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Warda K, Amari S, Boureddane M, Elkamouni Y, Arsalane L, Zouhair S, Bouskraoui M. Changes in pneumococcal serotypes distribution and penicillin resistance in healthy children five years after generalization of PCV10. Heliyon 2024; 10:e25741. [PMID: 38380016 PMCID: PMC10877248 DOI: 10.1016/j.heliyon.2024.e25741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/11/2024] [Accepted: 02/01/2024] [Indexed: 02/22/2024] Open
Abstract
Objective Streptococcus pneumoniae (S. pneumoniae) nasopharyngeal carriage has significantly decreased after the generalization of pneumococcal vaccination worldwide. This study sought to investigate changes in S. pneumoniae carriage rates, serotype distribution and penicillin non-susceptibility following the generalization of 10-valent pneumococcal conjugate vaccine. Methods A prospective study was conducted in Marrakesh, Morocco, between 2017 and 2018, among healthy children attending vaccination centers. We collected nasopharyngeal swabs and questionnaire data for each child. Using univariate logistic regression, we analyzed the association between S. pneumoniae carriage and various risk factors. Comparisons of serotype diversity and penicillin resistance between 2017 and 2018 and the period before introduction of vaccination (2008-2009, n = 660) were performed using Simpson index and the chi-squared test, respectively. Results During 2017-2018, 515 children aged between 6 and 36 months participated. The S. pneumoniae carriage rate was 43.3%. Looking at the distribution serotypes, the rate of PCV10 serotypes rate was only 9.6%. Among non-vaccine serotypes, an increase in serotypes 6C/6D (22; 14%), 19B/19C (17; 10.8%), and 15B/15C (11; 7%) was observed. A particular increase in serotype diversity was also observed after the generalization of PCV10 (p < 0.001). S. pneumoniae non-susceptible to penicillin decreased, reaching a rate of 26.6% in 2017-2018. Conclusion The significant change in S. pneumoniae carriage, serotype distribution, and penicillin resistance highlights the effectiveness of the pneumococcal conjugate vaccine among children in Marrakesh, Morocco.
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Affiliation(s)
- Karima Warda
- Laboratory of Microbiology and Virology, Cadi Ayad University, Marrakesh, Morocco
| | - Sara Amari
- Laboratory of Microbiology and Virology, Cadi Ayad University, Marrakesh, Morocco
| | - Majda Boureddane
- Laboratory of Microbiology and Virology, Cadi Ayad University, Marrakesh, Morocco
| | - Youssef Elkamouni
- Laboratory of Microbiology and Virology, Cadi Ayad University, Marrakesh, Morocco
- Laboratory of Microbiology-Virology and Molecular Biology, Avicenna Military Hospital, Marrakesh, Morocco
| | - Lamiae Arsalane
- Laboratory of Microbiology and Virology, Cadi Ayad University, Marrakesh, Morocco
- Laboratory of Microbiology-Virology and Molecular Biology, Avicenna Military Hospital, Marrakesh, Morocco
| | - Said Zouhair
- Laboratory of Microbiology and Virology, Cadi Ayad University, Marrakesh, Morocco
- Laboratory of Microbiology-Virology and Molecular Biology, Avicenna Military Hospital, Marrakesh, Morocco
| | - Mohammed Bouskraoui
- Laboratory of Microbiology and Virology, Cadi Ayad University, Marrakesh, Morocco
- Department of Pediatrics, Mohamed VI University Hospital Center, Marrakesh, Morocco
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Kawade A, Dayma G, Apte A, Telang N, Satpute M, Pearce E, Roalfe L, Patil R, Wang Y, Noori N, Gondhali A, Juvekar S, Oron AP, Sanghavi S, Goldblatt D, Dagan R, Bavdekar A. Effect of reduced two-dose (1+1) schedule of 10 and 13-valent pneumococcal conjugate vaccines (Synflorix TM and Prevenar13 TM)) on nasopharyngeal carriage and serotype-specific immune response in the first two years of life: Results from an open-labelled randomized controlled trial in Indian children. Vaccine 2023; 41:3066-3079. [PMID: 37045679 DOI: 10.1016/j.vaccine.2023.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/30/2023] [Accepted: 04/03/2023] [Indexed: 04/14/2023]
Abstract
INTRODUCTION This study aimed to assess the effect of a reduced dose regime (1 + 1) of PCV10 and PCV13 along with 3-dose regimes on pneumococcal vaccine-type (VT) carriage and immunogenicity in the first two years of life in PCV-naïve Indian children. METHODS A total of 805 healthy infants aged 6-8 weeks were randomised to 7 groups (n = 115). Six groups received SynflorixTM(PCV10) or Prevenar13TM(PCV13) in the following schedules: 3 + 0 (three primary at 6, 10, and 14 weeks); 2 + 1 (two primary 6 and 14 weeks with booster at 9 months; 1 + 1 (one primary at 14 weeks with booster at 9 months). The 7th group was a PCV-naïve control group. Nasopharyngeal swabs were collected at 6, 18 weeks, 9, 10, 15, and 18 months of age. Venous blood samples were collected at 18 weeks, 9, 10, and 18 months of age for assessment of sero-specific IgG antibodies. Additionally, functional activity using a serotype specific opsonophagocytic assay (OPA) was assessed at 10 and 18 months of age in a subset (20%) of participants. RESULTS All schedules of PCV13 showed significant 13VT carriage reduction in the second year of life as compared to control. At 15 months of age, PCV13 (1 + 1) showed 45 % reduction in 13VT-carriage compared to the control [OR = 0.55 (95% CI; 0.31-0.97), p= 0.038]. None of the PCV10 schedules showed significant reduction in 10VT carriage in the second year. Although not powered for these outcomes, at 18 months of age, 1 + 1 and 2 + 1 schedules of both vaccines demonstrated higher sero-responders for all serotypes, higher geometric mean concentrations (GMC) for all serotypes except 23F [with both vaccines], higher percent OPA responders and OPA geometric mean titres (GMT) compared to the 3 + 0 schedules for all serotypes. CONCLUSION The reduced dose schedule (1 + 1) of PCV13 results in significant VT-carriage reduction in the second year of life. Immune protection provided by 1 + 1 schedules of PCV10 and PCV13 in the second year of life is comparable to WHO-recommended 3-dose schedules.
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Affiliation(s)
- Anand Kawade
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India.
| | - Girish Dayma
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India
| | - Aditi Apte
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India
| | - Nilima Telang
- Department of Microbiology, KEM Hospital, Pune, India
| | | | - Emma Pearce
- Infection, Immunity and Inflammation Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Lucy Roalfe
- Infection, Immunity and Inflammation Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Rakesh Patil
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India
| | - Yanyun Wang
- Infection, Immunity and Inflammation Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Navideh Noori
- Institute for Disease Modeling, Global Health Division, Bill and Melinda Gates Foundation, 500 5th Ave N, Seattle, WA, USA
| | - Arun Gondhali
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India
| | - Sanjay Juvekar
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India
| | - Assaf P Oron
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | | | - David Goldblatt
- Infection, Immunity and Inflammation Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Ron Dagan
- The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ashish Bavdekar
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India.
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Amari S, Warda K, Bouraddane M, Katfy M, Elkamouni Y, Arsalane L, Zerouali K, Zouhair S, Bouskraoui M. Antibiotic Resistance of Streptococcus pneumoniae in the Nasopharynx of Healthy Children Less than Five Years Old after the Generalization of Pneumococcal Vaccination in Marrakesh, Morocco. Antibiotics (Basel) 2023; 12:antibiotics12030442. [PMID: 36978307 PMCID: PMC10044557 DOI: 10.3390/antibiotics12030442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/13/2023] [Accepted: 02/16/2023] [Indexed: 02/25/2023] Open
Abstract
Streptococcus pneumoniae (S. pneumoniae) remains one of the most important pathogens causing childhood infections. The spread of antibiotic-resistant bacteria is a leading cause of treatment failure in children. The purpose of this investigation is to report the antibiotic and multidrug resistance (MDR) of S. pneumoniae strains isolated from healthy children throughout the years 2020–2022. Antimicrobial susceptibility testing of S. pneumoniae strains in selected antimicrobials was performed using disk diffusion and E-test methods on bloodMueller–Hinton agar. The antimicrobials tested included oxacillin, amoxicillin, ceftriaxone, norfloxacin, gentamicin, vancomycin, erythromycin, clindamycin, pristinamycin, tetracycline, chloramphenicol, and trimethoprim-sulfamethoxazole. A total of 201 S. pneumoniae strains were isolated from the nasopharynx of healthy children in Marrakesh, Morocco. The highest rate of resistance of S. pneumoniae was found in penicillin (57.2%), followed by tetracycline (20.9%), and erythromycin (17.9%). The rates of resistance to clindamycin, trimethoprim-sulfamethoxazole, and chloramphenicol were 14.9%, 4%, and 1.5%, respectively. All isolates were susceptible to norfloxacin, gentamicin, vancomycin, and pristinamycin. Approximately 17% of all S. pneumoniae strains were resistant to at least three different antibiotic families. This study showed a low rate of antibiotics resistance among nasopharyngeal S. pneumoniae strains, and it is thus essential to monitor S. pneumoniae susceptibility in healthy children.
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Affiliation(s)
- Sara Amari
- Laboratoire de Lutte Contre les Maladies Infectieuses, Faculté de Médecine et de Pharmacie, Université Cadi Ayyad, Marrakech 40000, Morocco
| | - Karima Warda
- Laboratoire de Lutte Contre les Maladies Infectieuses, Faculté de Médecine et de Pharmacie, Université Cadi Ayyad, Marrakech 40000, Morocco
- Correspondence: ; Tel.:+212-670602083
| | - Majda Bouraddane
- Laboratoire de Lutte Contre les Maladies Infectieuses, Faculté de Médecine et de Pharmacie, Université Cadi Ayyad, Marrakech 40000, Morocco
| | - Mostafa Katfy
- Service de Microbiologie, CHU Ibn Rochd, Casablanca 20000, Morocco
| | - Youssef Elkamouni
- Laboratoire de Lutte Contre les Maladies Infectieuses, Faculté de Médecine et de Pharmacie, Université Cadi Ayyad, Marrakech 40000, Morocco
- Laboratoire de Bactériologie, Virologie, et Biologie Moléculaire, Hôpital Militaire Avicenne, Marrakech 40000, Morocco
| | - Lamiae Arsalane
- Laboratoire de Lutte Contre les Maladies Infectieuses, Faculté de Médecine et de Pharmacie, Université Cadi Ayyad, Marrakech 40000, Morocco
- Laboratoire de Bactériologie, Virologie, et Biologie Moléculaire, Hôpital Militaire Avicenne, Marrakech 40000, Morocco
| | - Khalid Zerouali
- Service de Microbiologie, CHU Ibn Rochd, Casablanca 20000, Morocco
| | - Said Zouhair
- Laboratoire de Lutte Contre les Maladies Infectieuses, Faculté de Médecine et de Pharmacie, Université Cadi Ayyad, Marrakech 40000, Morocco
- Laboratoire de Bactériologie, Virologie, et Biologie Moléculaire, Hôpital Militaire Avicenne, Marrakech 40000, Morocco
| | - Mohamed Bouskraoui
- Laboratoire de Lutte Contre les Maladies Infectieuses, Faculté de Médecine et de Pharmacie, Université Cadi Ayyad, Marrakech 40000, Morocco
- Service de Pédiatrie, Hôpital Universitaire Mohammed VI, Marrakech 40000, Morocco
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Pichichero M, Malley R, Kaur R, Zagursky R, Anderson P. Acute otitis media pneumococcal disease burden and nasopharyngeal colonization in children due to serotypes included and not included in current and new pneumococcal conjugate vaccines. Expert Rev Vaccines 2023; 22:118-138. [PMID: 36565291 DOI: 10.1080/14760584.2023.2162506] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Despite the introduction of effective pneumococcal conjugate vaccines (PCV), Streptococcus pneumoniae remains a major cause of acute otitis media (AOM) worldwide. New, higher valency vaccines that offer broader serotype coverage have been recently developed and others are in development. However, given the capsular serotypes expressed by pneumococci causing AOM, it is unclear to what extent differing or higher valency PCVs will provide additional protection. AREAS COVERED We conducted a systematic literature search of the MEDLINE database to identify articles published from January 2016 to September 2021 in 4 low and middle income and 10 high-income countries. We searched PubMed with terms: (Streptococcus pneumoniae) OR pneumococcal AND serotype AND (conjugate vaccine). We evaluated serotype distribution and the actual or projected coverage of pneumococcal serotypes by PCV10 (GlaxoSmithKline), PCV13 (Pfizer), PCV10SII (Serum Institute of India) PCV15 (Merck) and PCV20 (Pfizer). EXPERT OPINION Our review highlights the important epidemiological differences in serotype distribution and coverage by existing and higher valency vaccines to protect against AOM in children. These data provide support for further evaluation of serotype-independent vaccines for optimal control of pneumococcal AOM disease worldwide.
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Affiliation(s)
- Michael Pichichero
- Rochester General Hospital Research Institute, Center for Infectious Diseases, Rochester, NY, USA
| | - Richard Malley
- Boston Children's Hospital, Division of Infectious Diseases, Boston Massachusetts, USA
| | - Ravinder Kaur
- Rochester General Hospital Research Institute, Center for Infectious Diseases, Rochester, NY, USA
| | - Robert Zagursky
- Rochester General Hospital Research Institute, Center for Infectious Diseases, Rochester, NY, USA
| | - Porter Anderson
- Boston Children's Hospital, Division of Infectious Diseases, Boston Massachusetts, USA
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Tao J, Hossain MZ, Xu Z, Ho HC, Khan MA, Huang C, Zheng H, Ni J, Fan Y, Bogale D, Su H, Cheng J. Protective effect of pneumococcal conjugate vaccination on the short-term association between low temperatures and childhood pneumonia hospitalizations: Interrupted time-series and case-crossover analyses in Matlab, Bangladesh. ENVIRONMENTAL RESEARCH 2022; 212:113156. [PMID: 35331698 DOI: 10.1016/j.envres.2022.113156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/10/2022] [Accepted: 03/18/2022] [Indexed: 06/14/2023]
Abstract
Studies have shown that ambient extreme temperatures (heat and cold) were associated with an increased risk of childhood pneumonia, but the evidence is very limited in low-middle-income countries. It also remains unknown whether pneumococcal conjugate vaccine (PCV) could prevent temperature-related childhood pneumonia. This study collected data on ambient temperature and hospitalizations for childhood pneumonia in Matlab, Bangladesh from 2012 to 2016. Interrupted time series (ITS) analysis was employed to assess the impact of PCV (10-valent) intervention on childhood pneumonia hospitalizations. A time-stratified case-crossover analysis with a conditional logistic regression was performed to examine the association of childhood pneumonia hospitalizations with extreme temperatures and heatwaves before and after PCV10 intervention. Subgroup analyses were conducted to explore the modification effects of seasons, age, gender, and socioeconomic levels on temperature-related childhood pneumonia hospitalizations. We found that after PCV10 intervention, there was a sharp decrease in hospitalizations for childhood pneumonia (relative risk (RR): 0.59, 95% confidence interval (CI): 0.43-0.83). During the study period, heat effects on childhood pneumonia appeared immediately on the current day (odds ratio (OR): 1.28; 95% CI: 1.02-1.60, lag 0), while cold effects appeared 4 weeks later (OR: 1.53, 95% CI: 1.06-2.22, lag 28). Importantly, cold effects decreased significantly after PCV10 (p-value<0.05), but heat and heatwave effects increased after PCV10 (p-value<0.05). Particularly, children from families with a middle or low socioeconomic level, boys, and infants were more susceptible to heat-related pneumonia. This study suggests that PCV10 intervention in Bangladesh may help decrease cold-related not heat-related childhood pneumonia.
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Affiliation(s)
- Junwen Tao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Mohammad Zahid Hossain
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Zhiwei Xu
- School of Public Health, Faculty of Medicine, University of Queensland, 288 Herston Road, Herston, QLD, 4006, Australia
| | - Hung Chak Ho
- Department of Urban Planning and Design, The University of Hong Kong, Hong Kong, China
| | - Md Alfazal Khan
- Matlab Health Research Centre, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Hao Zheng
- Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Jing Ni
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Yinguan Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Daniel Bogale
- College of Health Sciences, Arsi University, Asela, Ethiopia
| | - Hong Su
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Jian Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China.
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Gonzales BE, Mercado EH, Pinedo-Bardales M, Hinostroza N, Campos F, Chaparro E, Del Águila O, Castillo ME, Saenz A, Reyes I, Ochoa TJ. Increase of Macrolide-Resistance in Streptococcus pneumoniae Strains After the Introduction of the 13-Valent Pneumococcal Conjugate Vaccine in Lima, Peru. Front Cell Infect Microbiol 2022; 12:866186. [PMID: 35615398 PMCID: PMC9125093 DOI: 10.3389/fcimb.2022.866186] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 04/04/2022] [Indexed: 12/27/2022] Open
Abstract
Streptococcus pneumoniae upper respiratory infections and pneumonia are often treated with macrolides, but recently macrolide resistance is becoming an increasingly important problem. The 13-valent pneumococcal conjugate vaccine (PCV13) was introduced in the National Immunization Program of Peru in 2015. This study aimed to evaluate the temporal evolution of macrolide resistance in S. pneumoniae isolates collected in five cross-sectional studies conducted before and after this vaccine introduction, from 2006 to 2019 in Lima, Peru. A total of 521 and 242 S. pneumoniae isolates recovered from nasopharyngeal swabs from healthy carrier children < 2 years old (2 carriage studies) and samples from normally sterile body areas from pediatric patients with invasive pneumococcal disease (IPD) (3 IPD studies), respectively, were included in this study. Phenotypic macrolide resistance was detected using the Kirby-Bauer method and/or MIC test. We found a significant increase in macrolide resistance over time, from 33.5% to 50.0% in carriage studies, and from 24.8% to 37.5% and 70.8% in IPD studies. Macrolide resistance genes [erm(B) and mef(A/E)] were screened using PCR. In carriage studies, we detected a significant decrease in the frequency of mef(A/E) genes among macrolide-resistant S. pneumoniae strains (from 66.7% to 50.0%) after introduction of PCV13. The most common mechanism of macrolide-resistant among IPD strains was the presence of erm(B) (96.0%, 95.2% and 85.1% in the 3 IPD studies respectively). Macrolide resistance was more common in serotype 19A strains (80% and 90% among carriage and IPD strains, respectively) vs. non-serotype 19A (35.5% and 34.4% among carriage and IPD strains, respectively). In conclusion, S. pneumoniae macrolide resistance rates are very high among Peruvian children. Future studies are needed in order to evaluate macrolide resistance trends among pneumococcal strains, especially now after the COVID-19 pandemic, since azithromycin was vastly used as empiric treatment of COVID-19 in Peru.
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Affiliation(s)
- Brayan E. Gonzales
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Erik H. Mercado
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Maria Pinedo-Bardales
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Noemi Hinostroza
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Francisco Campos
- Departamento de Pediatría, Hospital Nacional Docente Madre-Niño San Bartolomé, Lima, Peru
| | - Eduardo Chaparro
- Departamento de Pediatría, Hospital Nacional Cayetano Heredia, Lima, Peru
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Olguita Del Águila
- Servicio de Pediatría de Especialidades Clínicas, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
| | - María E. Castillo
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
- Oficina de Epidemiología, Instituto Nacional de Salud del Niño, Lima, Peru
| | - Andrés Saenz
- Departamento de Pediatría, Hospital Nacional Daniel Alcides Carrión, Lima, Peru
| | - Isabel Reyes
- Servicio de Hospitalización, Hospital de Emergencias Pediátricas, Lima, Peru
| | - Theresa J. Ochoa
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
- Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
- *Correspondence: Theresa J. Ochoa,
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Al-Lahham A. Prevalence of Pneumococcal Carriage among Jordanian Infants in the First 6 Months of Age, 2008-2016. Vaccines (Basel) 2021; 9:vaccines9111283. [PMID: 34835213 PMCID: PMC8622573 DOI: 10.3390/vaccines9111283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/23/2021] [Accepted: 11/02/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Streptococcus pneumoniae is an opportunistic human-adapted pathogen driven by nasopharyngeal carriage. Aims: To find the pneumococcal carriage rate, resistance, serotypes, and coverage of pneumococcal conjugate vaccines (PCVs) among infants in the first six months of age in the period from March 2008 to April 2016. Methods: Nasopharyngeal swabs (NP) were taken from healthy infants from the northern part of Jordan. Swabs were processed for cultivation, identification, resistance testing and serotyping according to standard methods. Results: During the surveillance period, 484 infants of this age group were tested, with a total carriage rate of 56.2%. 96.2% of infants one to two months of age got one PCV7 injection and were 58% carriers at the time of the first injection. At age three to four months, 84.9% had received two injections, with a carriage rate of 54.9% at the time of the second injection. At ages five to six months, 12.5% had received one to three injections, with a carriage rate of 43.8%. Predominant serotypes in all age groups were 19F (12.5%), 6A (11.4%), 11A (8.4%), 19A (7.0%), 6B (6.6%), 23F (5.9%), 15B (5.1%), 15A and 23A (4.0% each). Coverage of PCV7, PCV13 and the future PCV20 among all cases were 30.5%, 50.7% and 70.6%, respectively. The highest coverage rate of 78.6% was noticed in the age group at five to six months with the future PCV20. Antibiotic resistance was the highest in the first age group. Conclusions: Pneumococcal carriage starts from the first month of the infant’s life. The highest coverage was noticed for PCV20, which implies the necessity for inoculation with future vaccines.
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Affiliation(s)
- Adnan Al-Lahham
- Department of Biomedical Engineering, School of Applied Medical Sciences, German Jordanian University, Amman 11180, Jordan
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