Reduction in high rates of antibiotic-nonsusceptible invasive pneumococcal disease in tennessee after introduction of the pneumococcal conjugate vaccine.

Talbot TR, Poehling KA, Hartert TV, Arbogast PG, Halasa NB, Mitchel E, Schaffner W, Craig AS, Edwards KM, Griffin MR
Clin Infect Dis. 2004 39 (5): 641-8

PMID: 15356776 · DOI:10.1086/422653

BACKGROUND - Invasive pneumococcal disease (IPD) is a burgeoning problem, with rates of antibiotic-nonsusceptible IPD, in particular, increasing during the past decade. One measure to combat IPD is vaccination with the recently introduced 7-valent pneumococcal conjugate vaccine (PCV).

METHODS - To evaluate the effects of the introduction of PCV in 2000 on the epidemiology of antibiotic-nonsusceptible IPD, a database of IPD cases from January 1995 through December 2002 identified through active surveillance in 5 Tennessee counties was examined. For each case, clinical data were collected, and antibiotic susceptibility testing and serotyping were performed on available isolates.

RESULTS - Among children younger than 2 years, IPD rates peaked at 235 cases per 100,000 in 1999 before decreasing, after PCV licensure, to 46 cases per 100,000 in 2002 (P<.001). The proportion of penicillin-nonsusceptible IPD isolates from this age group declined from 59.8% in 1999 to 30.4% in 2002 (P<.01). After 2001, similar decreases in IPD rates and in the proportion of antibiotic-nonsusceptible isolates recovered were seen among persons aged 2 years and older (P<.01). Rates of IPD due to PCV-associated serotypes declined after PCV introduction in all age groups (P<.001), whereas the rate of IPD due to nonvaccine serotypes increased among persons aged 2 years and older.

CONCLUSIONS - In the 2 years since licensure, widespread PCV vaccination of children has resulted in dramatic declines in the proportion of antibiotic-nonsusceptible isolates in Tennessee. PCV vaccination of children also appears to be a highly effective method for reducing the burden of IPD in adults.

MeSH Terms (15)

Anti-Bacterial Agents Drug Resistance, Multiple, Bacterial Female Humans Infant Infant, Newborn Male Microbial Sensitivity Tests Middle Aged Pneumococcal Infections Pneumococcal Vaccines Population Surveillance Streptococcus pneumoniae Tennessee Vaccines, Conjugate

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