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Pneumococcal meningitis in the era of pneumococcal conjugate vaccine implementation

E Bingen1, C Levy, E Varon

  • 1Service de Microbiologie, Hôpital Robert Debré, 48 Bvd Serurier, F75019 Paris, France. edouard.bingen@rdb.ap-hop-paris.fr

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|December 7, 2007
PubMed

Insights

The seven-valent pneumococcal conjugate vaccine (PCV7) reduced pneumococcal meningitis cases in French children by 28.4%. However, non-vaccine serotypes increased, indicating a need for broader protection against this serious infection.

Area of Science:

  • Pediatric Infectious Diseases
  • Epidemiology
  • Vaccinology

Background:

  • Pneumococcal meningitis remains a significant cause of childhood morbidity and mortality.
  • The introduction of the seven-valent pneumococcal conjugate vaccine (PCV7) aimed to reduce the burden of this disease.
  • Understanding the evolving epidemiology and vaccine impact is crucial for public health strategies.

Purpose of the Study:

  • To analyze clinical and biological features of pneumococcal meningitis in French children.
  • To evaluate the impact of PCV7 on the incidence and serotype distribution of pneumococcal meningitis.
  • To identify risk factors for mortality in pediatric pneumococcal meningitis.

Main Methods:

  • Active surveillance network established by the French Pediatric Infectious Diseases Group from 2001 to 2005.
  • Inclusion of all children diagnosed with pneumococcal meningitis in participating pediatric wards and microbiology laboratories.
  • Data collection on risk factors, clinical presentation, vaccination status, cerebrospinal fluid analysis, treatment, and outcomes.

Main Results:

  • A total of 616 cases were reported, with a median age of 0.9 years; 13.1% had underlying conditions.
  • Penicillin non-susceptible strains accounted for 48.7% of cases.
  • A 28.4% decrease in cases was observed in 2005 compared to the prevaccinal period (2001-2002) in children aged 2-24 months (P < 0.05).
  • The proportion of PCV7-covered serotypes decreased, while non-vaccine and related serotypes increased.
  • The overall case fatality rate was 10.8% and not significantly associated with age, antibiotic susceptibility, or steroid use.

Conclusions:

  • PCV7 demonstrated a significant impact in reducing pneumococcal meningitis incidence in young children.
  • The rise in non-vaccine and related serotypes highlights the need for vaccines with broader serotype coverage.
  • Continued surveillance is essential to monitor the evolving epidemiology of pneumococcal meningitis and vaccine effectiveness.

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