title: Are risk factors associated with invasive pneumococcal disease according to different serotypes?
abstract: The aim of this study was to investigate risk factors for the most common serotypes of invasive pneumococcal disease (IPD). A total of 293 IPD cases were analyzed in children aged 3-59 mo in a community with intermediate vaccination coverage with the 7-valent pneumococcal vaccine (PCV7). IPD cases were reviewed during 2007-2009 in two pediatric hospitals in Catalonia (Spain). A multivariate analysis using unconditional logistic regression was performed to estimate the adjusted odds ratio. PCV7 coverage was 45.4%. Pneumonia with empyema (64.5%) was the most frequent clinical manifestation. The most common serotypes were: serotype 1 (21.2%), 19A (16.0%), 3 (12.6%) and 7F/A (6.8%). 70.0% of serotypes found were included in the 13-valent conjugate vaccine (PCV13), 39.2% in the 10-valent conjugate vaccine and 8.1% in the PCV7. PCV7 was protective in IPD cases due to PCV7-serotypes (aOR: 0.15, 95% CI:0.04-0.55). Serotype 1 was positively associated with attending day care or school (aOR: 3.55, 95% CI: 1.21-10.38) and age 24-59 mo (aOR: 7.70, 95% CI:2.70-21.98). Serotype 19A was positively associated with respiratory infection in the previous month (aOR: 2.26, 95% CI: 1.03-4.94), non-penicillin susceptible IPD (aOR: 1.89, 95% CI:1.13-3.16) and negatively associated with age 24-59 mo (aOR: 0.19, 95% CI:0.09-0.41). Serotype 3 was positively associated with vaccination (aOR: 4.87, 95% CI:2.05-11.59). No factors were associated with serotype 7F/A. Vaccination with pneumococcal vaccines including more serotypes may reduce the risk of disease in our setting.
authors.affiliation: Public Health Agency of Catalonia; Barcelona, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Ciruela
authors.forename: Núria
authors.initials: N
authors.lastname: Soldevila
authors.forename: Laura
authors.initials: L
authors.lastname: Selva
authors.forename: Sergi
authors.initials: S
authors.lastname: Hernández
authors.forename: Juan Jose
authors.initials: JJ
authors.lastname: Garcia-Garcia
authors.forename: Fernando
authors.initials: F
authors.lastname: Moraga
authors.forename: Mariona F
authors.initials: MF
authors.lastname: de Sevilla
authors.forename: Gemma
authors.initials: G
authors.lastname: Codina
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Planes
authors.forename: Cristina
authors.initials: C
authors.lastname: Esteva
authors.forename: Francis
authors.initials: F
authors.lastname: Coll
authors.forename: Neus
authors.initials: N
authors.lastname: Cardeñosa
authors.forename: Iolanda
authors.initials: I
authors.lastname: Jordan
authors.forename: Joan
authors.initials: J
authors.lastname: Batalla
authors.forename: Luis
authors.initials: L
authors.lastname: Salleras
authors.forename: Carmen
authors.initials: C
authors.lastname: Muñoz-Almagro
authors.forename: Angela
authors.initials: A
authors.lastname: Domínguez
mesh_terms: D002675:Child, Preschool; D006801:Humans; D007223:Infant; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D022242:Pneumococcal Vaccines / Q000276:immunology; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D065288:Serogroup; D013030:Spain / Q000453:epidemiology; D013296:Streptococcus pneumoniae / Q000145:classification* / Q000302:isolation & purification
chemical_list: D022242:Pneumococcal Vaccines
keywords: Streptococcus pneumoniae; invasive pneumococcal disease; pneumococcal conjugate vaccine; risk factors; serotypes