In contrast, PCV13 serotype disease has not disappeared, but plateaued, with a remaining residual incidence of 7.97 per 100 000 across all age groups and disease attributable to non-PCV13 serotypes has increased, especially in the elderly. By 2016/2017 in the UK, PCV7 serotype pneumococcal disease in children had virtually disappeared and PCV7 disease significantly reduced in adults. 10 A 7-valent PCV was introduced into the UK childhood vaccination programme in 2006, subsequently replaced in April 2010 with a 13-valent PCV (PCV13) and the schedule was modified in 2020 so that only two vaccine doses are now given (one at 12 weeks of age, followed by a booster at 12–13 months of age). 9 Thus, vaccine-driven serotype replacement may be leading to changes in pneumococcal disease phenotype and severity.Ī dose of PPV-23 (unconjugated 23-valent polysaccharide vaccine) is offered to all adults ≥65 years in the UK, and ≥2 year olds with at least one clinical risk factor for pneumococcal disease also receive this vaccine. 8 Recent evidence suggests that incidence of pneumococcal empyema, especially in adults aged >65 years, has increased following paediatric PCV deployment, possibly due to serotype 1 or 3 emergence. 5 6 Increasing pneumococcal empyema rates in children have been reported, 7 although the effect of paediatric PCV deployment on adult disease phenotype is debated. 4 Several US studies have shown that pneumococcal conjugate vaccine (PCV, a vaccine that is comprised of pneumococcal polysaccharides conjugated to a non-toxic diphtheria protein) introduction resulted in a significant reduction in both carriage and invasive pneumococcal disease (IPD) due to vaccine serotypes, especially in children. 1 3 The morbidity and mortality associated with simple parapneumonic effusion (SPE) are higher than with uncomplicated pneumonia. Approximately 15%–20% hospitalised pneumococcal CAP cases are associated with a pleural effusion 1 2 and 6% with empyema. Streptococcus pneumoniae remains the leading bacterial cause of community-acquired pneumonia (CAP), despite vaccine deployment.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |