Abstract
Despite patients with chronic respiratory diseases being commonly described as an at-risk population for pneumococcal infections, studies on pneumococcal vaccination efficacy in such patients are very limited and vaccination effectiveness remains controversial. In Italy the pneumococcal conjugate vaccine,(PCV7) was introduced in 2002. We aimed to evaluate the influence of the introduction of the PCV7 vaccination in Italy on the broncoalveolar lavage (BAL) positive cultures in children with chronic lung disease.
Methods: We conducted a retrospective study of paediatric patients with chronic lung disease who underwent flexible bronchoscopy with BAL between 2001-2013. For culture a cut-off of ≥105 colony-forming units/mL was used. Pneumococcal immunity is obtained after a vaccination cycle of three doses. We defined all patients born after 2002 with an age of at least 18 months probably vaccinated (local vaccination coverage +/- 85% from 2007-2011).
Results: We collected 538 BAL cultures from 515 children with an mean age at FOB 79.6 +/- 44 months (range 4,3-67,7). An infectious agent was detected in 33%, of which 51%, 3%, and 21% were Haemophilus influenza (HI), Moraxella catarrhalis, and Streptococcus pneumoniae (SP), respectively. Dual infection was detected in 12% (mostly HI and SP infection). If samples are confronted before and after the vaccination window, it shows a reduction in SP positive cultures (12.9% vs 8.6%).
Conclusion: PCV7 vaccination in children with chronic lung disease seems to have changed the presence of SP in BAL cultures although not statistically significant.
- Copyright ©the authors 2016