Association of serotype with respiratory presentations of pneumococcal infection, Ontario, Canada, 2003-2011

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• 作者：Altynay Shigayeva^a ; Wallis Rudnick^a ; ^b ; Karen Green^a ; Gregory Tyrrell^c ; Walter H.B. Demczuk^d ; Wayne L. Gold^b ; ^e ; Jonathan Gubbay^b ; ^f ; Frances Jamieson^b ; ^f ; Agron Plevneshi^a ; Sylvia Pong-Porter^a ; Susan Richardson^b ; ^g ; Allison McGeer^a ; ^b ; ^{amcgeer@mtsinai.on.ca" class="auth_mail" title="E-mail the corresponding author} ; For the Toronto Invasive Bacterial Diseases Network¹
• 关键词：Invasive pneumococcal disease ; Serotype ; Pneumonia ; Pneumococcal vaccine
• 刊名：Vaccine
• 出版年：2016
• 出版时间：3 February 2016
• 年：2016
• 卷：34
• 期：6
• 页码：846-853
• 全文大小：1096 K

文摘

Pneumococcal disease burden is difficult to quantify due to limited data regarding non-bacteremic disease. We assessed serotype-specific differences in pneumococcal disease presentations in adults in Toronto, Canada.

Methods

From 2003 to 2011, population-based surveillance for invasive pneumococcal disease was conducted and respiratory pneumococcal isolates collected in Metropolitan Toronto/Peel Region, Canada. Episodes of care were classified into disease categories.

Results

Of 3105 eligible cases of IPD, 2060 cases were bacteremic pneumonia, and 1045 bacteremia without pneumonia. Of 2751 eligible respiratory cases, 1542 (56.0%) were non-bacteremic pneumonia (NBPP), 467 (17.0%) were other acute respiratory infection (oARI), and 742 (27.0%) were isolates representing colonization. Serotypes 3 (11.3%), 19A (8.4%) and 22F (6.2%) were the most common; serotypes 1,5, and 8 were rare. Serotypes 4, 14, 7F, 9V, 12F, 14, 19A and 6C were over-represented in bacteremic disease, and serotypes 3, 6A, 11A, 19F, 23A, 23F, 35B, 35F were more common in NBPP. The proportion of cases due to PCV7 serotypes declined from 48.7% to 8.7% in bacteremic pneumonia, from 35.3% to 10.9% in NBPP, from 34.2% to 7.5% in oARI, and from 38.7% to 12.2% in colonizing isolates. In 2010–2011, PCV13 serotypes accounted for 62.6% of isolates associated with bacteremic pneumonia, 42.0% of bacteremia without pneumonia, 41.1% of NBPP, 25.7% of oARI, and 32.9% of colonizing isolates.

Conclusions

Serotype distributions differ significantly in different presentations of pneumococcal disease. Herd protection due to PCV7 has changed serotype distribution, but PCV13 serotypes remain important in all categories of disease.