. As only 23 of more than 90 pneumococcal serotypes and 4 of 13 clinically relevant Neisseria meningitidis serogroups are covered by available vaccines there is still tremendous clinical need for PS vaccines. This review focuses on glycovaccines and the immunological mechanisms for their success or failure. We discuss recent advances that may facilitate generation of high affinity anti-PS antibodies and confer specific immunity and long-lasting protection.

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Declining mortality from adult pneumococcal infections linked to children's vaccination

Cited by 32 publications

References 50 publications

Indirect effects of paediatric conjugate vaccines on invasive pneumococcal disease in older adults

Indirect effects of paediatric conjugate vaccines on invasive pneumococcal disease in older adults

Serotype Distribution and Antimicrobial Resistance of Streptococcus pneumoniae Invasive Isolates Collected at the Italian Hospital of Desio, Lombardy, from 2008 to 2016

From Immunologically Archaic to Neoteric Glycovaccines

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