Emerging pneumococcal carriage serotypes in a high-risk population receiving universal 7-valent pneumococcal conjugate vaccine and 23-valent polysaccharide vaccine since 2001

Amanda Leach, Peter Morris, G MCCALLUM, Carole Wilson, L STUBBS, Jemima Beissbarth, Susan Jacups, Kim Hare, Heidi Smith-Vaughan

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    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.
    Original languageEnglish
    Pages (from-to)-
    JournalBMC Infectious Diseases
    Volume9
    Issue number121
    Publication statusPublished - 2009

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    Conjugate Vaccines
    Pneumococcal Vaccines
    Polysaccharides
    Population
    Appointments and Schedules
    Vaccination
    23-valent pneumococcal capsular polysaccharide vaccine
    Serogroup
    Azithromycin
    Nose
    Penicillins
    Age Groups
    Cross-Sectional Studies

    Cite this

    @article{44069ab0a489433b98cef655ceb14d49,
    title = "Emerging pneumococcal carriage serotypes in a high-risk population receiving universal 7-valent pneumococcal conjugate vaccine and 23-valent polysaccharide vaccine since 2001",
    abstract = "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.",
    keywords = "23 valent Pneumococcal polysaccharide vaccine, 7 valent pneumococcal conjugate vaccine, azithromycin, bacterial vaccine, Pneumococcus vaccine, unclassified drug, 23 valent pneumococcal capsular polysaccharide vaccine, 23-valent pneumococcal capsular polysaccharide vaccine, heptavalent pneumococcal conjugate vaccine, Aborigine, antibiotic resistance, antibody titer, article, Australia, child, community assessment, controlled study, disease surveillance, drug uptake, drug use, female, high risk population, human, infant, male, nonhuman, nose secretion, penicillin resistance, pneumococcal infection, preschool child, rhinopharyngitis, serotype, serotyping, vaccination, classification, cross-sectional study, heterozygote, microbiology, nasopharynx, preventive health service, statistics, Streptococcus pneumoniae, Carrier State, Child, Child, Preschool, Cross-Sectional Studies, Drug Resistance, Bacterial, Female, Humans, Immunization Programs, Infant, Male, Nasopharynx, Pneumococcal Vaccines, Serotyping",
    author = "Amanda Leach and Peter Morris and G MCCALLUM and Carole Wilson and L STUBBS and Jemima Beissbarth and Susan Jacups and Kim Hare and Heidi Smith-Vaughan",
    year = "2009",
    language = "English",
    volume = "9",
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    journal = "BMC Infectious Diseases",
    issn = "1471-2334",
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    Emerging pneumococcal carriage serotypes in a high-risk population receiving universal 7-valent pneumococcal conjugate vaccine and 23-valent polysaccharide vaccine since 2001. / Leach, Amanda; Morris, Peter; MCCALLUM, G; Wilson, Carole; STUBBS, L; Beissbarth, Jemima; Jacups, Susan; Hare, Kim; Smith-Vaughan, Heidi.

    In: BMC Infectious Diseases, Vol. 9, No. 121, 2009, p. -.

    Research output: Contribution to journalArticleResearchpeer-review

    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

    VL - 9

    SP - -

    JO - BMC Infectious Diseases

    JF - BMC Infectious Diseases

    SN - 1471-2334

    IS - 121

    ER -