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Paediatric community‐acquired bacteraemia, pneumococcal invasive disease and antibiotic resistance fell after the pneumococcal conjugate vaccine was introduced
Author(s) -
Berger Yael,
Adler Amos,
Ariel Tenenbaum,
Rokney Assaf,
Averbuch Diana,
GrisaruSoen Galia
Publication year - 2019
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.14670
Subject(s) - medicine , streptococcus pneumoniae , vaccination , pneumococcal conjugate vaccine , antibiotics , conjugate vaccine , pediatrics , pneumococcal infections , staphylococcus aureus , antibiotic resistance , penicillin , emergency department , epidemiology , pneumococcal vaccine , serotype , immunology , microbiology and biotechnology , bacteria , genetics , psychiatry , biology
Abstract Aim This study examined the impact of the routine pneumococcal conjugate vaccination (PCV) on childhood community‐acquired bacteraemia (CAB) and antibiotic resistance patterns in Israeli children. Methods Israel added the PCV vaccine to its national immunisation programme in July 2009. We retrospectively analysed the medical records of all patients with CAB under 18 years at three children's hospitals in Tel Aviv and Jerusalem from 2007 to 2015. The microbiological data, clinical presentation, pneumococcal serotype distribution, antibiotic susceptibility and outcomes of infections were compared before and after the vaccine was introduced. Results There were 511 904 emergency department visits and 125 922 children were hospitalised. Of those, 238 had CAB before vaccination was introduced (mean age 17 months) and 316 had CAB after the introduction (mean age 21 months). Emergency department presentations for CAB fell from 141.8 to 91.8 per 100 000 visits: a relative risk reduction (RRR) of 35%. Hospitalisations for CAB decreased from 430 to 337 per 100 000 admissions: an RRR of 22%. Hospitalisations due to Staphylococcus aureus increased significantly and penicillin nonsusceptible blood Streptococcus pneumoniae isolates decreased significantly. Conclusion Introducing national pneumococcal conjugate vaccination significantly changed the epidemiology of CAB, with reduced antibiotic‐resistant Streptococcus pneumoniae and increased hospitalisation rates for Staphylococcus aureus infections.