Abstract
The objective of the study was to describe the incidence of pneumococcal nasopharyngeal carriage, serotype distribution and antibiotic resistance profile of pneumococcal nasopharyngeal isolates in healthy children aged 6 to 36 months following the implementation of conjugate vaccines. A nasopharyngeal swab was collected from 1105 healthy children following a stratified random sampling between September 2013 and April 2014. Demographics, vaccination status and data on possible risk factors were recorded. Isolates were serotyped and tested for antibiotic susceptibility. The nasopharyngeal carriage rate was 25.3%. Among 1105 children enrolled, 393 had received PCV13 and 685 PCV10. The prevailing isolated serotypes were: 23A (14.3%), 15A (8.9%), 6C (8.6%), 23B (7.5%), 19A (5.4%) and 15B (5%). The proportion of non-vaccine serotypes, PCV10 serotypes, PCV13 additional serotypes (3, 6A, 19A) was 76.8%, 2.1% and 10.4% respectively. Although children, who were fully or partially vaccinated with PCV13, were 63% less likely to be colonized with additional PCV13 serotypes compared to those vaccinated with PCV10, the difference is not significant (95%Cl = 0.14–1.02, p = 0.053). The highest antibiotic non-susceptible rates were found for erythromycin (28.2%) and penicillin (27.9%). The overall multidrug resistance rate was 13.2%, with serotypes 24F (4/6), 15A (14/25) and 19A (6/15) being the main contributors. Carriage rate was similar between children vaccinated with PCV10 or PCV13. The high incidence of 15A serotype which is also multidrug resistant should be underlined. Ongoing surveillance is needed to monitor the dynamics on nasopharyngeal carriage.
Highlights
Streptococcus pneumoniae (Sp) is a common cause of childhood bacteraemia, meningitis, otitis media, pneumonia and sinusitis [1]
Children, who were fully or partially vaccinated with 13-valent pneumococcal conjugate vaccine (PCV13), were 63% less likely to be colonized with additional PCV13 serotypes compared to those vaccinated with 10-valent pneumococcal conjugate vaccine (PCV10), the difference is not significant (95%Cl = 0.14–1.02, p = 0.053)
The aforementioned data indicates that 10 years post pneumococcal conjugate vaccines (PCVs) implementation in Cyprus, NP carriage rate in a representative sample of children was 25,3%
Summary
Streptococcus pneumoniae (Sp) is a common cause of childhood bacteraemia, meningitis, otitis media, pneumonia and sinusitis [1]. Nasopharyngeal Pneumococcal Carriage among Healthy Children in Cyprus, Post PCV Vaccines. In order to reduce the burden of pneumococcal disease, universal infant vaccination with a 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in 2000 in the United States, resulting in a dramatic decline of IPD among vaccinated children and in unvaccinated persons of all ages through herd immunity [6,7,8,9]. In Cyprus, PCV7 was introduced in the national vaccine schedule in February 2004 It was recommended for universal vaccination of children aged 2–23 months and for children aged 24–59 months who are at increased risk for pneumococcal disease [19]. The 3+1 dose scheme was adopted and thereafter was modified to 2+1 dose Both PCV13 and PCV10 were provided by private pediatricians who were vaccinating approximately 60% of children in Cyprus at that time. A nationwide population based study was conducted to describe the NP carriage rate, serotype distribution and the antibiotic resistance profile of NP carriage in healthy children aged 6 to 36 months, a decade after the introduction of conjugated pneumococcal vaccination
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