Nasopharyngeal Colonization in Southern Israel with Antibiotic-Resistant Pneumococci during the First 2 Years of Life: Relation to Serotypes Likely to Be Included in Pneumococcal Conjugate Vaccines

Abstract

Nasopharyngeal carriage of Streptococcus pneumoniae was studied in 162 healthy infants at ages 2, 4, 6, 7, 12, and 13 months and in an additional 352 healthy children at ages 12, 15, 18, 21, and 24 months. Carriage was 26%, 39%, and 62% at 2, 12, and 24 months, respectively, and the respective resistance to > or = 1 antibiotic was 11%, 19%, and 27%. The presence of an older sibling or antibiotic treatment during the month preceding the culture was associated with carriage of resistant pneumococci in infants, whereas attendance at large day care centers was associated with carriage during the second year of life. Antibiotic resistance was detected in all 7 serotypes included in the candidate pediatric conjugate vaccines and was significantly more prevalent among vaccine-type pneumococci than among non-vaccine-type pneumococci. The use of conjugate vaccines may reduce the spread of resistant pneumococci.

Prevalence of carriage of antimicrobial resistant strains of Streptococcus pneumoniae in primary school children in Hong Kong

“…It has been suggested that high rates of antibiotic use may eradicate carriage of pneumococci from most children, but may select for resistant strains when these are present [35]. It is generally considered that there is a high rate of prescription of antibiotics in Hong Kong [23,36].…”

Carriage of antibiotic-resistant pneumococci in a cohort of a daycare center

“…[26][27][28] A number of studies have demonstrated a strong association between daycare attendance and increased carriage of S. pneumoniae, especially of resistant strains. 13,28,29 Study findings demonstrated that daycare attendance and patterns of antibiotic use may be important factors influencing the epidemiology of antibiotic-resistant bacteria.…”

“…28,29 Thus, the frequent use of antimicrobial agents to treat upper respiratory infections, a common illness in children in daycare centers, and the close contact of large numbers of young children that commonly occurs in daycare settings, could facilitate the emergence of antibiotic-resistant bacteria. In our study, most of the courses of antibiotics for these children (68/79) were prescribed during the winter time (December-January).…”

La vacuna neumocócica conjugada heptavalente (Prevenar™): Diferencias en su efectividad en distintas poblaciones

“…También se mantuvieron cuando se analizó el efecto de haber recibido una pauta vacunal completa. Estos resultados indican que la efectividad de la VNC7v puede ser escasa en circunstancias como las que se observan en Navarra y son consistentes con los de la vigilancia epidemiológica de la ENI 79,127 .…”

“…A diferencia de la vacuna polisacárida, a las vacunas conjugadas antineumocócicas se les atribuye un efecto importante en la reducción de la colonización nasofaríngea por aquellos serotipos presentes en la vacuna 127 . Los hermanos menores de niños que asisten a guarderías tienen un riesgo elevado de ser portadores del neumococo, pero la vacunación de los niños que asisten a guarderías reduce la colonización en sus hermanos [127][128][129] .…”