1. Burden of Streptococcus pneumoniae Sepsis in Children After Introduction of Pneumococcal Conjugate Vaccines: A Prospective Population-based Cohort Study
- Author
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Martin Stocker, Sara Bernhard-Stirnemann, Christoph Berger, Ulrich Heininger, Christa Relly, Philipp Agyeman, Luregn J. Schlapbach, Walter Baer, Sandra A. Asner, Pierre A. Crisinel, Paul Hasters, Christoph Aebi, Christian R Kahlert, Klara M. Posfay-Barbe, Eric Giannoni, Anita Niederer-Loher, Eugénie Gradoux, University of Zurich, and Berger, Christoph
- Subjects
Male ,Sepsis/epidemiology/etiology/microbiology ,medicine.disease_cause ,2726 Microbiology (medical) ,Cohort Studies ,Pneumococcal Vaccines ,0302 clinical medicine ,030212 general & internal medicine ,Prospective Studies ,Child ,Pediatric intensive care unit ,Vaccines ,education.field_of_study ,ddc:618 ,3. Good health ,Infectious Diseases ,Streptococcus pneumoniae ,Child, Preschool ,Conjugate/adverse effects/therapeutic use ,Female ,Streptococcus pneumoniae/immunology/pathogenicity ,Meningitis ,Vaccine failure ,Microbiology (medical) ,medicine.medical_specialty ,Population ,610 Medicine & health ,complex mixtures ,Pneumococcal Infections ,Sepsis ,03 medical and health sciences ,030225 pediatrics ,Internal medicine ,medicine ,Humans ,Serotyping ,Preschool ,education ,Vaccines, Conjugate ,business.industry ,Pneumococcal Infections/etiology/microbiology ,Infant ,2725 Infectious Diseases ,Pneumococcal Vaccines/adverse effects/therapeutic use ,medicine.disease ,Systemic inflammatory response syndrome ,10036 Medical Clinic ,Bacteremia ,570 Life sciences ,biology ,business - Abstract
BackgroundPopulation-based studies assessing the impact of pneumococcal conjugate vaccines (PCV) on burden of pneumococcal sepsis in children are lacking. We aimed to assess this burden following introduction of PCV-13 in a nationwide cohort study.MethodsThe Swiss Pediatric Sepsis Study (September 2011 to December 2015) prospectively recruited children ResultsChildren with pneumococcal sepsis (n = 117) accounted for a crude incidence of 2.0 per 100 000 children (95% confidence interval [CI] 1.7–2.4) and 25% of community-acquired sepsis episodes. Case fatality rate was 8%. Forty-two (36%) patients required PICU admission. Children with meningitis (29; 25%) were more often infected by serotypes not included in PCV (69% vs 31%; P < .001). Sixteen (26%) of 62 children up to date with PCV immunization presented with vaccine failure, including 11 infected with serotype 3. In multivariable analyses, children with meningitis (odds ratio [OR] 6.8; 95% CI 2.4–19.3; P < .001) or infected with serotype 3 (OR 2.8; 95% CI 1.1–7.3; P = .04) were more often admitted to PICU. Children infected with serotype 3 had longer LOS (β coefficient 0.2, 95% CI .1–1.1; P = .01).ConclusionsThe incidence of pneumococcal sepsis in children shortly after introduction of PCV-13 remained substantial. Meningitis mostly due to non-vaccine serotypes and disease caused by serotype 3 represented significant predictors of severity.
- Published
- 2018
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