BACKGROUND: Pediatric respiratory infections caused by antibiotic-nonsusceptible Streptococcus pneumoniae (ANSP) continue to present an important challenge, even after introduction of 7-valent pneumococcal conjugate vaccine (PCV7). This randomized double-blind trial assessed the potential additional impact of PCV13 over PCV7 on reducing ANSP carriage. METHODS:Healthy infants were randomly assigned to receive PCV13 (n = 932) or PCV7 (n = 934) at ages 2, 4, 6, or 12 months. Eight nasopharyngeal specimens were collected by swabbing between ages 2 and 24 months. S. pneumoniae isolates were serotyped and tested for antimicrobial susceptibility by the disk-diffusion method and the Etest. Nasopharyngeal acquisition and prevalence of ANSP during ages 7-24 months were compared between the 2 vaccine groups. RESULTS: In general, new acquisition of pneumococci nonsusceptible to penicillin, erythromycin, clindamycin, penicillin plus erythromycin, and multiple drugs (≥3 antibiotics) was significantly lower in the PCV13 group compared with the PCV7 group; the main serotypes contributing to this significant decrease were serotype 19F, present in PCV13 and PCV7, and serotypes 6A and 19A, present in PCV13 only. CONCLUSIONS:PCV13 has a significant added benefit over PCV7 in reducing carriage of ANSP. Because carriage determines transmission, these results suggest that PCV13 will provide protection against ANSP disease that exceeds protection provided by PCV7. CLINICAL TRIALS REGISTRATION: NCT00508742.
RCT Entities:
BACKGROUND: Pediatric respiratory infections caused by antibiotic-nonsusceptible Streptococcus pneumoniae (ANSP) continue to present an important challenge, even after introduction of 7-valent pneumococcal conjugate vaccine (PCV7). This randomized double-blind trial assessed the potential additional impact of PCV13 over PCV7 on reducing ANSP carriage. METHODS: Healthy infants were randomly assigned to receive PCV13 (n = 932) or PCV7 (n = 934) at ages 2, 4, 6, or 12 months. Eight nasopharyngeal specimens were collected by swabbing between ages 2 and 24 months. S. pneumoniae isolates were serotyped and tested for antimicrobial susceptibility by the disk-diffusion method and the Etest. Nasopharyngeal acquisition and prevalence of ANSP during ages 7-24 months were compared between the 2 vaccine groups. RESULTS: In general, new acquisition of pneumococci nonsusceptible to penicillin, erythromycin, clindamycin, penicillin plus erythromycin, and multiple drugs (≥3 antibiotics) was significantly lower in the PCV13 group compared with the PCV7 group; the main serotypes contributing to this significant decrease were serotype 19F, present in PCV13 and PCV7, and serotypes 6A and 19A, present in PCV13 only. CONCLUSIONS: PCV13 has a significant added benefit over PCV7 in reducing carriage of ANSP. Because carriage determines transmission, these results suggest that PCV13 will provide protection against ANSP disease that exceeds protection provided by PCV7. CLINICAL TRIALS REGISTRATION: NCT00508742.
Authors: Lindsay R Grant; Laura L Hammitt; Sarah E O'Brien; Michael R Jacobs; Connie Donaldson; Robert C Weatherholtz; Raymond Reid; Mathuram Santosham; Katherine L O'Brien Journal: Pediatr Infect Dis J Date: 2016-08 Impact factor: 2.129
Authors: Michelle McFarland; Taylor P Szasz; Julie Y Zhou; Kara Motley; Janardan S Sivapalan; Megan Isaacson-Schmid; Elizabeth M Todd; Patrick G Hogan; Stephanie A Fritz; Carey-Ann D Burnham; Steen Hoffmann; Sharon Celeste Morley Journal: Vaccine Date: 2017-07-04 Impact factor: 3.641
Authors: Julie Y Zhou; Megan Isaacson-Schmid; Elizabeth C Utterson; Elizabeth M Todd; Michelle McFarland; Janardan Sivapalan; Joan M Niehoff; Carey-Ann D Burnham; S Celeste Morley Journal: Int J Infect Dis Date: 2015-09-03 Impact factor: 3.623
Authors: Theresa D Feola; Cynthia A Bonville; Donald A Cibula; Sherly Jose; Geetha Nattanmai; Joseph B Domachowske; Manika Suryadevara Journal: Hum Vaccin Immunother Date: 2016-05-24 Impact factor: 3.452