What is pneumococcal disease and why is it increasing in Spain to levels higher than pre-pandemic levels?

What is pneumococcal disease and why is it increasing in Spain to levels higher than pre-pandemic levels?
What is pneumococcal disease and why is it increasing in Spain to levels higher than pre-pandemic levels?

The pneumococcal disease or pneumococcus It is a serious infection caused by the bacteria Streptococcus pneumoniae. This pathology can produce a wide spectrum of clinical manifestations ranging from pneumonia, sepsis, meningitis, arthritis, cellulitis or endocarditis. Among patients with this infectious disease, the mortality rate is higher in children under five years of age and the elderly. The problem? Pneumococcus levels are increasing in Spain. Currently, they are even higher than those before the Covid-19 pandemic.

This surge in pneumococcal disease is one of the conclusions reached by a I study Spanish published today in the magazine Journal of InfectionIn it, a team from the Pneumococcal Reference Laboratory of the National Microbiology Center of the Carlos III Health Institute (ISCIII) —an agency dependent on the Ministry of Science, Innovation and Universities— demonstrates that the use of non-pharmacological measures such as the use of masks, hand washing, confinement, as well as social distancing caused a Significant decrease in cases of pneumococcal disease in the first two years of the pandemic.

However, after the lifting and easing of these measures, cases have risen above pre-pandemic levels. The research analyzes the situation of the invasive pneumococcal disease in Spain between 2019 and 2023 in pediatric and adult population. It has also analyzed the impact that the New conjugate vaccines recently approvedas well as those in the clinical development phase for the prevention of new emerging serotypes that have appeared after the pandemic.

A serotype of pneumococcus with high mortality is on the rise in Spain

There are many serotypes of pneumococcus. However, among the serotypes that have increased the most in Spain is serotype 3, which is one of those associated with higher mortalityThis mainly affects the population under 5 years of age and adults over 65 years of age.

Also noteworthy is the presence of the serotype 4, linked to infections in young adultsOn the other hand, serotype 24F in the pediatric population, and serotype 8 in the adult population, also continue to be important in the incidence of the disease.

Invasive multi-resistant strains of pneumococcus

He Streptococcus pneumoniae o pneumococcus is the main cause of community-acquired pneumonia of bacterial etiology, as well as sepsis and meningitis. This study led by the ISCIII confirms the Increase in cases due to invasive strainssome of which are associated with high levels of antibiotic resistance, which is a major concern for public health.

In this sense, this same research team already pointed out in 2022, in a study published in Lancet Microbeof the Possible increase in cases due to resistant strains at the beginning of the pandemic. In addition, another previous study, published in Clinical Infectious Diseases With data from 2009-2019, it had made it possible to generate a ‘map’ of invasive pneumococcal disease in Spain in the last decade, indicating an increase in cases.

The team led by Dr. José Yuste concludes that the use of new conjugate vaccineswith a broader spectrum of protection and/or immunogenicity than those previously available and recently authorized in Spain, could help prevent many of these casesincluding new emerging serotypes.

According to the ISCIII researcher, it is “important to remember that, in the adult population, Pneumococcal vaccination is not seasonal and can therefore be administered at any time of the year; unlike flu vaccines, which are modified every year and must be administered every year, the pneumococcal vaccine is generally administered only once in a lifetime.

The team responsible for the work is led by José Yuste, a researcher at the CNM-ISCIII. Julio Sempere, Covadonga Pérez-García, Samantha Hita, Aída Úbeda, Erick Joan Vidal, Joaquín Llorente and Mirian Domenech, from the Institute’s Pneumococcal Reference Laboratory, are also participating. In addition, the CIBER-ISCIII’s Respiratory Diseases (CIBERES) and Epidemiology and Public Health (CIBERESP) Areas, the Directorate General of Public Health of the Ministry of Health, and various Spanish universities and hospitals are collaborating.

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