PCV7: Impact on Invasive Pneumococcal Disease and Resistant S pneumoniae

Abstract

Infectious Disease| August 01 2006 PCV7: Impact on Invasive Pneumococcal Disease and Resistant S pneumoniae AAP Grand Rounds (2006) 16 (2): 13–14. https://doi.org/10.1542/gr.16-2-13 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation PCV7: Impact on Invasive Pneumococcal Disease and Resistant S pneumoniae. AAP Grand Rounds August 2006; 16 (2): 13–14. https://doi.org/10.1542/gr.16-2-13 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: invasive pneumococcal disease, pneumococcal 7-valent conjugate vaccine, streptococcus pneumoniae Sources: (1) Poehling KA, Talbot TR, Griffin MR, et al. Invasive pneumococcal disease among infants before and after the introduction of pneumococcal conjugate vaccine. JAMA. 2006;295:1668–1674; doi:10.1001/jama.295.14.1668 (2) Kyaw MH, Lynfield R, Schaffner W, et al. Effect of introduction of the pneumococcal conjugate vaccine on drug resistant Streptococcus pneumoniae. N Engl J Med. 2006;354:1455–1463; doi:10.1056/NEJMoa051642 Investigators from the Centers for Disease Control and Prevention (CDC), in collaboration with researchers from 8 states, report the effect of the heptavalent pneumococcal conjugate vaccine (PCV7) on invasive pneumococcal disease (IPD) in infants, and the resistance patterns of Streptococcus pneumoniae. In the study by Poehling et al, rates of IPD in neonates and young infants (0 to 90 days of age) before and after the introduction of PCV7 in 2000 were compared. The pre-PCV7 period assessed was 1997–1999 and the post-PCV7 period 2001–2004. All available isolates were serotyped starting in 1998. Eighty-nine infants with IPD were identified in the pre-PCV7 period and 57 in the post-PCV7 period. All were single episodes; the median age of patients was 46 days (range 0–88 days). For all 0- to 90-day-old infants, the mean IPD rate (per 100,000 live births) decreased from 11.8 (95% CI, 9.6–14.5) pre-PCV7 to 7.2 (95% CI, 5.6–9.4) post-PCV7 (P=.004). The IPD rate for 0- to 60-day-old infants also decreased significantly, even though PCV7 is not recommended for infants <2 months of age. Age, gender, type of IPD, and state from which IPD cases were identified were similar in the 2 periods. The proportion of IPD cases that occurred in black infants post-PCV7 was half that of the pre-PCV7 period, eliminating the previously observed racial difference in incidence.1 Mean IPD rates caused by PCV7 serotypes decreased significantly, but the rates for non-PCV7 serotypes remained unchanged. In the report from Kyaw et al, antibiotic susceptibilities were assessed on 24,825 S pneumoniae isolates from 28,336 adult and pediatric patients with IPD identified between January 1, 1996 and December 31, 2004. Isolates with intermediate- or high-level resistance were considered resistant. Multidrug resistance (MDR) was defined as non-susceptibility to at least 3 antibiotics. Isolates were serotyped and stratified into vaccine type, vaccine-related, and non-vaccine types. The rate of penicillin-resistant (PR) IPD decreased from its 1999 peak by 57%, from 6.3 to 2.7. Similar decreases were identified for erythromycin-resistant and MDR strains of S pneumoniae isolated in patients with IPD. Overall rates of PR-IPD due to vaccine serotypes fell from 5.0 to 0.7, an 87% decrease. Among children <5 years of age, the rate of PR-IPD ranged from 25.9 to 33.8 between 1996 and 1999 versus 7.5 in 2004. The largest decline was in children <2 years of age. Similar decreases were seen for erythromycin-resistant and MDR-IPD rates. For children <2 years of age, almost all IPD in both periods was caused by penicillin-resistant isolates that were either vaccine or vaccine-related serotypes. After the vaccine introduction, an increase in non-vaccine serotype IPD was seen in... You do not currently have access to this content.