Pneumococcal meningitis in adults after introduction of PCV7 and PCV13, Israel, july 2009–june 2015

Israeli Adult Invasive Pneumococcal Disease Group

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


The indirect effect of pneumococcal conjugate vaccine on adult pneumococcal meningitis has not been thoroughly investigated. We present data from active surveillance on pneumococcal meningitis in adults in Israel occurring during July 2009–June 2015. Pneumococcal meningitis was diagnosed for 221 patients, 9.4% of all invasive pneumococcal disease (IPD) cases. Although overall IPD incidence decreased during the study period, meningitis increased nonsignificantly from 0.66 to 0.85 cases/100,000 population. Incidence of vaccine type (VT) pneumococcal meningitis (VT13) decreased by 70%, but non-VT13 pneumococcal meningitis increased from 0.32 to 0.75 cases/100,000 population (incident rate ratio 2.35, 95% CI 1.27–4.35). Pneumococcal meningitis patients were younger and healthier than nonmeningitis IPD patients, and 20.2% had a history of previous head surgery or cerebrospinal fluid leak compared with <2.0% of nonmeningitis patients (p<0.0001). Non-VT13 types that rarely cause IPD (15B/C, 6C, 23A, 23B, 24F) seem to be emerging as common causes of meningitis.

Original languageAmerican English
Pages (from-to)1275-1284
Number of pages10
JournalEmerging Infectious Diseases
Issue number7
StatePublished - Jul 2018

Bibliographical note

Funding Information:
The IAIPD is part of the IsraNIP project. This study was supported in part by Wyeth (Pfizer), manufacturer of Prevnar 7 and Prevnar 13 (grant no. 0887Z1-4603). Wyeth (Pfizer) had no role in designing the study, collecting the data, analyzing the data, interpreting the data, writing the report, or in the decision to submit the paper for publication.

Publisher Copyright:
© 2018, Centers for Disease Control and Prevention (CDC). All rights reserved.


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