title: Trends of pneumococcal meningitis in children after introduction of the 13-valent pneumococcal conjugate vaccine in France.
abstract: BACKGROUND
  Streptococcus pneumoniae remains an important cause of bacterial meningitis in children younger than 2 years. Here, we analyzed data from an active surveillance network established 12 years ago by the Pediatric Infectious Disease Group and the Pediatric Clinical and Therapeutical Association to analyze the impact of pneumococcal conjugate vaccine (PCV7 implemented in 2002 and PCV13 in 2010) on pneumococcal meningitis (PM).
  
  
  METHODS
  Two hundred twenty-seven pediatric wards working with 168 microbiology departments throughout France were asked to report all cases of PM.
  
  
  RESULTS
  From 2001 to 2012, among 4808 bacterial meningitis cases, 1406 cases of PM (29.2%) were reported. After PCV13 implementation, from 2009 to 2012, the number of cases significantly decreased by 27.4% (P = 0.041, Cuzick trend test). For children younger than 2 years, the decrease was 28.2% (P = 0.039, Cuzick trend test). In the same period, the decrease was 66.7% in cases due to 6 additional PCV13 types, and the number of cases due to nonvaccine types remained stable. In 2012, the non-PCV13 serotype represented 67.6% of cases and were mainly represented by 12F (15%), 24F (15%), 22F (7%) and 15B/C (7%). For 88.6% of cases, initial antibiotic treatment was vancomycin with a third-generation cephalosporin. Overall mortality was 10.6%, most deaths (86.4%) occurred before day 15.
  
  
  CONCLUSIONS
  Two years after the PCV13 implementation, we found an impact on PM cases particularly for children younger than 2 years.
authors.affiliation: From the *GPIP, Pediatric Infectious Disease Group; †ACTIV, Pediatric Clinical and Therapeutical Association of the Val de Marne, Saint-Maur des Fossés; ‡Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France; §National Reference Center for Pneumococci, Laboratoire de Microbiologie, Assistance Publique-Hôpitaux de Paris, Hopital Européen Georges-Pompidou; ¶Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale, U980; ‖University Paris Descartes, Sorbonne Paris Cité, Imagine Institute; **Pediatric Hematology-Immunology Unit, Necker-Enfants Malades Hospital; ††Center for the Study of Primary Immunodeficiencies, Assistance Publique-Hôpitaux de Paris, Necker Hospital, Paris, France; ‡‡Pediatric Emergency Unit and Infectious Diseases, CHRU, Lille University Hospital, UDSL, Lille; §§Univ Paris Diderot, Sorbonne Paris Cité, France; ¶¶Service de Microbiologie, Hôpital Robert-Debré, Paris; and ‖‖Unité Court Séjour, Petits Nourrisson, Service de Néonatologie, Centre Hospitalier Intercommunal de Créteil, France.
authors.forename: Corinne
authors.initials: C
authors.lastname: Levy
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Varon
authors.forename: Capucine
authors.initials: C
authors.lastname: Picard
authors.forename: Stéphane
authors.initials: S
authors.lastname: Béchet
authors.forename: Alain
authors.initials: A
authors.lastname: Martinot
authors.forename: Stéphane
authors.initials: S
authors.lastname: Bonacorsi
authors.forename: Robert
authors.initials: R
authors.lastname: Cohen
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D062665:Epidemiological Monitoring; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008586:Meningitis, Pneumococcal / Q000453:epidemiology* / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D065288:Serogroup; D013296:Streptococcus pneumoniae / Q000145:classification / Q000302:isolation & purification*; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: C538862:13-valent pneumococcal vaccine; D022242:Pneumococcal Vaccines