Trends in incidence of pneumococcal disease before introduction of conjugate vaccine: South West England, 1996–2005

Abstract

SUMMARYIntroduction of pneumococcal conjugate and polysaccharide vaccines into the United Kingdom's routine immunization programmes is expected to change the epidemiology of invasive pneumococcal disease (IPD). We have documented the epidemiology of IPD in an English region (South West) with high-quality surveillance data before these programmes were established. We analysed data on isolates of Streptococcus pneumoniae from blood and CSF between 1996 and 2005 from microbiology laboratories in the South West that were reported and/or referred for serotyping to the Health Protection Agency Centre for Infections. The mean annual incidence of IPD increased from 11 . 2/100 000 in 1996 to 13 . 6/100 000 in 2005 (P<0 . 04). After adjusting for annual blood-culture sampling rates in hospitals serving the same catchment populations, an increase in annual incidence of IPD was no longer observed (P=1 . 0). Variation in overall incidence between laboratories could also be explained by variation in blood culture rates. The proportion of disease caused by serotypes 6B, 9V and 14 decreased significantly (P=0 . 001, P=0 . 007, and P=0 . 027 respectively) whereas that caused by serotype 4, 7F and 1 increased (P=0 . 001, P=0 . 003, and P<0 . 001 respectively) between 2000 and 2005. The level of penicillin non-susceptibility and resistance to erythromycin remained stable (2 % and 12% respectively). This study provides an important baseline to assess the impact of changing vaccination programmes on the epidemiology of IPD, thus informing future use of pneumococcal vaccines.

Temporal Trends of Invasive Streptococcus pneumoniae Serotypes and Antimicrobial Resistance Patterns in Spain from 1979 to 2007

“…However, when adjusting for the annual coverage of the SRLP for the 1996-to-2006 period, the estimated incidence rate was relatively stable (10.7 per 100,000). This is comparable to rates in other European countries and regions, especially in studies that adjusted for underascertainment, such as those of France, in which an estimate of 11.4 cases per 100,000 people was derived for the years 1996 to 2005 (21), and of southwest England, with an estimated 10 to 13.6 cases per 100,000 between 1996 and 2005 (19).…”

Effectiveness of the ten-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10) against invasive pneumococcal disease: a cluster randomised trial

“…24,26 The Finnish population is generally homogeneous, but access to treatment and diagnostic practices may vary between areas. However, variability in the IPD incidence between the study clusters in 2004-2008 was low.…”

Epidemiology of Invasive Pneumococcal Disease among Adult Patients in Barcelona Before and After Pediatric 7‐Valent Pneumococcal Conjugate Vaccine Introduction, 1997–2007

“…The spread of serotype 1 (ST306) was described in Sweden in the late 1990s, when the prevalence of this serotype increased from 1% of IPD isolates in 1992 to 10% in 1997, which was related to the expansion of Sweden 1 -ST306 clone [31]. Currently, the prevalence of this serotype is also increasing in other European countries [28,32]. Although the Sweden 1 -ST306 was detected in our area throughout the study period, its prevalence increased significantly in the late PCV7 period, when it accounted for 10% of invasive strains.…”