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Are risk factors associated with invasive pneumococcal disease according to different serotypes?

Pilar Ciruela1, Núria Soldevila, Laura Selva

  • 1Public Health Agency of Catalonia; Barcelona, Spain.

Human Vaccines & Immunotherapeutics
|January 9, 2013
PubMed

Insights

This study identified risk factors for common invasive pneumococcal disease (IPD) serotypes in young children. Expanding vaccine serotype coverage, like with PCV13, may reduce IPD risk.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Vaccinology

Background:

  • Invasive pneumococcal disease (IPD) remains a significant public health concern, particularly in young children.
  • The 7-valent pneumococcal conjugate vaccine (PCV7) has reduced IPD incidence, but serotype replacement and disease due to non-PCV7 serotypes persist.
  • Understanding risk factors for specific IPD serotypes is crucial for optimizing prevention strategies.

Purpose of the Study:

  • To investigate risk factors associated with the most common serotypes of invasive pneumococcal disease (IPD) in children aged 3-59 months.
  • To analyze the impact of intermediate PCV7 vaccination coverage on IPD epidemiology.
  • To identify clinical and demographic factors associated with specific pneumococcal serotypes.

Main Methods:

  • Retrospective analysis of 293 IPD cases in children (3-59 months) in Catalonia, Spain (2007-2009).
  • Multivariate analysis using unconditional logistic regression to determine adjusted odds ratios (aOR) for risk factors.
  • Assessment of pneumococcal conjugate vaccine (PCV) coverage and serotype distribution.

Main Results:

  • Pneumonia with empyema was the most frequent clinical manifestation (64.5%).
  • Dominant serotypes included 1 (21.2%), 19A (16.0%), 3 (12.6%), and 7F/A (6.8%).
  • PCV7 was protective against PCV7-serotype IPD (aOR: 0.15). Serotype 1 associated with daycare attendance and older age (24-59 mo). Serotype 19A linked to prior respiratory infection and non-susceptible strains, but negatively associated with age 24-59 mo. Serotype 3 associated with vaccination (aOR: 4.87).

Conclusions:

  • Serotype 1, 19A, and 3 are significant contributors to IPD in this setting.
  • Daycare attendance, prior respiratory infections, and non-susceptible strains are key risk factors for specific serotypes.
  • Vaccination with pneumococcal vaccines covering a broader range of serotypes, such as PCV13, is recommended to reduce IPD burden.

Keywords:
Streptococcus pneumoniaeinvasive pneumococcal diseasepneumococcal conjugate vaccinerisk factorsserotypes

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