title: Decrease of invasive pneumococcal disease (IPD) in adults after introduction of pneumococcal 13-valent conjugate vaccine in Spain.
abstract: A prospective laboratory-based multicenter study that collected all adult invasive pneumococcal disease (IPD) episodes from 6 Spanish hospitals before (2008-2009) and after (2012-2013). The 13-valent pneumococcal conjugate vaccine (PCV13) licensure was conducted in order to analyze the impact of PCV13 introduction for children on adult IPD. A total of 1558 IPD episodes were detected. The incidence of IPD decreased significantly in the second period by -33.9% (95% CI, -40.3% to -26.8%). IPD due to PCV7 serotypes (-52.7%; 95% CI, -64.2% to -37.5%) and to PCV13 additional serotypes (-55.0% 95% CI, -62.0% to -46.7%) significantly decreased whereas IPD due to non-PCV13 serotypes remained stable (1.0% 95% CI, -12.9% to 17.2%). IPD due to all PCV13 additional serotypes significantly declined with the exception of serotype 3 (-11.3%; 95%CI -35.0% to 21.1%). IPD due to two non-PCV13 serotypes varied: serotype 6C that rose (301.6%; 95%CI, 92.7% to 733.3%, p<0.001), related to the expansion of ST3866C, and serotype 8 that decreased (-34.9%, 95%CI, -57.1 to -1.2, p = 0.049), related to a decline of the ST638. The recombinant clone ST652111A (variant of ST1569V) increased in frequency. The decrease of serotype 19A IPD was linked to a fall in those antibiotic susceptible clones. In the last period, rates of penicillin- and cefotaxime-resistance remained under 10% and 4%, respectively. Adult IPD decreased after the PCV13 introduction in Spain due to herd protection. The spread of multidrug resistant clones (ST3866C, ST652111A) related to non-PCV13 serotypes needs further surveillance.
authors.affiliation: Hosp. Univ. de Bellvitge-Universitat de Barcelona-IDIBELL, L'Hospitalet de Llobregat, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Càmara
authors.affiliation: Hosp. Univ. Donostia, Donostia-San Sebastián, Spain.|CIBER Enfermedades Respiratorias, Madrid, Spain.
authors.forename: José María
authors.initials: JM
authors.lastname: Marimón
authors.affiliation: CIBER Enfermedades Respiratorias, Madrid, Spain.|Hosp. General Univ. Gregorio Marañón, Madrid, Spain.
authors.forename: Emilia
authors.initials: E
authors.lastname: Cercenado
authors.affiliation: Hosp. Univ. Vall d'Hebrón, Barcelona, Spain.
authors.forename: Nieves
authors.initials: N
authors.lastname: Larrosa
authors.affiliation: CIBER Enfermedades Respiratorias, Madrid, Spain.|H. U. Germans Trias i Pujol, Badalona, Spain.
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Quesada
authors.affiliation: Corp. Sanitària Parc Taulí, IU-UAB, Sabadell, Spain.
authors.forename: Dionísia
authors.initials: D
authors.lastname: Fontanals
authors.affiliation: Hosp. Univ. de Bellvitge-Universitat de Barcelona-IDIBELL, L'Hospitalet de Llobregat, Spain.|CIBER Enfermedades Respiratorias, Madrid, Spain.
authors.forename: Meritxell
authors.initials: M
authors.lastname: Cubero
authors.affiliation: Hosp. Univ. Donostia, Donostia-San Sebastián, Spain.|CIBER Enfermedades Respiratorias, Madrid, Spain.
authors.forename: Emilio
authors.initials: E
authors.lastname: Pérez-Trallero
authors.affiliation: Laboratorio de Referencia de neumococo, ISCIII, Madrid, Spain.
authors.forename: Asunción
authors.initials: A
authors.lastname: Fenoll
authors.affiliation: Hosp. Univ. de Bellvitge-Universitat de Barcelona-IDIBELL, L'Hospitalet de Llobregat, Spain.|CIBER Enfermedades Respiratorias, Madrid, Spain.
authors.forename: Josefina
authors.initials: J
authors.lastname: Liñares
authors.affiliation: Hosp. Univ. de Bellvitge-Universitat de Barcelona-IDIBELL, L'Hospitalet de Llobregat, Spain.|CIBER Enfermedades Respiratorias, Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Ardanuy
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D011446:Prospective Studies; D013030:Spain; D055815:Young Adult
chemical_list: C538862:13-valent pneumococcal vaccine; D022242:Pneumococcal Vaccines