Serotype distribution of invasive Streptococcus pneumoniae in Canada after the introduction of the 13-valent pneumococcal conjugate vaccine, 2010–2012

Canadian Journal of Microbiology - Tập 59 Số 12 - Trang 778-788 - 2013
Walter Demczuk1, Irene Martín1, Averil Griffith1, Brigitte Lefebvre2, Allison McGeer3, Marguerite Lovgren4, Gregory J. Tyrrell4, Shalini Desai5, Lindsey Sherrard5, Heather J Adam6,7, Matthew W. Gilmour6,7, George G. Zhanel6
1National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, MB R3E 3R2, Canada
2Laboratoire de santé publique du Québec, 20045 chemin Sainte-Marie, Ste-Anne-de-Bellevue, QC H9X 3R5, Canada.
3Department of Microbiology, Mount Sinai Hospital, 600 University Avenue, Room 210, Toronto, ON M5G 1X5, Canada.
4The Provincial Laboratory for Public Health (Microbiology), Walter Mackenzie Health Sciences Centre, 8440 – 112 Street, Edmonton, AB T6G 2J2, Canada.
5Vaccine Preventable Diseases Section, Surveillance and Outbreak Response Division, Centre for Immunization and Respiratory Infectious Diseases, Public Health Agency of Canada, Room 273A, 2nd Floor, 130 Colonnade Road, AL 6502A, Ottawa, ON K1A 0K9, Canada.
6Department of Medical Microbiology and Infectious Diseases, Faculty of Medicine, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
7Diagnostic Services Manitoba, Health Sciences Centre, 820 Sherbrook Street, Winnipeg, MB R3A 1R9, Canada.

Tóm tắt

The introduction of the 7-valent pneumococcal vaccine (PCV7) in Canada was very effective in reducing invasive pneumococcal disease (IPD) in children; however, increases of non-PCV7 serotypes have subsequently offset some of these reductions. A 13-valent pneumococcal vaccine (PCV13) targeting additional serotypes was implemented between 2010 and 2011, and in 2012 changes in the incidence of disease and the distribution of IPD serotypes began to emerge. The incidence of IPD in children <5 years of age declined from 18.0 to 14.2 cases per 100 000 population between 2010 and 2012; however, the incidence in ages ≥5 years remained relatively unchanged over the 3-year period, at about 9.7 cases per 100 000 population. From 2010 to 2012, PCV13 serotypes declined significantly from 66% (224/339) to 41% (101/244, p < 0.001) in children <5 years of age, and from 54% (1262/2360) to 43% (1006/2353, p < 0.001) in children ≥5 years of age. Serotypes 19A, 7F, 3, and 22F were the most common serotypes in 2012, with 19A decreasing from 19% (521/2727) to 14% (364/2620, p < 0.001), 7F decreasing from 14% (389/2727) to 12% (323/2620, p = 0.04), and 22F increasing from 7% (185/2727) to 11% (279/2620, p < 0.001) since 2010. Serotype 3 increased from 7% (23/339) to 10% (24/244) in <5-year-olds (p = 0.22) over the 3-year period. The highest rates of antimicrobial resistance were observed with clarithromycin (23%), penicillin using meningitis breakpoints (12%), clindamycin (8%), and trimethoprim–sulfamethoxazole (6%). Shifts in the distribution of IPD serotypes and reductions in the incidence of disease suggest that current immunization programs in Canada are effective in reducing the burden of IPD in children. While we acknowledge the limited data on the effectiveness of the PCV13 vaccine, to our knowledge, this study represents one of the first descriptions of the potential impact of the PCV13 vaccine in the Canadian population. Continued surveillance will be important to recognize replacement serotypes, to determine the extent of herd immunity effects in nonpaediatric populations, and to assess the overall effectiveness of PCV13 in reducing IPD in Canada.

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Canadian Journal of Microbiology

Tập 59 Số 12

778-788

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