1 - Instituto de Microbiologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa
2 - Hospital Dona Estefânia. Centro Hospitalar de Lisboa Central
3 - Portuguese Group for the Study of Streptococcal Infections
4 - Portuguese Study Group of Invasive Pneumococcal Disease of the Pediatric Infectious Disease Society
- SCIENTIFIC RePortS | DOI:10.1038/s41598-018-36799
Resumo: We evaluated the impact of continued 13-valent pneumococcal conjugate vaccine (PCV13) use in the private market (uptake of 61%) in pediatric invasive pneumococcal disease (pIPD) in Portugal (2012–2015). The most frequently detected serotypes were: 3 (n=32, 13.8%), 14 (n=23, 9.9%), 1 (n=23, 9.9%), 7F (n=15, 6.4%), 19A (n=13, 5.6%), 6B and 15B/C (both n=12, 5.2%), and 24F, 10A and 12B (all with n=10, 4.3%). Taken together, non-PCV13 serotypes were responsible for 42.2% of pIPD with a known serotype. The use of PCR to detect and serotype pneumococci in both pleural and cerebrospinal fuid samples contributed to 18.1% (n=47) of all pIPD. Serotype 3 was mostly detected by PCR (n=21/32, 65.6%) and resulted from a relevant number of vaccine failures. The incidence of pIPD varied in the diferent age groups but without a clear trend. There were no obvious declines of the incidence of pIPD due to serotypes included in any of the PCVs, and PCV13 serotypes still accounted for the majority of pIPD (57.8%). Our study indicates that a higher vaccination uptake may be necessary to realize the full benefts of PCVs, even after 15 years of moderate use, and highlights the importance of using molecular methods in pIPD surveillance, since these can lead to substantially increased case ascertainment and identifcation of particular serotypes as causes of pIPD.
Palavras Chave: 13-valent pneumococcal conjugate vaccine; PCV13; Portugal; Streptococcus pneumoniae; serotype; vaccine-preventable diseases