In 2001 PCV7 vaccination was recommended for children

<5 years at increased risk for IPD. In November 2005, PCV7 vaccination became recommended for all children younger than 2 years in Switzerland which included a 2 + 1 dosing schedule at 2, 4 and 12 months without catch-up campaign. According MK-2206 cost to the Swiss National Vaccination Coverage Survey, the vaccine coverage was about 53% for one dose, 50% for 2 doses and 37% for 3 doses at the age of 2 years in 2008–2010 [12]. In 2005–2007, the PCV7 coverage was only about 2% for the first dose. Since 2011, PCV13 replaces PCV7. In addition, the 23-valent pneumococcal polysaccharide vaccine (PPV23) has been recommended for individuals GSK-3 phosphorylation aged ≥65 years or those ≥2 years with known risk factors for IPD since 2000 [13]. However, the protection efficacy of the currently used PPV23 seems to be limited [14]. This raises the question whether PCV13 could replace or supplement PPV23 vaccination in these two age groups in Switzerland. Apart from prospective efficacy studies, this decision should in part be based on the age-dependent IPD serotype epidemiology, too. The main objective of this study is thus the description of the current serotype epidemiology of IPD in adult Swiss residents. The specific objectives are: (i) analysis of temporal

trends of single serotypes, (ii) association of serotypes with age and clinical manifestations, (iii) association of serotypes with type and number of different comorbidities and (iv) correlation between serotype and case-fatality. In Switzerland, IPD notification to the Federal Office of Public Health (FOPH) is mandatory for laboratories and physicians within one week after IPD confirmation. Using a standardized

IPD reporting form, information on age, gender, vaccination history, Electron transport chain clinical manifestation of IPD, comorbidities and death are collected. No patient follow up took place. Clinical manifestations of IPD to be ticked on the form included invasive pneumonia, meningitis, sepsis and ‘others’ accompanied by a free-text line. If patients were reported to suffer from sepsis only, we subsequently attributed ‘bacteremia without focus’ to this group. Patients with pneumonia (including empyema) may simultaneously present with other clinical manifestations. If cases presented with both pneumonia and meningitis, patients were only accounted for the latter. Other manifestations included arthritis and the ones noted by the physician as free text. Comorbidities reported on the forms included chronic kidney disease, immunosuppression, recurring airway diseases, recurring otitis, splenectomy, nephrotic syndrome, basal skull fracture, chronic lung diseases, diabetes mellitus, functional asplenia, cerebrospinal fistula and ‘others’ accompanied by a free-text line.