Journal of Pediatric Infectious Diseases 2020; 15(04): 169-175
DOI: 10.1055/s-0040-1702925
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Epidemiological, Clinical, and Microbiological Characteristics of Serotype-3 Streptoccocus pneumoniae Infection after a Partial Introduction of the 13-Valent Pneumococcal Conjugate Vaccine: A Prospective Observational Study

Anna Solé-Ribalta
1  Department of Pediatrics, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
,
Maria F. de Sevilla
1  Department of Pediatrics, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
2  Malalties Prevenibles amb Vacunes, Institut de recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
3  CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
,
Fernando Moraga-Llop
4  Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
,
Alvaro D. Conradi
5  Department of Pediatrics, Hospital de Nens, Barcelona, Spain
,
Sergi Hernández
6  Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
,
Johanna Martínez-Osorio
1  Department of Pediatrics, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
,
Sebastià González-Peris
4  Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
,
Conchita Izquierdo
6  Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
,
Cristina Esteva
2  Malalties Prevenibles amb Vacunes, Institut de recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
3  CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
7  Microbiology Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
,
Gemma Codina
4  Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
,
Ana M. Planes
4  Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
,
Sonia Uriona
4  Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
,
Magda Campins
4  Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
,
Pilar Ciruela
3  CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
6  Agència de Salut Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
,
Luis Salleras
3  CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
8  Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
,
Ángela Domínguez
3  CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
8  Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
,
Carmen Muñoz-Almagro
2  Malalties Prevenibles amb Vacunes, Institut de recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
3  CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
7  Microbiology Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
9  Departament de Medicina, Universitat Internacional de Catalunya, Barcelona, Spain
,
Juan J. García-Garcia
1  Department of Pediatrics, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
2  Malalties Prevenibles amb Vacunes, Institut de recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
3  CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
› Author Affiliations
Funding This study was supported by the PI11/02081 and PI11/02345 projects, integrated in the Plan Nacional de I + D + I, and funded by the ISCIII—Subdirección General de Evaluación y Fomento de la Investigación Sanitaria and the Fondo Europeo de Desarrollo Regional (FEDER).
Further Information

Publication History

13 September 2019

17 January 2020

Publication Date:
02 March 2020 (online)

Abstract

Objective After the introduction of 13-valent pneumococcal conjugate vaccine (PCV13), a decrease of serotype-3 invasive pneumococcal disease (IPD) has not been homogenously observed around Europe. The aim of the study is to analyze the incidence of serotype-3 IPD in our area (Catalonia, Spain) and describe what microbiological and clinical characteristics distinguish serotype-3 IPD from nonserotype-3 IPD.

Methods This study is a prospective observational study performed in three hospitals of Barcelona (Spain), from January 2012 to June 2016. Patients younger than 18 years with a diagnosis of IPD were included. Epidemiological, clinical, and microbiological data were collected.

Results A total of 253 cases of IPD were included; of these, 53 were caused by serotype 3. The incidence rate of serotype-3 IPD remained stable over the study years (risk ratio [RR] = 0.64; 95% confidence interval [CI]: 0.3–1.38). In 92.5% (49/53) of the cases of serotype-3 IPD, the diagnosis was pneumonia and 89.8% (44/49) of them reported a complicated pneumonia. Also, 98.1% (52/53) were detected by positive real-time polymerase chain reaction (PCR) in blood or pleural effusion. Seventeen patients were properly vaccinated with PCV13 before the infection.

Conclusion After the introduction of PCV13 a global decline of invasive pneumococcal disease has been reported, specially, due to a decrease of serotypes 1 and 19A cases. Serotype-3 Streptococcus pneumoniae IPD remained stable throughout the years of study, being currently the main serotype causing IPD in our area. Serotype 3 causes mostly pneumonia and physicians must be aware of possible complications. Real-time PCR have a significantly higher diagnostic yield for serotype 3 compared with culture. Some vaccination failures were observed.