BACKGROUND: In Japan, the clinical characteristics and recent serotype distribution among adult @entity1 of invasive @entity66 (IPD) have not been fully investigated since the introduction of the pneumococcal conjugate vaccine ( @entity1485 ) in @entity1 . From November 2010, PCV7 was encouraged by an official program, funded by government, subsequently included in the routine schedule in April 2013, and replaced with a PCV13 in November 2013. METHODS: Between April 2013 and March 2015, @entity1 with IPD older than 15 years were evaluated based on the enhanced national surveillance in ten prefectures of Japan. The serotype distribution of the isolates was analyzed in these @entity1 . RESULTS: The analysis included 291 @entity1 : 107 @entity1 (37%) were female and the median age was 70 years. Of 281 @entity1 with available data, 202 (72%) had underlying diseases, including 107 @entity1 (38%) with immunocompromised status. The case fatality proportion for all case was 20%. In subgroup analysis, the case fatality proportion (29%) in immunocompromised @entity1 was much higher than that (0-16%) in each age group of nonimmunocompromised @entity1 (15-39 years, 40-64 years, and   >=    65 years). While the proportion of @entity2259 without any focus (27%) was higher than that (8-10%) in nonimmunocompromised @entity1 , the proportions of vaccine types (PCV13, 32%; PPSV23, 51%) of the causative isolates were lower than those in each age group of nonimmunocompromised @entity1 . Among 291 isolates, the most frequent serotypes were 3 (17%), @entity5686 (13%), and 22F (10%). Twelve percent of the isolates were PCV7 serotypes, 46% were PCV13 serotypes, and 66% were PPSV23 serotypes. CONCLUSIONS: The majority of adult @entity1 of IPD had underlying diseases, including immunocompromised conditions. A low proportion (12%) of PCV7-type IPD was observed in this population where PCV7 for @entity1 had been included in the routine immunization schedule.

Invasive XXXX among adults in Japan, April 2013 to March 2015: disease characteristics and serotype distribution.

@entity1 :: ('9606', 'Species') :: ['children', 'patients'] @entity66 :: ('MESH:D004194', 'Disease') :: ['pneumococcal disease'] @entity5686 :: ('57823', 'Gene') :: ['19A'] @entity1485 :: ('158372', 'Species') :: ['PCV'] @entity2259 :: ('MESH:D016470', 'Disease') :: ['bacteremia']
@entity66 :: (MESH:D004194,Disease) :: ['pneumococcal disease']
