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Antimicrobial resistance in Streptococcus pneumoniae has increased in recent decades. We linked two surveillance programs to evaluate trends in incidence, serotype distribution, and antimicrobial resistance in invasive pneumococcal disease (IPD) since the heptavalent pneumococcal conjugate vaccine (PCV7) was introduced in BC in 2003.IPD case reports for BC from 2002-2005 from the BC Centre for Disease Control were linked to serotype and antimicrobial susceptibility results from the National Centre for Streptococcus (NCS).There was a significant decrease in IPD incidence in children <5 from 54/100,000 in 2002 to 16/100,000 population in 2005 (70% decrease, p < 0.001). The most dramatic decline was in children aged 1 year, where the rate fell from 135/100,000 to 15/100,000 (89% decrease, p for trend <0.001). Overall, 728/1288 (56.5%) reported cases of IPD were referred to NCS. For all matched cases, the proportion of isolates of PCV7 preventable serotypes decreased from 68.9% to 43.8% (p for trend <0.001) between 2002 and 2005. In children <2 years, this proportion decreased from 83.0% (39/47 cases) to 16.7% (1/6 cases) (p = 0.006). The prevalence of non-susceptible isolates was highest for trimethoprim-sulfamethoxazole (15.3%, 111/725 tested), penicillin (9.1%, 66/728), and erythromycin (9.1%, 66/727). 10.3% (75/728) were non-susceptible to > or =2 classes of antimicrobials. Children <15 years of age had the highest proportion of non-susceptible isolates.The incidence of IPD in children has decreased significantly since the introduction of PCV7. Comprehensive serotype and antimicrobial susceptibility can aid in evaluating the impact of immunization programs.

Type

Journal article

Journal

Canadian journal of public health = Revue canadienne de sante publique

Publication Date

01/2008

Volume

99

Pages

57 - 61

Addresses

Department of Health Care, Epidemiology, University of British Columbia, Vancouver, BC. mwinters@interchange.ubc.ca

Keywords

Humans, Pneumococcal Infections, Penicillins, Erythromycin, Pneumococcal Vaccines, Population Surveillance, Incidence, Case-Control Studies, Drug Resistance, Microbial, Adolescent, Adult, Aged, Middle Aged, Immunization Programs, British Columbia, Female, Male, Trimethoprim, Sulfamethoxazole Drug Combination