title: Impact of vaccination on invasive pneumococcal disease in adults with focus on the immunosuppressed.
abstract: Pneumococcal conjugate vaccine (PCV13) has been recently added to the vaccine recommendations for immunosuppressed adults (ISP). We conducted a multicenter observational prospective study aimed to assess the evolving epidemiology of invasive pneumococcal disease (IPD) in adults, with especial focus on ISP. All IPD cases admitted from 1999 to 2014 were included. ISP was defined as patients on current cancer chemotherapy, immunosuppressive therapy for autoimmune disease, biological therapy, chronic systemic steroid use, hemodialysis, neutropenia or HIV infection. A total of 799 IPD episodes were analyzed, 198 were considered ISP. IPD incidence decreased from 20 to 8/100,000-population year (p < 0.004) over the study period. No changes in mortality were observed. Penicillin resistance experienced a significant decline. In 694 episodes the serotype was known. Global vaccine coverage considering the whole study period, was for PCV7 21.6% vs. 28.8% in general and in immunosuppressed population (p = 0.04) and for PCV13 64.5% and 56.6% respectively (p = 0.05). The proportion of IPD isolates included in PCV7 and PCV13 significantly decreased over time. A reduction in the incidence of IPD in adults was seen late after the vaccine licensure, both in general population and in ISP. Coverage of PCV13 vaccine might be suboptimal for ISP in the coming years.
authors.affiliation: Service of Internal Medicine, Infectious Diseases Unit, Hospital Universitari Mútua Terrassa, Barcelona, Spain; Universitat Internacional de Catalunya, Spain. Electronic address: asangilbetriu@gmail.com.
authors.forename: Anna
authors.initials: A
authors.lastname: Sangil
authors.affiliation: Service of Microbiology, CatLab, Barcelona, Spain.
authors.forename: Mariona
authors.initials: M
authors.lastname: Xercavins
authors.affiliation: Service of Internal Medicine, Infectious Diseases Unit, Hospital Universitari Mútua Terrassa, Barcelona, Spain.
authors.forename: Mònica
authors.initials: M
authors.lastname: Rodríguez-Carballeira
authors.affiliation: Service of Internal Medicine, Infectious Diseases Unit, Consorci Sanitari de Terrassa, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Andrés
authors.affiliation: Service of Internal Medicine, Infectious Diseases Unit, Hospital Universitari Mútua Terrassa, Barcelona, Spain.
authors.forename: Montse
authors.initials: M
authors.lastname: Riera
authors.affiliation: Service of Internal Medicine, Infectious Diseases Unit, Consorci Sanitari de Terrassa, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Espejo
authors.affiliation: Service of Microbiology, CatLab, Barcelona, Spain.
authors.forename: Josefa
authors.initials: J
authors.lastname: Pérez
authors.affiliation: Service of Internal Medicine, Infectious Diseases Unit, Hospital Universitari Mútua Terrassa, Barcelona, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Garau
authors.affiliation: Service of Internal Medicine, Infectious Diseases Unit, Hospital Universitari Mútua Terrassa, Barcelona, Spain; Universitat Internacional de Catalunya, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Calbo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010403:Penicillin Resistance; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000401:mortality; D022242:Pneumococcal Vaccines / Q000008:administration & dosage; D011446:Prospective Studies; D065288:Serogroup; D013030:Spain / Q000453:epidemiology; D013296:Streptococcus pneumoniae / Q000145:classification / Q000187:drug effects; D013997:Time Factors; D014611:Vaccination / Q000706:statistics & numerical data
chemical_list: C538862:13-valent pneumococcal vaccine; D022242:Pneumococcal Vaccines
keywords: Immunosuppressed; Invasive pneumococcal disease; Pneumococcal conjugate vaccines; Serotypes; Streptococcus pneumoniae