TY - JOUR 
A1 - Tagarro García, Alfredo
AU - Benito, Andrea
AU - Sánchez, Aida
AU - Aznar, Esteban
AU - Otheo, Enrique
AU - Sanz Rosa, David
T1 - Bacteremic pneumonia before and after withdrawal of 13-valent pneumococcal conjugate vaccine from a public vaccination program in Spain: a case-control study
Y1 - 2016
SN - 00223476
UR - http://hdl.handle.net/11268/4818
AB - The objective of this study is to compare the incidence and epidemiology of bacteremic community-acquired pneumonia (CAP) in the setting of changes in 13-valent pneumococcal conjugate vaccine (PCV13) coverage. In the region of Madrid, universal immunization with the PCV13 started in May 2010. In July 2012, public funding ceased. Vaccination coverage decreased from >95% to 82% in 2013 and to 67% in 2014. We performed a multicenter surveillance and case-control study from 2009-2014. Cases were hospitalized children with bacteremic CAP. Controls were children selected 1:1 from next-admitted with negative blood cultures and typical, presumed bacterial CAP. Annual incidence of bacteremic CAP declined from 7.9/100 000 children (95% CI 5.1-11.1) in 2009 to 2.1/100 000 children (95% CI 1.1-4.1) in 2012. In 2014, 2 years after PCV13 was withdrawn from the universal vaccination program, the incidence of bacteremic CAP increased to 5.4/100 000 children (95% CI 3.5-8.4). We enrolled 113 cases and 113 controls. Streptococcus pneumoniae caused most of bloodstream infections (78%). Empyema was associated with bacteremia (P = .003, OR 3.6; 95% CI 1.4-8.9). Simple parapneumonic effusion was not associated with bacteremia. Incomplete PCV immunization was not a risk factor for bacteremic pneumonia.
KW - CAP (Community-acquired pneumonia)
KW - IPD (Invasive pneumococcal disease)
KW - PCV13 (13-valent pneumococcal conjugate vaccine)
KW - PCV7 (7-valent pneumococcal conjugate vaccine)
KW - WBC (White blood cell)
KW - Pulmones - Enfermedades
KW - Pediatría
KW - Aparato respiratorio
KW - Pediatría
LA - spa
ER -