TY - JOUR
T1 - Emerging pneumococcal carriage serotypes in a high-risk population receiving universal 7-valent pneumococcal conjugate vaccine and 23-valent polysaccharide vaccine since 2001
AU - Leach, Amanda
AU - Morris, Peter
AU - MCCALLUM, G
AU - Wilson, Carole
AU - STUBBS, L
AU - Beissbarth, Jemima
AU - Jacups, Susan
AU - Hare, Kim
AU - Smith-Vaughan, Heidi
PY - 2009
Y1 - 2009
N2 - Background: In Australia in June 2001, a unique pneumococcal vaccine schedule commenced for Indigenous infants; seven-valent pneumococcal conjugate vaccine (7PCV) given at 2, 4, and 6 months of age and 23-valent pneumococcal polysaccharide vaccine (23PPV) at 18 months of age. This study presents carriage serotypes following this schedule. Methods: We conducted cross sectional surveys of pneumococcal carriage in Aboriginal children 0 to 6 years of age living in remote Aboriginal communities (RACs) in 2003 and 2005. Nasal secretions were collected and processed according to published methods. Results: 902 children (mean age 25 months) living in 29 communities in 2003 and 818 children (mean age 35 months) in 17 communities in 2005 were enrolled. 87% children in 2003 and 96% in 2005 had received two or more doses of 7PCV. From 2003 to 2005, pneumococcal carriage was reduced from 82% to 76% and reductions were apparent in all age groups; 7PCV-type carriage was reduced from 11% to 8%, and 23PPV-non-7PCV-type carriage from 31% to 25% respectively. Thus non-23PPV-type carriage increased from 57% to 67%. All these changes were statistically significant, as were changes for some specific serotypes. Shifts could not be attributed to vaccination alone. The top 10 of 40 serotypes identified were (in descending order) 16F, 19A, 11A, 6C, 23B, 19F, 6A, 35B, 6B, 10A and 35B. Carriage of penicillin non-susceptible (MIC > = 0.12 ?g/mL) strains (15% overall) was detected in serotypes (descending order) 19A, 19F, 6B, 16F, 11A, 9V, 23B, and in 4 additional serotypes. Carriage of azithromycin resistant (MIC > = 2 ?g/mL) strains (5% overall), was detected in serotypes (descending order) 23B, 17F, 9N, 6B, 6A, 11A, 23F, and in 10 additional serotypes including 6C. Conclusion: Pneumococcal carriage remains high (?80%) in this vaccinated population. Uptake of both pneumococcal vaccines increased, and carriage was reduced between 2003 and 2005. Predominant serotypes in combined years were 16F, 19A, 11A, 6C and 23B. Antimicrobial non-susceptibility was detected in these and 17 additional serotypes. Shifts in serotype-specific carriage suggest a need more research to clarify the association between pneumococcal vaccination and carriage at the serotype level. � 2009 Leach et al; licensee BioMed Central Ltd.
AB - Background: In Australia in June 2001, a unique pneumococcal vaccine schedule commenced for Indigenous infants; seven-valent pneumococcal conjugate vaccine (7PCV) given at 2, 4, and 6 months of age and 23-valent pneumococcal polysaccharide vaccine (23PPV) at 18 months of age. This study presents carriage serotypes following this schedule. Methods: We conducted cross sectional surveys of pneumococcal carriage in Aboriginal children 0 to 6 years of age living in remote Aboriginal communities (RACs) in 2003 and 2005. Nasal secretions were collected and processed according to published methods. Results: 902 children (mean age 25 months) living in 29 communities in 2003 and 818 children (mean age 35 months) in 17 communities in 2005 were enrolled. 87% children in 2003 and 96% in 2005 had received two or more doses of 7PCV. From 2003 to 2005, pneumococcal carriage was reduced from 82% to 76% and reductions were apparent in all age groups; 7PCV-type carriage was reduced from 11% to 8%, and 23PPV-non-7PCV-type carriage from 31% to 25% respectively. Thus non-23PPV-type carriage increased from 57% to 67%. All these changes were statistically significant, as were changes for some specific serotypes. Shifts could not be attributed to vaccination alone. The top 10 of 40 serotypes identified were (in descending order) 16F, 19A, 11A, 6C, 23B, 19F, 6A, 35B, 6B, 10A and 35B. Carriage of penicillin non-susceptible (MIC > = 0.12 ?g/mL) strains (15% overall) was detected in serotypes (descending order) 19A, 19F, 6B, 16F, 11A, 9V, 23B, and in 4 additional serotypes. Carriage of azithromycin resistant (MIC > = 2 ?g/mL) strains (5% overall), was detected in serotypes (descending order) 23B, 17F, 9N, 6B, 6A, 11A, 23F, and in 10 additional serotypes including 6C. Conclusion: Pneumococcal carriage remains high (?80%) in this vaccinated population. Uptake of both pneumococcal vaccines increased, and carriage was reduced between 2003 and 2005. Predominant serotypes in combined years were 16F, 19A, 11A, 6C and 23B. Antimicrobial non-susceptibility was detected in these and 17 additional serotypes. Shifts in serotype-specific carriage suggest a need more research to clarify the association between pneumococcal vaccination and carriage at the serotype level. � 2009 Leach et al; licensee BioMed Central Ltd.
KW - 23 valent Pneumococcal polysaccharide vaccine
KW - 7 valent pneumococcal conjugate vaccine
KW - azithromycin
KW - bacterial vaccine
KW - Pneumococcus vaccine
KW - unclassified drug
KW - 23 valent pneumococcal capsular polysaccharide vaccine
KW - 23-valent pneumococcal capsular polysaccharide vaccine
KW - heptavalent pneumococcal conjugate vaccine
KW - Aborigine
KW - antibiotic resistance
KW - antibody titer
KW - article
KW - Australia
KW - child
KW - community assessment
KW - controlled study
KW - disease surveillance
KW - drug uptake
KW - drug use
KW - female
KW - high risk population
KW - human
KW - infant
KW - male
KW - nonhuman
KW - nose secretion
KW - penicillin resistance
KW - pneumococcal infection
KW - preschool child
KW - rhinopharyngitis
KW - serotype
KW - serotyping
KW - vaccination
KW - classification
KW - cross-sectional study
KW - heterozygote
KW - microbiology
KW - nasopharynx
KW - preventive health service
KW - statistics
KW - Streptococcus pneumoniae
KW - Carrier State
KW - Child
KW - Child, Preschool
KW - Cross-Sectional Studies
KW - Drug Resistance, Bacterial
KW - Female
KW - Humans
KW - Immunization Programs
KW - Infant
KW - Male
KW - Nasopharynx
KW - Pneumococcal Vaccines
KW - Serotyping
M3 - Article
SN - 1471-2334
VL - 9
SP - -
JO - BMC Infectious Diseases
JF - BMC Infectious Diseases
IS - 121
ER -