781. Invasive Pneumococcal Disease, before and After Implementation of the Conjugate Vaccine in Israel: a multi-center retrospective study.
Session: Poster Abstract Session: Vaccines: Pneumococcal
Thursday, October 27, 2016
Room: Poster Hall
Background: The 7-valent pneumococcal conjugate vaccine (PCV7) has been part of the national vaccination program (NVP) in Israel since July 2009, and was replaced by 13-valent pneumococcal conjugate vaccine (PCV13) by November 2010. We examined the difference in the rate, clinical and microbiological profile and severity of invasive pneumococcal disease (IPD) in children in the greater Tel-Aviv area before and following the NVP area.

Methods: A retrospective chart review at 3 tertiary care pediatric hospitals serving the population of greater Tel-Aviv area. The medical records of all children aged 0 to 18 years who visited the hospitals between January 2007 and December 2012 with a positive blood and/ or cerebrospinal fluid (CSF) culture for S. pneumoniae were retrieved for analysis.

Results: The study included 309 children with positive blood or CSF cultures due to community acquired infection with S. pneumoniae. 88% of isolates in the pre- prevnar area were PCV7 or PCV13 serotypes, compared to 65% in the post- prevnar period. The most common serotype in the pre-vaccine period was serotype 5 and in the post- vaccine period serotype 1(19% and 23% of all the serotypes isolated respectively) .The number of children hospitalized for invasive pneumococcal disease fell by 33% from 332 per 100,000 admissions on the first period (before July 2009), to 223 per 100,000 admissions on the second period (p < 0.05). The number of children treated in the Emergency room for IPD fell by 45%, from 29 per 100,000 children in the first period, to 16 per 100,000 children on the second period (p < 0.05). The rate of admission due pneumococcal bacteremia with pneumonia and occult bacteremia due to S. pneumoniae declined significantly between the periods. There was no significant decline in the pneumococcal meningitis (PM) rates between the 2 periods.

Conclusion: The study confirms that introduction of the conjugate pneumococcal vaccine to the Israeli NVP resulted in a substantial reduction in the IPD burden in children. We did not observe a decrease in the number of cases of PM although the proportion of cases caused by PCV7 serotypes significantly decreased. Ongoing surveillance is warranted to continue to assess the impact of PCV13 on IPD in the pediatric population in Israel.

Hanna Kletzel, MD1, Gideon Paret, Prof.2, Avihu Bar Yochai, MD3, David Schwartz, PhD1 and Galia Grisaru-Soen, MD4, (1)Sourasky Medical Center, Tel Aviv, Israel, (2)Pediatrics, Safra Children’s Hospital, Ramat-Gan, Israel, (3)Assaf Harofeh Medical Center, Zrifin, Israel, (4)Sourasky Medical Center, Tel-Aviv, Israel

Disclosures:

H. Kletzel, None

G. Paret, None

A. Bar Yochai, None

D. Schwartz, None

G. Grisaru-Soen, None

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