scholarly journals 1003. Clinical Implications of Emerging Nonvaccine-Serotype Invasive Pneumococcal Disease Among Adults in the Republic of Korea in the Era of Protein-Conjugated Pneumococcal Vaccine

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S298-S299
Author(s):  
Jong Hun Kim ◽  
Seung Hee Baik ◽  
Joon Young Song ◽  
In-Gyu Bae ◽  
Hyo Youl Kim ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Multiple Logistic Regression Analysis ◽  
Pneumococcal Vaccination ◽  
Case Fatality ◽  
Republic Of Korea ◽  
Surveillance Program ◽  
Clinical Implications ◽  
National Immunization ◽  
The Republic

Abstract Background In the Republic of Korea (ROK), protein conjugated vaccines (PCV13 and PCV10) in replacement of PCV7 have been used in children since 2010, and then included in the childhood national immunization program (NIP) in 2014. This study investigated indirect effect of PVCs on serotypes in PCV-naïve adult invasive pneumococcal disease (IPD) and its clinical implications. Methods A prospective observational cohort study was conducted, through the serotype surveillance program following the NIP implementation of 23-valent pneumococcal polysaccharide vaccine (PPV23) for elderly population (≥65 years) from 2013 to 2015. Clinical data and pneumococcal isolates from adult IPD patients (≥18 years) were collected from 20 hospitals. Clinical characteristics were compared between vaccine-serotype (VT) and nonvaccine-serotype (NVT) groups. Results Of a total of 319 IPD patients enrolled, 189 cases (59.2%) were available for serotypes. Among them, the proportion of PCV-naïve cases was 99.5% (188/189) and 189 patients consisted of NVT (n = 64, 33.9%) and VT group (n = 125, 66.1%). Compared with the previous study in the ROK (2004–2010), the proportion of PCV13 serotypes was decreased (61.4% vs. 37.0%, P < 0.001) and PPV23 serotypes were stationary (71.5% vs. 65.6%), but NVT serotypes were increased (23.4% vs. 33.9%, P = 0.033) in our study. The most common serotype was 3 (20.8%) and 34 (23.4%) in VT and NVT group, respectively. VT group had more bacteremic pneumonia (72.0% vs. 48.4%, P = 0.002). There was no difference of the case fatality rate between NVT and VT groups (29.7% vs. 35.2%, P = 0.447). Multiple logistic regression analysis showed that chronic kidney disease (odds ratio [OR] 10.26, 95% confidence interval [CI] 1.94–54.44, P = 0.006), younger age of 18–49 years (OR 4.04, 95% CI 1.29–12.71, P = 0.017), deep-seated infection (OR 3.73, 95% CI 1.34–10.39, P = 0.012), meropenem resistance (OR 3.21, 95% CI 1.49–6.91, P = 0.003) were significantly associated with NVT-IPD cases. Conclusion Our study indicates that emerging and expanding NVT-IPD among adults, probably due to indirect herd effect of widespread use of pediatric PCV. Further changes of IPD serotypes might occur and IPD serotypes should be monitored for developing better pneumococcal vaccination policy. Disclosures All authors: No reported disclosures.

scholarly journals Impact of the COVID-19 Pandemic on Invasive Pneumococcal Disease and Risk of Pneumococcal Coinfection with SARS-CoV-2: prospective national cohort study, England

2020 ◽  
Author(s):  
Zahin Amin-Chowdhury ◽  
Felicity Aiano ◽  
Anna Mensah ◽  
Carmen Sheppard ◽  
David Litt ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Age Distribution ◽  
Age Groups ◽  
Pneumococcal Vaccination ◽  
Case Fatality ◽  
Limited Data ◽  
National Cohort ◽  
Pneumococcal Serotype ◽  
Independent Association

Abstract Background Streptococcus pneumoniae coinfection with influenza results in synergistic lethality, but there are limited data on pneumococcal coinfection with SARS-CoV-2. Methods Public Health England conducts invasive pneumococcal disease (IPD) and SARS-CoV-2 surveillance in England. IPD trends during 2000/01-2019/20 were analysed and cases between during February-June 2020 were linked with laboratory-confirmed SARS-CoV-2 infections. Multivariable logistic regression was used to assess risk factors for death. Results IPD incidence in 2019/20 (7.6/100,000; n=3,964) was 30% (IRR 0.70, 95%CI, 0.18-2.67) lower compared to 2018/19 (10.9/100,000; n=5,666) with large reductions observed across all age-groups during March-June 2020. The serotypes responsible for IPD during 2019/20 were similar to previous years. There were 160,886 SARS-CoV-2 and 1,137 IPD cases during February-June 2020, including 40 IPD/COVID-19 (0.025% [95%sCI, 0.018-0.034] of SARS-CoV-2 infections; 3.5% [95%CI, 2.5-4.8] of IPD cases), 21 with COVID-19 diagnosed 3-27 days after IPD and 27 who developed COVID-19 ≥28 days after IPD. Case-fatality rates (CFR) were 63.2% (25/40), 47.6% (10/21) and 33.3% (9/27), respectively (p<0.001). In addition to an independent association with increasing age and pneumococcal serotype group, CFR was 7.8-fold (95% CI, 3.8-15.8) higher in those with IPD/COVID-19 co-infection and 3.9-fold (95% CI, 1.4-10.7) higher in patients who developed COVID-19 3-27 days after IPD compared to patients with IPD only. Conclusions Large declines in IPD were observed following COVID-19 lockdown in England. IPD/COVID-19 confections were rare but associated with high CFR, mainly in older adults. The rarity, age distribution and serotype distribution of IPD/SARS-CoV-2 coinfections does not support wider extension of pneumococcal vaccination.

scholarly journals Adult invasive pneumococcal disease in the Republic of Korea: Risk medical conditions and mortality stratified by age group

2018 ◽  
Vol 74 ◽  
pp. 136-144 ◽  
Author(s):  
Jong Hun Kim ◽  
Seung Hee Baik ◽  
Byung Chul Chun ◽  
Joon Young Song ◽  
In-Gyu Bae ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Republic Of Korea ◽  
Age Group ◽  
Medical Conditions ◽  
The Republic

scholarly journals Pediatric Invasive Pneumococcal Disease Three Years after PCV13 Introduction in the National Immunization Plan—The Continued Importance of Serotype 3

2021 ◽  
Vol 9 (7) ◽  
pp. 1428
Author(s):  
Catarina Silva-Costa ◽  
Joana Gomes-Silva ◽  
Lúcia Prados ◽  
Mário Ramirez ◽  
José Melo-Cristino ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Antimicrobial Resistance ◽  
Conjugate Vaccine ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Molecular Methods ◽  
Vaccine Uptake ◽  
Serotype Distribution ◽  
Conjugate Vaccines ◽  
National Immunization

The introduction of pneumococcal conjugate vaccines PCV7 and PCV13 led to decreases in incidence of pediatric invasive pneumococcal disease (pIPD) and changes in serotype distribution. We evaluated the consequences of higher vaccine uptake after the introduction of PCV13 in the National Immunization Plan (NIP) in 2015. Besides culture and conventional serotyping, the use of molecular methods to detect and serotype pneumococci in both pleural and cerebrospinal fluid samples contributed to 30% of all pIPD (n = 232) in 2015–2018. The most frequently detected serotypes were: 3 (n = 59, 26%), 10A (n = 17, 8%), 8 (n = 16, 7%) and 19A (n = 10, 4%). PCV13 serotypes still accounted for 46% of pIPD cases. Serotypes not included in any currently available conjugate vaccine (NVT) are becoming important causes of pIPD, with the increases in serotypes 8 and 33F being of particular concern given the importance of serotype 8 in adult IPD and the antimicrobial resistance of serotype 33F isolates. This study highlights the importance of using molecular methods in pIPD surveillance since these allowed a better case ascertainment and the identification of serotype 3 as the leading cause of pIPD. Even in a situation of vaccine uptake >95% for 3 years, PCV13 serotypes remain important causes of pIPD.

scholarly journals Coeliac disease and invasive pneumococcal disease: a population-based cohort study

2017 ◽  
Vol 145 (6) ◽  
pp. 1203-1209 ◽  
Author(s):  
A. RÖCKERT TJERNBERG ◽  
J. BONNEDAHL ◽  
M. INGHAMMAR ◽  
A. EGESTEN ◽  
G. KAHLMETER ◽  
...  
Keyword(s):  
Cohort Study ◽  
Coeliac Disease ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Cox Regression ◽  
Statistical Significance ◽  
Pneumococcal Vaccination ◽  
Population Based ◽  
Increased Risk ◽  
Severe Infections

SUMMARYSevere infections are recognized complications of coeliac disease (CD). In the present study we aimed to examine whether individuals with CD are at increased risk of invasive pneumococcal disease (IPD). To do so, we performed a population-based cohort study including 29 012 individuals with biopsy-proven CD identified through biopsy reports from all pathology departments in Sweden. Each individual with CD was matched with up to five controls (n = 144 257). IPD events were identified through regional and national microbiological databases, including the National Surveillance System for Infectious Diseases. We used Cox regression analyses to estimate hazard ratios (HRs) for diagnosed IPD. A total of 207 individuals had a record of IPD whereas 45/29 012 had CD (0·15%) and 162/144 257 were controls (0·11%). This corresponded to a 46% increased risk for IPD [HR 1·46, 95% confidence interval (CI) 1·05–2·03]. The risk estimate was similar after adjustment for socioeconomic status, educational level and comorbidities, but then failed to attain statistical significance (adjusted HR 1·40, 95% CI 0·99–1·97). Nonetheless, our study shows a trend towards an increased risk for IPD in CD patients. The findings support results seen in earlier research and taking that into consideration individuals with CD may be considered for pneumococcal vaccination.

Tick surveillance of migratory birds during 2010–2011 on Hong and Heuksan Islands, Jeollanam Province, Republic of Korea 

2018 ◽  
Vol 23 (11) ◽  
pp. 2214 ◽  
Author(s):  
Sung-Tae Chong ◽  
Heung Chul Kim ◽  
Jong-Gil Park ◽  
Chang-Yong Choi ◽  
Chang-Uk Park ◽  
...  
Keyword(s):  
Disease Surveillance ◽  
National Park ◽  
Migratory Birds ◽  
Bird Species ◽  
Republic Of Korea ◽  
Surveillance Program ◽  
Haemaphysalis Longicornis ◽  
Haemaphysalis Concinna ◽  
Park Service ◽  
The Republic

Migratory birds were captured, examined, banded and then released in accordance with a bird banding protocol of the Bird Research Center, National Park Research Institute, Korea National Park Service, from January-December 2010–2011 on Hong and Heuksan Islands, Jeollanam (Jeonnam) Province, in the Republic of Korea (ROK). Concurrently, ticks were collected from captured birds as part of a tick-borne disease surveillance program. A total of 381 ticks belonging to three genera and eight species – Ixodes turdus (297 ticks), Ixodes nipponensis (16), Haemaphysalis flava (46), Haemaphysalis longicornis (9), Haemaphysalis formosensis (5), Haemaphysalis ornithophila (6), Haemaphysalis concinna (1), and Amblyomma testudinarium (1)—were collected from 32 bird species belonging to 3 families. This is the first host report of A. testudinarium (1 nymph) collected from White’s Thrush, Zoothera aurea (Aves: Passeriformes: Turdidae), in the ROK. Most ticks were collected from birds during the months of April (44.1%) and November (54.2%).

scholarly journals 2701. The Impact of Infant 13-valent Conjugate Pneumococcal Vaccination Program on Invasive Pneumococcal Disease in Children in British Columbia, Canada

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S950-S950
Author(s):  
Nirma K Vadlamudi ◽  
David Patrick ◽  
Linda Hoang ◽  
Fawziah Marra
Keyword(s):  
British Columbia ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Pneumococcal Vaccination ◽  
Annual Incidence ◽  
Immunization Program ◽  
Incremental Change ◽  
Laboratory Surveillance ◽  
Rate Ratios ◽  
The Impact

Abstract Background A significant reduction in invasive pneumococcal disease (IPD) has been reported following implementation of the 7-valent pneumococcal conjugate vaccine (PCV7) infant immunization program, but not much has been reported after introduction of the 13-valent vaccine (PCV13). This study represents the effect of PCV13 on IPD in British Columbia, Canada over a 14 year period (2002–2015). Methods Using provincial IPD laboratory surveillance data, we calculated the annual incidence following implementation of PCV7 (September 2004), and PCV13 (September 2010) in children less than 17 years of age. We also compared incidence rate ratios (IRR) against pre-PCV13 (2004–2010) and pre-PCV7 (2002–2003) baselines for overall and age-specific IPD rates using Poisson regression. Results A total of 697 cases were reported over the 14 year period. The overall annual incidence decreased from 10.9 cases per 100,000 population in 2002 to 4.64 cases per 100,000 population in 2015. While overall decline of IPD was 59% (IRR 0.41; 95% CI: 0.35–0.51) compared with baseline, this reduction was greatest after introduction of PCV7 (IRR 0.44; 95% CI: 0.37–0.53); the incremental change after introduction of PCV13 was non-significant (IRR 0.94; 95% CI: 0.78–1.13). The greatest reduction in IPD was in children <2 years of age (PCV13 vs baseline: IRR 0.19; 95% CI: 0.14–0.25), followed by children 3–5 years of age (PCV13 vs baseline: IRR 0.34; 95% CI: 0.21–0.56); no significant change was observed in 6–17 year olds. Conclusion While IPD rates have been significantly reduced since the introduction of the PCV vaccines, the impact of the additional 6 serotypes in the PCV13 vaccine is non-significant. Disclosures All authors: No reported disclosures.

scholarly journals Decreasing case fatality rate following invasive pneumococcal disease, North East England, 2006–2016

2019 ◽  
Vol 147 ◽  
Author(s):  
C. Houseman ◽  
K. E. Chapman ◽  
P. Manley ◽  
R. Gorton ◽  
D. Wilson ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Case Fatality Rate ◽  
Pneumococcal Disease ◽  
Demographic Data ◽  
Case Fatality ◽  
Risk Groups ◽  
Significant Decline ◽  
Fatality Rate ◽  
North East ◽  
Increased Risk

AbstractDeclining mortality following invasive pneumococcal disease (IPD) has been observed concurrent with a reduced incidence due to effective pneumococcal conjugate vaccines. However, with IPD now increasing due to serotype replacement, we undertook a statistical analysis to estimate the trend in all-cause 30-day case fatality rate (CFR) in the North East of England (NEE) following IPD. Clinical, microbiological and demographic data were obtained for all laboratory-confirmed IPD cases (April 2006–March 2016) and the adjusted association between CFR and epidemiological year estimated using logistic regression. Of the 2510 episodes of IPD included in the analysis, 486 died within 30 days of IPD (CFR 19%). Increasing age, male sex, a diagnosis of septicaemia, being in ⩾1 clinical risk groups, alcohol abuse and individual serotypes were independently associated with increased CFR. A significant decline in CFR over time was observed following adjustment for these significant predictors (adjusted odds ratio 0.93, 95% confidence interval 0.89–0.98; P = 0.003). A small but significant decline in 30-day all-cause CFR following IPD has been observed in the NEE. Nonetheless, certain population groups remain at increased risk of dying following IPD. Despite the introduction of effective vaccines, further strategies to reduce the ongoing burden of mortality from IPD are needed.

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