Pneumococcal nasopharyngeal carriage in children following heptavalent pneumococcal conjugate vaccination in infancy

Lakshman, Raman; Murdoch, Craig; Race, Gillian; Burkinshaw, Roger; Shaw, L; Finn, Adam

doi:10.1136/adc.88.3.211

Cited by 58 publications

(37 citation statements)

References 18 publications

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“…The study group comprised children undergoing adenotonsillectomy, but the rates and downward trend with age of nasal colonization were similar to those reported previously in healthy children by us and others [29][30][31]. Further, the trends with age in levels of serum IgG antibodies to the pneumococcal protein antigens in this group resembled trends we observed in several sets of sera from healthy UK children (Fig.…”

Section: Discussionsupporting

confidence: 72%

Serum and mucosal antibody responses to pneumococcal protein antigens in children:relationships with carriage status

et al. 2005

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Streptococcus pneumoniae causes significant morbidity and mortality especially in children. Some pneumococcal protein antigens can protect mice against infection. Little information is available concerning the nature of naturally acquired protective immunity to pneumococci in humans induced by these antigens. This study investigates the relationships between systemic and local antibody production and carriage in children. Children undergoing adenoidectomy (n=112, ages 2-12 years) were studied. Nasopharyngeal swabs were collected for pneumococcal culture. Serum and saliva were assayed for antibodies to several pneumococcal proteins: choline binding protein A (CbpA), pneumolysin (Ply), pneumococcal surface adhesin A (PsaA) and pneumococcal surface protein A (PspA). Adenoidal mononuclear cells (MNC) were cultured with pneumococcal culture supernatants or recombinant proteins. Cell culture supernatants were analyzed for antigen-specific antibodies. Carriage rates fell with age and serum levels of anti-CbpA, Ply and PspA rose. Anti-CbpA and -Ply serum and salivary IgG antibody levels were higher in children who were culture negative than those who were colonized. Antigen stimulation increased respective antigen-specific IgG production by adenoidal MNC and these responses were greater in those who were colonized than in culture-negative children. Antibodies to CbpA and Ply may protect children aged 2 years and older against pneumococcal colonization. Adenoids may be important local induction and effector sites for both mucosal and systemic antibody production to pneumococcal proteins in children.

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Section: Discussionsupporting

confidence: 72%

Serum and mucosal antibody responses to pneumococcal protein antigens in children:relationships with carriage status

et al. 2005

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“…The prevalence of carriers appeared constant throughout the study period, with no evidence of seasonal fluctuations. Results from previous studies have been mixed with some demonstrating an increase in carriage during the winter months [6,28], whereas others have not [7]. The reasons for these differences are uncertain.…”

Section: Discussionmentioning

confidence: 96%

A longitudinal household study of Streptococcus pneumoniae nasopharyngeal carriage in a UK setting

Hussain¹,

Melegaro

Pebody³

et al. 2005

Epidemiol. Infect.

170

163

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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.

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“…In one study, the effects on VT colonization were no longer evident by the ages of 2 to 5 years following 3 PCV doses in infancy and the 23vPPS at the age of 13 months (21). Similarly, a study in South Africa found no differences among non-HIV-infected children in VT colonization in the 3-PCV-dose group compared with the placebo group 5 years after vaccination in infancy (22a).…”

Section: Discussionmentioning

confidence: 98%

“…Clinical trials using 5-, 7-, or 9-valent pneumococcal conjugate vaccines have shown a reduction in VT carriage compared with that for unvaccinated infants (21,23,27) or toddlers (5,6,42). However, the overall rate of NP pneumococcal carriage remained essentially unchanged, due to serotype replacement with NVT pneumococci (5,10,23,24,27).…”

mentioning

confidence: 93%

Pneumococcal Nasopharyngeal Carriage following Reduced Doses of a 7-Valent Pneumococcal Conjugate Vaccine and a 23-Valent Pneumococcal Polysaccharide Vaccine Booster

Russell

Carapetis

Satzke

et al. 2010

Clin Vaccine Immunol

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This study was conducted to evaluate the effect of a reduced-dose 7-valent pneumococcal conjugate vaccine (PCV) primary series followed by a 23-valent pneumococcal polysaccharide vaccine (23vPPS) booster on nasopharyngeal (NP) pneumococcal carriage. For this purpose, Fijian infants aged 6 weeks were randomized to receive 0, 1, 2, or 3 PCV doses. Within each group, half received 23vPPS at 12 months. NP swabs were taken at 6, 9, 12, and 17 months and were cultured for Streptococcus pneumoniae. Isolates were serotyped by multiplex PCR and a reverse line blot assay. There were no significant differences in PCV vaccine type (VT) carriage between the 3-and 2-dose groups at 12 months. NP VT carriage was significantly higher (P, <0.01) in the unvaccinated group than in the 3-dose group at the age of 9 months. There appeared to be a PCV dose effect in the cumulative proportion of infants carrying the VT, with less VT carriage occurring with more doses of PCV. Non-PCV serotype (NVT) carriage rates were similar for all PCV groups. When groups were pooled by receipt or nonreceipt of 23vPPS at 12 months, there were no differences in pneumococcal, VT, or NVT carriage rates between the 2 groups at the age of 17 months. In conclusion, there appeared to be a PCV dose effect on VT carriage, with less VT carriage occurring with more doses of PCV. By the age of 17 months, NVT carriage rates were similar for all groups. 23vPPS had no impact on carriage, despite the substantial boosts in antibody levels.

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Pneumococcal nasopharyngeal carriage in children following heptavalent pneumococcal conjugate vaccination in infancy

Cited by 58 publications

References 18 publications

Serum and mucosal antibody responses to pneumococcal protein antigens in children:relationships with carriage status

Serum and mucosal antibody responses to pneumococcal protein antigens in children:relationships with carriage status

A longitudinal household study of Streptococcus pneumoniae nasopharyngeal carriage in a UK setting

Pneumococcal Nasopharyngeal Carriage following Reduced Doses of a 7-Valent Pneumococcal Conjugate Vaccine and a 23-Valent Pneumococcal Polysaccharide Vaccine Booster

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