RESUMO
STUDY OBJECTIVE: To assess the incidence of invasive pneumococcal disease and coverage of the causative serotypes by pneumococcal vaccines in the Czech Republic. METHODS: The incidence and fatality rates of reported cases of pneumococcal meningitis (EPIDAT) in 1997-2006 are analyzed. In addition, the data of the National Reference Laboratory for Streptococci and Enterococci from 2000-2006 are presented. The incidence of invasive pneumococcal disease was calculated for the catchment population of the collaborating laboratories. Pneumococcal typing was performed in the National Reference Laboratory. The percentages of pneumococcal serotypes isolated from invasive disease in 2000-2006 and included in the pneumococcal vaccines were calculated. RESULTS: The incidence of invasive pneumococcal disease ranged from 2.30 to 4.28/100000 population. The age-specific incidence of invasive pneumococcal disease in 2000-2006 was the highest in the lowest age groups 0-11 months (15.75/100000) and 1-4 years (8.22/100000), followed by the age group of 65 years and older (7.3/100000). The total fatality rate of pneumococcal meningitis in 1997-2006 was 13.7%. The highest age-specific fatality rate was recorded in 65-year olds and over (24%). In the age group 0-11 months, the coverage of pneumococcal serotypes is 66% by the 7-valent conjugate vaccine, 76% by the 10-valent conjugate vaccine and 82% by thel3-valent conjugate vaccine. In the age group 1-4 years, the respective rates are 65.1%, 76.4% and 85.8%. The coverage of serotypes by conjugate vaccines is higher in the youngest age groups (0-11 months and 1-4 years) compared to adults (40-64 years and 65 years and older). CONCLUSION: Based on laboratory data, the incidence of invasive pneumococcal disease in the Czech Republic in 2000-2006 is comparable with the rates reported in other European countries. The highest incidence rates were observed in the youngest age groups. The distribution of serotypes causing invasive pneumococcal disease differs between children and adults. The coverage of serotypes by conjugate pneumococcal vaccines is higher in children (66-65%) compared to adults (34-65%). It is desirable to launch a nationwide programme of surveillance of invasive pneumococcal disease. Furthermore, it is recommended that a conjugate pneumococcal vaccine should be included in the children's immunization schedule.
