Abstract
Invasive pneumococcal disease (IPD) presents high mortality in the population at risk. The aim of this work is to know the evolution, clinical and microbiological characteristics of IPD in the adult population of Majorca, since the introduction of a public funded program for pneumococcal conjugate vaccine (PCV-13) in the pediatric population in the Balearic Islands in 2016. For this purpose, a retrospective multicenter study was carried out in which all episodes of IPD in adult patients from the four hospitals of the public health system of Majorca were included, comparing the periods between 2012 and 2015 and between 2016 and 2019. Clinical variables, serotypes and antibiotic sensitivity were collected. There were 498 cases of IPD; 56.8% were male with a mean age of 67 (standard deviation: 16). Most infections were bacterial pneumonias (73.7%). Of the total cases, 264 (53%) presented complications. Of the 498 cases, 351 strains were obtained, of which 145 (41.3%) belong to vaccinal serotypes (included in the PCV-13 vaccine) and 206 (58.7%) to non-vaccinal serotypes (not included in the PCV-13 vaccine). The percentage of IPD caused by vaccinal serotypes was lower in the second period (47.8% vs. 34.5%; p = 0.012).
Highlights
There are up to 100 different serotypes currently described, some more associated with Invasive pneumococcal disease (IPD) and with resistance to different antimicrobials [5,6] vaccines against pneumococcus have been available for some time, it has been in recent decades, with the introduction of pneumococcal conjugate vaccine (PCV), that significant progress has been made in preventing these infections [7,8]
IPD was defined as isolation of S. pneumoniae in any sterile fluid in patients with clinical symptoms or signs of infection
We observed a decrease in the incidence of IPD by vaccine serotypes since the inclusion of VCN-13 in the vaccination calendar
Summary
Invasive pneumococcal disease (IPD), in its different forms of presentation (bacterial pneumonia, septicemia or meningitis), presents high morbidity and mortality. This is especially evident in at-risk populations, such as those under 2 and over 65 years of age, as well as patients with immunodeficiencies of any type and those with anatomical or functional asplenia [3,4]. IPD is observed in immunocompetent persons with certain comorbidities, such as cardiovascular, respiratory, hepatic, renal and metabolic diseases [1,2,3,4]. There are up to 100 different serotypes currently described, some more associated with IPD and with resistance to different antimicrobials [5,6] vaccines against pneumococcus have been available for some time, it has been in recent decades, with the introduction of pneumococcal conjugate vaccine (PCV), that significant progress has been made in preventing these infections [7,8]
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