Nasopharyngeal carriage of Streptococcus pneumoniae in Taiwan before and after the introduction of a conjugate vaccine

Kuo, Chang‐Fu; Hwang, Kao Pin; Hsieh, Yao‐Ching; Cheng, Chi-Hui; Huang, Fang; Shen, Yea Huei; Huang, Yhu Chering; Chiu, Cheng Hsun; Chen, Po Yen; Lin, Tzou Yien

doi:10.1016/j.vaccine.2011.05.034

Cited by 48 publications

(40 citation statements)

References 38 publications

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“…22,23 In contrast to the impressive impact of PCVs on different pneumococcal diseases, with the potential of rapidly achieving near eradication of vaccine serotype disease in the vaccinated age group, 3,14 vaccine impact on overall pneumococcal carriage was less prominent. [8][9][10] This lesser effect was observed in many studies, 6,7,19,24 however, over time, vaccine impact on VT-carriage reached a magnitude similar to that observed with IPD. 10,19 In contrast to IPD, replacement of NP carriage of VT serotype by non-VT serotypes occurred rapidly and extensively, leading to increased colonization and transmission of non-VT strains.…”

Section: Introductionmentioning

confidence: 58%

“…This replacement in the NP niche was reported to occur rapidly and extensively, leading to increased colonization and transmission of non-VT strains. 6,7,19,24 Notably, this universal observation of replacement in carriage was associated with an overall marked reduction in pneumococcal disease, indicating that most replacement serotypes are less invasive strains with a lower disease potential. 10,19,25,32,33 While overall-pneumococcal carriage rates were stable following PCV introduction in several reports, 7,24,34 a similar reduction to that observed in our study was found in a rural South African community 35 and among American Indian children <5 years old.…”

Section: Discussionmentioning

confidence: 92%

“…6 The spread of S. pneumoniae beyond the nasopharynx (promoting pneumococcal disease) depends upon several factors including the virulence of the organism/specific serotype, the host immunocompetence, and the existence of preceding viral infection. 7 Pneumococcal NP carriage rates vary in different settings worldwide. [8][9][10] This variation may derive, at least in part, from demographic, ethnical and cultural differences, with higher carriage rates observed in populations suffering from poverty, over-crowding, exposure to smoking and poor hygienic conditions, [10][11][12] as well as history of breast feeding, day-care center attendance and antibiotic treatment at the individual and societal levels.…”

Section: Introductionmentioning

confidence: 99%

“…[8][9][10] This variation may derive, at least in part, from demographic, ethnical and cultural differences, with higher carriage rates observed in populations suffering from poverty, over-crowding, exposure to smoking and poor hygienic conditions, [10][11][12] as well as history of breast feeding, day-care center attendance and antibiotic treatment at the individual and societal levels. 7 The introduction of the pneumococcal conjugate vaccines (PCVs) to the national immunization plans (NIP) worldwide resulted in substantial rate reductions of various pneumococcal disease end-points, including invasive pneumococcal disease (IPD), 13,14 pneumonia, [15][16][17][18] and otitis media, 3 including unvaccinated age groups and individuals. [17][18][19][20][21] Pneumococcal conjugate vaccines protect against carriage among vaccinated individuals and therefore prevent transmission to unvaccinated children and susceptible adults.…”

Section: Introductionmentioning

confidence: 99%

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Pneumococcal nasopharyngeal carriage in children <5 years of age visiting the pediatric emergency room in relation to PCV7 and PCV13 introduction in southern Israel

Ben‐Shimol

Givon-Lavi

Greenberg

et al. 2015

Human Vaccines & Immunotherapeutics

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The 7-valent and the 13-valent pneumococcal conjugate vaccines (PCV7 and PCV13, respectively) were introduced to the Israeli National Immunization plan in July 2009 and November 2010, respectively. Our aim was to assess pneumococcal conjugate vaccines (PCVs) uptake and dynamics in serotype-specific pneumococcal nasopharyngeal (NP) carriage in children <5 years old in southern Israel, during the immediate 5 y following PCV introduction. This was an ongoing, prospective, population-based, active surveillance, from July 2009 through December 2014. PCVs uptake and NP cultures were obtained daily from children seen at the Pediatric Emergency Room for any reason. Overall, 10,702 vaccine status and 7,610 NP swabs were obtained. Both PCV7 and PCV13 uptake were high, reaching~90% by July 2012 and December 2013, respectively. All-pneumococcal carriage rates significantly declined by 10%, from 54.3% in the early-PCV7 period, to 49.1% in the PCV13 impact period. The respective declines for PCV7, 6A and additional PCV13 serotypes carriage rates were 76%, 90% and 66%. In contrast, non-PCV13 serotypes carriage rates increased significantly throughout the study by 71%. All-pneumococcal carriage rates in children <12 months old decreased significantly by 15%, with similar trends observed in other age groups. Initially, all-pneumococcal carriage rates were 45.7%, and 61.9% in Jewish and Bedouin children, respectively (P < 0.001), with a significant 17% reduction throughout the study observed only in Bedouins. While early carriage rates were higher in unvaccinated children compared to vaccinated children, PCV impact on carriage were similar in both groups. In conclusion, a relatively moderate decline in pneumococcal carriage rates, facilitated by a substantial decrease of vaccine-serotypes and increase of non-vaccine serotypes was observed in the immediate period following PCVs introduction in southern Israel.

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Section: Introductionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pneumococcal nasopharyngeal carriage in children <5 years of age visiting the pediatric emergency room in relation to PCV7 and PCV13 introduction in southern Israel

Ben‐Shimol

Givon-Lavi

Greenberg

et al. 2015

Human Vaccines & Immunotherapeutics

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“…While non-typeable pneumococcal isolates are more commonly associated with carriage rather than invasive disease, non-typeable pneumococci has been isolated from children with IPD. 17,30,31 Furthermore, recent evidence suggests that non-typeable pneumococci have high genetic recombination potential leading to the possibility of spreading antibiotic resistance making their identification important for surveillance studies 32,33,34 Approximately 50% of the pneumococcal isolates found during our study were non-PCV13 serotypes (with an additional 44% of the types being non-typeable). One-third of the a CLSI breakpoints used for determination of susceptibility ( 2 mg/mL penicillin, 2 mg/mL cefotaxime, 2 mg/mL trimethoprim-sulfamethoxazole).…”

Section: Discussionmentioning

confidence: 84%

Nasopharyngeal pneumococcal carriage rates among HIV-infected adults following widespread pediatric use of conjugate pneumococcal vaccine-13

Feola

Bonville

Cibula

et al. 2016

Human Vaccines & Immunotherapeutics

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Background: Nasopharyngeal pneumococcal carriage rates among HIV-infected adults has not been described since conjugate pneumococcal vaccine-13 (PCV13) was added to the universal infant and childhood vaccination schedule in 2010. Methods: HIV-infected adults presenting for routine health care visits to the Designated AIDS Center in Syracuse, NY between December 2013 and June 2015 were eligible for enrollment. Demographic, medical, and social history were recorded after obtaining informed consent. Nasopharyngeal samples were collected and cultured for the presence of Streptococcus pneumoniae using standard microbiologic techniques. Antibiotic susceptibility testing was performed using E-test!. Results: 707 nasopharyngeal samples were collected from 414 HIV-infected adults. 18 samples were culture positive for S. pneumoniae; 1 (6%) isolate was of vaccine-type, 9 (50%) were non-vaccine types, and 8 (44%) were non-typeable. The 18 isolates were recovered from 15 different patients (4% of those enrolled). Three patients were culture positive for pneumococcus isolated from 2 consecutive samples, with non-typeable pneumococci identified consecutively from 2 patients and serotype 35B identified consecutively from 1 patient. The most commonly identified non-vaccine serotypes were 35B and 15B/C. Identified pneumococci were penicillin and cefotaxime susceptible. Conclusion: Four percent of HIVinfected adults in our study population were colonized with S. pneumoniae. The non-vaccine serotypes 35B and 15B/C predominated.

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The association of anemia with the clinical outcomes of community‐acquired pneumonia in children

Chang

Shih

Liu

et al. 2022

Pediatric Pulmonology

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Objectives Anemia is associated with severe outcomes in adult community‐acquired pneumonia (CAP), but few studies investigated its association with pediatric CAP. Hence, we tried to delineate the association of anemia with the clinical outcomes of CAP in children. Methods This retrospective cohort study was conducted from 2010 to 2019 in a medical center. Inpatients aged 6 months to 17 years who were diagnosed with CAP and without major underlying diseases were included. The subjects' clinical data within 24 h of admission and clinical outcomes were collected. We accessed the rates of adverse outcomes and the adjusted odds ratios (ORs) of these outcomes between anemic and nonanemic patients, as well as among patients with different types of anemia. Results In this study of 3601 patients, the prevalence of anemia was 11.6% (418/3601). Anemic patients had higher rates of intensive care (16.8% vs. 3.6%; p < 0.001), endotracheal intubation (11.0% vs. 1.3%; p < 0.001), and empyema (8.6% vs. 0.6%; p < 0.001) than nonanemic patients. In addition, anemia was independently associated with intensive care (adjusted OR, 3.00; 95% confidence interval [CI], 2.03–4.42), endotracheal intubation (adjusted OR, 3.79; 95% CI, 2.17–6.63), and empyema (adjusted OR, 4.72; 95% CI, 2.30–9.69). Iron‐deficiency anemia (IDA) and normocytic anemia were associated with these adverse outcomes but not with anemia due to thalassemia trait. Conclusion Anemia is a biomarker associated with poor outcomes in pediatric CAP, and patients with IDA or normocytic anemia should be carefully monitored and managed since they may have higher disease severity.

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Nasopharyngeal carriage of Streptococcus pneumoniae in Taiwan before and after the introduction of a conjugate vaccine

Cited by 48 publications

References 38 publications

Pneumococcal nasopharyngeal carriage in children <5 years of age visiting the pediatric emergency room in relation to PCV7 and PCV13 introduction in southern Israel

Pneumococcal nasopharyngeal carriage in children <5 years of age visiting the pediatric emergency room in relation to PCV7 and PCV13 introduction in southern Israel

Nasopharyngeal pneumococcal carriage rates among HIV-infected adults following widespread pediatric use of conjugate pneumococcal vaccine-13

The association of anemia with the clinical outcomes of community‐acquired pneumonia in children

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