Serotype epidemiology of invasive pneumococcal disease in Swiss adults: A nationwide population-based study.

Meichtry, Jurka; Born, Rita; Küffer, Marianne; Zwahlen, Marcel; Albrich, Werner C.; Brugger, Silvio; Mühlemann, Kathrin; Hilty, Markus (2014). Serotype epidemiology of invasive pneumococcal disease in Swiss adults: A nationwide population-based study. Vaccine, 32(40), pp. 5185-5191. Elsevier 10.1016/j.vaccine.2014.07.060

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BACKGROUND In Switzerland, the heptavalent (PCV7) and 13-valent pneumococcal conjugate vaccine (PCV13) were recommended for all infants aged <2 years in 2007 and 2011, respectively. Due to herd effects, a protective impact on the invasive pneumococcal disease (IPD) rates in adults had been expected. METHODS Within this study, data from the nationwide mandatory surveillance was analyzed for all adult patients ≥16 years with IPD of known serotype/serogroup during 2003-2012. Trend (for IPD cases from 2003 to 2012) and logistic regression analyses (2007-2010) were performed to identify changes in serotype distribution and to identify the association of serotypes with age, clinical manifestations, comorbidities and case fatality, respectively. FINDINGS The proportion of PCV7 serotypes among all IPD cases (n=7678) significantly declined in adults from 44.7% (2003) before to 16.7% (2012) after the recommendation of PCV7 (P<0.001). In contrast, the proportion of non-PCV7 serogroup/serotypes increased for non-PCV13 but also PCV13 serotypes (not included in PCV7) at the same time. Serotype distribution varied significantly across ages, clinical manifestations and comorbidities. Serotype was furthermore associated with case fatality (P=0.001). In a multivariable logistic regression model, analyzing single serotypes showed that case-fatality was increased for the serotypes 3 (P=0.008), 19A (P=0.03) and 19F (P=0.005), compared to serotype 1 and 7F. CONCLUSION There was a significant decline in PCV7 serotypes among adults with IPD in Switzerland after introduction of childhood vaccination with PCV7. Pneumococcal serotypes were associated with case fatality, age, clinical manifestation and comorbidities of IPD in adults. These results may prove useful for future vaccine recommendations for adults in Switzerland.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases > Research
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology
04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine
04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases > Mycobacteriology

UniBE Contributor:

Meichtry, Jurka; Küffer, Marianne; Zwahlen, Marcel; Brugger, Silvio; Mühlemann, Kathrin and Hilty, Markus

Subjects:

600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0264-410X

Publisher:

Elsevier

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

14 Oct 2014 15:28

Last Modified:

21 Oct 2015 11:18

Publisher DOI:

10.1016/j.vaccine.2014.07.060

PubMed ID:

25077419

Uncontrolled Keywords:

Case fatality Epidemiology Manifestations Serotypes Streptococcus pneumoniae Switzerland

BORIS DOI:

10.7892/boris.57573

URI:

https://boris.unibe.ch/id/eprint/57573

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