Decline in pneumococcal nasopharyngeal carriage in children 6–23 months with respiratory illnesses following pneumococcal conjugate vaccine implementation
| Autor: | Leore Kotler, David Greenberg, Bart Adriaan van der Beek, Noga Givon-Lavi, Shalom Ben-Shimol, Ron Dagan |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Population medicine.disease_cause Pneumococcal Infections Pneumococcal conjugate vaccine Pneumococcal Vaccines Internal medicine Streptococcus pneumoniae medicine Humans Prospective Studies Respiratory system Child education education.field_of_study Vaccines Conjugate General Veterinary General Immunology and Microbiology business.industry Respiratory disease Public Health Environmental and Occupational Health Respiratory infection medicine.disease Pneumonia Infectious Diseases Carriage Carrier State Molecular Medicine business medicine.drug |
| Zdroj: | Vaccine. 39:5757-5761 |
| ISSN: | 0264-410X |
| DOI: | 10.1016/j.vaccine.2021.08.082 |
| Popis: | Background Following pneumococcal conjugate vaccines (PCVs) implementation, worldwide, pneumococcal carriage rates remained stable, indicating full replacement of vaccine-serotypes (VT) with non-VT. However, data are scarce regarding PCV impact on pneumococcal carriage rates in healthy vs. sick children. We assessed pneumococcal carriage rates dynamics in healthy and sick children 6–23 months, following PCV introduction. Methods This is a prospective, population-based surveillance conducted during the years 2009–2017, in southern Israel. Three groups were defined as follows: Children without respiratory infection signs (the healthy/non-respiratory group); Children who had a chest radiography at the hospital (the Hosp-CXR group); and children with community-acquired alveolar pneumonia (CAAP). Rate ratios (RRs; 95% CI) were calculated, comparing between late-13-valent PCV (PCV13) period (2016–2017) and early-PCV period (2009–2010). Rate ratios were adjusted for antibiotic administration, seasonality and ethnicity, and separate calculations were performed for 6–11 and 12–23 month old children. Results Overall, 51% of 8627 nasopharyngeal cultures were positive. In 2009–2010 (early-PCV period), the overall carriage rate was 55%; serotypes included in the PCV13 carriage rates were 28%, 31% and 38% in the healthy/non-respiratory, Hosp-CXR, and CAAP groups, respectively. Overall carriage rates in healthy/non-respiratory episodes were stable (~54%) when comparing between 2016 and 17 and 2009–10 (RR = 0.98; 0.84–1.15). In contrast, rates significantly declined for Hosp-CXR (RR = 0.78; 0.63–0.98) and CAAP (RR = 0.65; 0.47–0.89). These trends were driven by ~ 80% VT reductions, coupled with non-VT increase. Conclusions Following 7-valent PCV/ PCV13 introduction, pneumococcal carriage rates declined in respiratory diseases, but not in healthy children and children without respiratory infections. These trends suggest that a reduction in pneumococcal carriage rates during respiratory infections indicates a decline in respiratory infections caused by VT, while carriage rates in non-respiratory cases reflect non-VT predominance, that have low disease potential for respiratory disease. |
| Databáze: | OpenAIRE |
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