Changes in Hospitalizations for Pneumonia After Universal Vaccination With Pneumococcal Conjugate Vaccines 7/13 Valent and Haemophilus influenzae Type b Conjugate Vaccine in a Pediatric Referral Hospital in Uruguay

• Published in: The Pediatric infectious disease journal Vol. 33; no. 7; pp. 753 - 759
• Main Authors: Pírez, María Catalina, Algorta, Gabriela, Chamorro, Flavia, Romero, Claudia, Varela, Adriana, Cedres, Alejandra, Giachetto, Gustavo, Montano, Alicia
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD by Lippincott Williams & Wilkins, Inc 01-07-2014; Lippincott Williams & Wilkins
• Subjects: Adolescent; Bacterial diseases; Biological and medical sciences; Child; Child, Preschool; Community-Acquired Infections - epidemiology; Female; Haemophilus Vaccines - administration & dosage; Heptavalent Pneumococcal Conjugate Vaccine; Hospitalization - trends; Human bacterial diseases; Humans; Immunization Programs; Infant; Infant, Newborn; Infectious diseases; Male; Medical sciences; Pneumococcal Vaccines - administration & dosage; Pneumology; Pneumonia, Bacterial - epidemiology; Respiratory system : syndromes and miscellaneous diseases; Staphylococcal infections, streptococcal infections, pneumococcal infections; Uruguay - epidemiology; Vaccination - utilization; South America; Uruguay; America; Pediatrics; Pneumonia; Vaccination; Haemophilus influenzae; Prevention; Streptococcal infection; Bacteria; Micrococcales; Micrococcaceae; Hospital; Child; Pneumococcal infection; Staphylococcus aureus; Human; Lung disease; Respiratory disease; Hospitalization; Mixed vaccine; Streptococcus pneumoniae; Infection; Pasteurellaceae; Streptococcaceae; Immunoprophylaxis; vaccine; Bacteriosis; Staphylococcal infection
• ISSN: 0891-3668; 1532-0987
• DOI: 10.1097/INF.0000000000000294

BACKGROUND:In 1994, Uruguay included Haemophilus influenzae b (Hib) conjugated vaccine in a 3 + 1 schedule. In March 2008, 7-valent pneumococcal conjugate vaccines (PCV7) was included in a 2 +1 schedule. In 2010, 13-valent PCV replaced PCV7. Catch-up immunization was offered. The aim of this study was to describe the etiology of community-acquired pneumonia (CAP) in children 0–14 years of age hospitalized at the Hospital Pediatrico-Centro Hospitalario Pereira Rossell between 2003 and 2012.
METHODS:Annual hospitalization rates (per 10,000 discharges) for CAP and bacterial-confirmed CAP in children 0–14 years of age was described prior PCV7 vaccination (2003–2007), during the year of implementation of PCV7 (2008) and after the introduction of PCV7 (2009–2012). Data regarding age, strains isolated from pleural fluid and/or blood, vaccination status, pneumococcal and H. influenzae serotypes were obtained from Hospital Pediatrico-Centro Hospitalario Pereira Rossell databases and vaccination records.
RESULTS:Hospitalization rates for CAP and pneumococcal CAP between prevaccine years and the last year after introduction of vaccination with PCV (2012) significantly decreased by 78.1% and 92.4%, respectively. Significant reduction for 13-valent PCV vaccine serotypes and significant increase for nonvaccine serotypes was observed. A decrease in Staphylococcus aureus pneumonia was observed. Hospitalization rates for H. influenzae CAP remain stable before and after pneumococcal vaccination.
CONCLUSIONS:Three years after PCV7/13 introduction into the routine vaccination schedule, there was a rapid and significant reduction in rates of CAP and P-CAP. An increase of etiology of CAP by other agents was not observed.