Risk Factors for Death from Invasive Pneumococcal Disease, Europe, 2010

Abstract

Risk varies by Streptococcus pneumoniae serotype.

Pneumococcal serotype distribution: A snapshot of recent data in pediatric and adult populations around the world

“…Despite the availability of PCV, among the 21 studies assessing IPD among children, serotypes included in PCV accounted for >60% of the total serotypes in 11 reports. 6,11,12,14,[16][17][18][19][20][21][22] Serotype 19A was among the most commonly identified in all of the geographic regions included in this review. In addition, serotypes 1 and 14 were prominent in Europe and Latin America and serotypes 6B, 14 and 19F were important in Africa-East Mediterranean, demonstrating geographic variations in the prevalence of PCV serotypes among pediatric IPD cases.…”

“…There were 9 studies reporting serotype distribution data among adults aged 65 y and older with IPD 5,6,18,24,[55][56][57][58][59] and another 3 with similar data on non-IPD conditions (Table 2). [60][61][62] Conjugate vaccine serotypes (i.e., serotypes included in PCV13) causing IPD among older adults were highly prevalent (> 60% of serotypes) in only 2 studies, one Polish 6 and one Spanish.…”

“…Two studies from Spain contained both IPD and non-IPD data (Table 1). 17,20 Conjugate vaccine serotypes (i.e., serotypes included in PCV13) causing IPD among children were highly prevalent (> 60% of serotypes) in 11 reports, 6,11,12,14,16-22 including 6 of 7 European studies, 6,[16][17][18][19][20] while the highest prevalence from North American studies was 46%. 25 In contrast, conjugate vaccine serotypes causing non-IPD conditions among children were more than 50% prevalent in only 5 of 30 studies (Table 1).…”

Emergence of Multidrug-Resistant Pneumococcal Serotype 35B among Children in the United States

“…In Europe, other nonvaccine serotypes predominate; however, a moderate increase in serotype 35B IPD among adults and children has been described (12,13). Nevertheless, serotype 35B has been associated with the highest risk for death due to IPD (relative risk [RR], 4.98; 95% confidence interval [CI], 2.49 to 9.95) among all serotypes affecting adults and children in Europe (13).…”

Indirect Effects of Pneumococcal Conjugate Vaccines in National Immunization Programs for Children on Adult Pneumococcal Disease

“…The pneumococcal conjugate vaccine (PCV) has been developed to overcome the limitations of the pneumococcal polysaccharide vaccine (PPV), which has poor immunogenicity in infants younger than 2 years of age [5]. Since the initial United States (US) approval of PCV7 in 2000, pneumococcal conjugate vaccines have been adopted into routine infant immunization programs in many countries [6], resulting in a significant reduction in the incidence of IPD among children [78]. In addition to poor immunogenicity among infants, there is also evidence to suggest reduced immunogenicity of PPV among elderly adults and adults with certain immune compromising conditions [9].…”