Are risk factors associated with invasive pneumococcal disease according to different serotypes?

作者：Ciruela Pilar^*; Soldevila Nuria; Selva Laura; Hernandez Sergi; Jose Garcia Garcia Juan; Moraga Fernando; de Sevilla Mariona F; Codina Gemma; Maria Planes Ana; Esteva Cristina; Coll Francis; Cardenosa Neus; Jordan Iolanda; Batalla Joan; Salleras Luis; Munoz Almagro Carmen; Dominguez Angela

来源：Human Vaccines & Immunotherapeutics, 2013, 9(3): 712-719.

DOI：10.4161/hv.23270

• invasive pneumococcal disease
• risk factors
• serotypes
• Streptococcus pneumoniae
• pneumococcal conjugate vaccine

The aim of this study was to investigate risk factors for the most common serotypes of invasive pneumococcal disease (IPD). A total of 293 IPD cases were analyzed in children aged 3-59 mo in a community with intermediate vaccination coverage with the 7-valent pneumococcal vaccine (PCV7). IPD cases were reviewed during 2007-2009 in two pediatric hospitals in Catalonia (Spain). A multivariate analysis using unconditional logistic regression was performed to estimate the adjusted odds ratio. PCV7 coverage was 45.4%. Pneumonia with empyema (64.5%) was the most frequent clinical manifestation. The most common serotypes were: serotype 1 (21.2%), 19A (16.0%), 3 (12.6%) and 7F/A (6.8%). 70.0% of serotypes found were included in the 13-valent conjugate vaccine (PCV13), 39.2% in the 10-valent conjugate vaccine and 8.1% in the PCV7. PCV7 was protective in IPD cases due to PCV7-serotypes (aOR: 0.15, 95% CI: 0.04-0.55). Serotype 1 was positively associated with attending day care or school (aOR: 3.55, 95% CI: 1.21-10.38) and age 24-59 mo (aOR: 7.70, 95% CI: 2.70-21.98). Serotype 19A was positively associated with respiratory infection in the previous month (aOR: 2.26, 95% CI: 1.03-4.94), non-penicillin susceptible IPD (aOR: 1.89, 95% CI: 1.13-3.16) and negatively associated with age 24-59 mo (aOR: 0.19, 95% CI: 0.09-0.41). Serotype 3 was positively associated with vaccination (aOR: 4.87, 95% CI: 2.05-11.59). No factors were associated with serotype 7F/A. Vaccination with pneumococcal vaccines including more serotypes may reduce the risk of disease in our setting.

• 出版日期2013-3