TY - JOUR
T1 - The relative invasive disease potential of Streptococcus pneumoniae among children after PCV introduction
T2 - A systematic review and meta-analysis
AU - Balsells, Evelyn
AU - Dagan, Ron
AU - Yildirim, Inci
AU - Gounder, Prabhu P.
AU - Steens, Anneke
AU - Muñoz-Almagro, Carmen
AU - Mameli, Chiara
AU - Kandasamy, Rama
AU - Givon Lavi, Noga
AU - Daprai, Laura
AU - van der Ende, Arie
AU - Trzciński, Krzysztof
AU - Nzenze, Susan A.
AU - Meiring, Susan
AU - Foster, Dona
AU - Bulkow, Lisa R.
AU - Rudolph, Karen
AU - Valero-Rello, Ana
AU - Ducker, Struan
AU - Vestrheim, Didrik Frimann
AU - von Gottberg, Anne
AU - Pelton, Stephen I.
AU - Zuccotti, Gian Vincenzo
AU - Pollard, Andrew J.
AU - Sanders, Elisabeth A.M.
AU - Campbell, Harry
AU - Madhi, Shabir A.
AU - Nair, Harish
AU - Kyaw, Moe H.
N1 - Publisher Copyright:
© 2018 The British Infection Association
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Objectives: Burden of pneumococcal disease depends on the prevalence and invasive disease potential of serotypes. We aimed to estimate the invasive disease potential of serotypes in children under 5 years of age by combining data from different settings with routine immunisation with pneumococcal conjugate vaccines (PCV). Methods: We conducted a systematic review, supplemented by unpublished data, to identify data on the frequency of pneumococcal serotypes in carriage and invasive pneumococcal disease (IPD). We estimated the invasive disease potential of serotypes as the ratio of IPD in relation to carriage (odds ratio and 95%CI) compared with 19A (reference serotype) by meta-analysis. We report results based on a random effects model for children aged 0–23, 24–29, and 0–59 months and by invasive clinical syndromes. Results: In comparison with 19A, serotypes 1, 7F, and 12F had a significantly higher invasive disease potential in children aged 0–23 and 0–59 months for all IPD and clinical syndromes (OR > 5). Several non-vaccine types (NVTs) (6C, 15A, 15BC, 16F, 23B, in these two age groups) had a lower invasive disease potential than 19A (OR 0.1–0.3). NVTs 8, 12F, 24F, and 33F were at the upper end of the invasiveness spectrum. Conclusions: There is substantial variation among pneumococcal serotypes in their potential to cause IPD and disease presentation, which is influenced by age and time after PCV introduction. Surveillance of IPD and carriage is critical to understand the expected effectiveness of current PCVs (in the longer term) and guide the development of future vaccines.
AB - Objectives: Burden of pneumococcal disease depends on the prevalence and invasive disease potential of serotypes. We aimed to estimate the invasive disease potential of serotypes in children under 5 years of age by combining data from different settings with routine immunisation with pneumococcal conjugate vaccines (PCV). Methods: We conducted a systematic review, supplemented by unpublished data, to identify data on the frequency of pneumococcal serotypes in carriage and invasive pneumococcal disease (IPD). We estimated the invasive disease potential of serotypes as the ratio of IPD in relation to carriage (odds ratio and 95%CI) compared with 19A (reference serotype) by meta-analysis. We report results based on a random effects model for children aged 0–23, 24–29, and 0–59 months and by invasive clinical syndromes. Results: In comparison with 19A, serotypes 1, 7F, and 12F had a significantly higher invasive disease potential in children aged 0–23 and 0–59 months for all IPD and clinical syndromes (OR > 5). Several non-vaccine types (NVTs) (6C, 15A, 15BC, 16F, 23B, in these two age groups) had a lower invasive disease potential than 19A (OR 0.1–0.3). NVTs 8, 12F, 24F, and 33F were at the upper end of the invasiveness spectrum. Conclusions: There is substantial variation among pneumococcal serotypes in their potential to cause IPD and disease presentation, which is influenced by age and time after PCV introduction. Surveillance of IPD and carriage is critical to understand the expected effectiveness of current PCVs (in the longer term) and guide the development of future vaccines.
KW - Invasive disease potential
KW - Meta-analysis
KW - Pneumococcal conjugate vaccine
KW - Serotype
KW - Streptococcus pneumoniae
UR - http://www.scopus.com/inward/record.url?scp=85052082968&partnerID=8YFLogxK
U2 - 10.1016/j.jinf.2018.06.004
DO - 10.1016/j.jinf.2018.06.004
M3 - Article
C2 - 29964140
AN - SCOPUS:85052082968
SN - 0163-4453
VL - 77
SP - 368
EP - 378
JO - Journal of Infection
JF - Journal of Infection
IS - 5
ER -