Impact of Pneumococcal Conjugate Vaccines on Antibiotic-Nonsusceptible Invasive Pneumococcal Disease in the United States. (28th April 2022)

• Record Type: Journal Article
• Authors: Bajema, Kristina L; Gierke, Ryan; Farley, Monica M; Schaffner, William; Thomas, Ann; Reingold, Arthur L; Harrison, Lee H; Lynfield, Ruth; Burzlaff, Kari E; Petit, Susan; Barnes, Meghan; Torres, Salina; Vagnone, Paula M Snippes; Beall, Bernard; Pilishvili, Tamara
• Is Part Of: Journal of infectious diseases. Volume 226:Number 2(2022)
• Page Start: 342
• Page End: 351
• Publication Date: 2022-04-28
• Subjects: antibiotic nonsusceptibility; Streptococcus pneumoniae; pneumococcal conjugate vaccine; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiac154
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract: Background: Antibiotic-nonsusceptible invasive pneumococcal disease (NS-IPD) incidence declined dramatically in the United States after introduction of pneumococcal conjugate vaccines (PCVs) into the infant immunization schedule (7-valent PCV7 in 2000, replaced by the 13-valent PCV13 in 2010). We evaluated the long-term impact of PCVs on NS-IPD. Methods: We identified IPD cases through the Centers for Disease Control Active Bacterial Core surveillance during 1998–2018. Isolates intermediate or resistant to ≥1 antibiotic class were classified as nonsusceptible. We calculated annual rates of IPD (cases per 100 000 persons). Results: From 1998 through 2018, NS-IPD incidence decreased from 43.9 to 3.2 among children <5 years and from 19.8 to 9.4 among adults ≥65 years. Incidence of vaccine-type NS-IPD decreased in all age groups, whereas incidence of nonvaccine type (NVT) NS-IPD increased in all age groups; the greatest absolute increase in NVT NS-IPD occurred among adults ≥65 years (2.3 to 7.2). During 2014–2018, NVTs 35B, 33F, 22F, and 15A were the most common NS-IPD serotypes. Conclusions: Nonsusceptible IPD incidence decreased after PCV7 and PCV13 introduction in the United States. However, recent increases in NVT NS-IPD, most pronounced among older adults, have been observed. New higher valency PCVs containing the most common nonsusceptible serotypes, including 22F and 33F, could help further reduce NS-IPD. Abstract : Antibiotic-nonsusceptible invasive pneumococcal disease (NS-IPD) incidence decreased after 7- and 13-valent pneumococcal conjugate vaccine (PCV) introduction in the United States. Expanded valency PCVs recently recommended for adult use could contribute to further reductions in NS-IPD.