Incidence of macrolide resistance in Streptococcus pneumoniae after introduction of the pneumococcal conjugate vaccine: population-based assessment

Stephens, David S.; Zughaier, Susu M.; Whitney, Cynthia G.; Baughman, Wendy; Barker, Lawrence; Jackson, Delois; Orenstein, Walter A.; Arnold, Kathryn E.; Schuchat, Anne; Farley, Monica M.

doi:10.1016/s0140-6736(05)71043-6

Cited by 168 publications

(116 citation statements)

References 24 publications

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“…As in the pre-PCV era, antimicrobial resistance was mainly seen among PCV serotypes, the introduction of PCV was thought to be a potential tool to decrease pneumococcal resistance [40], and initial results during a clinical trial [9], and following PCV introduction, suggested that indeed there had been both an absolute [41,42] and relative [43] reduction in disease caused by resistant strains compared with susceptible strains of pneumococci. These reductions have been undermined by the rapid evolution of resistance in non-vaccine strains causing invasive disease such that the proportion of such strains resistant to antibiotics has now reached prevaccine levels [44,45], even if the absolute number of cases of disease has decreased.…”

Section: Role Of Antimicrobial Resistance In the Persistence And Seromentioning

confidence: 99%

Contribution of vaccines to our understanding of pneumococcal disease

Klugman

2011

Phil. Trans. R. Soc. B

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Pneumonia is the leading cause of mortality in children in developing countries and is also the leading infectious cause of death in adults. The most important cause of pneumonia is the Gram-positive bacterial pathogen, Streptococcus pneumoniae, also known as the pneumococcus. It has thus become the leading vaccine-preventable cause of death and is a successful and diverse human pathogen. The development of conjugate pneumococcal vaccines has made possible the prevention of pneumococcal disease in infants, but has also elucidated aspects of pneumococcal biology in a number of ways. Use of the vaccine as a probe has increased our understanding of the burden of pneumococcal disease in children globally. Vaccination has also elucidated the clinical spectrum of vaccine-preventable pneumococcal infections; the identification of a biological niche for multiple pneumococcal serotypes in carriage and the differential invasiveness of pneumococcal serotypes; the impact of pneumococcal transmission among children on disease burden in adults; the role of carriage as a precursor to pneumonia; the plasticity of a naturally transformable pathogen to respond to selective pressure through capsular switching and the accumulation of antibioticresistance determinants; and the role of pneumococcal infections in hospitalization and mortality associated with respiratory viral infections, including both seasonal and pandemic influenza. Finally, there has been a recent demonstration that pneumococcal pneumonia in children may be an important cause of hospitalization for those with underlying tuberculosis.

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Section: Role Of Antimicrobial Resistance In the Persistence And Seromentioning

confidence: 99%

Contribution of vaccines to our understanding of pneumococcal disease

Klugman

2011

Phil. Trans. R. Soc. B

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“…Since most PCV7 serotypes (6B, 9V, 14, 19F, and 23F) are usually penicillin and multidrug resistant, the rates of penicillin-resistant disease have decreased (17). Moreover, a decrease in macrolide-resistant IPD was observed in the United States (29), mainly due to a reduction of serotype 14 pneumococci harboring mef(E).…”

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Serotype and Genotype Replacement among Macrolide-Resistant Invasive Pneumococci in Adults: Mechanisms of Resistance and Association with Different Transposons

et al. 2010

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“…Thus, mass vaccination of children has resulted in a herd effect, as demonstrated by a reduced incidence of IPD among older adults in the United States (28). In addition, as the majority of the resistant PMEN clones have serotypes represented in PCV-7, vaccination is potentially an effective way to control the spread of resistant clones (45). However, the reduction of vaccine serotypes in asymptomatic carriage and IPD has, to some extent, been countered by replacement with nonvaccine serotypes (23,42), requiring an improved surveillance program when PCV-7 is introduced in a population.…”

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Phenotypic and Genotypic Characterization of Streptococcus pneumoniae Strains Colonizing Children Attending Day-Care Centers in Norway

et al. 2008

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A cross-sectional study of nasopharyngeal colonization with Streptococcus pneumoniae was performed among 573 children attending 29 day-care centers (DCCs) in Norway prior to the start of mass vaccination with the heptavalent pneumococcal conjugate vaccine (PCV-7). A sensitive sampling method was employed, including transport in an enrichment broth and serotyping of pneumococci directly from the broth, in addition to traditional single-colony isolation from blood agar plates. The prevalence of carriage was high, peaking at 88.7% in 2-year-olds. More than one serotype was isolated from 12.7% of the carriers. Of 509 isolates obtained, 227 (44.6%) belonged to the PCV-7 serotypes. Penicillin nonsusceptibility was rare (1.8% of the isolates). Nonsusceptibility to erythromycin (5.9%), clindamycin (2.0%), and tetracycline (5.5%) was associated with PCV-7 serotypes (P < 0.001). Multilocus sequence typing was performed on the whole strain collection, revealing 102 sequence types (STs), of which 31 (30.4%) were novel. Eleven isolates (2.2%) belonged to the England 14 -9 clone, and 19 isolates (3.7%) belonged to, or were single-locus variants of, the Portugal 19F -21 clone. The pneumococcal populations within the DCCs were composed of a majority of isolates with STs shared between the DCCs and a minority of isolates with STs unique for each DCC. The highest numbers of different STs, including novel STs, were found within the most frequent serotypes. Our study indicates that carriage of S. pneumoniae is highly prevalent among children in Norwegian DCCs, with a genetically diverse pneumococcal population consisting of unique microepidemic DCC populations.

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Incidence of macrolide resistance in Streptococcus pneumoniae after introduction of the pneumococcal conjugate vaccine: population-based assessment

Cited by 168 publications

References 24 publications

Contribution of vaccines to our understanding of pneumococcal disease

Contribution of vaccines to our understanding of pneumococcal disease

Serotype and Genotype Replacement among Macrolide-Resistant Invasive Pneumococci in Adults: Mechanisms of Resistance and Association with Different Transposons

Phenotypic and Genotypic Characterization of Streptococcus pneumoniae Strains Colonizing Children Attending Day-Care Centers in Norway

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