Robert Cohen1, Emmanuelle Varon2, Catherine Doit3, Catherine Schlemmer4, Olivier Romain4, Franck Thollot5, Stéphane Béchet4, Stéphane Bonacorsi3, Corinne Levy6. 1. Université Paris Est, IMRB-GRC GEMINI, 94000 Créteil, France; ACTIV, Association Clinique et Thérapeutique Infantile du Val de Marne, Saint-Maur des Fossés, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Chambéry, France; Unité Court Séjour, Petits Nourrissons, Service de Néonatologie, Centre Hospitalier Intercommunal de Créteil, France. 2. National Reference Center for Pneumococci, Laboratoire de Microbiologie, Assistance Publique-Hôpitaux de Paris, Hopital Européen Georges-Pompidou, Paris, France. 3. Univ Paris Diderot, Sorbonne Paris Cité, France; Service de Microbiologie, Hôpital Robert-Debré, 75019 Paris, France. 4. ACTIV, Association Clinique et Thérapeutique Infantile du Val de Marne, Saint-Maur des Fossés, France. 5. ACTIV, Association Clinique et Thérapeutique Infantile du Val de Marne, Saint-Maur des Fossés, France; AFPA, Association Française de Pédiatrie Ambulatoire, Chambéry, France. 6. Université Paris Est, IMRB-GRC GEMINI, 94000 Créteil, France; ACTIV, Association Clinique et Thérapeutique Infantile du Val de Marne, Saint-Maur des Fossés, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Chambéry, France. Electronic address: corinne.levy@activ-france.fr.
Abstract
BACKGROUND: This nasopharyngeal (NP) carriage surveillance study was requested by the European Agency for the Evaluation of Medicinal Products as a post-licensing commitment to determine whether the use of the pneumococcal conjugate vaccines (PCVs) including 7 then 13 valents (introduced in 2001 and 2010, respectively) caused a shift in the distribution of Streptococcus pneumoniae serotypes in children with acute otitis media and modified the resistance of this bacterial species to antibiotics. METHODS: Between 2001 and 2014, 121 pediatricians obtained nasopharyngeal swabs from children with acute otitis media aged 6-24 months. The swabs were analyzed by the French National Reference Centre for Pneumococci. Demographics, medical history and physical examination findings were recorded. RESULTS: Over the 13 years, among the 7991 enrolled patients, the proportion of PCV-vaccinated children (≥1 dose) increased (54.3-99.7%, p<0.001). Overall, pneumococcal carriage was reduced from 71.2% to 56.2% from 2001 to 2014 (p<0.001) and carriage of PCV7 serotypes (STs) from 44.5% to 1.2% (p<0.001). The carriage of 6 additional STs plus 6C increased from 17.2% to 24.3% from 2001 to 2010 (p<0.001) and decreased after PCV13 implementation (21.4-3.5%, p<0.001). The proportion of ST 19A carriage increased from 8.6% to 15.8% from 2001 to 2010 (p<0.001) and decreased to 1.2% in 2014. After PCV13 implementation, the most frequently carried non-PCV13 STs were ST 15B/C, 11A, 15A, and 35B. Penicillin non-susceptible pneumococcal strains decreased from 67.1% in 2001 to 33.1% in 2014 (p<0.001). CONCLUSIONS: By the number of patients enrolled and the duration, this study is the largest performed to date. It allows to demonstrate a strong impact of PCVs and to describe the complex dynamics of pneumococcal carriage during AOM. As pneumococcal carriage decreased during AOM, a reduction in the incidence of pneumococcal AOM could be expected.
BACKGROUND: This nasopharyngeal (NP) carriage surveillance study was requested by the European Agency for the Evaluation of Medicinal Products as a post-licensing commitment to determine whether the use of the pneumococcal conjugate vaccines (PCVs) including 7 then 13 valents (introduced in 2001 and 2010, respectively) caused a shift in the distribution of Streptococcus pneumoniae serotypes in children with acute otitis media and modified the resistance of this bacterial species to antibiotics. METHODS: Between 2001 and 2014, 121 pediatricians obtained nasopharyngeal swabs from children with acute otitis media aged 6-24 months. The swabs were analyzed by the French National Reference Centre for Pneumococci. Demographics, medical history and physical examination findings were recorded. RESULTS: Over the 13 years, among the 7991 enrolled patients, the proportion of PCV-vaccinated children (≥1 dose) increased (54.3-99.7%, p<0.001). Overall, pneumococcal carriage was reduced from 71.2% to 56.2% from 2001 to 2014 (p<0.001) and carriage of PCV7 serotypes (STs) from 44.5% to 1.2% (p<0.001). The carriage of 6 additional STs plus 6C increased from 17.2% to 24.3% from 2001 to 2010 (p<0.001) and decreased after PCV13 implementation (21.4-3.5%, p<0.001). The proportion of ST 19A carriage increased from 8.6% to 15.8% from 2001 to 2010 (p<0.001) and decreased to 1.2% in 2014. After PCV13 implementation, the most frequently carried non-PCV13 STs were ST 15B/C, 11A, 15A, and 35B. Penicillin non-susceptible pneumococcal strains decreased from 67.1% in 2001 to 33.1% in 2014 (p<0.001). CONCLUSIONS: By the number of patients enrolled and the duration, this study is the largest performed to date. It allows to demonstrate a strong impact of PCVs and to describe the complex dynamics of pneumococcal carriage during AOM. As pneumococcal carriage decreased during AOM, a reduction in the incidence of pneumococcal AOM could be expected.
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