title: [Invasive pneumococcal disease in the Community of Valencia. Six years of surveillance (2007-2012)].
abstract: BACKGROUND
  The introduction of conjugated anti-pneumonia vaccines has led to a change in the epidemiology of Invasive Pneumococcal Disease (IPD). The aim of this study is to describe the trends in IPD in the Community of Valencia during the period 2007-2012.
  
  
  METHODS
  A retrospective, descriptive and longitudinal study was conducted on IPD in the Community of Valencia during the period 2007-2012, The information sources used were the Epidemiological Surveillance Analysis (Análisis de la Vigilancia Epidemiológica (AVE)) and the Valencian Microbiology Network (Red Microbiológica Valenciana (RedMIVA)) of the Valencia Health Department.
  
  
  RESULTS
  The incidence of IPD decreased between 2007 and 2012 in all age groups, mainly in the under 5 year-olds, dropping from 30.5 cases to 12.3 cases per 10(5) inhabitants (p< .001). Pneumonia was the principal presentation of the disease, with a decrease in its rates from 6.9 to 4.1 cases per 10(5) inhabitants (p< .001). A gradual, non-significant, reduction from 26% to 12% (p=.23) was observed in the proportion of cases due to the serotypes contained in the heptavalent vaccine (PCV7), mainly in the under 5 year-olds. The cases due to additional serotypes in 13-valent conjugated vaccine (1, 3, 5, 6A, 7F and 19A) also showed a decreasing trend, mainly in vaccinated under 5 year-olds (52.6% vs 14.3%; p=.03), while the cases due to non-vaccine serotypes significantly increased from 42.3% to 56.7% in the general population (p=.002), and from 47.4% to 78.6% in vaccinated under 5 year-olds (p=.08).
  
  
  CONCLUSIONS
  The results of this study show a reduction in the incidence of IPD, with a decrease in the proportion of cases produced by vaccine serotypes, and an increase in the proportion of those not vaccinated. Epidemiological Surveillance is necessary to monitor the trends in the disease.
authors.affiliation: Medicina Preventiva y Salud Pública, Hospital Universitario Doctor Peset, Valencia, España. Electronic address: ciancotti_luc@gva.es.
authors.forename: Lucía Rosa
authors.initials: LR
authors.lastname: Ciancotti Oliver
authors.affiliation: Servicio de Vigilancia y Control Epidemiológico, Dirección General de Salud Pública, Conselleria de Sanitat, Comunitat Valenciana, Valencia, España.
authors.forename: Isabel
authors.initials: I
authors.lastname: Huertas Zarco
authors.affiliation: Servicio de Vigilancia y Control Epidemiológico, Dirección General de Salud Pública, Conselleria de Sanitat, Comunitat Valenciana, Valencia, España.
authors.forename: Elvira
authors.initials: E
authors.lastname: Pérez Pérez
authors.affiliation: Servicio de Vigilancia y Control Epidemiológico, Dirección General de Salud Pública, Conselleria de Sanitat, Comunitat Valenciana, Valencia, España.
authors.forename: Esther
authors.initials: E
authors.lastname: Carmona Martí
authors.affiliation: Servicio de Vigilancia y Control Epidemiológico, Dirección General de Salud Pública, Conselleria de Sanitat, Comunitat Valenciana, Valencia, España.
authors.forename: Rosa
authors.initials: R
authors.lastname: Carbó Malonda
authors.affiliation: Servicio de Microbiología, Hospital Universitario Politécnico La Fe, Valencia, España.
authors.forename: Ana
authors.initials: A
authors.lastname: Gil Bru
authors.affiliation: Servicio de Vigilancia y Control Epidemiológico, Dirección General de Salud Pública, Conselleria de Sanitat, Comunitat Valenciana, Valencia, España.
authors.forename: Francisco
authors.initials: F
authors.lastname: González Moran
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult
keywords: Enfermedad neumocócica invasiva; Incidence; Incidencia; Invasive pneumococcal disease; Pneumococcal conjugate vaccine; Reemplazo de serotipos; Serotype replacement; Vacuna conjugada antineumocócica