Jennifer Milucky1, Maria de Gloria Carvalho2, Nadine Rouphael3, Nancy M Bennett4, H Keipp Talbot5, Lee H Harrison6, Monica M Farley7, Jeremy Walston8, Fabiana Pimenta2, Fernanda C Lessa9. 1. Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases, Atlanta, Georgia. Electronic address: wii7@cdc.gov. 2. Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases, Atlanta, Georgia. 3. Emory University School of Medicine, Department of Medicine, Atlanta, Georgia; Hope Clinic of the Emory Vaccine Center, Emory University, Decatur, Georgia. 4. University of Rochester School of Medicine and Dentistry, Department of Medicine, Rochester, New York. 5. Vanderbilt University Medical Center, Nashville, Tennessee. 6. Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. 7. Emory University School of Medicine, Department of Medicine, Atlanta, Georgia; Atlanta Veterans Affairs Medical Center, Atlanta, Georgia. 8. Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine. 9. Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases, Atlanta, Georgia. Electronic address: flessa@cdc.gov.
Abstract
BACKGROUND: Vaccination of children with 13-valent pneumococcal conjugate vaccine (PCV13) led to declines in vaccine-type pneumococcal nasopharyngeal carriage among adults through indirect effects. In August 2014, PCV13 immunization of all U.S. adults ≥65 years of age was recommended. This study sought to define prevalence and serotype distribution of pneumococcal carriage among adults ≥65 years of age and to describe risk factors for colonization soon after introduction of PCV13 in adults. METHODS: A cross-sectional survey of non-institutionalized U.S. adults ≥65 years of age was conducted in four states in 2015-2016. Demographic information, risk factors for disease, PCV13 vaccination history, and nasopharyngeal (NP) and oropharyngeal (OP) swabs were collected. NP and OP swabs were processed separately and pneumococcal isolates were serotyped by Quellung reaction. Antimicrobial susceptibility of pneumococcal isolates was performed. NP swabs also underwent real-time PCR for pneumococcal detection and serotyping. RESULTS: Of 2989 participants, 45.3% (1354/2989) had been vaccinated with PCV13. Fifty-five (1.8%) carried pneumococcus (45 identified by culture and 10 by real-time PCR only) and PCV13 serotypes were found in eight (0.3%) participants. Almost half (22/45) of pneumococcal isolates were not susceptible to at least one of the antibiotics tested. Vaccine-type carriage among vaccinated and unvaccinated individuals was similar (0.2% vs. 0.1%, respectively). Respiratory symptoms were associated with higher odds of pneumococcal colonization (adjusted OR: 2.1; 95% CI = 1.1-3.8). CONCLUSIONS: Pneumococcal carriage among non-institutionalized adults ≥65 years of age was very low. Less than 0.5% of both vaccinated and unvaccinated individuals in our study carried vaccine-type serotypes. Over a decade of PCV vaccination of children likely led to indirect effects in adults. However, given the low vaccine-type carriage rates we observed in an already high PCV13 adult coverage setting, it is difficult to attribute our findings to the direct versus indirect effects of PCV13 on adult carriage. Published by Elsevier Ltd.
BACKGROUND: Vaccination of children with 13-valent pneumococcal conjugate vaccine (PCV13) led to declines in vaccine-type pneumococcal nasopharyngeal carriage among adults through indirect effects. In August 2014, PCV13 immunization of all U.S. adults ≥65 years of age was recommended. This study sought to define prevalence and serotype distribution of pneumococcal carriage among adults ≥65 years of age and to describe risk factors for colonization soon after introduction of PCV13 in adults. METHODS: A cross-sectional survey of non-institutionalized U.S. adults ≥65 years of age was conducted in four states in 2015-2016. Demographic information, risk factors for disease, PCV13 vaccination history, and nasopharyngeal (NP) and oropharyngeal (OP) swabs were collected. NP and OP swabs were processed separately and pneumococcal isolates were serotyped by Quellung reaction. Antimicrobial susceptibility of pneumococcal isolates was performed. NP swabs also underwent real-time PCR for pneumococcal detection and serotyping. RESULTS: Of 2989 participants, 45.3% (1354/2989) had been vaccinated with PCV13. Fifty-five (1.8%) carried pneumococcus (45 identified by culture and 10 by real-time PCR only) and PCV13 serotypes were found in eight (0.3%) participants. Almost half (22/45) of pneumococcal isolates were not susceptible to at least one of the antibiotics tested. Vaccine-type carriage among vaccinated and unvaccinated individuals was similar (0.2% vs. 0.1%, respectively). Respiratory symptoms were associated with higher odds of pneumococcal colonization (adjusted OR: 2.1; 95% CI = 1.1-3.8). CONCLUSIONS:Pneumococcal carriage among non-institutionalized adults ≥65 years of age was very low. Less than 0.5% of both vaccinated and unvaccinated individuals in our study carried vaccine-type serotypes. Over a decade of PCV vaccination of children likely led to indirect effects in adults. However, given the low vaccine-type carriage rates we observed in an already high PCV13 adult coverage setting, it is difficult to attribute our findings to the direct versus indirect effects of PCV13 on adult carriage. Published by Elsevier Ltd.
Authors: Rosemeire Cobo Zanella; Maria Cristina de Cunto Brandileone; Samanta Cristine Grassi Almeida; Ana Paula Silva de Lemos; Claudio Tavares Sacchi; Claudia R Gonçalves; Maria Gisele Gonçalves; Lucila Okuyama Fukasawa; Marcos Daniel Saraiva; Luís Fernando Rangel; Julia Lusis Lassance Cunha; Thereza Cristina Ariza Rotta; Christian Douradinho; Wilson Jacob-Filho; Ruth Minamisava; Ana Lúcia Andrade Journal: PLoS One Date: 2019-08-22 Impact factor: 3.240
Authors: Robert E Gertz; Fabiana C Pimenta; Sopio Chochua; Shanda Larson; Anne-Kathryn Venero; Godfrey Bigogo; Jennifer Milucky; Maria da Gloria Carvalho; Bernard Beall Journal: mBio Date: 2021-05-18 Impact factor: 7.867