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Decline in pneumococcal meningitis after the introduction of the heptavalent-pneumococcal conjugate vaccine in northern France

2007; BMJ; Volume: 92; Issue: 11 Linguagem: Inglês

10.1136/adc.2007.119891

1468-2044

François Dubos, I. Maréchal, M. O. Husson, C. Courouble, M. Aurel, A. Martinot,

Pneumocystis jirovecii pneumonia detection and treatment

Background: The impact of the heptavalent-pneumococcal conjugate vaccine on the incidence of pneumococcal meningitis in Europe has not yet been assessed. Objective: To determine whether heptavalent-pneumococcal conjugate vaccine implementation in northern France has resulted in a decrease in the incidence of pneumococcal meningitis in children. Design: Multicentre retrospective cohort study from 2000 through 2005. Settings: All paediatric departments of the 18 hospitals in northern France. Patients: Patients <18 years of age, admitted for laboratory-confirmed pneumococcal meningitis during the study period, were included. Interventions: Data were collected from medical files and the microbiological laboratories of each hospital and compared with the regional hospital discharge codes, using a capture–recapture method. Main outcome measures: The study assessed and compared global and age-related incidence rates of pneumococcal meningitis in 2001 (pre-vaccine era) and 2005. Results: 77 cases were found through the capture–recapture method. The incidence rate of pneumococcal meningitis varied from 1.65/100 000 children <18 years in 2001 to 0.80/100 000 children in 2005 (53% reduction, 95% CI 31 to 74; p = 0.08). This has so far been significant only for children <2 years of age (8.9/100 000 in 2001 to 1.8/100 000 in 2005; 82% reduction, 95% CI 52 to 95; p = 0.03). Conclusion: A decline in pneumococcal meningitis has been observed in infants since heptavalent-pneumococcal conjugate vaccination began in our area.