Invasive pneumococcal disease and factors influencing morbimortality

Abstract

Objective: To analyze the association between coverage of conjugate vaccines and risk factors for morbidity and mortality in invasive pneumococcal disease (IPD) in order to evaluate new prevention approaches. Literature review: In Brazil, the presence of conjugate vaccines for pneumococcus plays a substantial role in reducing the incidence and morbidity/mortality of IPD in the population, particularly due to the high incidence of subtype 11. However, these individuals have a higher risk of contracting IPD caused by serotypes not covered by the PCV13 and PPV23 vaccines. This highlights need for future conjugate vaccines to adapt to new bacterial strains. Factors influencing mortality include prior use antibiotics, inappropriate initial antibiotic treatment, microbial resistance and the use vancomycin. The use of penicillin or amoxicillin has been identified as protective factor. Final considerations: For individuals at high risk, the PCV13+PPV23 conjugate vaccine is crucial for reducing morbidity and mortality. However, the increasing incidence of serotypes 19A and 6A emphasizes the need for vaccination against these strains. Prior use of antibiotics in potentially severe patients have been associated with worse outcomes. Early diagnosis and treatment initiation are modifiable protective factors.