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Published on: February 23, 2014
Proportion of invasive pneumococcal infections in German children preventable by pneumococcal conjugate vaccines
R von Kries1, A Siedler, H J Schmitt
1Institute for Social Pediatrics, Ludwig-Maximilians-Universität, Munich, Germany. ag.epi@LRZ.uni-muenchen.de
Insights
Invasive pneumococcal disease (IPD) surveillance in German children revealed significant incidence rates, particularly for meningitis. Serotype distribution partially aligned with current conjugate vaccines, with no penicillin or cefotaxime resistance observed.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Invasive pneumococcal disease (IPD) remains a significant global health concern.
- Data on IPD incidence and serotype distribution in European countries, including Germany, are limited.
- Streptococcus pneumoniae is a primary cause of bacterial meningitis and other invasive infections in children.
Purpose of the Study:
- To determine the incidence and serotype distribution of IPD in children in Germany.
- To assess the coverage of existing and developing pneumococcal conjugate vaccines based on identified serotypes.
- To evaluate antimicrobial resistance patterns of Streptococcus pneumoniae isolates.
Main Methods:
- Population-based, nationwide prospective surveillance of IPD cases in children from January 1997 to December 1998.
- Data collected through monthly reports from all pediatric hospitals and clinical microbiology laboratories.
- Serotyping of isolates and assessment of resistance to penicillin and cefotaxime.
Main Results:
- A total of 896 IPD cases were reported, with incidences per 10(5) children varying by age group (e.g., 18.9 in <1 year olds).
- Meningitis accounted for 404 cases, with an incidence of 9.7 per 10(5) children aged <1 year.
- Serotypes covered by 7-, 9-, and 11-valent vaccines accounted for 52%, 62%, and 71% of cases, respectively.
- No penicillin or cefotaxime resistance was observed in any isolates.
- IPD manifestations other than meningitis appear less common in Germany compared to other countries.
Conclusions:
- The study provides crucial baseline data on IPD incidence and serotype distribution in German children.
- Current pneumococcal conjugate vaccines offer partial but not complete serotype coverage for IPD in Germany.
- The lack of antimicrobial resistance is a positive finding, but ongoing surveillance is essential.
Abstract:
The incidence and serotype distribution of Streptococcus pneumoniae as a cause of invasive diseases are unknown with regard to most European countries. From January 1997 through December 1998, population-based nationwide prospective surveillance was undertaken for invasive pneumococcal disease (IPD) in children in Germany, based on monthly independent reports from all pediatric hospitals and from clinical microbiology laboratories. On the basis of 896 reported IPD cases (including 404 with meningitis), the incidences per 10(5) children in different age groups were as follows: children aged <1 year, 18.9 (9.7 for meningitis); children aged <2 years, 16. 0 (7.2 for meningitis); for children aged <5 years, 8.9 (3.9 for meningitis); and for children aged <16 years, 3.2 (1.4 for meningitis). The proportions of cases involving strains (304 serotyped) included in conjugate vaccines were as follows: for the 7-valent vaccine, 52%; for the 9-valent, 62%; and for the 11-valent, 71%. None of the isolates were resistant to penicillin or cefotaxime. Although the rate for meningitis is similar, other manifestations of IPD are less commonly diagnosed in Germany than in other countries. The serotype distribution only partially matched that used in the recent development of pneumococcal conjugate vaccines.
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