Epidemiological Aspects of Pneumococcal Meningitis in the Russian Federation

Introduction. Pneumococcal meningitis (PM) refers to severe manifestations of pneumococcal disease with high mortality and frequent post-infectious complications. In the context of the introduction of vaccination against pneumococcal infections in the Russian Federation healthcare practice increases the importance of close monitoring of the spread of the PM in the country, identifying areas of concern, the definition of risk and serotype structure of pneumococcus, which is an essential component of the assessment of the effectiveness of vaccination. Materials and methods. We collected 1380 cases identified by the PM on the territory of the Russian Federation in 2010 - 2014. We analyzed the incidence, mortality, mortality, age distribution, social belonging PM patients in the whole country, and in the federal districts. Determined serotype affiliation 35 pneumococcal strains isolated from patients with PM in Russia in 2015. Results. The proportion of pneumococci in the etiological structure of bacterial meningitis during the 2010 - 2014 fluctuated in the range of 18.4 - 24.8% and averaged 22.1%. The incidence of the PM in the Russian Federation in 2010 - 2014 determined at the level of 0.19, the death rate - 0.03. The level of mortality in pneumococcal meningitis in the Russian Federation in 2010 - 2014 increased from 13 (2010) to 21.1% (2014), the average was 17.1%. The most vulnerable age groups were adults over 25 years old and children up to 6 years. Among children under the age of 6 years mortality was 10.7%. The study of serotypes of 35 pneumococcal strains showed that in 2015 serotype structure of invasive pneumococcal vaccine serotypes maintained dominance, the proportion reached 75% for PCV13 and 54% for PCV10. Conclusion. The problem of pneumococcal meningitis remains valid in the Russian Federation. Active use of vaccines, especially in children, will reduce the incidence of this infection and the severity of its consequences.

пневмококковый менингит, эпидемиологический надзор, серотипы пневмококка, pneumococcal meningitis, epidemiological, pneumococcal meningitis, epidemiological

1. Ludwig E., Bonanni P., Rohde G., Sayiner A., Torres A. The remaining challenges of pneumococcal disease in adults. Eur Respir Rev. 2012; 21: 57 – 64.

2. Robinson K.A., Baughman W., Rothrock G., Barrett N.L., Pass M., Lexau C. et al. Epidemiology of invasive Streptococcus pneumoniae infections in the United States. 1995 – 1998: opportunities for prevention in the conjugate vaccine era. JAMA. 2001; 285: 1729 – 1735.

3. Centers for Disease Control and Prevention. 2013; Acute Bacterial Core Surveillance Report, Emerging Infections Program Network, Streptococcus pneumonia, 2011. 2013.

4. Kyaw M.H., Christie P., Clarke S.C., Mooney J.D., Ahmed S., Jones I.G., et al. Invasive pneumococcal disease in Scotland, 1999 – 2001: use of record linkage to explore associations between patients and disease in relation to future vaccination policy. Clin. Infect. Dis. 2003; 37: 1283 – 1291.

5. Reinert R.R., Haupts S., van der Linden M., Heeg C., Cil M.Y., Al-Lahham A. et al. Invasive pneumococcal disease in adults in North-Rhine Westphalia, Germany, 2001 – 2003. Clin. Microbiol. Infect. 2005; 11: 985 – 991.

6. Lynch J.P., Zhanel G.G. Streptococcus pneumonia: epidemiology, risk factors and strategies for prevention. Semin Respir Crit care Med. 2009; 30: 189-209

7. McIntosh E.D., Fritzell B., Fletcher M.A. Burden of paediatric invasive pneumococcal disease in Europe, 2005. Epidemiology and Infection. 2007;135 (4): 644 – 656.

8. Beloshitsky G.V., Koroleva I.S., Koschkina N. A. Pneumococcal meningitidis in Russian Federation. Jepidemiologija i Vakcinoprofilaktika. [Epidemiology and Vaccinal prevention]. 2009; 2 (45): 21 – 26 (in Russian).

9. Kuch A., Sadowy E., Skoczynska A., Hryniewicz W. First report of Streptococcus pneumoniae serotype 6D isolates from invasive infections. Vaccine. 2010; 28: 6506 – 6407.

10. Calix J.J., Nahm M.H. A new pneumococcal serotype, 11E, has a variably inactivated wcjE gene. J. Infect. Dis. 2010, 202 (1): 29 – 38.

11. Finland M., Barnes M.W. Changes in occurrence of capsular serotypes of Streptococcus pneumoniae at Boston Coty Hospital during selected years between 1935 and 1974. J. Clin. Microbiol.1977; 5: 154 – 166.

12. Hausdorff W.P., Bryant J., Paradiso P.R., Siber G.R. Which pneumococcal serogroups cause the most invasive disease: implications for conjugate vaccine formulation and use, part I. Clinical Infectious Diseases 2000; 30 (1): 100 – 121.

13. Sidorenko S.V., Lobzin J.V., Harith S.M., Queen I.S., Tatochenko V.K. Pneumococcal infection and modern possibilities of its prevention - an epidemiological review of the situation in the world and in Russia . Questions of modern therapy. 2010; 9 (1): 54 – 61 (in Russian).

14. Galanis I., Lindstrang A., Darenberg J., Browall S., Nannapaneni P., Sjostrom K. et al. Effects of PCV7 and PCV13 on invasive pneumococcal dissease and carriage in Stockholm, Sweden. Eur. Respir. J. (in press).

15. Lepoutre A., Varon E., Georges S., Dorleans F., Janoir C., Gutmann L. et al.. Impact of the pneumococcal conjugate vaccines on invasive pneumococcal disease in France, 2001 – 2012. Vaccine. 2015; 33: 359 – 366.

16. Metcalf B.J., Gertz R.E., Gladstone R.A., Walker H., Sherwood L.K., Jackson D. et al. Strain features and distributions in pneumococci from children with invasive disease before and after 13-valent conjugate vaccine implementation in the USA. Clinical Microbiology and Infection. 2016; 22 – 1: 9 – 29. 17.

17. Pneumonia hospitalizations among young children before and after introduction of pneumococcal conjugate vaccine – United States, 1997 – 2006. MMWR. 2009; 58 (1): 1 – 4.

18. Prez-Trallero E., Marimón J. M., Ercibengoa M., Vicente D., Pérez-Yarza E. G. Invasive Streptococcus pneumoniae infections in children and older adults in the north of Spain before and after the introduction of the heptavalent pneumococcal conjugate vaccine. Eur. J. Clin. Microbiol. Infect. Dis. 2009; 28: 731 – 738.

19. Order of the Ministry of Health of the Russian Federation from March 21, 2014 of No 125n «On approval of a national calendar of preventive vaccinations and the calendar of preventive vaccination on epidemic indications» (in Russian).

20. Beloshitsky G.V., Koroleva I.S. Serotype characteristic strains of S. pneumoniae in Moscow. Jepidemiologija i Vakcinoprofilaktika. [Epidemiology & Vaccinal Prevention], 2014; 1 (74): 90 – 97 (in Russian).

21. Beloshitsky G.V., Koroleva I.S., Koroleva M.A. The serotypic landscape of pneumococci isolated on pneumococcal meningitis in the Russian Federation. [Epidemiology & Vaccinal Prevention], 2015; 2 (81): 19 – 25 (in Russian).

22. Slotved H.C., Kaltoft M., Skovsted I.C., Kerrn M.B., Espersen F. Simple rapid latex agglutination test for serotyping of pneumococci (Pneumotest-Latex). J. Clin. Microbiol. 2004; 42 (6): 2518 – 2522.