Effect of Vaccination on Pneumococci Isolated from the Nasopharynx of Healthy Children and the Middle Ear of Children with Otitis Media in Iceland

Quirk, Sigríður Júlía; Haraldsson, Gunnsteinn; Erlendsdóttir, Helga; Hjálmarsdóttir, Martha Á.; Tonder, Andries J. van; Hrafnkelsson, Birgir; Sigurdsson, Samuel; Bentley, Stephen D.; Haraldsson, Ásgeir; Brueggemann, Angela B.; Kristinsson, Karl G.

doi:10.1128/jcm.01046-18

Cited by 28 publications

(49 citation statements)

References 76 publications

(76 reference statements)

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“…Isolates that did not belong to vaccine serotypes were serotyped using PCR. The PCR was done as sPCR, or mPCR including a panel of all the serotypes included in the PHiD-CV and selected serotypes previously detected in our studies- [8,9,[24][25][26]. Serogroup/serotype-specific primer pairs were used with primer pairs for cpsA for the cps locus and lytA for autolysin as internal controls.…”

Section: Serotypingmentioning

confidence: 99%

“…Serogroup/serotype-specific primer pairs were used with primer pairs for cpsA for the cps locus and lytA for autolysin as internal controls. In addition, primers for cpsB were used to confirm the absence of capsular genes, when cpsA was negative [24,[27][28][29][30]. Serotypes of serogroup 6 were identified using previously described PCR methods [31][32][33].…”

Section: Serotypingmentioning

confidence: 99%

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Reduction of antimicrobial resistant pneumococci seven years after introduction of pneumococcal vaccine in Iceland

et al. 2020

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Background Penicillin non-susceptible (PNSP) and multi-resistant pneumococci have been prevalent in Iceland since early nineties, mainly causing problems in treatment of acute otitis media. The 10-valent protein conjugated pneumococcal vaccine (PHiD-CV) was introduced into the childhood vaccination program in 2011. The aim of the study was to investigate the changes in antimicrobial susceptibility and serotype distribution of penicillin non-susceptible pneumococci (PNSP) in Iceland 2011-2017. Methods and findings All pneumococcal isolates identified at the Landspítali University Hospital in 2011-2017, excluding isolates from the nasopharynx and throat were studied. Susceptibility testing was done according to the EUCAST guidelines using disk diffusion with chloramphenicol, erythromycin, clindamycin, tetracycline, trimethoprim/sulfamethoxazole and oxacillin for PNSP screening. Penicillin and ceftriaxone minimum inhibitory concentrations (MIC) were measured for oxacillin resistant isolates using the E-test. Serotyping was done using latex agglutination and/or multiplex PCR. The total number of pneumococcal isolates that met the study criteria was 1

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Section: Serotypingmentioning

confidence: 99%

Section: Serotypingmentioning

confidence: 99%

Reduction of antimicrobial resistant pneumococci seven years after introduction of pneumococcal vaccine in Iceland

et al. 2020

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“…We used luminescent derivatives of serotypes 19F (19F/x) and 7F (7F/x), both of which translocate from the nasal passages into the middle ear, resulting in acute otitis media in murine models (28). The capsule types 7F and 19F are serotypes included in the PCV-13 vaccine but are still frequently isolated from patients with AOM, even in the post-PCV-13 era (29,30). At 24 h after challenge with the 19F/x strain, significant reductions in overall titers were observed in response to the PCV-13 vaccination administered alone or with YLN vaccination compared to titers for alum-vaccinated mice.…”

Section: Resultsmentioning

confidence: 99%

A Cross-Reactive Protein Vaccine Combined with PCV-13 Prevents Streptococcus pneumoniae- and Haemophilus influenzae-Mediated Acute Otitis Media

et al. 2019

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Acute otitis media is one of the most common childhood infections worldwide. Currently licensed vaccines against the common otopathogen Streptococcus pneumoniae target the bacterial capsular polysaccharide and confer no protection against nonencapsulated strains or capsular types outside vaccine coverage. Mucosal infections such as acute otitis media remain prevalent, even those caused by vaccine-covered serotypes. Here, we report that a protein-based vaccine, a fusion construct of epitopes of CbpA to pneumolysin toxoid, confers effective protection against pneumococcal acute otitis media for non-PCV-13 serotypes and enhances protection for PCV-13 serotypes when coadministered with PCV-13. Having cross-reactive epitopes, the fusion protein also induces potent antibody responses against nontypeable Haemophilus influenzae and S. pneumoniae, engendering protection against acute otitis media caused by emerging unencapsulated otopathogens. These data suggest that augmenting capsule-based vaccination with conserved, cross-reactive protein-based vaccines broadens and enhances protection against acute otitis media.

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“…The serotype replacement observed in our study is in concordance with previous publications. 10,17,27 An increased involvement of serotypes 3, 6C, and 19A in the nasopharynx and MEF samples was already seen in the years after PCV7 and PCV10 implementations and these serotypes are of concern now. 10,16,27 In a report by Naucler et al, comparing PCV10 and PCV13 vaccination programs, an effect of both vaccines against serotype 3 (which is only included in PCV13) has not been shown.…”

Section: Discussionmentioning

confidence: 99%

“…10,17,27 An increased involvement of serotypes 3, 6C, and 19A in the nasopharynx and MEF samples was already seen in the years after PCV7 and PCV10 implementations and these serotypes are of concern now. 10,16,27 In a report by Naucler et al, comparing PCV10 and PCV13 vaccination programs, an effect of both vaccines against serotype 3 (which is only included in PCV13) has not been shown. 8 On the other hand, serotypes 19A and 6C, which are not included in PCV10, have been found to increase only in a cohort of PCV10 immunized patients and no cross-protection between serotypes 19F and 19A, and between 6B and 6C, has been observed.…”

Section: Discussionmentioning

confidence: 99%

Bacterial Spectrum of Acute Otitis Media in Bulgarian Children during the 10-Valent Pneumococcal Conjugate Vaccine Era

Setchanova

Stancheva²,

Попова³

et al. 2020

J Pediatr Infect Dis

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Objective The 10-valent pneumococcal conjugate vaccine (PCV10) was introduced in Bulgaria for universal childhood vaccination in 2010. The objective of this study was to describe bacterial pathogens responsible for acute otitis media (AOM) in children in the era of routine PCV10 immunization. Materials and Methods Middle ear fluid (MEF)/otorrhea or nasopharyngeal specimens were collected between May 2012 and April 2017 from 425 children aged < 12 years diagnosed with AOM; 71.5% of them were vaccinated. Capsular types of Streptococcus pneumoniae and Haemophilus influenzae and antimicrobial nonsusceptibility were determined. Results Among 240 children with “severe” AOM, the studied specimens were MEF/otorrhea, and a total of 132 (55.0%) children were culture-positive. The most frequently identified bacteria were S. pyоgenes (31.1%), followed by Staphylococcus aureus (21.2%), S. pneumoniae (20.4%), and nontypeable H. influenzae (12.1%). Among 185 nasopharyngeal specimens obtained from children at the onset of a “mild” AOM episode, 67.0% were culture-positive for otopathogens. The most common pathogens were S. pneumoniae (41.9%), followed by H. influenzae (25.8%), Moraxella catarrhalis (23.4%), and S. pyоgenes (14.5%), alone or in combinations. Among children with pneumococcal AOM (79), PCV10 serotypes (VTs) were 21.5%. A high prevalence (50%) of nonvaccine serotypes 3 (14), 19A (11), and 6C (7) was found among vaccinated children. Rates of nonsusceptibility of S. pneumoniae to penicillin, amoxicillin and erythromycin, and of multidrug resistance, were 51.2, 10.1, 51.2, and 51.2, respectively. The rate of ampicillin-non-susceptibility in H. influenzae was 25%. All M. catarrhalis isolates were β-lactamase producers, and 32.2% of S. pyogenes were erythromycin-resistant. Conclusion Following implementation of PCV10, S. pyogenes was the most prevalent pathogen in children with “severe” AOM. Numbers of S. pneumoniae recovered from MEF/otorrhea significantly decreased, as did the overall proportion of VTs among AOM patients. Streptococcus pneumoniae, H. influenzae, and M. catarrhalis were the most commonly found pathogens in the nasopharynx of children with less severe AOM episodes.

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Effect of Vaccination on Pneumococci Isolated from the Nasopharynx of Healthy Children and the Middle Ear of Children with Otitis Media in Iceland

Abstract: Vaccination with pneumococcal conjugate vaccines (PCVs) disrupts the pneumococcal population. Our aim was to determine the impact of the 10-valent PCV on the serotypes, genetic lineages, and antimicrobial susceptibility of pneumococci isolated from children in Iceland.

Cited by 28 publications

References 76 publications

Reduction of antimicrobial resistant pneumococci seven years after introduction of pneumococcal vaccine in Iceland

Reduction of antimicrobial resistant pneumococci seven years after introduction of pneumococcal vaccine in Iceland

A Cross-Reactive Protein Vaccine Combined with PCV-13 Prevents Streptococcus pneumoniae- and Haemophilus influenzae-Mediated Acute Otitis Media

Bacterial Spectrum of Acute Otitis Media in Bulgarian Children during the 10-Valent Pneumococcal Conjugate Vaccine Era

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