445. Trends in Serotype-Specific Pneumococcal Carriage in Children Visiting Emergency Room (PER) Post PCV7 and PCV13 Introduction Correlate with Trends in Serotype-Specific Otitis Media Incidence (OM)
Session: Poster Abstract Session: Pneumococcal Vaccine in Children and Adults
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • IDSA Dagan Trends.pdf (1.2 MB)
  • Background: Although surveillance of trends in invasive pneumococcal diseases (IPD) post introduction of PCVs into the National Immunization Program (NIP) are commonly conducted, information on trends in pneumococcal OM is scarce, due to difficulty in conducting studies using middle ear fluid (MEF) culture.  We took advantage of ongoing studies on both carriage and OM to assess whether trends in carriage predict trends in pneumococcal OM.

     

    Methods: Our medical center serves a captive population of ~30,000 children <2 years enabling incidence calculation.  In a prospective ongoing study, we have enrolled the first 8 children <5 years presenting to the PER each working day since November 2009 and performed nasopharyngeal culture for S. pneumoniae.  In a second ongoing prospective study, we have been studying all cases of OM in whom MEF is sought (mainly complex OM), methods of which have been previously described (Dagan et al, 49th IDSA/Abst. 1343).  PCV7 was introduced in Jul 2009; PCV13 gradually replaced PCV7 since Nov 2012; in Apr 2012, ≥70% of all children <2 years received ≥2 doses of PCV13.

    Results: Carriage of PCV7+6A serotypes was reduced by 75% within 3 years from its introduction.  Carriage of 1, 3, 5, 7F, 19A was reduced by 65% 2 years after PCV13 introduction (Figure 1).  This reduction correlated with a sharp reduction in pneumococcal and overall incidence (per 1,000 children <2 years at risk) of OM for each serotype group (Figure 2).

     

    Conclusion: This unique set of data enables not only to establish trends in pneumococcal carriage rate and pneumococcal OM incidence, but also demonstrates that conducting surveillance on trends of carriage rate among children visiting PER can predict trends in pneumococcal serotype-specific OM rates.

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    Description: M:\DAGAN FILES\DAGAN 2013\ABSTRACTS 2013\Graphs for IDSA abstract 2013 JPEG\Slide2.JPG

    Ron Dagan, MD, David Greenberg, MD, Eugene Leibovitz, MD, Simon Raiz, MD and Noga Givon-Lavi, PhD, Ben-Gurion Univ of the Negev and Soroka Univ Med Ctr, Beer-Sheva, Israel

    Disclosures:

    R. Dagan, Pfizer: Investigator, Scientific Advisor and Speaker's Bureau, Consulting fee, Research grant and Speaker honorarium
    Berna/Crucell: Investigator, Scientific Advisor and Speaker's Bureau, Consulting fee, Research grant and Speaker honorarium
    MSD: Investigator and Scientific Advisor, Consulting fee and Research grant
    Novartis: Investigator and Scientific Advisor, Consulting fee and Research grant
    Novartis: Scientific Advisor, Consulting fee
    Protea/NASVAX: Investigator, Scientific Advisor and Shareholder, Consulting fee, Research grant and shares

    D. Greenberg, Pfizer: Speaker's Bureau, Speaker honorarium
    MSD: Investigator, Scientific Advisor and Speaker's Bureau, Consulting fee, Research grant and Speaker honorarium
    GSK: Scientific Advisor and Speaker's Bureau, Consulting fee and Speaker honorarium

    E. Leibovitz, None

    S. Raiz, None

    N. Givon-Lavi, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.