Trends in invasive pneumococcal disease in cancer patients after the introduction of 7-valent pneumococcal conjugate vaccine: A 20-year longitudinal study at a major urban cancer center Journal Article

   

Authors:	Lee, Y. J.; Huang, Y. T.; Kim, S. J.; Kerpelev, M.; Gonzalez, V.; Kaltsas, A.; Papanicolaou, G.
Article Title:	Trends in invasive pneumococcal disease in cancer patients after the introduction of 7-valent pneumococcal conjugate vaccine: A 20-year longitudinal study at a major urban cancer center
Abstract:	Background Rates of invasive pneumococcal disease (IPD) declined since routine childhood immunization with the 7-valent pneumococcal conjugate vaccine (PCV7) in 2000. We studied the impact of PCV7 on the incidence of IPD in cancer patients. Methods This was a retrospective analysis of adult and pediatric patients treated at Memorial Sloan Kettering Cancer Center from 1992 to 2012. Recovery of Streptococcus pneumoniae from a sterile site defined IPD. IPD incidence was calculated as cases per 1,000 unique patient-visits per year (UPV). IPD incidence was calculated for the periods: "before PCV7" (1992-2000), "after PCV7" (2001-2010) and "after PCV13" (2011-2012). Results Of 343 IPD cases, 165, 155, and 23 cases occurred "before PCV7," "after PCV7" and "after PCV13" respectively. The IPD incidence declined from 0.43 "before PCV7" to 0.17 "after PCV7" (95% confidence interval [CI]: 0.33-0.46, P <.001) and 0.11 "after PCV13" (95% CI: 0.42-0.96, P =.004). Adults with hematologic malignancies and children had the highest incidence. In patients 1-4 years old, the incidence declined from 11.2 "before PCV7" to 2.38 "after PCV7" (79% decrease, 95% CI: 0.1-0.4, P <.001). In patients with hematologic malignancies, the incidence declined from 2.55 "before PCV7" to 0.92 "after PCV7" (64% decrease, 95% CI: 0.27-0.47, P <.001). Conclusions The incidence of IPD among cancer patients sharply declined after introduction of PCV7; especially in high risk groups. The decline in adults suggests an indirect effect from PCV7 childhood vaccination. © The Author(s) 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
Keywords:	adolescent; adult; child; preschool child; aged; major clinical study; cancer patient; morbidity; cohort analysis; pneumococcus vaccine; retrospective study; high risk patient; age; hematologic malignancy; pneumococcal infection; streptococcus pneumoniae; longitudinal study; pneumococcal conjugate vaccine; serotype; serotyping; cancer; human; male; female; priority journal; article; solid malignant neoplasm; invasive pneumococcal disease
Journal Title:	Clinical Infectious Diseases
Volume:	66
Issue:	2
ISSN:	1058-4838
Publisher:	Oxford University Press
Date Published:	2018-01-15
Start Page:	244
End Page:	253
Language:	English
DOI:	10.1093/cid/cix739
PROVIDER:	scopus
PUBMED:	29020313
PMCID:	PMC5850633
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85040540765&doi=10.1093%2fcid%2fcix739&partnerID=40&md5=cedd266cd2a99a013a7bda5e2d43d3cb
Notes:	Article -- Export Date: 1 February 2018 -- Source: Scopus

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