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Nasopharyngeal s. pneumoniae carriage and density in Belgian infants after 9 years of pneumococcal conjugate vaccine programme.
Vaccine. 2018 01 02; 36(1):15-22.V

Abstract

BACKGROUND

In Belgium, the infant pneumococcal conjugate vaccine (PCV) programme changed from PCV7 (2007-2011) to PCV13 (2011-2015) and to PCV10 (2015-2016). A 3-year nasopharyngeal carriage study was initiated during the programme switch in 2016. Main objective of the year 1 assessment was to obtain a baseline measurement of pneumococcal carriage prevalence, carriage density, serotype distribution and antibiotic resistance.

MATERIALS/METHODS

Two infant populations aged 6-30 months and without use of antibiotics in the seven days prior to sampling were approached: (1) attending one of 85 randomly selected day-care centres (DCC); (2) presenting with AOM at study-trained general practitioners and paediatricians. Demographic and clinical characteristics were documented and a single nasopharyngeal swab was taken. S. pneumoniae were cultured, screened for antibiotic resistance and serotyped, and quantitative Taqman real-time PCR (qRT-PCR) targeting LytA was performed.

RESULTS

Culture-based (DCC: 462/760; 60.8% - AOM: 27/39; 69.2%) and LytA-based (DCC: 603/753; 80.1% - AOM: 32/39; 82.1%) carriage prevalence was high. Average pneumococcal DNA load in LytA-positive day-care samples was 6.5 × 106 copies/µl (95%CI = 3.9-9.2 × 106, median = 3.5 × 105); DNA load was positively associated with signs of common cold and negatively with previous antibiotic use. Culture-based frequency of 13 pneumococcal vaccine (PCV) serotypes was 5.4% in DCC and 7.7% in AOM, with 19F and 14 being most frequent, and frequencies below 0.5% for serotypes 3, 6A, 19A in both populations. Predominant non-PCV serotypes were 23B and 23A in day-care and 11A in infants with AOM. In day-care, resistance to penicillin was rare (<0.5%) and absent against levofloxacin; 32.7% and 16.9% isolates were cotrimoxazole- and erythromycin-resistant respectively.

CONCLUSION

Four years after PCV13 introduction in the vaccination programme, PCV13 serotype carriage was rare in infants throughout Belgium and penicillin resistance was rare. Continued surveillance in the context of a PCV programme switch is necessary.

Authors+Show Affiliations

Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610 Wilrijk, Belgium. Electronic address: ine.wouters@uantwerpen.be.Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610 Wilrijk, Belgium.Reference Centre for Pneumococci, University Hospitals Leuven, Campus Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium.Centre for Health Economics Research and Modelling Infectious Diseases, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610 Wilrijk, Belgium.Reference Centre for Pneumococci, University Hospitals Leuven, Campus Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium.Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610 Wilrijk, Belgium.Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610 Wilrijk, Belgium.Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610 Wilrijk, Belgium.Centre for the Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610 Wilrijk, Belgium.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29180027

Citation

Wouters, Ine, et al. "Nasopharyngeal S. Pneumoniae Carriage and Density in Belgian Infants After 9 Years of Pneumococcal Conjugate Vaccine Programme." Vaccine, vol. 36, no. 1, 2018, pp. 15-22.
Wouters I, Van Heirstraeten L, Desmet S, et al. Nasopharyngeal s. pneumoniae carriage and density in Belgian infants after 9 years of pneumococcal conjugate vaccine programme. Vaccine. 2018;36(1):15-22.
Wouters, I., Van Heirstraeten, L., Desmet, S., Blaizot, S., Verhaegen, J., Goossens, H., Van Damme, P., Malhotra-Kumar, S., & Theeten, H. (2018). Nasopharyngeal s. pneumoniae carriage and density in Belgian infants after 9 years of pneumococcal conjugate vaccine programme. Vaccine, 36(1), 15-22. https://doi.org/10.1016/j.vaccine.2017.11.052
Wouters I, et al. Nasopharyngeal S. Pneumoniae Carriage and Density in Belgian Infants After 9 Years of Pneumococcal Conjugate Vaccine Programme. Vaccine. 2018 01 2;36(1):15-22. PubMed PMID: 29180027.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nasopharyngeal s. pneumoniae carriage and density in Belgian infants after 9 years of pneumococcal conjugate vaccine programme. AU - Wouters,Ine, AU - Van Heirstraeten,Liesbet, AU - Desmet,Stefanie, AU - Blaizot,Stéphanie, AU - Verhaegen,Jan, AU - Goossens,Herman, AU - Van Damme,Pierre, AU - Malhotra-Kumar,Surbhi, AU - Theeten,Heidi, AU - ,, Y1 - 2017/11/24/ PY - 2017/08/24/received PY - 2017/11/06/revised PY - 2017/11/15/accepted PY - 2017/11/29/pubmed PY - 2018/8/1/medline PY - 2017/11/29/entrez KW - Day-care KW - Infants KW - Nasopharyngeal carriage KW - Otitis media KW - S. pneumoniae SP - 15 EP - 22 JF - Vaccine JO - Vaccine VL - 36 IS - 1 N2 - BACKGROUND: In Belgium, the infant pneumococcal conjugate vaccine (PCV) programme changed from PCV7 (2007-2011) to PCV13 (2011-2015) and to PCV10 (2015-2016). A 3-year nasopharyngeal carriage study was initiated during the programme switch in 2016. Main objective of the year 1 assessment was to obtain a baseline measurement of pneumococcal carriage prevalence, carriage density, serotype distribution and antibiotic resistance. MATERIALS/METHODS: Two infant populations aged 6-30 months and without use of antibiotics in the seven days prior to sampling were approached: (1) attending one of 85 randomly selected day-care centres (DCC); (2) presenting with AOM at study-trained general practitioners and paediatricians. Demographic and clinical characteristics were documented and a single nasopharyngeal swab was taken. S. pneumoniae were cultured, screened for antibiotic resistance and serotyped, and quantitative Taqman real-time PCR (qRT-PCR) targeting LytA was performed. RESULTS: Culture-based (DCC: 462/760; 60.8% - AOM: 27/39; 69.2%) and LytA-based (DCC: 603/753; 80.1% - AOM: 32/39; 82.1%) carriage prevalence was high. Average pneumococcal DNA load in LytA-positive day-care samples was 6.5 × 106 copies/µl (95%CI = 3.9-9.2 × 106, median = 3.5 × 105); DNA load was positively associated with signs of common cold and negatively with previous antibiotic use. Culture-based frequency of 13 pneumococcal vaccine (PCV) serotypes was 5.4% in DCC and 7.7% in AOM, with 19F and 14 being most frequent, and frequencies below 0.5% for serotypes 3, 6A, 19A in both populations. Predominant non-PCV serotypes were 23B and 23A in day-care and 11A in infants with AOM. In day-care, resistance to penicillin was rare (<0.5%) and absent against levofloxacin; 32.7% and 16.9% isolates were cotrimoxazole- and erythromycin-resistant respectively. CONCLUSION: Four years after PCV13 introduction in the vaccination programme, PCV13 serotype carriage was rare in infants throughout Belgium and penicillin resistance was rare. Continued surveillance in the context of a PCV programme switch is necessary. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/29180027/Nasopharyngeal_s__pneumoniae_carriage_and_density_in_Belgian_infants_after_9_years_of_pneumococcal_conjugate_vaccine_programme_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(17)31616-X DB - PRIME DP - Unbound Medicine ER -