Impacto de la vacuna neumocócica conjugada 13-valente en niños. Efecto de su retirada del calendario infantil de vacunación (Madrid)

Abstract

ObjectiveIn June 2010, the Madrid autonomous community approved that the 13-valent pneumococcal conjugate vaccine (PCV13) replace PCV7 for routine administration to children. However in June 2012, was suppressed. The objective was to analyse the trends of invasive pneumococcal serotypes and antimicrobial resistances patterns in children in 2012-2014, particularly after the stopping vaccination of PCV13. MethodsDuring 2012-2014, 24 cases (24 patients) of invasive pneumococcal disease (IPD) were identified. Susceptibilities to penicillin and cefotaxime were determined by microdilution. The strains were sent for serotyping to Department of Microbiology of Hospital Clínico Universitario (Madrid). ResultsA total of 24 isolates of pneumococcus were made at Hospital Infantil Niño Jesús (Madrid), 22 in blood, one in cerebrospinal fluid, and one in pleural fluid. The highest rates of IPD were found in children aged 12-23months old and ≥36months. Distribution by clinical presentation was: 50% (12) primary bacteremia, 29% (7) bacteremic pneumonia, 13% (3) bacteremic meningitis, 4% (1) meningitis, 4% (1) empyema, and 4% (1) bacteremic pneumonia secondary to otitis. Seventy-eight percent of serotypes were non-PCV13. During the PCV13 universal vaccination period (January-May 2012), 4/6 isolates were non-PCV13 (10A, 23B, 8, 11A). During the PCV13 suppression period (from June 2012) 14/17 isolates were non-PCV13 (23B, 10A, 15A, 6C, 15B, 24F). All isolates were susceptible. ConclusionIn the population studied, the suppression of the PCV13 did not cause a rebound in the number of IPD for serotypes included. The PCV13 offers clear benefits as a preventive measure against IPD in children.