Long-term effect of 10-valent pneumococcal conjugate vaccine on nasopharyngeal carriage of Streptococcus pneumoniae in children in Brazil.

Autor: Brandileone MC; National Laboratory for Meningitis and Pneumococcal Infections, Laboratory for Meningitis, Pneumonia and Pneumococcal Infection, Center of Bacteriology, Brazil. Electronic address: maria.brandileone@ial.sp.gov.br., Zanella RC; National Laboratory for Meningitis and Pneumococcal Infections, Laboratory for Meningitis, Pneumonia and Pneumococcal Infection, Center of Bacteriology, Brazil. Electronic address: rosemeire.zanella@ial.sp.gov.br., Almeida SCG; National Laboratory for Meningitis and Pneumococcal Infections, Laboratory for Meningitis, Pneumonia and Pneumococcal Infection, Center of Bacteriology, Brazil. Electronic address: samanta.almeida@ial.sp.gov.br., Cassiolato AP; National Laboratory for Meningitis and Pneumococcal Infections, Laboratory for Meningitis, Pneumonia and Pneumococcal Infection, Center of Bacteriology, Brazil., Lemos APS; National Laboratory for Meningitis and Pneumococcal Infections, Laboratory for Meningitis, Pneumonia and Pneumococcal Infection, Center of Bacteriology, Brazil. Electronic address: ana.lemos@ial.sp.gov.br., Salgado MM; Molecular Biology Laboratory, Center of Immunology, Institute Adolfo Lutz (IAL), São Paulo, State of São Paulo, Brazil. Electronic address: maristela.salgado@ial.sp.gov.br., Higa FT; Molecular Biology Laboratory, Center of Immunology, Institute Adolfo Lutz (IAL), São Paulo, State of São Paulo, Brazil. Electronic address: fabio.higa@ial.sp.gov.br., Minamisava R; Faculty of Nursing, Federal University of Goiás, Goiânia, State of Goiás, Brazil., Andrade AL; Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, State of Goiás, Brazil.
Jazyk: angličtina
Zdroj: Vaccine [Vaccine] 2019 Aug 23; Vol. 37 (36), pp. 5357-5363. Date of Electronic Publication: 2019 Jul 24.
DOI: 10.1016/j.vaccine.2019.07.043
Abstrakt: Brazil introduced the 10-valent pneumococcal vaccine (PCV10) to the routine national immunization program (NIP) in March 2010. In 2017, we investigated the effects of PCV10 on nasopharyngeal carriage of vaccine-types (VT) and non-vaccine-types (NVT) of Streptococcus pneumoniae (Spn) among children living in São Paulo city. We also compared the prevalence of VT and NVT with previous carriage surveys performed in 2010 (baseline) and 2013.
Method: The carriage survey was conducted among 531 children, aged 12 months to <24 months, recruited from public Primary Health Units during the immunization campaign, using previous surveys methodology, except for qPCR, which was performed in the 2017 survey only.
Results: No statistical difference was found in the prevalence of Spn either by culture (59.7%) or by qPCR (61.2%). Spn carriage increased from 40.3% (baseline) to 59.7% (2017 survey) (p < 0.001). Colonization by VT isolates significantly decreased by 90.9% (19.8-1.8%) and 95.5% (19.8-0.9%) in the 2013 and 2017 surveys, respectively, compared to that at baseline. NVT isolates increased significantly by 128% (19.6-44.8%) and 185% (19.6-55.9%) in the respective post-PCV10 surveys, most led to high prevalence of serotypes 6C (27%), 15B (9.8%), 19A (9.2%), 15A (6.0%), and 16F (5.7%). In 2017, reduction in serotype 6A (4.2-0.6%, p < 0.001) and increase in serotype 19A (1.8-6.0%, p = 0.001) were found; serotype 3 isolate was not detected in the present survey. We identified the emergence of 19A isolates CC320, associated with high penicillin (MIC ≥ 2.0 mg/L) and cefotaxime (MIC ≥ 1.0 mg/L) values.
Conclusion: After 7 years of PCV10 introduction in the NIP, colonization by VT among toddlers decreased substantially to a residual level, along with substantial serotype replacement by novel serotypes not present in any current conjugated pneumococcal vaccine and serotype 19A. The present findings can assist policy decisions in Brazil.
(Copyright © 2019 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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