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Emerging pneumococcal carriage serotypes in a high-risk population receiving universal 7-valent pneumococcal conjugate vaccine and 23-valent polysaccharide vaccine since 2001

Leach, Amanda J., Morris, Peter S., McCallum, Gabrielle B., Wilson, Cate A., Stubbs, Liz, Beissbarth, Jemima, Jacups, Susan P., Hare, Kim M. and Smith-Vaughan, Heidi C. (2009). Emerging pneumococcal carriage serotypes in a high-risk population receiving universal 7-valent pneumococcal conjugate vaccine and 23-valent polysaccharide vaccine since 2001. BMC Infectious Diseases,9(1):121-129.

Document type: Journal Article
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IRMA ID 10016xPUB10
Title Emerging pneumococcal carriage serotypes in a high-risk population receiving universal 7-valent pneumococcal conjugate vaccine and 23-valent polysaccharide vaccine since 2001
Author Leach, Amanda J.
Morris, Peter S.
McCallum, Gabrielle B.
Wilson, Cate A.
Stubbs, Liz
Beissbarth, Jemima
Jacups, Susan P.
Hare, Kim M.
Smith-Vaughan, Heidi C.
Journal Name BMC Infectious Diseases
Publication Date 2009
Volume Number 9
Issue Number 1
ISSN 1471-2334   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-69949133684
Start Page 121
End Page 129
Total Pages 9
Place of Publication United Kingdom
Publisher BioMed Central Ltd.
Abstract Background
In Australia in June 2001, a unique pneumococcal vaccine schedule commenced for Indigenous infants; seven-valent pneumococcal conjugate vaccine (7PCV) given at 2, 4, and 6 months of age and 23-valent pneumococcal polysaccharide vaccine (23PPV) at 18 months of age. This study presents carriage serotypes following this schedule.

Methods
We conducted cross sectional surveys of pneumococcal carriage in Aboriginal children 0 to 6 years of age living in remote Aboriginal communities (RACs) in 2003 and 2005. Nasal secretions were collected and processed according to published methods.

Results
902 children (mean age 25 months) living in 29 communities in 2003 and 818 children (mean age 35 months) in 17 communities in 2005 were enrolled. 87% children in 2003 and 96% in 2005 had received two or more doses of 7PCV. From 2003 to 2005, pneumococcal carriage was reduced from 82% to 76% and reductions were apparent in all age groups; 7PCV-type carriage was reduced from 11% to 8%, and 23PPV-non-7PCV-type carriage from 31% to 25% respectively. Thus non-23PPV-type carriage increased from 57% to 67%. All these changes were statistically significant, as were changes for some specific serotypes. Shifts could not be attributed to vaccination alone. The top 10 of 40 serotypes identified were (in descending order) 16F, 19A, 11A, 6C, 23B, 19F, 6A, 35B, 6B, 10A and 35B. Carriage of penicillin non-susceptible (MIC > = 0.12 μg/mL) strains (15% overall) was detected in serotypes (descending order) 19A, 19F, 6B, 16F, 11A, 9V, 23B, and in 4 additional serotypes. Carriage of azithromycin resistant (MIC > = 2 μg/mL) strains (5% overall), was detected in serotypes (descending order) 23B, 17F, 9N, 6B, 6A, 11A, 23F, and in 10 additional serotypes including 6C.

Conclusion
Pneumococcal carriage remains high (~80%) in this vaccinated population. Uptake of both pneumococcal vaccines increased, and carriage was reduced between 2003 and 2005. Predominant serotypes in combined years were 16F, 19A, 11A, 6C and 23B. Antimicrobial non-susceptibility was detected in these and 17 additional serotypes. Shifts in serotype-specific carriage suggest a need more research to clarify the association between pneumococcal vaccination and carriage at the serotype level.
Keywords pneumococcal conjugate vaccine (7PCV)
pneumococcal polysaccharide vaccine (23PPV)
Indigenous infants
DOI http://dx.doi.org/10.1186/1471-2334-9-121   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)


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