Background: PCV7 was introduced as universal childhood vaccination in Israel on Jul2009 and was gradually replaced by PCV13 from Nov2010. Here we report data on adult invasive pneumococcal disease (IPD), two years post PCV13 implementation.
Methods: An ongoing nationwide active surveillance (all 27 laboratories performing blood cultures in Israel), providing all blood/CSF pneumococci from persons >18y initiated on Jul2009. Capture-recapture method assured reporting of >95% cases. All isolates were serotyped in one central laboratory. Medical history and outcomes were recorded in ~90%.
Results: 1810 IPD cases were reported during the 4-year period.Overall vaccine type (VT7/VT13) serotypes decreased by 69%/55% within 4 years. This was accompanied by a 47% increase in nonVT13 strains. These changes were most apparent in winter season and were seen in all age groups, including in individuals with comorbidities. Non-VT serotypes that significantly increased were 12F, 15A and 10A. A continuous reduction in isolates with penicillin MIC>0.06 was observed (26% to 11%, p<0.001).
Conclusions: Four years after PCV universal implementation in children, incidence of adult IPD caused by VT7 and VT13 decreased in all age groups. Despite increase in non-VT IPD, overall pneumococcal IPD decreased. However, additional follow-up is still needed to determine the long-term impact on adult IPD.
