Changes in hospitalizations for pneumonia after universal vaccination with pneumococcal conjugate vaccines 7/13 valent and haemophilus influenzae type b conjugate vaccine in a Pediatric Referral Hospital in Uruguay.
BACKGROUND
In 1994, Uruguay included Haemophilus influenzae b (Hib) conjugated vaccine in a 3 + 1 schedule. In March 2008, 7-valent pneumococcal conjugate vaccines (PCV7) was included in a 2 +1 schedule. In 2010, 13-valent PCV replaced PCV7. Catch-up immunization was offered. The aim of this study was to describe the etiology of community-acquired pneumonia (CAP) in children 0-14 years of age hospitalized at the Hospital Pediatrico-Centro Hospitalario Pereira Rossell between 2003 and 2012.


METHODS
Annual hospitalization rates (per 10,000 discharges) for CAP and bacterial-confirmed CAP in children 0-14 years of age was described prior PCV7 vaccination (2003-2007), during the year of implementation of PCV7 (2008) and after the introduction of PCV7 (2009-2012). Data regarding age, strains isolated from pleural fluid and/or blood, vaccination status, pneumococcal and H. influenzae serotypes were obtained from Hospital Pediatrico-Centro Hospitalario Pereira Rossell databases and vaccination records.


RESULTS
Hospitalization rates for CAP and pneumococcal CAP between prevaccine years and the last year after introduction of vaccination with PCV (2012) significantly decreased by 78.1% and 92.4%, respectively. Significant reduction for 13-valent PCV vaccine serotypes and significant increase for nonvaccine serotypes was observed. A decrease in Staphylococcus aureus pneumonia was observed. Hospitalization rates for H. influenzae CAP remain stable before and after pneumococcal vaccination.


CONCLUSIONS
Three years after PCV7/13 introduction into the routine vaccination schedule, there was a rapid and significant reduction in rates of CAP and P-CAP. An increase of etiology of CAP by other agents was not observed.
From the *Facultad de Medicina, Universidad de la República; and †Laboratorio de Microbiología, Hospital Pediátrico, Centro Hospitalario Pereira Rossell, Montevideo, Uruguay.
María Catalina
MC
Pírez
Gabriela
G
Algorta
Flavia
F
Chamorro
Claudia
C
Romero
Adriana
A
Varela
Alejandra
A
Cedres
Gustavo
G
Giachetto
Alicia
A
Montano
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology*; D005260:Female; D018073:Haemophilus Vaccines / Q000008:administration & dosage*; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D018410:Pneumonia, Bacterial / Q000453:epidemiology*; D014583:Uruguay / Q000453:epidemiology; D014611:Vaccination / Q000706:statistics & numerical data*
C538862:13-valent pneumococcal vaccine; D018073:Haemophilus Vaccines; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022242:Pneumococcal Vaccines