Population-based surveillance for invasive pneumococcal disease and pneumonia in infants and young children in Goi芒nia, Brazil

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• 作者：Ana Lucia Andrade^a ; Renato Oliveira^a ; Maria A. Vieira^a ; Ruth Minamisava^b ; Vicente Pessoa Jr.^a ; Maria Cristina C. Brandileone^c ; Sueli L.A. Alves^d ; Fernando Alfieri^e ; Rosana Pagliarini^e ; José ; Cassio Moraes^f ; Sharon Gray^g ; Gail L. Rodgers^g ; ^{gail.rodgers@pfizer.com}
• 关键词：Streptococcus pneumoniae ; Pneumococcal infections ; Pneumococcal pneumonia ; Population-based incidence ; Pneumococcal conjugate vaccines
• 刊名：Vaccine
• 出版年：2012
• 期刊代码：89_0264410x
• 类别：imm
• 出版时间：27 February, 2012
• 卷：30
• 期：10
• 页码：1901-1909
• 文件大小：437 K

摘要

Background

Streptococcus pneumoniae is the leading cause of vaccine-preventable death in children <5 years of age globally. We determined incidence rates of invasive pneumococcal disease (IPD), clinical and chest X-ray-confirmed pneumonia (CXR + Pn), S. pneumoniae serotype distribution, and antimicrobial susceptibility in children in Goi芒nia, Brazil.

Methods

Prospective, population-based surveillance was conducted from May 2007 to May 2009 in children 28 days to <36 months of age presenting to all 33 pediatric healthcare services (outpatient departments, emergency rooms, hospitals) in Goi芒nia. Eligibility criteria were temperature 鈮?9.0 掳C in the previous 24 h and/or clinical suspicion of pneumonia or IPD.

Results

14,509 subjects were enrolled. Median age was 14.0 months. S. pneumoniae was detected in 64 samples from 62 subjects: 58 (90.6%) blood; 4 (6.3%) cerebrospinal fluid; and 2 (3.1%) pleural fluid. Incidence rate of IPD (culture- and polymerase chain reaction-positive) for all children aged 28 days to <36 months was 57.5/100,000; overall incidence for culture-positive only was 54.9/100,000. Age stratification of culture-positive-only subjects found the highest rates were, 114.6/100,000 and 69.8/100,000, respectively, for the 6 months to <12 months and 12 months to <24 months age groups. The overall incidence of invasive pneumonia and pneumococcal meningitis was 37.2/100,000 and 5.3/100,000, respectively. The most common IPD serotypes were 14 (45.0%), 6B (13.3%), 18C (6.7%), and 23F (5.0%). Eight isolates (13.3%) were penicillin nonsusceptible. The cumulative percentages of serotypes included in 7-valent, 10-valent, and 13-valent pneumococcal conjugate vaccines were 78.3%, 80.0%, and 88.3%, respectively. The overall incidence of clinical pneumonia and CXR + Pn was, 9598/100,000 and 3428/100,000, respectively. CXR + Pn rates for hospitalized and non-hospitalized subjects were 1751/100,000 and 1677/100,000, respectively.

Conclusions

The burden of IPD and pneumonia is considerable in children in a large Brazilian city, and is seen in hospitalized as well as ambulatory subjects. Vaccination with pneumococcal conjugate vaccines has the potential to decrease this burden.