Impact of the pediatric 13-valent pneumococcal conjugate vaccine on serotype distribution and clinical characteristics of pneumococcal pneumonia in adults: The Japan Pneumococcal Vaccine Effectiveness Study (J-PAVE) |
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| Institution: | 1. Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan;2. Department of Clinical Tropical Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan;3. Department of General Internal Medicine, Kameda Medical Center, Chiba, Japan;4. Department of Infectious Diseases, Nagasaki Rosai Hospital, Nagasaki, Japan;5. Department of Internal Medicine, Juzenkai Hospital, Nagasaki, Japan;6. Department of Pulmonology, Kameda Medical Center, Chiba, Japan;7. Department of Respiratory Medicine, Chikamori Hospital, Kochi, Japan;8. Department of General Internal Medicine, Fukushima Medical University, Fukushima, Japan;9. Department of Laboratory Medicine, Kameda Medical Center, Chiba, Japan;1. Department of Medical Microbiology, College of Medicine, Faculty of Health Sciences, University of Manitoba, 727 McDermot Avenue, Winnipeg, Manitoba R3E 3P5, Canada;2. Clinical Microbiology–Health Sciences Centre, Diagnostic Services Manitoba, MS673-820 Sherbrook Street, Winnipeg, Manitoba R3A 1R9, Canada;1. Merck Vaccines, 770 Sumneytown Pike, WP97-B364, West Point, PA 19426, USA;2. Merck Research Laboratories, Upper Gwynedd, PA 19454, USA;1. Division of Clinical Infectious Diseases, Department of Medicine, School of Medicine, Showa University, Tokyo, Japan;2. Division of Infection Control Sciences, Department of Clinical Pharmacy, School of Pharmacy, Showa University, Tokyo, Japan;1. Department of Internal Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands;2. Department of Medical Microbiology and Immunology, St. Antonius Hospital, Nieuwegein, The Netherlands;3. Interstitial Lung Diseases Centre of Excellence, Department of Pulmonology, St. Antonius Hospital, Nieuwegein, The Netherlands;4. Division of Heart and Lungs, University Medical Centre Utrecht, Utrecht, The Netherlands;5. Department of Respiratory Medicine, Catharina Hospital, Eindhoven, The Netherlands;6. Department of Sciences, University College Roosevelt, Middelburg, The Netherlands;7. Department of Clinical Pharmacy, St. Antonius Hospital, The Netherlands;8. Division of Pharmacoepidemiology and Clinical Pharmacology, Department of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands;1. Department of Respiratory Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan;2. Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan;3. Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan;1. Department of Respiratory Medicine, City Hospital Campus, Nottingham University Hospitals NHS Trust, Hucknall Road, Nottingham NG5 1PB, UK;2. Respiratory and Systemic Infection Laboratory, Public Health England, Microbiology Services Division, Colindale Avenue, London NW9 5EQ, UK;3. Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK |
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| Abstract: | BackgroundThe pediatric 13-valent pneumococcal conjugate vaccine (PCV13) was included in the pediatric immunization programme in Japan in late 2013. The impact of vaccination on the serotype distribution and clinical characteristics of pneumococcal pneumonia has not been described.MethodsThe first phase of this multicentre prospective study was conducted at community-based hospitals in Japan from 2011 to 2014. The second phase was conducted from 2016 to 2017. Pneumococcal isolates and clinical data were collected from patients with community-acquired pneumonia who were ≥15 years of age. Patients were classified by pneumococcal serotype to PCV13 serotype, 23-valent pneumococcal polysaccharide vaccine (PPV23) non-PCV13 serotype, and non-vaccine serotype.ResultsA total of 484 patients were enrolled, 241 in the first phase and 243 in the second. The proportion of PCV13 serotypes decreased from 53% to 33% (p < 0.001), whereas PPV23 non-PCV13 serotypes did not change (p = 0.754). PCV13 serotypes were associated with increased risk of elevated blood urea nitrogen (adjusted odds ratio 2.49; 95% confidence interval: 1.49–4.16) and hospitalization (adjusted odds ratio 1.74; 95% confidence interval: 1.02–2.95). These associations were not observed in patients with PPV23 non-PCV13 serotypes.ConclusionsThe occurrence of pneumococcal pneumonia caused by vaccine-covered serotypes dramatically decreased following the introduction of pediatric PCV13. The PCV13 serotypes were associated with pneumonia severity. |
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| Keywords: | Pneumococcal pneumonia PCV13 serotypes PPV23 Vaccine |
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