Impact of pneumococcal conjugate vaccine (PCV7 and PCV13) on pneumococcal invasive diseases in Italian children and insight into evolution of pneumococcal population structure

Camilli, Romina; D’Ambrosio, Fabio; Grosso, María Del; Araujo, Fernanda Pimentel de; Caporali, Maurizio; Manso, Martina Del; Gherardi, Giovanni; D’Ancona, Fortunato; Pantosti, Annalisa

doi:10.1016/j.vaccine.2017.07.010

Cited by 47 publications

(50 citation statements)

References 40 publications

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“…Serotypes 19A and 14 were associated with strains not susceptible to penicillin, nor to cefotaxime, whereas serotype 23B and 24F were not susceptible to penicillin. Other authors have also described non-susceptibility to penicillin in serotypes 19A and 14 [23,25], in serotype 24F [14,23] or in serotype 23B [27]. Skoczyńska et al [25] found that not susceptibility to penicillin besides was associated with the vaccine-serotypes 19F, 6B and 9V, which in our study could not be demonstrated, perhaps due to the small number of strains studied.…”

Section: Discussioncontrasting

confidence: 64%

“…The percentage of strains not susceptible to penicillin (36.1%) or to cefotaxime (16.4%) was higher than that described by other authors [23,25]. Serotypes 19A and 14 were associated with strains not susceptible to penicillin, nor to cefotaxime, whereas serotype 23B and 24F were not susceptible to penicillin.…”

Section: Discussionmentioning

confidence: 53%

“…In relation with the distribution of the main serotypes, Ceyhan et al [22] found that, in Turkish children in the same age group than us, serotype 19F was the most frequent, followed by 14, 3 and 6B (in equal amounts), while Camilli et al [23], in Italian children aged <5 years in 2012-2014, found that serotypes 1, 19A and 14 were among the four most frequent serotypes, together with 24F. The diagnostic techniques used in these studies may be one of the main explanatory factors for these differences [24].…”

Section: Discussionmentioning

confidence: 70%

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Pneumococcal serotypes in children and relationship with clinical presentation and antimicrobial susceptibility in the PCV13 era

Izquierdo¹,

Ciruela²,

Hernández³

et al. 2019

Preprint

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Background: The aim of this study was to analyse the serotypes causing invasive pneumococcal disease (IPD) according to the clinical presentation, and antimicrobial susceptibility in children aged ≤17 years before the introduction of the 13-valent pneumococcal conjugate vaccine (PCV13) in the official paediatric schedule. Methods: We conducted a prospective study in children ≤17 years with IPD attended in three Catalan hospitals between January 2012 and June 2016. IPD cases were diagnosed by culture or RT-PCR. Demographic, microbiological, and clinical data were analysed. Associations were assessed using the odds ratio (OR) and 95% confidence intervals (CI). Results: Of the 253 cases included, 34.4% were aged < 2 years, 38.7% 2-4 years and 26.9% 5-17 years. Over 64% of cases were PCV13 serotypes. Cases with PCV13 serotypes were associated with overall pneumonia (OR:7.47[4.0-13.96]) and complicated pneumonia (OR:7.2[4.04-12.75]), overall and in each age group (p<0.05). Serotypes 3 and 1 were associated with complicated pneumonia (p<0.05). Non-PCV13 serotypes were associated with meningitis (OR:7.32[2.33-22. 99]) and occult bacteremia (OR:3.6[1.56-8.76]). Serotype 19A was more frequent in children aged <2 years and serotype 3 and 1 in those aged 2-4 years and >4 years, respectively. Forty-four cases (36.1%) were non-susceptible to penicillin and 16.4% were also non-susceptible to cefotaxime. There were no significant differences between PCV13 and non-PCV13 cases with non-susceptible penicillin strains (36.1% and 36.0%, respectively), while PCV13 cases showed more frequently non-susceptible cefotaxime strains (23.6%; p=0.010). Serotypes 19A and 14 were associated with non-susceptibility to both penicillin and cefotaxime strains (p=0.003 and p<0.001, respectively) and serotype 19A with resistant to penicillin (p=0.002) Conclusions: PCV13 serotypes were the most frequent serotypes in children aged ≤17years, mainly serotype 3, 1 and 19A. Non-PCV13 serotypes were associated with meningitis and occult bacteraemia while PCV13 serotypes with pneumonia. PCV13 and non-PCV13 cases presented high frequency of non-susceptibility to penicillin. Serotypes 19A, and 14 were associated with non-susceptibility to both penicillin and cefotaxime, and serotype19A with penicillin resistance.

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Section: Discussioncontrasting

confidence: 64%

Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 70%

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Pneumococcal serotypes in children and relationship with clinical presentation and antimicrobial susceptibility in the PCV13 era

Izquierdo¹,

Ciruela²,

Hernández³

et al. 2019

Preprint

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“…A similar trend was observed when assessed across all ages in which a switch to PCV10 was estimated to result in a 79% increase in IPD to an average of 4.6 cases per 100,000, a relevant increase in incidence of IPD due to serotypes 3 (from 0.1/100,000 to 0.9/100,000) and 19A (from 0.2/100,000 to 1.4/100,000). Across all ages, 2.6 cases of IPD per 100,000 remained with 53% due to non-PCV13 type disease and 8%-10% each due to serotypes 1 and 14 ( Figure 1c) [15].…”

Section: Epidemiological Resultsmentioning

confidence: 98%

Estimating the Clinical and Economic Impact of Switching from the 13-Valent Pneumococcal Conjugate Vaccine (PCV13) to the 10-Valent Pneumococcal Conjugate Vaccine (PCV10) in Italy

et al. 2020

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Background: Invasive and non-invasive pneumococcal diseases are significant health and economic burdens, especially in children and the elderly. Italy included the 7-valent (PCV7) and 13-valent pneumococcal conjugate vaccine (PCV13) in the National Immunization Program in 2007 and 2010, respectively, allowing a dramatic reduction in the burden of pneumococcal disease. In the era of budget constraints, decision-makers may consider switching from the higher-valent, more costly PCV13, to the lower-cost PCV10. This study estimated the potential public health and economic impact of changing vaccine programs from PCV13 to PCV10 in Italy. Methods: A decision-analytic forecasting model estimated the impact of PCV programs. Real-world surveillance data were used to forecast serotype distribution and disease incidence among children and the elderly over a specified 5-year time horizon. Costs and outcomes included estimates of cases and deaths avoided, quality-adjusted life years (QALYs) gained, and total costs from a payer perspective, discounted at an assumed rate of 3.0%, and robustness validated through several scenarios and sensitivity analyses. Results: A switch from PCV13 to PCV10 would increase invasive pneumococcal disease (IPD) cases by 59.3% (4317 cases) over a 5-year horizon, primarily due to serotypes 3 and 19A. Pneumonia increased by 8.3% and acute otitis media (AOM) by 96.1%. Maintaining a PCV13 program would prevent a total incremental 531,435 disease cases (1.02M over a 10-year time horizon) and 641 deaths due to invasive pneumococcal disease (IPD), with €23,642 per QALY gained over 5 years versus PCV10. One-way and probabilistic sensitivity analyses showed that a PCV13-based program remained cost-effective in 99.7% of the simulations in Italy as parameters varied within their plausible range; percent vaccinated had the most impact. Conclusions: Maintaining the PCV13 strategy would provide substantial public health and economic benefits in Italy and is cost-effective. Switching from PCV13 to PCV10 would increase the incidence of pneumococcal disease primarily linked to re-emergence of serotypes 3 and 19A.

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“…This benefit of early detection may have reduced in recent years because children in most European countries receive conjugate pneumococcal vaccinations as part of routine infant vaccination schedules. However, strains not included in the vaccine remain a problem, which may worsen in the future (Payne et al, 2013;Tin Tin Htar et al, 2015;Waight et al, 2015;Camilli et al, 2017;Latasa Zamalloa et al, 2017;Oligbu et al, 2018). Antibiotic prophylaxis therefore remains necessary.…”

Section: Consensus Statementsmentioning

confidence: 99%

Newborn screening for sickle cell disease in Europe: recommendations from a Pan‐European Consensus Conference

et al. 2018

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Summary Sickle Cell Disease (SCD) is an increasing global health problem and presents significant challenges to European health care systems. Newborn screening (NBS) for SCD enables early initiation of preventive measures and has contributed to a reduction in childhood mortality from SCD. Policies and methodologies for NBS vary in different countries, and this might have consequences for the quality of care and clinical outcomes for SCD across Europe. A two‐day Pan‐European consensus conference was held in Berlin in April 2017 in order to appraise the current status of NBS for SCD and to develop consensus‐based statements on indications and methodology for NBS for SCD in Europe. More than 50 SCD experts from 13 European countries participated in the conference. This paper aims to summarise the discussions and present consensus recommendations which can be used to support the development of NBS programmes in European countries where they do not yet exist, and to review existing programmes.

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Impact of pneumococcal conjugate vaccine (PCV7 and PCV13) on pneumococcal invasive diseases in Italian children and insight into evolution of pneumococcal population structure

Cited by 47 publications

References 40 publications

Pneumococcal serotypes in children and relationship with clinical presentation and antimicrobial susceptibility in the PCV13 era

Pneumococcal serotypes in children and relationship with clinical presentation and antimicrobial susceptibility in the PCV13 era

Estimating the Clinical and Economic Impact of Switching from the 13-Valent Pneumococcal Conjugate Vaccine (PCV13) to the 10-Valent Pneumococcal Conjugate Vaccine (PCV10) in Italy

Newborn screening for sickle cell disease in Europe: recommendations from a Pan‐European Consensus Conference

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