BACKGROUND: Streptococcus pneumoniae is a leading cause of invasive bacterial disease and pneumonia among children. Antimicrobial resistance among pneumococci has increased in recent years and complicates treatment. The introduction of heptavalent pneumococcal conjugate vaccine (PCV7) could reduce acquisition of antimicrobial-resistant pneumococci. METHODS: We obtained 1350 nasopharyngeal swabs for culture from 1275 children aged 3-59 months presenting at 3 clinics in Anchorage, Alaska, during the winters of 2000, 2001, and 2002, as PCV7 was being introduced into the routine immunization schedule. We recorded the frequency of use of antibiotics as well as the dates of doses of PCV7 for enrolled children. We used multivariate logistic regression modeling to identify independent risk factors for overall carriage of pneumococci and carriage of PCV7-type pneumococci, cotrimoxazole-nonsusceptible (COT-NS) pneumococci, or penicillin-nonsusceptible (PCN-NS) pneumococci. RESULTS: The proportion of children who were up-to-date for age, with respect to PCV7 vaccination, increased from 0% in 2000 to 55% in 2002. Carriage of PCV7-type pneumococci decreased by 43% (P<.0001). Risk of carriage of PCV7-type pneumococci was lower in 2002 than in 2000, independent of vaccination status, suggesting an indirect effect of vaccination. Carriage of COT-NS, but not PCN-NS, pneumococci also decreased (38%; P=.02), not only among vaccinated children but also among unvaccinated children without recent use of antibiotics. CONCLUSIONS: Introduction of PCV7 into the routine infant immunization schedule in a community with a high prevalence of antimicrobial-resistant pneumococci appears to reduce transmission of PCV7 vaccine serotypes and COT-NS pneumococci but has no impact on overall carriage of pneumococci or carriage of PCN-NS pneumococci.
BACKGROUND:Streptococcus pneumoniae is a leading cause of invasive bacterial disease and pneumonia among children. Antimicrobial resistance among pneumococci has increased in recent years and complicates treatment. The introduction of heptavalent pneumococcal conjugate vaccine (PCV7) could reduce acquisition of antimicrobial-resistant pneumococci. METHODS: We obtained 1350 nasopharyngeal swabs for culture from 1275 children aged 3-59 months presenting at 3 clinics in Anchorage, Alaska, during the winters of 2000, 2001, and 2002, as PCV7 was being introduced into the routine immunization schedule. We recorded the frequency of use of antibiotics as well as the dates of doses of PCV7 for enrolled children. We used multivariate logistic regression modeling to identify independent risk factors for overall carriage of pneumococci and carriage of PCV7-type pneumococci, cotrimoxazole-nonsusceptible (COT-NS) pneumococci, or penicillin-nonsusceptible (PCN-NS) pneumococci. RESULTS: The proportion of children who were up-to-date for age, with respect to PCV7 vaccination, increased from 0% in 2000 to 55% in 2002. Carriage of PCV7-type pneumococci decreased by 43% (P<.0001). Risk of carriage of PCV7-type pneumococci was lower in 2002 than in 2000, independent of vaccination status, suggesting an indirect effect of vaccination. Carriage of COT-NS, but not PCN-NS, pneumococci also decreased (38%; P=.02), not only among vaccinated children but also among unvaccinated children without recent use of antibiotics. CONCLUSIONS: Introduction of PCV7 into the routine infant immunization schedule in a community with a high prevalence of antimicrobial-resistant pneumococci appears to reduce transmission of PCV7 vaccine serotypes and COT-NS pneumococci but has no impact on overall carriage of pneumococci or carriage of PCN-NS pneumococci.
Authors: F M Russell; J R Carapetis; C Satzke; L Tikoduadua; L Waqatakirewa; R Chandra; A Seduadua; S Oftadeh; Y B Cheung; G L Gilbert; E K Mulholland Journal: Clin Vaccine Immunol Date: 2010-10-13
Authors: Paul A Kristiansen; Fabien Diomandé; Stanley C Wei; Rasmata Ouédraogo; Lassana Sangaré; Idrissa Sanou; Denis Kandolo; Pascal Kaboré; Thomas A Clark; Abdoul-Salam Ouédraogo; Ki Ba Absatou; Charles D Ouédraogo; Musa Hassan-King; Jennifer Dolan Thomas; Cynthia Hatcher; Mamoudou Djingarey; Nancy Messonnier; Marie-Pierre Préziosi; Marc LaForce; Dominique A Caugant Journal: Clin Vaccine Immunol Date: 2011-01-12
Authors: Tammy Zulz; Jay D Wenger; Karen Rudolph; D Ashley Robinson; Alexey V Rakov; Dana Bruden; Rosalyn J Singleton; Michael G Bruce; Thomas W Hennessy Journal: J Clin Microbiol Date: 2013-02-13 Impact factor: 5.948
Authors: Matthew J Ferrari; Florence Fermon; Fabienne Nackers; Augusto Llosa; Claire Magone; Rebecca F Grais Journal: Int Health Date: 2014-09-05 Impact factor: 2.473
Authors: Michael R Jacobs; Caryn E Good; Bernard Beall; Saralee Bajaksouzian; Anne R Windau; Cynthia G Whitney Journal: J Clin Microbiol Date: 2008-01-30 Impact factor: 5.948