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Serotype distribution and antimicrobial susceptibilities of nasopharyngeal isolates of Streptococcus pneumoniae from healthy children in the 13-valent pneumococcal conjugate vaccine era.
Vaccine 2014; 32(5):527-34V

Abstract

Few epidemiological data are available since the introduction of 13-valent pneumococcal vaccine (PCV13) in 2010. We conducted a cross-sectional study to estimate the prevalence of Streptococcus pneumoniae (SP) nasopharyngeal carriage in healthy Italian infants and young children and to evaluate the impact of PCV13 on pneumococcal colonization. In the trimester September-December 2011 nasopharyngeal swabs were collected from healthy children aged 3-59 months presenting for routine well careat 16 primary care pediatricians in Milan. SP carriage isolates were serotyped and tested for antimicrobial resistance using EUCAST breakpoints. Among 1250 enrolled children, 618 had received at least 1 dose of PCV13, 292 at least 1 dose of PCV7, 94 a combination of the two vaccines and 246 were not vaccinated. The prevalence of SP carriage was 27% (95% confidence interval [CI] 25-30). At multivariable analysis, age≥25 months (prevalence ratio [PR]=0.74) and use of antibiotics in the previous 3 months (PR=0.67) were associated with lower SP carriage prevalence. Having siblings (PR=1.79 for 1 sibling and PR=2.23 for ≥2 siblings), day-care attendance (PR=2.27) and respiratory tract infections in the previous 3 months (PR=1.39) were associated with higher SP carriage prevalence. The immunization status for SP was not associated with SP carriage at univariable or at multivariable analysis. The most common carriage isolates were 6C, 19A and 23A. The prevalence of the six additional PCV13 serotypes carriage in children appropriately vaccinated with PCV13 was lower than in children appropriately vaccinated with PCV7 (0 vs. 0.060); the greater reduction in prevalence of carriage was observed for serotype 19A (0 vs. 0.041). Serotype 6C was the most common drug-resistant serotype (17.2%). Further epidemiological studies are needed to assess changes in circulating SP serotypes following the large-scale introduction of PCV13.

Authors+Show Affiliations

Department of Paediatrics, L. Sacco Hospital, University of Milan, Italy. Electronic address: gianvincenzo.zuccotti@unimi.it.Department of Paediatrics, L. Sacco Hospital, University of Milan, Italy.Microbiology Laboratory, Policlinico, Cà Granda Ospedale Maggiore Foundation, Milan, Italy.Microbiology Laboratory, Policlinico, Cà Granda Ospedale Maggiore Foundation, Milan, Italy.Department of Paediatrics, L. Sacco Hospital, University of Milan, Italy.Clinical Epidemiology Unit, Liver Research Center, Trieste, Italy.Prevention Department, Local Health Authority, Milan, Italy.Unità Organizzativa Governo della prevenzione e tutela sanitaria, Direzione Generale Sanità, Regione Lombardia, Milan, Italy.Microbiology Laboratory, Policlinico, Cà Granda Ospedale Maggiore Foundation, Milan, Italy.No 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 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 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 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)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24342249

Citation

Zuccotti, Gianvincenzo, et al. "Serotype Distribution and Antimicrobial Susceptibilities of Nasopharyngeal Isolates of Streptococcus Pneumoniae From Healthy Children in the 13-valent Pneumococcal Conjugate Vaccine Era." Vaccine, vol. 32, no. 5, 2014, pp. 527-34.
Zuccotti G, Mameli C, Daprai L, et al. Serotype distribution and antimicrobial susceptibilities of nasopharyngeal isolates of Streptococcus pneumoniae from healthy children in the 13-valent pneumococcal conjugate vaccine era. Vaccine. 2014;32(5):527-34.
Zuccotti, G., Mameli, C., Daprai, L., Garlaschi, M. L., Dilillo, D., Bedogni, G., ... Vessia, C. (2014). Serotype distribution and antimicrobial susceptibilities of nasopharyngeal isolates of Streptococcus pneumoniae from healthy children in the 13-valent pneumococcal conjugate vaccine era. Vaccine, 32(5), pp. 527-34. doi:10.1016/j.vaccine.2013.12.003.
Zuccotti G, et al. Serotype Distribution and Antimicrobial Susceptibilities of Nasopharyngeal Isolates of Streptococcus Pneumoniae From Healthy Children in the 13-valent Pneumococcal Conjugate Vaccine Era. Vaccine. 2014 Jan 23;32(5):527-34. PubMed PMID: 24342249.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serotype distribution and antimicrobial susceptibilities of nasopharyngeal isolates of Streptococcus pneumoniae from healthy children in the 13-valent pneumococcal conjugate vaccine era. AU - Zuccotti,Gianvincenzo, AU - Mameli,Chiara, AU - Daprai,Laura, AU - Garlaschi,Maria Laura, AU - Dilillo,Dario, AU - Bedogni,Giorgio, AU - Faccini,Marino, AU - Gramegna,Maria, AU - Torresani,Erminio, AU - ,, AU - Ballerini,Emanuela, AU - Benincaso,Annarita, AU - Bonvissuto,Milena, AU - Bricalli,Dorella, AU - Brioschi,Manuela, AU - Calloni,Cinzia Simona, AU - Camiletti,Marina Irene, AU - Colella,Giacomo, AU - De Angelis,Laura, AU - Decarlis,Silvia, AU - Di Nello,Francesca, AU - Dozzi,Massimiliano, AU - Galli,Erica, AU - Gandini,Vera, AU - Giuliani,Maria Grazia, AU - Laviola,Franca, AU - Loda,Barbara, AU - Macedoni,Maddalena, AU - Mazzucchi,Elisabetta, AU - Metta,Maria Gabriella, AU - Moscatiello,Anna, AU - Nannini,Pilar, AU - Petruzzi,Mariangela, AU - Picicco,Damiano, AU - Picciotti,Michela, AU - Pisanelli,Stefania, AU - Porta,Norberto, AU - Ramponi,Giulia, AU - Redaelli,Francesca, AU - Rubini,Riccardo, AU - Sala,Natascia, AU - Saitta,Vincenzo, AU - Scelza,Giuseppina, AU - Tiso,Rosa Maria, AU - Tomasetto,Mariangela, AU - Torcoletti,Matteo, AU - Travaini,Marta, AU - Valentini,Maurizio, AU - Vessia,Chiara, Y1 - 2013/12/14/ PY - 2013/09/09/received PY - 2013/11/25/revised PY - 2013/12/02/accepted PY - 2013/12/18/entrez PY - 2013/12/18/pubmed PY - 2014/8/12/medline KW - 13-Valent pneumococcal conjugate vaccine KW - CI KW - Children KW - IPD KW - MDR KW - MIC KW - NC KW - NVS KW - PCV13 KW - PCV7 KW - PR KW - Pneumococcal nasopharyngeal carriage KW - SP KW - Streptococcus pneumoniae KW - confidence interval KW - invasive pneumococcal diseases KW - minimal inhibitory concentration KW - multidrug resistance KW - nasopharyngeal carriage KW - non vaccine serotypes KW - pneumococcal 13-valent vaccine KW - pneumococcal 7-valent vaccine KW - prevalence ratio SP - 527 EP - 34 JF - Vaccine JO - Vaccine VL - 32 IS - 5 N2 - Few epidemiological data are available since the introduction of 13-valent pneumococcal vaccine (PCV13) in 2010. We conducted a cross-sectional study to estimate the prevalence of Streptococcus pneumoniae (SP) nasopharyngeal carriage in healthy Italian infants and young children and to evaluate the impact of PCV13 on pneumococcal colonization. In the trimester September-December 2011 nasopharyngeal swabs were collected from healthy children aged 3-59 months presenting for routine well careat 16 primary care pediatricians in Milan. SP carriage isolates were serotyped and tested for antimicrobial resistance using EUCAST breakpoints. Among 1250 enrolled children, 618 had received at least 1 dose of PCV13, 292 at least 1 dose of PCV7, 94 a combination of the two vaccines and 246 were not vaccinated. The prevalence of SP carriage was 27% (95% confidence interval [CI] 25-30). At multivariable analysis, age≥25 months (prevalence ratio [PR]=0.74) and use of antibiotics in the previous 3 months (PR=0.67) were associated with lower SP carriage prevalence. Having siblings (PR=1.79 for 1 sibling and PR=2.23 for ≥2 siblings), day-care attendance (PR=2.27) and respiratory tract infections in the previous 3 months (PR=1.39) were associated with higher SP carriage prevalence. The immunization status for SP was not associated with SP carriage at univariable or at multivariable analysis. The most common carriage isolates were 6C, 19A and 23A. The prevalence of the six additional PCV13 serotypes carriage in children appropriately vaccinated with PCV13 was lower than in children appropriately vaccinated with PCV7 (0 vs. 0.060); the greater reduction in prevalence of carriage was observed for serotype 19A (0 vs. 0.041). Serotype 6C was the most common drug-resistant serotype (17.2%). Further epidemiological studies are needed to assess changes in circulating SP serotypes following the large-scale introduction of PCV13. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/24342249/Serotype_distribution_and_antimicrobial_susceptibilities_of_nasopharyngeal_isolates_of_Streptococcus_pneumoniae_from_healthy_children_in_the_13_valent_pneumococcal_conjugate_vaccine_era_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(13)01697-6 DB - PRIME DP - Unbound Medicine ER -