Pneumococcal meningitis in adults in 2014–2018 after introduction of pediatric 13-valent pneumococcal conjugate vaccine in Japan

• Published in: Scientific reports Vol. 12; no. 1; p. 3066
• Main Authors: Chang, Bin, Tamura, Kosuke, Fujikura, Hiroyuki, Watanabe, Hiroshi, Tanabe, Yoshinari, Kuronuma, Koji, Fujita, Jiro, Oshima, Kengo, Maruyama, Takaya, Abe, Shuichi, Kasahara, Kei, Nishi, Junichiro, Kubota, Tetsuya, Kinjo, Yuki, Serizawa, Yusuke, Shimbashi, Reiko, Fukusumi, Munehisa, Shimada, Tomoe, Sunagawa, Tomimasa, Suzuki, Motoi, Oishi, Kazunori
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 23.02.2022; Nature Publishing Group; Nature Portfolio
• Subjects: 631/326; 692/308; 692/699; Adolescent; Adult; Age Factors; Aged; Ceftriaxone; Epidemiology; Female; Humanities and Social Sciences; Humans; Incidence; Japan - epidemiology; Male; Meningitis; Meningitis, Pneumococcal - epidemiology; Meningitis, Pneumococcal - microbiology; Meningitis, Pneumococcal - mortality; Middle Aged; multidisciplinary; Mutation; Patients; Pediatrics; Penicillin; Pneumococcal Infections - epidemiology; Pneumococcal Infections - mortality; Pneumococcal Vaccines; Science; Science (multidisciplinary); Serogroup; Serotypes; Splenectomy - adverse effects; Splenectomy - statistics & numerical data; Streptococcus infections; Streptococcus pneumoniae - genetics; Streptococcus pneumoniae - immunology; Streptococcus pneumoniae - isolation & purification; Time Factors; Vaccines; Young Adult; Japan
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-022-06950-w

We assessed the impact of the pediatric 13-valent pneumococcal conjugate vaccine (PCV13) on pneumococcal meningitis in adults in Japan in 2014–2018 by comparing epidemiological characteristics of adults with invasive pneumococcal disease with (n = 222) and without (n = 1258) meningitis. The annual incidence of pneumococcal meningitis in 2016–2018 was 0.20–0.26 cases/100,000 population . Age (p < 0.001) and case fatality rate (p = 0.003) were significantly lower in patients with meningitis than in those without meningitis. The odds of developing meningitis were higher in asplenic/hyposplenic or splenectomized patients (adjusted odds ratio [aOR] 2.29, 95% CI 1.27–4.14), for serotypes 10A (aOR 3.26, 95% CI 2.10–5.06) or 23A (aOR 3.91, 95% CI 2.47–6.19), but lower for those aged ≥ 65 years (aOR 0.59, 95% CI 0.44–0.81). PCV13 had an indirect effect on nonmeningitis, but its impact on meningitis was limited because of an increase in non-PCV13 serotypes. Of meningitis isolates, 78 (35.1%) and 3 (1.4%) were penicillin G- or ceftriaxone-resistant, respectively. We also confirmed an association of the pbp1b A641C mutation with meningitis (aOR 2.92, 95% CI 1.51–5.65).