Related Experiment Video
Updated: Jul 8, 2025
Following in Real Time the Impact of Pneumococcal Virulence Factors in an Acute Mouse Pneumonia Model Using Bioluminescent Bacteria
Published on: February 23, 2014
Invasive Pneumococcal Disease After 2 Decades of Pneumococcal Conjugate Vaccine Use
Inci Yildirim1,2,3,4, Rotem Lapidot5,6, Yazdani Basha Shaik-Dasthagirisaheb6
1Department of Pediatrics, Section of Infectious Diseases and Global Health, Yale University School of Medicine, New Haven, Connecticut.
Insights
Invasive pneumococcal disease (IPD) incidence in children significantly declined by 72% over two decades following the introduction of pneumococcal conjugate vaccines (PCV7 and PCV13). Surveillance identified shifts in dominant serotypes and declining antimicrobial resistance.
Area of Science:
- Pediatric infectious diseases
- Vaccinology
- Epidemiology
Background:
- Invasive pneumococcal disease (IPD) remains a significant public health concern in children.
- The introduction of pneumococcal conjugate vaccines (PCV7 and PCV13) has aimed to reduce the burden of IPD.
- Understanding the evolving epidemiology of IPD is crucial for public health strategies.
Purpose of the Study:
- To describe the changing epidemiology of IPD in children in Massachusetts over 20 years.
- To assess the impact of PCV7 and PCV13 vaccine implementation on IPD incidence and serotype distribution.
- To monitor antimicrobial susceptibility patterns of Streptococcus pneumoniae isolates.
Main Methods:
- A population-based surveillance system tracked IPD cases in children (<18 years) from 2002 to 2021.
- Streptococcus pneumoniae isolates were serotyped and tested for antimicrobial susceptibility.
- Incidence rates and rate ratios were calculated to assess trends.
Main Results:
- Overall IPD incidence in children decreased by 72% between 2002 and 2021.
- Rates continued to decline after PCV13 replaced PCV7, reaching the lowest point during 2020-2021.
- Shifts in dominant serotypes were observed, with non-PCV13 serotypes becoming more prevalent and showing increased penicillin nonsusceptibility.
Conclusions:
- Sustained surveillance is essential for detecting emerging IPD serotypes.
- Vaccine development needs to consider the changing landscape of circulating pneumococcal strains.
- Ongoing monitoring informs vaccine policy and public health interventions.
Objectives:
We sought to describe the evolving epidemiology of invasive pneumococcal disease (IPD) among children in Massachusetts, United States, over the last 2 decades during which sequential 7-valent pneumococcal conjugate vaccines (PCV7) and 13-valent PCVs (PCV13) were implemented.
Methods:
Cases of IPD in children aged <18 years were detected between 2002 and 2021 through an enhanced population-based, statewide surveillance system. Streptococcus pneumoniae isolates from normally sterile sites were serotyped and evaluated for antimicrobial susceptibility. IPD incidence rates and rate ratios with 95% confidence intervals (CIs) were calculated.
Results:
We identified 1347 IPD cases. Incidence of IPD in children aged <18 years declined 72% over 2 decades between 2002 and 2021 (incidence rate ratios 0.28, 95% CI 0.18-0.45). IPD rates continued to decline after replacement of PCV7 with PCV13 (incidence rate ratios 0.25, 95% CI 0.16-0.39, late PCV7 era [2010] versus late PCV13 era [2021]). During the coronavirus disease 2019 pandemic years, 2020 to 2021, the rate of IPD among children aged <18 years reached 1.6 per 100 000, the lowest incidence observed over the 20 years. In PCV13 era, approximately one-third of the IPD cases in children aged >5 years had at least 1 underlying condition (98, 30.3%). Serotypes 19A and 7F contributed 342 (48.9%) of all cases before implementation of PCV13 (2002-2010). Serotype 3 (31, 8.6%), and non-PCV13 serotypes 15B/C (39, 10.8%), 33F (29, 8.0%), 23B (21, 0.8%), and 35B (17, 4.7%) were responsible for 37.8% of cases in PCV13 era (2011-2021). Penicillin nonsusceptibility continued to decline (9.8% vs 5.3% in pre-/late PCV13 era, P = .003), however has become more common among non-PCV13 serotypes compared with vaccine serotypes (14.8% vs 1.4%, P < .001).
Conclusions:
Robust ongoing surveillance networks are critical for identifying emerging serotypes and development of next-generation vaccine formulations.
More Related Videos
06:06Constructing Mutants in Serotype 1 Streptococcus pneumoniae strain 519/43
Published on: September 11, 2020
12:21A Mouse Model for the Transition of Streptococcus pneumoniae from Colonizer to Pathogen upon Viral Co-Infection Recapitulates Age-Exacerbated Illness
Published on: September 28, 2022
Related Concept Videos
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:29Pneumonia II: Pathophysiology
01:30Pneumonia III: Complications and Assessment
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:28Pulmonary Tuberculosis II
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...