Enfermedad neumocócica invasiva en la Comunitat Valenciana. Seis años de vigilancia (2007-2012) / Invasive pneumococcal disease in the Community of Valencia. Six years of surveillance (2007-2012)

INTRODUCCIÓN: La introducción de las vacunas conjugadas antineumocócicas ha supuesto un cambio en la epidemiología de la enfermedad neumocócica invasiva (ENI). El objetivo de nuestro estudio ha sido describir la evolución de la ENI en la Comunidad Valenciana durante el periodo 2007-2012. MATERIAL Y MÉTODOS: Estudio descriptivo longitudinal retrospectivo de ENI en la Comunidad Valenciana durante el periodo 2007-2012. Las fuentes de información utilizadas han sido el sistema de Análisis de la Vigilancia Epidemiológica (AVE) y la Red Microbiológica Valenciana (RedMIVA) de la Conselleria de Sanitat. RESULTADOS: La incidencia de ENI ha disminuido entre 2007 y 2012 en todos los grupos de edad, mayoritariamente en menores de 5 años, pasando de 30,5 a 12,3 casos por 105 habitantes (p < 0,001). La neumonía constituye la principal forma de presentación de la enfermedad, con disminución de sus cifras de 6,9 a 4,1 casos por 105 (p < 0,001). Se ha observado una reducción progresiva no significativa de la proporción de casos por serotipos contenidos en la vacuna heptavalente (PCV7), principalmente en menores de 5 años, del 26 al 12% (p = 0,23). Los casos por serotipos adicionales de la vacuna conjugada 13-valente (1, 3, 5, 6A, 7F y 19A) también muestran tendencia descendente, principalmente en menores de 5 años vacunados (52,6% vs 14,3%; p = 0,03), mientras que se incrementa significativamente la proporción de casos por serotipos no vacunales, del 42,3 al 56,7% en población general (p = 0,002), y del 47,4 al 78,6% en menores de 5 años vacunados (p = 0,08). CONCLUSIONES: Los resultados de este estudio muestran una reducción de la incidencia de ENI, con disminución de la proporción de casos producidos por serotipos vacunales e incremento de la proporción de los no vacunales. La vigilancia epidemiológica resulta necesaria para monitorizar la evolución de la enfermedad

INTROCUCTION: The introduction of conjugated anti-pneumonia vaccines has led to a change in the epidemiology of Invasive Pneumococcal Disease (IPD). The aim of this study is to describe the trends in IPD in the Community of Valencia during the period 2007-2012. Material and methods: A retrospective, descriptive and longitudinal study was conducted on IPD in the Community of Valencia during the period 2007-2012, The information sources used were the Epidemiological Surveillance Analysis (Análisis de la Vigilancia Epidemiológica (AVE)) and the Valencian Microbiology Net York (Red Microbiológica Valenciana (RedMIVA)) of the Valencia Health Department. Results: The incidence of IPD decreased between 2007 and 2012 in all age groups, mainly in the under 5 year-olds, dropping from 30.5 cases to 12.3 cases per 105 inhabitants (p < .001). Pneumonia was the principal presentation of the disease, with a decrease in its rates from 6.9 to 4.1 cases per 105 inhabitants (p < .001). A gradual, non-significant, reduction from 26% to 12% (p = .23) was observed in the proportion of cases due to the serotypes contained in the heptavalent vaccine (PCV7), mainly in the under 5 year-olds. The cases due to additional serotypes in 13-valent conjugated vaccine (1, 3, 5, 6A, 7F and 19A) also showed a decreasing trend, mainly in vaccinated under 5 year-olds (52.6% vs 14.3%; p = .03), while the cases due to non-vaccine serotypes significantly increased from 42.3% to 56.7% in the general population (p = .002), and from 47.4% to 78.6% in vaccinated under 5 year-olds (p = .08). Conclusions: The results of this study show a reduction in the incidence of IPD, with a decrease in the proportion of cases produced by vaccine serotypes, and an increase in the proportion of those not vaccinated. Epidemiological Surveillance is necessary to monitor the trends in the disease (AU)

[Invasive pneumococcal disease in the Community of Valencia. Six years of surveillance (2007-2012)]. / Enfermedad neumocócica invasiva en la Comunitat Valenciana. Seis años de vigilancia (2007-2012).

INTRODUCTION: The introduction of conjugated anti-pneumonia vaccines has led to a change in the epidemiology of Invasive Pneumococcal Disease (IPD). The aim of this study is to describe the trends in IPD in the Community of Valencia during the period 2007-2012. MATERIAL AND METHODS: A retrospective, descriptive and longitudinal study was conducted on IPD in the Community of Valencia during the period 2007-2012, The information sources used were the Epidemiological Surveillance Analysis (Análisis de la Vigilancia Epidemiológica (AVE)) and the Valencian Microbiology Network (Red Microbiológica Valenciana (RedMIVA)) of the Valencia Health Department. RESULTS: The incidence of IPD decreased between 2007 and 2012 in all age groups, mainly in the under 5 year-olds, dropping from 30.5 cases to 12.3 cases per 10(5) inhabitants (p< .001). Pneumonia was the principal presentation of the disease, with a decrease in its rates from 6.9 to 4.1 cases per 10(5) inhabitants (p< .001). A gradual, non-significant, reduction from 26% to 12% (p=.23) was observed in the proportion of cases due to the serotypes contained in the heptavalent vaccine (PCV7), mainly in the under 5 year-olds. The cases due to additional serotypes in 13-valent conjugated vaccine (1, 3, 5, 6A, 7F and 19A) also showed a decreasing trend, mainly in vaccinated under 5 year-olds (52.6% vs 14.3%; p=.03), while the cases due to non-vaccine serotypes significantly increased from 42.3% to 56.7% in the general population (p=.002), and from 47.4% to 78.6% in vaccinated under 5 year-olds (p=.08). CONCLUSIONS: The results of this study show a reduction in the incidence of IPD, with a decrease in the proportion of cases produced by vaccine serotypes, and an increase in the proportion of those not vaccinated. Epidemiological Surveillance is necessary to monitor the trends in the disease.