Vaccines as tools against resistance: the example of pneumococcal conjugate vaccine.

Pneumococcal conjugate vaccine not only reduces the incidence of invasive antibiotic-resistant pneumococcal infections in young children receiving the vaccine, but it also reduces transmission of these strains to their younger siblings and to adults. Evidence from the United States indicates that the burden of resistant pneumococcal invasive disease in adults is reduced by immunization of children with these vaccines. Data from Israel and California suggest that antibiotic use is reduced in immunized children, and this reduction in use may further reduce the selection of antibiotic-resistant strains in immunized communities. Surveillance is needed to monitor the spread of antimicrobial resistance into nonvaccine serotypes, which may lead to a resurgence of resistance.