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A 13-year survey of pneumococcal nasopharyngeal carriage in children with acute otitis media following PCV7 and PCV13 implementation.
Vaccine 2015; 33(39):5118-26V

Abstract

BACKGROUND

This nasopharyngeal (NP) carriage surveillance study was requested by the European Agency for the Evaluation of Medicinal Products as a post-licensing commitment to determine whether the use of the pneumococcal conjugate vaccines (PCVs) including 7 then 13 valents (introduced in 2001 and 2010, respectively) caused a shift in the distribution of Streptococcus pneumoniae serotypes in children with acute otitis media and modified the resistance of this bacterial species to antibiotics.

METHODS

Between 2001 and 2014, 121 pediatricians obtained nasopharyngeal swabs from children with acute otitis media aged 6-24 months. The swabs were analyzed by the French National Reference Centre for Pneumococci. Demographics, medical history and physical examination findings were recorded.

RESULTS

Over the 13 years, among the 7991 enrolled patients, the proportion of PCV-vaccinated children (≥1 dose) increased (54.3-99.7%, p<0.001). Overall, pneumococcal carriage was reduced from 71.2% to 56.2% from 2001 to 2014 (p<0.001) and carriage of PCV7 serotypes (STs) from 44.5% to 1.2% (p<0.001). The carriage of 6 additional STs plus 6C increased from 17.2% to 24.3% from 2001 to 2010 (p<0.001) and decreased after PCV13 implementation (21.4-3.5%, p<0.001). The proportion of ST 19A carriage increased from 8.6% to 15.8% from 2001 to 2010 (p<0.001) and decreased to 1.2% in 2014. After PCV13 implementation, the most frequently carried non-PCV13 STs were ST 15B/C, 11A, 15A, and 35B. Penicillin non-susceptible pneumococcal strains decreased from 67.1% in 2001 to 33.1% in 2014 (p<0.001).

CONCLUSIONS

By the number of patients enrolled and the duration, this study is the largest performed to date. It allows to demonstrate a strong impact of PCVs and to describe the complex dynamics of pneumococcal carriage during AOM. As pneumococcal carriage decreased during AOM, a reduction in the incidence of pneumococcal AOM could be expected.

Authors+Show Affiliations

Université Paris Est, IMRB-GRC GEMINI, 94000 Créteil, France; ACTIV, Association Clinique et Thérapeutique Infantile du Val de Marne, Saint-Maur des Fossés, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Chambéry, France; Unité Court Séjour, Petits Nourrissons, Service de Néonatologie, Centre Hospitalier Intercommunal de Créteil, France.National Reference Center for Pneumococci, Laboratoire de Microbiologie, Assistance Publique-Hôpitaux de Paris, Hopital Européen Georges-Pompidou, Paris, France.Univ Paris Diderot, Sorbonne Paris Cité, France; Service de Microbiologie, Hôpital Robert-Debré, 75019 Paris, France.ACTIV, Association Clinique et Thérapeutique Infantile du Val de Marne, Saint-Maur des Fossés, France.ACTIV, Association Clinique et Thérapeutique Infantile du Val de Marne, Saint-Maur des Fossés, France.ACTIV, Association Clinique et Thérapeutique Infantile du Val de Marne, Saint-Maur des Fossés, France; AFPA, Association Française de Pédiatrie Ambulatoire, Chambéry, France.ACTIV, Association Clinique et Thérapeutique Infantile du Val de Marne, Saint-Maur des Fossés, France.Univ Paris Diderot, Sorbonne Paris Cité, France; Service de Microbiologie, Hôpital Robert-Debré, 75019 Paris, France.Université Paris Est, IMRB-GRC GEMINI, 94000 Créteil, France; ACTIV, Association Clinique et Thérapeutique Infantile du Val de Marne, Saint-Maur des Fossés, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Chambéry, France. Electronic address: corinne.levy@activ-france.fr.

Pub Type(s)

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

Language

eng

PubMed ID

26271823

Citation

Cohen, Robert, et al. "A 13-year Survey of Pneumococcal Nasopharyngeal Carriage in Children With Acute Otitis Media Following PCV7 and PCV13 Implementation." Vaccine, vol. 33, no. 39, 2015, pp. 5118-26.
Cohen R, Varon E, Doit C, et al. A 13-year survey of pneumococcal nasopharyngeal carriage in children with acute otitis media following PCV7 and PCV13 implementation. Vaccine. 2015;33(39):5118-26.
Cohen, R., Varon, E., Doit, C., Schlemmer, C., Romain, O., Thollot, F., ... Levy, C. (2015). A 13-year survey of pneumococcal nasopharyngeal carriage in children with acute otitis media following PCV7 and PCV13 implementation. Vaccine, 33(39), pp. 5118-26. doi:10.1016/j.vaccine.2015.08.010.
Cohen R, et al. A 13-year Survey of Pneumococcal Nasopharyngeal Carriage in Children With Acute Otitis Media Following PCV7 and PCV13 Implementation. Vaccine. 2015 Sep 22;33(39):5118-26. PubMed PMID: 26271823.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A 13-year survey of pneumococcal nasopharyngeal carriage in children with acute otitis media following PCV7 and PCV13 implementation. AU - Cohen,Robert, AU - Varon,Emmanuelle, AU - Doit,Catherine, AU - Schlemmer,Catherine, AU - Romain,Olivier, AU - Thollot,Franck, AU - Béchet,Stéphane, AU - Bonacorsi,Stéphane, AU - Levy,Corinne, Y1 - 2015/08/11/ PY - 2015/06/19/received PY - 2015/07/28/revised PY - 2015/08/03/accepted PY - 2015/8/15/entrez PY - 2015/8/15/pubmed PY - 2016/6/21/medline KW - Acute otitis media KW - Children KW - PCV7 and PCV13 impact KW - Pneumococcal nasopharyngeal carriage SP - 5118 EP - 26 JF - Vaccine JO - Vaccine VL - 33 IS - 39 N2 - BACKGROUND: This nasopharyngeal (NP) carriage surveillance study was requested by the European Agency for the Evaluation of Medicinal Products as a post-licensing commitment to determine whether the use of the pneumococcal conjugate vaccines (PCVs) including 7 then 13 valents (introduced in 2001 and 2010, respectively) caused a shift in the distribution of Streptococcus pneumoniae serotypes in children with acute otitis media and modified the resistance of this bacterial species to antibiotics. METHODS: Between 2001 and 2014, 121 pediatricians obtained nasopharyngeal swabs from children with acute otitis media aged 6-24 months. The swabs were analyzed by the French National Reference Centre for Pneumococci. Demographics, medical history and physical examination findings were recorded. RESULTS: Over the 13 years, among the 7991 enrolled patients, the proportion of PCV-vaccinated children (≥1 dose) increased (54.3-99.7%, p<0.001). Overall, pneumococcal carriage was reduced from 71.2% to 56.2% from 2001 to 2014 (p<0.001) and carriage of PCV7 serotypes (STs) from 44.5% to 1.2% (p<0.001). The carriage of 6 additional STs plus 6C increased from 17.2% to 24.3% from 2001 to 2010 (p<0.001) and decreased after PCV13 implementation (21.4-3.5%, p<0.001). The proportion of ST 19A carriage increased from 8.6% to 15.8% from 2001 to 2010 (p<0.001) and decreased to 1.2% in 2014. After PCV13 implementation, the most frequently carried non-PCV13 STs were ST 15B/C, 11A, 15A, and 35B. Penicillin non-susceptible pneumococcal strains decreased from 67.1% in 2001 to 33.1% in 2014 (p<0.001). CONCLUSIONS: By the number of patients enrolled and the duration, this study is the largest performed to date. It allows to demonstrate a strong impact of PCVs and to describe the complex dynamics of pneumococcal carriage during AOM. As pneumococcal carriage decreased during AOM, a reduction in the incidence of pneumococcal AOM could be expected. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/26271823/A_13_year_survey_of_pneumococcal_nasopharyngeal_carriage_in_children_with_acute_otitis_media_following_PCV7_and_PCV13_implementation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(15)01124-X DB - PRIME DP - Unbound Medicine ER -