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Decline in the incidence of invasive pneumococcal disease at a medical center in Taiwan, 2000-2012.

Lai CC, Lin SH, Liao CH, Sheng WH, Hsueh PR - BMC Infect. Dis. (2014)

Bottom Line: The coverage rate of 7-valent protein conjugated vaccine (PCV-7) and PCV-10 decreased significantly; however, the coverage rate of PCV-13 and pneumococcal polysaccharide vaccine (PPV-23) remained stable over time.Serotypes 14 and 23F were the two most common serotypes found in adult patients, and serotypes 14 and 19A were the two most common serotypes isolated from children.Although the incidence of IPD has decreased, serotype 19A is an emerging problem in Taiwan.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan. hsporen@ntu.edu.tw.

ABSTRACT

Background: It is essential to investigate the serotype distribution of pneumococcal diseases in each region and its associated clinical features. This study investigated the annual incidence of invasive pneumococcal disease (IPD) and the distribution of serotypes of isolates causing IPD at a medical center in northern Taiwan during the period 2000 to 2012.

Methods: Serotypes of all available Streptococcus pneumoniae isolates causing IPD were determined using the latex agglutination test.

Results: During the study period, the annual incidence (per 10,000 admissions) of IPD decreased significantly from 9.8 in 2000 to 2.1 in 2012 (P < 0.001). The annual incidence of all-cause bacteremia, primary pneumococcal bacteremia, bacteremic pneumonia, peritonitis, and meningitis also decreased significantly during the study period (P < 0.05). In contrast to the decrease in annual incidence of pneumococcal serotypes 14, 23F and 6B, the incidence and the proportion of serotype 19A significantly increased with time (P < 0.001). The coverage rate of 7-valent protein conjugated vaccine (PCV-7) and PCV-10 decreased significantly; however, the coverage rate of PCV-13 and pneumococcal polysaccharide vaccine (PPV-23) remained stable over time. Serotype 14 and 19A isolates were commonly isolated from blood and pleural effusion, respectively. Serotypes 14 and 23F were the two most common serotypes found in adult patients, and serotypes 14 and 19A were the two most common serotypes isolated from children.

Conclusions: Although the incidence of IPD has decreased, serotype 19A is an emerging problem in Taiwan. The distribution of serotypes of pneumococci varied with clinical symptoms and age. As the changing distribution of pneumococcal serotype with time, the coverage rate of pneumococcal vaccines would be different.

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Coverage rates of different pneumococcal vaccines among S. pneumoniae isolates recovered from patients with invasive pneumococcal diseases at National Taiwan University Hospital from 2000 to 2012.
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Figure 3: Coverage rates of different pneumococcal vaccines among S. pneumoniae isolates recovered from patients with invasive pneumococcal diseases at National Taiwan University Hospital from 2000 to 2012.

Mentions: The coverage rates of conjugated vaccines including PCV-7 (PrevnarR; Pfizer), PCV-10 (Synflorix; GSK), PCV-13 (Prevnar 13; Pfizer) and PPV-23 (Pneumovax 23; Merck Sharp & Dohme Corp.) are shown in Figure 3. The overall coverage rates during the period 2000–2012 were 65.2% for PCV-7, 65.9% for PCV-10, 85.8% for PCV-13, and 91.2% for PPV-23. The coverage rates of PCV-7 and PCV-10 significantly decreased with time, but the PCV-13 and PPV-23 coverage rates remained stable. Moreover, PCV-7 and PCV-10 had only a 25% coverage rate in 2012. In contrast, the coverage rates of PCV-13 and PCV-23 were each 80.0% in 2012. The reason coverage of PCV-13 was better than that of PPV-23 in 2010 and 2011 is that there were four serotype 6A isolates found in 2010 and two serotype 6A isolates found in 2011 that were covered by PCV-13 but not by PPV-23.


Decline in the incidence of invasive pneumococcal disease at a medical center in Taiwan, 2000-2012.

Lai CC, Lin SH, Liao CH, Sheng WH, Hsueh PR - BMC Infect. Dis. (2014)

Coverage rates of different pneumococcal vaccines among S. pneumoniae isolates recovered from patients with invasive pneumococcal diseases at National Taiwan University Hospital from 2000 to 2012.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3927834&req=5

Figure 3: Coverage rates of different pneumococcal vaccines among S. pneumoniae isolates recovered from patients with invasive pneumococcal diseases at National Taiwan University Hospital from 2000 to 2012.
Mentions: The coverage rates of conjugated vaccines including PCV-7 (PrevnarR; Pfizer), PCV-10 (Synflorix; GSK), PCV-13 (Prevnar 13; Pfizer) and PPV-23 (Pneumovax 23; Merck Sharp & Dohme Corp.) are shown in Figure 3. The overall coverage rates during the period 2000–2012 were 65.2% for PCV-7, 65.9% for PCV-10, 85.8% for PCV-13, and 91.2% for PPV-23. The coverage rates of PCV-7 and PCV-10 significantly decreased with time, but the PCV-13 and PPV-23 coverage rates remained stable. Moreover, PCV-7 and PCV-10 had only a 25% coverage rate in 2012. In contrast, the coverage rates of PCV-13 and PCV-23 were each 80.0% in 2012. The reason coverage of PCV-13 was better than that of PPV-23 in 2010 and 2011 is that there were four serotype 6A isolates found in 2010 and two serotype 6A isolates found in 2011 that were covered by PCV-13 but not by PPV-23.

Bottom Line: The coverage rate of 7-valent protein conjugated vaccine (PCV-7) and PCV-10 decreased significantly; however, the coverage rate of PCV-13 and pneumococcal polysaccharide vaccine (PPV-23) remained stable over time.Serotypes 14 and 23F were the two most common serotypes found in adult patients, and serotypes 14 and 19A were the two most common serotypes isolated from children.Although the incidence of IPD has decreased, serotype 19A is an emerging problem in Taiwan.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan. hsporen@ntu.edu.tw.

ABSTRACT

Background: It is essential to investigate the serotype distribution of pneumococcal diseases in each region and its associated clinical features. This study investigated the annual incidence of invasive pneumococcal disease (IPD) and the distribution of serotypes of isolates causing IPD at a medical center in northern Taiwan during the period 2000 to 2012.

Methods: Serotypes of all available Streptococcus pneumoniae isolates causing IPD were determined using the latex agglutination test.

Results: During the study period, the annual incidence (per 10,000 admissions) of IPD decreased significantly from 9.8 in 2000 to 2.1 in 2012 (P < 0.001). The annual incidence of all-cause bacteremia, primary pneumococcal bacteremia, bacteremic pneumonia, peritonitis, and meningitis also decreased significantly during the study period (P < 0.05). In contrast to the decrease in annual incidence of pneumococcal serotypes 14, 23F and 6B, the incidence and the proportion of serotype 19A significantly increased with time (P < 0.001). The coverage rate of 7-valent protein conjugated vaccine (PCV-7) and PCV-10 decreased significantly; however, the coverage rate of PCV-13 and pneumococcal polysaccharide vaccine (PPV-23) remained stable over time. Serotype 14 and 19A isolates were commonly isolated from blood and pleural effusion, respectively. Serotypes 14 and 23F were the two most common serotypes found in adult patients, and serotypes 14 and 19A were the two most common serotypes isolated from children.

Conclusions: Although the incidence of IPD has decreased, serotype 19A is an emerging problem in Taiwan. The distribution of serotypes of pneumococci varied with clinical symptoms and age. As the changing distribution of pneumococcal serotype with time, the coverage rate of pneumococcal vaccines would be different.

Show MeSH
Related in: MedlinePlus