Understanding the Evolution of Antibiotic-nonsusceptible Pneumococcal Nasopharyngeal Colonization Following Pneumococcal Conjugate Vaccine Implementation in Young Children.
Clin Infect Dis
; 69(4): 648-656, 2019 08 01.
Article
in En
| MEDLINE
| ID: mdl-30371763
ABSTRACT
BACKGROUND:
Four main processes determine pneumococcal conjugate vaccine (PCV) antibiotic-nonsusceptible Streptococcus pneumoniae (ANSP) carriage reduction of PCV serotypes, increase of non-PCV serotypes, potential overall reduction in carriage, and within-serotype nonsusceptibility resulting from continuous antibiotic pressure. The post-PCV implementation dynamics of these components were examined in young children from 2 distinct ethnic populations Jewish and Bedouin.METHODS:
We performed ongoing, prospective, population-based, active surveillance initiated at the time of 7- and 13-valent PCVs (PCV7; PCV13) implementation. Nasopharyngeal cultures for S. pneumoniae were obtained daily from children aged <5 years who visited the only pediatric emergency room in the district during a 6-year period (2009 to 2015).RESULTS:
Of 8446 nasopharyngeal samples, 48.3% were positive (42.0% and 52.8% for Jewish and Bedouin children, respectively; P < .001). Nonsusceptibility was significantly more frequent among PCV serotypes than among non-PCV serotypes and among Bedouin children than among Jewish children. PCV serotype carriage declined by 80%, while that of non-PCV serotypes increased by 140%. The overall (all serotypes) pneumococcal carriage significantly declined (33% and 11% in Bedouin and Jewish children, respectively). Among non-PCV isolates, the proportion of ANSP significantly increased with time in both populations. As a summation of all 4 processes, ANSP carriage significantly decreased among both Bedouin and Jewish children.CONCLUSIONS:
PCV impact on ANSP nasopharyngeal carriage is a dynamic, multicomponent process, highly dependent on antibiotic consumption in the community, which may result in a continuous increase in antibiotic resistance in the replacing serotypes.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Pneumococcal Infections
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Streptococcus pneumoniae
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Carrier State
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Pneumococcal Vaccines
Type of study:
Observational_studies
Limits:
Child, preschool
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Female
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Humans
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Infant
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Male
Country/Region as subject:
Asia
Language:
En
Year:
2019
Type:
Article