Impact of the Seven-valent Pneumococcal Conjugate Vaccine on Acute Otitis Media in Japanese Children

Ozawa, Daiki; Yano, Hisakazu; Endo, Shiro; Hidaka, Hiroshi; Kakuta, Risako; Okitsu, Naohiro; Kanamori, Hajime; Ogawa, Miho; Ichimura, Sachiko; Shimojima, Masayuki; Inomata, Shinji; Kaku, Mitsuo; Katori, Yukio

doi:10.1097/inf.0000000000000776

Cited by 21 publications

(4 citation statements)

References 24 publications

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“…The high incidence of serotype 15A (8.9%) detected in our study is important since recent data have indicated that this serotype often colonizes vaccinated children and may cause multi-drug resistant Sp acute otitis media [ 39 , 40 ].…”

Section: Discussionmentioning

confidence: 77%

Nasopharyngeal Pneumococcal Carriage among Healthy Children in Cyprus Post Widespread Simultaneous Implementation of PCV10 and PCV13 Vaccines

et al. 2016

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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.

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Section: Discussionmentioning

confidence: 77%

Nasopharyngeal Pneumococcal Carriage among Healthy Children in Cyprus Post Widespread Simultaneous Implementation of PCV10 and PCV13 Vaccines

et al. 2016

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“…The strain with LVFX MIC of 64 mg/mL was also resistant to ABPC, CTRX, and MINO, and intermediate to STFX, IPM and CAM. There are reports in Japan and the United Kingdom that, after the introduction of pneumococcal conjugate vaccines, multidrug-resistant serotype 15A increased [22,23], thus, there are concerns about multidrugresistant S. pneumoniae. QRDR alteration was found in 30.8% (61/198 strains) and 87.5% (21/24 strains) of LVFX-susceptible strains with LVFX MIC of 0.5e2 mg/mL in S. pyogenes and H. influenzae, respectively.…”

Section: Discussionmentioning

confidence: 99%

Investigation of the susceptibility trends in Japan to fluoroquinolones and other antimicrobial agents in a nationwide collection of clinical isolates: A longitudinal analysis from 1994 to 2016

Tateda

Ohno

Ishii

et al. 2019

Journal of Infection and Chemotherapy

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The susceptibilities of clinical isolates to fluoroquinolones and other antimicrobial agents were surveyed to obtain an accurate understanding of trends in incidence and antimicrobial resistance. The samples were collected from across Japan, biennially or triennially, between 1994 and 2016 and a defined level of resistance to fluoroquinolone was determined. Streptococcus pneumoniae, Streptococcus pyogenes and Haemophilus influenzae exhibited stable and high rates of susceptibility to fluoroquinolones over the period examined. For methicillin-resistant Staphylococcus aureus the rate of resistance to levofloxacin and ciprofloxacin was 81.3e93.5% and 83.2e94.2%, respectively, which was markedly higher than that of methicillin-susceptible S. aureus, while sitafloxacin-resistant methicillin-susceptible and methicillin-resistant S. aureus were isolated at 0.3e0.7% and 16.9e36.5%, respectively. The rate of levofloxacin or ciprofloxacin-resistant Escherichia coli increased from around 2e3% between 1994 and 1998 to around 35% in 2016, but the rate of fluoroquinolonesusceptible Klebsiella pneumoniae stayed high at over 94.6% during the study period. Although no fluoroquinolone-resistance in clinical isolates of Salmonella spp. was detected from 1994 to 2002, the resistance rate increased slightly after 2004 and reached to 1.9%e4.7% in 2016. The rate of fluoroquinolone-susceptible Pseudomonas aeruginosa isolated from urinary tract and respiratory tract infections improved during the period examined from 41.8e67.0% to 91.2e94.2%, and from 78.9-88.5% to 90.1e94.6%, respectively. Against Acinetobacter spp., the susceptibility rate of fluoroquinolones was almost constant at around 90%, but one multidrug-resistant isolate was detected in 2013. Overall, the susceptibility to fluoroquinolones was maintained over 20 years against tested bacteria except for MRSA and E. coli.

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“…Deployment of PCV7 was followed by increased prevalence of serotype 19A isolates, many of them multidrug-resistant, and, although serotype 19A is now covered by PCV13, a niche may be created for yet further types. Internationally, several groups have remarked on the increased prevalence of multidrug-resistant serotype 15A and 35B isolates [ 14 - 21 ] and a recent PHE analysis of invasive pneumococcal infections, using the data series of Table 3 , noted 15A to be among several serotypes now increasing in numbers and proportion in the UK [ 13 ]. The present analysis extends these findings, confirming that serotype 15A S. pneumoniae are of growing importance, as also shown (i) in the BSAC bacteraemia series ( Table 1 ), which overlaps the PHE series but also includes Scotland and Ireland, (ii) the BSAC series LRTI ( Table 2 ), which is the sole UK surveillance to test S. pneumoniae from their predominant disease setting, and (iii) among PHE reference submissions, which provide a rolling snapshot of resistance phenotypes causing concern to microbiologists at sending laboratories, which are predominantly in England, Wales and Northern Ireland, although with a few isolates received from elsewhere ( Table 5 ).…”

Section: Discussionmentioning

confidence: 99%

“…Again, however, rises are being seen in other, non-vaccine, serotypes, principally 8, 10A, 12F, 15A and 24F [ 13 ]. Serotype 15A is of particular interest since multidrug-resistant isolates belonging to this serotype have been reported as far apart as east Asia [ 14 - 16 ], North America [ 17 , 18 ], Norway [ 19 ], Italy [ 20 ] and Australia [ 21 ]. Here, we explore the rise of serotype 15A S. pneumoniae in the UK and Ireland at epidemiological and molecular levels, using data from both the British Society for Antimicrobial Chemotherapy (BSAC) and Public Health England (PHE) surveillances.…”

Section: Introductionmentioning

confidence: 99%

Rise of multidrug-resistant non-vaccine serotype 15A Streptococcus pneumoniae in the United Kingdom, 2001 to 2014

et al. 2016

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Conjugate vaccines have reduced pneumococcal disease in vaccinated children and unvaccinated adults, but non-vaccine serotypes are of concern, particularly if antibiotic resistant. We reviewed Streptococcus pneumoniae collected via: (i) the British Society for Antimicrobial Chemotherapy (BSAC) surveillances from 2001–2014; (ii) Public Health England’s (PHE) invasive isolate surveillance from 2005–2014 and (iii) referral to PHE for resistance investigation from 2005–2014. Serotype 15A increased in all series, with many representatives showing triple resistance to macrolides, tetracyclines and penicillin. 15A was consistently among the 10 most prevalent serotypes from 2011 in PHE and BSAC invasive isolate/bacteraemia surveillance but never previously; 26–33% of these invasive 15A isolates had triple resistance. BSAC respiratory isolates were only serotyped in 2013/14 and 2014/15 (October to September); 15A was most prevalent serotype in both periods, comprising 9–11% of isolates, 38–48% of them with triple resistance. Serotype 15A represented 0–4% of S. pneumoniae referred to PHE for reference investigation annually until 2008 but rose to 29% (2013) and 32% (2014). Almost all multidrug-resistant 15A isolates were sequence type (ST) 63 variants, whereas susceptible 15A isolates were clonally diverse. The rise of serotype 15A suggests that pneumococcal conjugate vaccines will need ongoing adaptation.

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Impact of the Seven-valent Pneumococcal Conjugate Vaccine on Acute Otitis Media in Japanese Children

Abstract: After this research was completed, PCV7 was switched to a PCV13 that also contained serotype 3 and serotype 19A. We need to consider the possibility that serotype 15A, which is not included in PCV13, may increase and cause intractable AOM in the future.

Cited by 21 publications

References 24 publications

Nasopharyngeal Pneumococcal Carriage among Healthy Children in Cyprus Post Widespread Simultaneous Implementation of PCV10 and PCV13 Vaccines

Nasopharyngeal Pneumococcal Carriage among Healthy Children in Cyprus Post Widespread Simultaneous Implementation of PCV10 and PCV13 Vaccines

Investigation of the susceptibility trends in Japan to fluoroquinolones and other antimicrobial agents in a nationwide collection of clinical isolates: A longitudinal analysis from 1994 to 2016

Rise of multidrug-resistant non-vaccine serotype 15A Streptococcus pneumoniae in the United Kingdom, 2001 to 2014

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