Invasive Pneumococcal Disease in New Zealand, 2010

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Rate per 100 000Figure 4 shows the trends since 2006 in the rates of disease due to serotypes not included inPCV-7. Any changes in rates of disease due to non-PCV-7 serotypes in recent years havebeen predominantly due to changes in the incidence of serotype 1 disease (Appendix 9).An increase in serotype 1 disease was first noted in 2007 (Appendix 9). This serotypeaccounted for 2.9, 6.3, 11.1, 23.0 and 15.0% of culture-positive IPD cases in 2006, 2007,2008, 2009 and 2010, respectively. In 2007 and 2008, most of the serotype 1 disease was incases 5-34 years of age. But in 2009, this type also became common (21.8%, 12/55) amonginfants
3.11 Antimicrobial susceptibilityTable 10 shows the antimicrobial susceptibility of the 514 culture-positive IPD cases in 2010.The penicillin and cefotaxime MICs displayed the typical bimodal distribution(Appendix 10).6.0% of isolates had combined penicillin (meningitis interpretation) and erythromycinresistance, and 1.0% had combined penicillin-intermediate resistance (non-meningitisinterpretation) and erythromycin resistance. Among the penicillin-resistant isolates(meningitis interpretation), 30.1% (28/93) were multiresistant to 3 additional antibiotics,commonly co-trimoxazole, erythromycin and tetracycline with or without cefotaximeresistance.Table 10. Antimicrobial susceptibility among isolates from invasive pneumococcaldisease cases, 2010Interpretive standardsS 1 I 1 R 1PercentMIC (mg/L) S I Rpenicillinmeningitis ≤0.06 - ≥0.12 81.9 - 18.1non-meningitis ≤2 4 ≥8 99.0 1.0 0.0oral treatment ≤0.06 0.12-1 ≥2 81.9 12.1 6.0cefotaximemeningitis ≤0.5 1 ≥2 91.8 6.2 1.9non-meningitis ≤1 2 ≥4 98.1 0.4 1.6Zone diameter (mm)chloramphenicol ≥21 - ≤20 98.1 - 2.0clindamycin 2 ≥19 16-18 ≤15 94.8 0.2 5.1co-trimoxazole ≥19 16-18 ≤15 73.5 2.1 24.3erythromycin ≥21 16-20 ≤15 91.1 0.0 9.0moxifloxacin ≥18 15-17 ≤14 99.8 0.2 0.0rifampicin ≥19 17-18 ≤16 100.0 0.0 0.0tetracycline ≥23 19-22 ≤18 91.6 0.8 7.6vancomycin ≥17 - - 100.0 - -1 S, susceptible; I, intermediate; R, resistant.2 The percentage resistant given is for constitutive clindamycin resistance. One further isolate (0.2%) hadinducible clindamycin resistance.Trends in penicillin and cefotaxime resistance and multidrug resistance for the last 10 years(2001-2010) are shown in Appendix 11. Both penicillin and cefotaxime resistance, based onthe meningitis interpretive standards, decreased between 2008 and 2009 after the introductionof PCV-7 in 2008, but there was no further decrease in resistance to either antibiotic between2009 and 2010.Invasive pneumococcal disease 19 September 2011in NZ, 2010
Page 1 and 2: INVASIVE PNEUMOCOCCAL DISEASEIN NEW
Page 3 and 4: DISCLAIMERThis report or document (
Page 5 and 6: CONTENTSSUMMARY ...................
Page 7 and 8: SUMMARYA 4-dose schedule of the 7-v
Page 9 and 10: 1. INTRODUCTIONPrior to 2009, the n
Page 11 and 12: Data analyses were performed with S
Page 13 and 14: 3. RESULTSIn 2010, 535 IPD cases we
Page 15 and 16: The all-age rate of IPD in 2010 (12
Page 17: 3.4 Disease incidence by ethnicityT
Page 20 and 21: 3.7 Risk factors among IPD casesThe
Page 23 and 24: 3.10 Serotype distributionTable 9.
Page 25: Rate per 100 000The rate of disease
Page 29 and 30: Percent of penicillin-resistant iso
Page 31 and 32: type most frequently reported to ha
Page 33 and 34: REFERENCES1 Green MJ, Cawley PFM. I
Page 35 and 36: Appendix 1. Laboratory criteria upo
Page 37 and 38: Appendix 3. Rates of invasive pneum
Page 39 and 40: Appendix 5.2010Risk factors among i
Page 41 and 42: Appendix 7. Serotypes among invasiv
Page 43 and 44: Appendix 9. Serotype 1 invasive pne
Page 45 and 46: Appendix 11. Trends in penicillin r
Page 47 and 48: Appendix 13. Penicillin and cefotax
Page 49: Appendix 15. Trends in penicillin r

Invasive Pneumococcal Disease in New Zealand, 2010

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