Epidemiological characteristics and serotype distribution of culture-confirmed pediatric pneumococcal pneumonia before and after PCV 10 introduction, a multicenter study in Bogota, Colombia, 2008–2019

Iván Felipe Gutiérrez-Tobar, Juan Pablo Londoño-Ruiz, Cristina Mariño-Drews, Sandra Beltrán-Higuera, Germán Camacho-Moreno, Aura Lucia Leal-Castro, Jaime Alberto Patiño-Niño, Martha Isabel Álvarez-Olmos, Rocio Barrero-Barreto, Fabio Espinosa, María Alejandra Suarez, Nicolás Ramos, Vivian Marcela Moreno-Mejia, Alejandra Marín, Claudia Rocio Sierra Parada, Angela Pescador, Anita Montañez

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Background: Pneumococcal conjugate vaccines (PCVs) have decreased pneumonia in children. Colombia introduced mass vaccination with PCV10 in 2012. Methods: Cases of pneumococcal pneumonia from 10 hospitals were included. Two periods were compared: pre-PCV10: 2008–2011 and post-PCV10: 2014–2019. The objective was to compare epidemiological and clinical characteristics before and after PCV10 vaccination. Results: A total of 370 cases were included. Serotypes 1 (15, 11.2%) and 14 (33, 24.6%) were the most frequent in the pre-PCV10 period, with only 4 (3%) cases of serotype 19A and 1 case (0.7%) serotype 3. From the pre-PCV10 period to the post-PCV10 period, cases of serotypes 1 (6, 3.1%) and 14 (1, 7.8%) decreased, while cases of serotypes 19A (58, 30.2%), serotype 3 (32, 16.7%) and 6A (7, 3.6%) increased (p < 0.001); complicated pneumonia (CP) increased significantly (13.4% to 31.8%) (p < 0.001); hospitalizations increased from 8 (5.5–15) to 12 (7–22) days (p < 0.001); and the frequency of PICU admission increased from 32.8% to 51.6% (p = 0.001). The use of ampicillin-sulbactam (0.7% to 24%) and ceftriaxone/clindamycin (0.7% to 5.7%) increased in the post-PCV10 period. The duration of empirical antibiotic treatment was 7 (4–11) days in the pre-PCV10 period and increased to 10 (6–17) days (p < 0.001) in the post-PCV10 period. Lethality showed a slight nonsignificant increase (7.5% vs. 9.9%; p = 0.57) in the post-PCV10 period. Conclusions: PCV10 significantly decreased cases of serotypes 1 and 14, with an increase in cases of serotypes 19A, 3 and 6A, which were the predominant serotypes and had greater severity (e.g., admission to the PICU, CP and more resistance, with an increase in the use of broad-spectrum antibiotics and longer hospitalization) and subsequently included in PCV13. Current data support national and regional evidence on the importance of replacing PCV10 with a higher valence that includes 19A, such as PCV13, with the aim of reducing circulation, particularly of this serotype.

Original languageEnglish
Pages (from-to)2875-2883
Number of pages9
JournalVaccine
Volume40
Issue number20
DOIs
StatePublished - 3 May 2022
Externally publishedYes

Keywords

  • Children
  • Pneumonia
  • Serotype
  • Streptococcus pneumoniae

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