SUMMARYA 10-month longitudinal household study of pre-school children and their families was undertaken with monthly visits collecting epidemiological data and nasopharyngeal swabs in Hertfordshire, England from 2001 to 2002. Pneumococcal culture was with standard methods. In total, 121 families (489 individuals) took part. Mean prevalence of carriage ranged from 52 % for age groups 0-2 years, 45 % for 3-4 years, 21 % for 5-17 years and 8 % for o18 years. Carriage occurred more than once in 86 % of children aged 0-2 years compared to 36 % of those aged o18 years. The most prevalent serotypes in the 0-2 years age group were 6B followed by 19F, 23F, 6A and 14. Young children were responsible for the majority of introductions of new serotypes into a household. Erythromycin resistance (alone or in combination) occurred in 10% of samples and penicillin non-susceptibility in 3 . 7%. Overall the recently licensed 7-valent conjugate vaccine (PCV) would protect against 64 % of serotypes with no intra-serogroup cross protection and 82% with such protection. Nasopharyngeal carriage of S. pneumoniae is common in a UK setting in the pre-conjugate vaccine era. PCV would protect against a large proportion of carriage isolates. However, the impact of vaccination on non-vaccine serotypes will need to be monitored.
Adults respond to NP carriage by mounting anticapsular and weak antiprotein antibody responses, and naturally induced anticapsular IgG can prevent carriage.
This study aimed to identify risk factors and assess the impact of coincidental antibiotic therapy on carriage of Streptococcus pneumoniae. Index children from birth to 3 years and their households were recruited from primary health-care registers in four UK general practices. Nasopharyngeal swabs were taken monthly from study participants ten times between October 2001 and July 2002. Multilevel random-effect models were used to adjust for statistical dependence between repeated measurements and family clustering of carriage. Carriage results were available for 3753 swabs from 489 individuals in 121 families. Crude prevalence of carriage was 25%. On multivariable analysis, risk of carriage was reduced by antibiotic use the previous month [odds ratio (OR) 0.34, 95% confidence interval (CI) 0.22-0.52], but increased if a child attended day care for >20 h per week (OR 2.52, 95% CI 1.41-4.52). Taking antibiotics significantly reduces the risk of carriage the following month in a setting with a low prevalence of pneumococcal antimicrobial resistance.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.