Epidemiology of invasive pneumococcal disease in older people in Spain (2007-2009): implications for future vaccination strategies.

Recently, the 13-valent pneumococcal conjugate vaccine (PCV13) has been recommended for adults. We analyzed the epidemiology of invasive pneumococcal disease (IPD) in older adults in Spain before PCV13 introduction.IPD episodes, defined as clinical findings together with an invasive pneumococcal iso...

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Main Authors: Carmen Ardanuy, José María Marimón, Laura Calatayud, Montserrat Giménez, Marta Alonso, Immaculada Grau, Román Pallarés, Emilio Pérez-Trallero, Josefina Liñares
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2012-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC3425535?pdf=render
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author Carmen Ardanuy
José María Marimón
Laura Calatayud
Montserrat Giménez
Marta Alonso
Immaculada Grau
Román Pallarés
Emilio Pérez-Trallero
Josefina Liñares
author_facet Carmen Ardanuy
José María Marimón
Laura Calatayud
Montserrat Giménez
Marta Alonso
Immaculada Grau
Román Pallarés
Emilio Pérez-Trallero
Josefina Liñares
author_sort Carmen Ardanuy
collection DOAJ
description Recently, the 13-valent pneumococcal conjugate vaccine (PCV13) has been recommended for adults. We analyzed the epidemiology of invasive pneumococcal disease (IPD) in older adults in Spain before PCV13 introduction.IPD episodes, defined as clinical findings together with an invasive pneumococcal isolate, were prospectively collected from patients aged over 65 years in three hospitals in Spain from 2007 to 2009. A total of 335 IPD episodes were collected. Pneumonia was the main clinical syndrome, while chronic obstructive pulmonary disease, diabetes mellitus and cancer were the main underlying diseases. Pneumococcal isolates were serotyped and the molecular typing was performed by PFGE/MLST. PCV13 serotypes accounted for 59.3% of isolates, the most prevalent being serotypes 19A (15.1%), 3 (9.6%), 7F (7.5%), 14 (6.9%) and 1 (5.4%). The most frequent non-PCV13 serotypes were serotypes 16F (4.5%), 22F (3.6%), 24F (3.3%) and 6C (2.1%). The most common genotypes were CC230 (8.5%, serotypes 19A and 24F), CC156 (8.2%, serotypes 9V and 14), ST191 (7.9%, serotype 7F), CC260 (6.6%, serotype 3), ST306 (5.2%, serotype 1), CC30 (4.6%, serotype 16F) and ST433 (3.6%, serotype 22F). Comparing the 335 IPD isolates to 174 invasive pneumococci collected at the same hospitals in 1999-2000, PCV7 serotypes decreased (45.4% vs 18.4%,p<0.001), non-PCV7 serotypes included in PCV13 increased (26.4% vs 41.0%,p = 0.001) and two non-PCV13 serotypes increased (serotype 6C 0% vs 2.1%, p = 0.05; serotype 24F 0.6% vs 3.3%, p = 0.04,).In our older adult population two serotypes (19A and 3) included in PCV13 accounted for about a quarter of IPD episodes in people ≥65 years. Non-PCV13 emerging serotypes should be carefully monitored in future surveillance studies.
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spelling doaj.art-943c4a894472437dbd6ffe14988e8ae92022-12-21T23:07:01ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-0178e4361910.1371/journal.pone.0043619Epidemiology of invasive pneumococcal disease in older people in Spain (2007-2009): implications for future vaccination strategies.Carmen ArdanuyJosé María MarimónLaura CalatayudMontserrat GiménezMarta AlonsoImmaculada GrauRomán PallarésEmilio Pérez-TralleroJosefina LiñaresRecently, the 13-valent pneumococcal conjugate vaccine (PCV13) has been recommended for adults. We analyzed the epidemiology of invasive pneumococcal disease (IPD) in older adults in Spain before PCV13 introduction.IPD episodes, defined as clinical findings together with an invasive pneumococcal isolate, were prospectively collected from patients aged over 65 years in three hospitals in Spain from 2007 to 2009. A total of 335 IPD episodes were collected. Pneumonia was the main clinical syndrome, while chronic obstructive pulmonary disease, diabetes mellitus and cancer were the main underlying diseases. Pneumococcal isolates were serotyped and the molecular typing was performed by PFGE/MLST. PCV13 serotypes accounted for 59.3% of isolates, the most prevalent being serotypes 19A (15.1%), 3 (9.6%), 7F (7.5%), 14 (6.9%) and 1 (5.4%). The most frequent non-PCV13 serotypes were serotypes 16F (4.5%), 22F (3.6%), 24F (3.3%) and 6C (2.1%). The most common genotypes were CC230 (8.5%, serotypes 19A and 24F), CC156 (8.2%, serotypes 9V and 14), ST191 (7.9%, serotype 7F), CC260 (6.6%, serotype 3), ST306 (5.2%, serotype 1), CC30 (4.6%, serotype 16F) and ST433 (3.6%, serotype 22F). Comparing the 335 IPD isolates to 174 invasive pneumococci collected at the same hospitals in 1999-2000, PCV7 serotypes decreased (45.4% vs 18.4%,p<0.001), non-PCV7 serotypes included in PCV13 increased (26.4% vs 41.0%,p = 0.001) and two non-PCV13 serotypes increased (serotype 6C 0% vs 2.1%, p = 0.05; serotype 24F 0.6% vs 3.3%, p = 0.04,).In our older adult population two serotypes (19A and 3) included in PCV13 accounted for about a quarter of IPD episodes in people ≥65 years. Non-PCV13 emerging serotypes should be carefully monitored in future surveillance studies.http://europepmc.org/articles/PMC3425535?pdf=render
spellingShingle Carmen Ardanuy
José María Marimón
Laura Calatayud
Montserrat Giménez
Marta Alonso
Immaculada Grau
Román Pallarés
Emilio Pérez-Trallero
Josefina Liñares
Epidemiology of invasive pneumococcal disease in older people in Spain (2007-2009): implications for future vaccination strategies.
PLoS ONE
title Epidemiology of invasive pneumococcal disease in older people in Spain (2007-2009): implications for future vaccination strategies.
title_full Epidemiology of invasive pneumococcal disease in older people in Spain (2007-2009): implications for future vaccination strategies.
title_fullStr Epidemiology of invasive pneumococcal disease in older people in Spain (2007-2009): implications for future vaccination strategies.
title_full_unstemmed Epidemiology of invasive pneumococcal disease in older people in Spain (2007-2009): implications for future vaccination strategies.
title_short Epidemiology of invasive pneumococcal disease in older people in Spain (2007-2009): implications for future vaccination strategies.
title_sort epidemiology of invasive pneumococcal disease in older people in spain 2007 2009 implications for future vaccination strategies
url http://europepmc.org/articles/PMC3425535?pdf=render
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