The impact of vaccination on the burden of invasive pneumococcal disease from a nationwide surveillance program in Lebanon: an unexpected increase in mortality driven by non-vaccine serotypes. (2nd December 2022)

• Record Type: Journal Article
• Authors: Reslan, Lina; Youssef, Nour; Boutros, Celina F.; Assaf-Casals, Aia; Fayad, Danielle; Khafaja, Sarah; Akl, Fata; Finianos, Marc; Rizk, Amena A.; Shaker, Rouba; Zaghlout, Alissar; Lteif, Mireille; El Hafi, Bassam; Moumneh, Mohammad Bahij; Feghali, Rita; Ghanem, Soha; Jisr, Tamima; Karayakoupoglou, Gilbert; Naboulsi, Malak; Hamze, Monzer; Samad, Salam; Khoury, Elie; Sarraf, Ricardo; Osman, Marwan; Bou Raad, Elie; El Amin, Hadi; Abadi, Ibrahim; Abdo, Hicham; Chedid, Marwan; Chamseddine, Fatima; Barakat, Angelique; Houmani, Mohammad; Haddad, Antoine; Abdel Nour, Georges; Mokhbat, Jacques E.; Daoud, Ziad; El-Zaatari, Mohamad; Salem Sokhn, Elie; Ghosn, Nada; Ammar, Walid; Hamadeh, Randa; Matar, Ghassan M.; Araj, George F.; Dbaibo, Ghassan S.;
• Is Part Of: Expert review of vaccines. Volume 21:Number 12(2022)
• Page Start: 1905
• Page End: 1921
• Publication Date: 2022-12-02
• Subjects: Antimicrobial resistance -- AMR -- burden -- impact -- adults -- children -- invasive pneumococcal disease -- IPD -- mortality -- pneumococcal conjugate vaccine -- PCV7 -- PCV13 -- serotype -- Streptococcus pneumoniae -- surveillance -- non-vaccine type -- vaccine-type; Vaccines -- Periodicals; Vaccination -- Periodicals; 615.37205
• DOI: 10.1080/14760584.2022.2143349
• Languages: English
• ISSNs: 1476-0584

Abstract

ABSTRACT: Background: The impact of pneumococcal conjugate vaccines (PCVs) on the burden of invasive pneumococcal disease (IPD) and serotype distribution was examined across age groups from data collected by the Lebanese Inter-Hospital Pneumococcal Surveillance Program. Methods: Between 2005 and 2020, 593 invasive Streptococcus pneumoniae isolates were collected from 79 hospitals throughout Lebanon. Serotypes and antimicrobial resistance (AMR) profiles were identified, and trends compared over 3 eras: PCV7, post-PCV7/ pre-PCV13, and PCV13 eras. Results: The prevalence of PCV7 serotypes decreased significantly from 43.6% in the PCV7 era to 17.8% during the PCV13 era ( p <0.001). PCV13-only serotypes remained stable in the PCV13 compared to the post-PCV7 eras, especially serotypes 1 and 3, whereas non-vaccine types (NVT) increased throughout the study period, especially 24 and 16F. The mortality rate increased substantially from 12.5% (PCV7 era) to 24.8% (PCV13 era). A significant decrease in AMR was observed across the three study eras. Conclusion: PCVs substantially impacted IPD and AMR in vaccinated and unvaccinated populations despite an increase in mortality driven by NVT. Broadening the recommendation of vaccination to include older age-groups, using higher valency vaccines, and implementing stringent antimicrobial stewardship are likely to further impact the burden of IPD.