Decreased prevalence of Moraxella catarrhalis in addition to Streptococcus pneumoniae in children with upper respiratory tract infection after introduction of conjugated pneumococcal vaccine - A retrospective cohort study
Abstract
OBJECTIVES
To study effects of the introduction of pneumococcal conjugate vaccines (PCV) on the interspecies dynamics of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis in pre-school children with respiratory tract infection.
METHODS
Nasopharyngeal samples from children aged ≤ 6 years with upper respiratory tract infection (n=14,473) in South Sweden were analysed during 14 consecutive years; 5 years prior to and 9 years following PCV introduction. The yearly prevalence was calculated, and multivariate count regressions between prevalence and estimated yearly proportions of vaccinated children were performed. Associations between pneumococcal serotypes and the other pathogens were assessed.
RESULTS
When comparing the pre-vaccine period with the years following introduction, the prevalence of S. pneumoniae decreased by 65.5% (16.6 to 5.7 per 1,000 individuals; p<0.001), whereas M. catarrhalis and H. influenzae decreased by 52.6% (21.7 to 10.3 per 1,000 individuals; p<0.001) and 47.1% (13.7 to 7.3 per 1,000 individuals; p<0.001), respectively. In multivariate negative binomial regressions adjusted for yearly numbers of samples taken, S. pneumoniae and M. catarrhalis were significantly negatively associated with increasing vaccine coverage proportions (aPR (adjusted prevalence rate) =0.17; p<0.001, and aPR=0.48; p<0.001, respectively), whereas H. influenzae (aPR=0.75; p=0.17) was not. In addition, the proportion of cultures positive for S. pneumoniae…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 14,473 participants or records.
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