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Impact of a conjugate vaccine on community-wide carriage of nonsusceptible Streptococcus pneumoniae in Alaska.
J Infect Dis. 2004 Dec 01; 190(11):2031-8.JI

Abstract

BACKGROUND

Streptococcus pneumoniae is a leading cause of invasive bacterial disease and pneumonia among children. Antimicrobial resistance among pneumococci has increased in recent years and complicates treatment. The introduction of heptavalent pneumococcal conjugate vaccine (PCV7) could reduce acquisition of antimicrobial-resistant pneumococci.

METHODS

We obtained 1350 nasopharyngeal swabs for culture from 1275 children aged 3-59 months presenting at 3 clinics in Anchorage, Alaska, during the winters of 2000, 2001, and 2002, as PCV7 was being introduced into the routine immunization schedule. We recorded the frequency of use of antibiotics as well as the dates of doses of PCV7 for enrolled children. We used multivariate logistic regression modeling to identify independent risk factors for overall carriage of pneumococci and carriage of PCV7-type pneumococci, cotrimoxazole-nonsusceptible (COT-NS) pneumococci, or penicillin-nonsusceptible (PCN-NS) pneumococci.

RESULTS

The proportion of children who were up-to-date for age, with respect to PCV7 vaccination, increased from 0% in 2000 to 55% in 2002. Carriage of PCV7-type pneumococci decreased by 43% (P<.0001). Risk of carriage of PCV7-type pneumococci was lower in 2002 than in 2000, independent of vaccination status, suggesting an indirect effect of vaccination. Carriage of COT-NS, but not PCN-NS, pneumococci also decreased (38%; P=.02), not only among vaccinated children but also among unvaccinated children without recent use of antibiotics.

CONCLUSIONS

Introduction of PCV7 into the routine infant immunization schedule in a community with a high prevalence of antimicrobial-resistant pneumococci appears to reduce transmission of PCV7 vaccine serotypes and COT-NS pneumococci but has no impact on overall carriage of pneumococci or carriage of PCN-NS pneumococci.

Authors+Show Affiliations

Division of Applied Public Health Training, Epidemiology Program Office, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA. mmoore4@cdc.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

15529269

Citation

Moore, Matthew R., et al. "Impact of a Conjugate Vaccine On Community-wide Carriage of Nonsusceptible Streptococcus Pneumoniae in Alaska." The Journal of Infectious Diseases, vol. 190, no. 11, 2004, pp. 2031-8.
Moore MR, Hyde TB, Hennessy TW, et al. Impact of a conjugate vaccine on community-wide carriage of nonsusceptible Streptococcus pneumoniae in Alaska. J Infect Dis. 2004;190(11):2031-8.
Moore, M. R., Hyde, T. B., Hennessy, T. W., Parks, D. J., Reasonover, A. L., Harker-Jones, M., Gove, J., Bruden, D. L., Rudolph, K., Parkinson, A., Butler, J. C., & Schuchat, A. (2004). Impact of a conjugate vaccine on community-wide carriage of nonsusceptible Streptococcus pneumoniae in Alaska. The Journal of Infectious Diseases, 190(11), 2031-8.
Moore MR, et al. Impact of a Conjugate Vaccine On Community-wide Carriage of Nonsusceptible Streptococcus Pneumoniae in Alaska. J Infect Dis. 2004 Dec 1;190(11):2031-8. PubMed PMID: 15529269.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of a conjugate vaccine on community-wide carriage of nonsusceptible Streptococcus pneumoniae in Alaska. AU - Moore,Matthew R, AU - Hyde,Terri B, AU - Hennessy,Thomas W, AU - Parks,Debra J, AU - Reasonover,Alisa L, AU - Harker-Jones,Marcella, AU - Gove,James, AU - Bruden,Dana L, AU - Rudolph,Karen, AU - Parkinson,Alan, AU - Butler,Jay C, AU - Schuchat,Anne, Y1 - 2004/10/27/ PY - 2004/03/11/received PY - 2004/06/08/accepted PY - 2004/11/6/pubmed PY - 2004/12/31/medline PY - 2004/11/6/entrez SP - 2031 EP - 8 JF - The Journal of infectious diseases JO - J Infect Dis VL - 190 IS - 11 N2 - BACKGROUND: Streptococcus pneumoniae is a leading cause of invasive bacterial disease and pneumonia among children. Antimicrobial resistance among pneumococci has increased in recent years and complicates treatment. The introduction of heptavalent pneumococcal conjugate vaccine (PCV7) could reduce acquisition of antimicrobial-resistant pneumococci. METHODS: We obtained 1350 nasopharyngeal swabs for culture from 1275 children aged 3-59 months presenting at 3 clinics in Anchorage, Alaska, during the winters of 2000, 2001, and 2002, as PCV7 was being introduced into the routine immunization schedule. We recorded the frequency of use of antibiotics as well as the dates of doses of PCV7 for enrolled children. We used multivariate logistic regression modeling to identify independent risk factors for overall carriage of pneumococci and carriage of PCV7-type pneumococci, cotrimoxazole-nonsusceptible (COT-NS) pneumococci, or penicillin-nonsusceptible (PCN-NS) pneumococci. RESULTS: The proportion of children who were up-to-date for age, with respect to PCV7 vaccination, increased from 0% in 2000 to 55% in 2002. Carriage of PCV7-type pneumococci decreased by 43% (P<.0001). Risk of carriage of PCV7-type pneumococci was lower in 2002 than in 2000, independent of vaccination status, suggesting an indirect effect of vaccination. Carriage of COT-NS, but not PCN-NS, pneumococci also decreased (38%; P=.02), not only among vaccinated children but also among unvaccinated children without recent use of antibiotics. CONCLUSIONS: Introduction of PCV7 into the routine infant immunization schedule in a community with a high prevalence of antimicrobial-resistant pneumococci appears to reduce transmission of PCV7 vaccine serotypes and COT-NS pneumococci but has no impact on overall carriage of pneumococci or carriage of PCN-NS pneumococci. SN - 0022-1899 UR - https://www.unboundmedicine.com/medline/citation/15529269/Impact_of_a_conjugate_vaccine_on_community_wide_carriage_of_nonsusceptible_Streptococcus_pneumoniae_in_Alaska_ L2 - https://academic.oup.com/jid/article-lookup/doi/10.1086/425422 DB - PRIME DP - Unbound Medicine ER -