Nasopharyngeal Carriage of Streptococcus pneumoniae in Gambian Children who Participated in a 9-valent Pneumococcal Conjugate Vaccine Trial and in Their Younger Siblings

BACKGROUND:Nasopharyngeal carriage of Streptococcus pneumoniae is extremely prevalent in The Gambia. We studied the effects of vaccination with pneumococcal conjugate vaccines on the carriage of individual serotypes and on antimicrobial resistance in vaccinated children and their younger siblings. M...

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Published in:	The Pediatric infectious disease journal Vol. 28; no. 11; pp. 990 - 995
Main Authors:	Cheung, Yin-Bun, Zaman, Syed M. A, Nsekpong, Ekpedeme David, Van Beneden, Chris A, Adegbola, Richard A, Greenwood, Brian, Cutts, Felicity T
Format:	Journal Article
Language:	English
Published:	Hagerstown, MD Lippincott Williams & Wilkins, Inc 01-11-2009 Lippincott Williams & Wilkins
Subjects:	Anti-Bacterial Agents - pharmacology Antibacterial agents Antibiotics. Antiinfectious agents. Antiparasitic agents Bacterial diseases Biological and medical sciences Carrier State - epidemiology Carrier State - microbiology Cross-Sectional Studies Drug Resistance, Bacterial Female Gambia - epidemiology Human bacterial diseases Humans Immunity, Herd Infant Infectious diseases Longitudinal Studies Male Medical sciences Microbial Sensitivity Tests Nasopharynx - microbiology Pharmacology. Drug treatments Placebos - administration & dosage Pneumococcal Infections - epidemiology Pneumococcal Infections - microbiology Pneumococcal Vaccines - immunology Siblings Staphylococcal infections, streptococcal infections, pneumococcal infections Streptococcus pneumoniae - drug effects Streptococcus pneumoniae - isolation & purification Vaccines, Conjugate - immunology Gambia Human Pediatrics carriage conjugate vaccine Nasopharynx Sibling Mixed vaccine Streptococcus pneumoniae Infection Resistance Streptococcaceae Antibiotic antibiotic resistance Streptococcal infection Bacteriosis Bacteria Micrococcales Antibacterial agent Child Pneumococcal infection Colonization
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Summary:	BACKGROUND:Nasopharyngeal carriage of Streptococcus pneumoniae is extremely prevalent in The Gambia. We studied the effects of vaccination with pneumococcal conjugate vaccines on the carriage of individual serotypes and on antimicrobial resistance in vaccinated children and their younger siblings. METHODS:A longitudinal study of a subsample of children (n = 2342) who participated in a randomized, placebo controlled trial of a 9-valent pneumococcal conjugate vaccines (PCV-9) in The Gambia, and a cross-sectional study of non-PCV-9-vaccinated younger siblings (n = 675). RESULTS:Recipients of PCV-9 were less likely to carry vaccine serotypes 4, 6B, 9V, 14, 19F, and 23F but more likely to carry vaccine-associated 19A and 9 nonvaccine serotypes at approximately 6 months postvaccination (age, 12 months) than were controls (each P < 0.05). At approximately 16 months postvaccination, carriage of vaccine-associated-serotype 6A was also significantly reduced (P < 0.01) while 3 other nonvaccine serotypes were more prevalent in the PCV-9 recipients (each P < 0.05). At 16 months, but not 6 months, postvaccination PCV-9 recipients had lower rate of carrying isolates resistant to tetracycline and trimethoprim-sulfamethoxazole (TMP-SMZ) than controls (risk ratio0.90 and 0.95, respectively; each P < 0.05). There was no difference in patterns of carriage of pneumococci in younger siblings of PCV-9 or placebo recipients. CONCLUSIONS:The effects of 9-valent pneumococcal conjugate vaccines on carriage of pneumococci persisted for at least 16 months postvaccination in Gambian children. Vaccination had no indirect effect on carriage in younger siblings and there was limited impact on antibiotic resistance.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-News-1 ObjectType-Feature-3 content type line 23
ISSN:	0891-3668 1532-0987
DOI:	10.1097/INF.0b013e3181a78185