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Paediatric invasive pneumococcal disease on the island of Gran Canaria: 16-year prospective study (2001-2016)
Milagrosa Santana Hernández1, Ione Ahedey Aguiar-Santana1, Fernando Artiles Campelo2
1Unidad de Urgencias de Pediatría, Hospital Universitario Materno Infantil de Canarias, Las Palmas de Gran Canaria, Spain.
Insights
The introduction of the PCV13 vaccine significantly reduced invasive pneumococcal disease (IPD) incidence in children on Gran Canaria. While IPD rates and antibiotic resistance declined, pleural effusions increased post-vaccination.
Area of Science:
- Pediatric Infectious Diseases
- Vaccinology
- Epidemiology
Background:
- Invasive pneumococcal disease (IPD) remains a significant public health concern in pediatric populations worldwide.
- The introduction of pneumococcal conjugate vaccines (PCVs) has aimed to reduce the burden of IPD.
- Understanding the impact of PCV13 on IPD epidemiology in specific regions is crucial for public health strategies.
Purpose of the Study:
- To evaluate the incidence, clinical features, serotype distribution, and antibiotic resistance of IPD in children on Gran Canaria.
- To assess the impact of the PCV13 vaccine on these IPD characteristics before and after its introduction.
Main Methods:
- A prospective, hospital-based study was conducted on 190 pediatric patients (0-14 years) with confirmed IPD.
- Data were collected from January 2001 to December 2016, divided into pre-PCV13 and post-PCV13 periods.
- Clinical data, serotypes, and antibiotic resistance patterns were analyzed and compared between the two periods.
Main Results:
- IPD incidence decreased by 66.4% post-PCV13 introduction (from 13.1 to 4.4 per 100,000).
- A significant reduction in vaccine-serotype IPD and erythromycin resistance was observed.
- Pleural effusions and empyemas showed an increase in the post-PCV13 period.
Conclusions:
- The PCV13 vaccine has been effective in reducing overall IPD incidence and antibiotic resistance in children on Gran Canaria.
- An increase in non-bacteremic or less severe forms of IPD, such as pleural effusions, was noted post-vaccination.
- Continued surveillance is necessary to monitor long-term trends and potential shifts in IPD epidemiology.
Objectives:
To calculate the incidence of invasive pneumococcal disease (IPD) in the paediatric population of Gran Canaria (Spain), its clinical and epidemiological characteristics, serotype distribution, antibiotic resistance, and variations in these variables before and after the introduction of the PCV13 vaccine.
Methods:
Prospective hospital-based study including all patients (190) aged 0-14 years admitted with confirmed IPD between January 2001-May 2010 (152 cases) and June 2010-December 2016 (38 cases). Patients were divided into 3 age groups (<2 years; 2-5 years; and >5 years). Clinical symptoms were mutually-exclusively classified as meningitis, bacteraemic pneumonia, pleural effusion (PE), empyema or bacteraemia without a focus.
Results:
Most cases occurred in boys (59.47%), during autumn-winter (65.79%), in children aged <2 years (55.79%) and with mean age increasing from the pre-PCV13 to the post-PCV13 period (2.5 vs 3.1 years). Incidence between periods reduced by 66.4% (p<0.001): from 13.1/100,000 to 4.4/100,000. PEs (3.9% vs 18.4%, p<0.005) and empyemas (1.5% vs 16.7%, p=NS) increased in the post-PCV13 period whereas all other symptoms decreased, although this was not statistically significant. Vaccine serotypes (77% vs 40.6%, p=0.000), particularly serotypes 19A (23.9% vs 12.5%) and 14 (14.2% vs 9.4%), as well as erythromycin resistance (57.2% vs 7.9%, p=0.000) decreased in the post-PCV13 period.
Conclusion:
IPD incidence, vaccine serotypes and erythromycin resistance decreased in the post-PCV13 period whereas PEs increased.
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