Pneumococcal carriage in young children after introduction of PCV13 in Hong Kong

Chan, Kate Ching Ching; Subramanian, Reema; Chong, Patrick S.K.; Nelson, E. Anthony S.; Lam, Hugh Simon; Li, Albert Martin; Ip, Margaret

doi:10.1016/j.vaccine.2016.05.047

Cited by 37 publications

(22 citation statements)

References 38 publications

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“…Regarding pneumococcal carriage, it is not yet clear whether the PCVs led to a reduced carriage rate. Results from various countries are discordant; while some studies found a reduction in the overall pneumococcal carriage, others did not observe this effect [11, 12]. …”

Section: Introductionmentioning

confidence: 99%

Influence of the pneumococcal conjugate vaccines on the temporal variation of pneumococcal carriage and the nasal microbiota in healthy infants: a longitudinal analysis of a case–control study

et al. 2017

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BackgroundBacterial colonization of the upper airways is a prerequisite for subsequent invasive disease. With the introduction of the 7- and 13-valent pneumococcal conjugate vaccines (PCV7 and PCV13), changes in pneumococcal upper airway colonization have been described. It is, however, less evident whether the vaccines lead to compositional changes of the upper airway microbiota. Here, we performed a case–control study using samples from a longitudinal infant cohort from Switzerland. We compared pneumococcal carriage and the nasal microbiota within the first year of life of healthy infants vaccinated with either PCV7 (n = 20, born in 2010) or PCV13 (n = 21, born between 2011 and 2013). Nasal swabs were collected every second week (n = 763 in total). Pneumococcal carriage was analyzed by quantitative PCR of the pneumococcal-specific lytA gene. Analysis of the bacterial core microbiota was performed based on 16S rRNA sequencing and subsequent oligotyping. We exclusively performed oligotyping of the core microbiota members, which were defined as the five most abundant bacterial families (Moraxellaceae, Streptococcaceae, Staphylococcaceae, Corynebacteriaceae, and Pasteurellaceae). Linear mixed effect (LME) and negative binomial regression models were used for statistical analyses.ResultsWe found a higher number of samples positive for pneumococcal carriage in PCV7- compared to PCV13-vaccinated infants (LME model; P = 0.01). In contrast, infants vaccinated in the PCV13 era had an increased alpha diversity as measured by the richness and the Shannon Diversity Index (LME model; P = 0.003 and P = 0.01, respectively). Accordingly, the PCV13 era was associated with clusters of a higher diversity than PCV7-associated clusters. Furthermore, infants vaccinated with PCV13 had a higher binary-based within-subject microbiota similarity, as well as a decreased Jensen–Shannon distance over time as compared to PCV7-vaccinated infants, indicating a higher microbiota stability in the PCV13 era (LME model and t test; P = 0.06 and P = 0.03, respectively).ConclusionsWe hypothesize that the higher diversity and stability of the upper airway microbiota in the PCV13 era is the result of the lower pneumococcal carriage rate. This seems to indicate that the nasal bacterial microbiota of infants has changed in recent years as compared to the beginning of this study.Electronic supplementary materialThe online version of this article (doi:10.1186/s40168-017-0302-6) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Influence of the pneumococcal conjugate vaccines on the temporal variation of pneumococcal carriage and the nasal microbiota in healthy infants: a longitudinal analysis of a case–control study

et al. 2017

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“…In Germany, Canada, Denmark, France and Japan serotype 15A was found to be one of the sharply increasing serotypes in IPD with mostly non-susceptible to penicilin. 2,[5][6][7] In the study of Nakano et al six mortality cases were observed in a nationwide surveillance program of IPD and non-IPD cases from 2012 (PCV7 era) to 2014 (PCV13 era) in Japan and three of them (50%) included serotype 15A. 8 Serotype 15A was significantly found more prevalent in isolates of patients with meningitis than other illnesses e.g.…”

Section: Discussionmentioning

confidence: 99%

“…1,4 The widespread use of pneumococcus vaccines has significantly decreased the incidence of serious IPD and carriage in children due to the coverage of PCV13 serotypes. 2 The reduction in nasopharyngeal carriage of vaccine serotypes has also led to a substantial herd effect (indirect protection) in the older children and adults similarly in Turkey. 1 However IPD continues to occur with the serotype replacement due to an increase circulation of new pneumococcal serotypes not included in the PCV recently.…”

Section: Discussionmentioning

confidence: 99%

“…The changes in the serotype distribution of IPD are associated with serotype distribution of colonization and geographic locations. 2,4,7 Serotype replacement in IPD may suggest simultaneous replacement of PCV serotypes with non-PCV serotypes among pneumococci that colonize the nasopharynx of children. 3 Nazofarengeal carriage of serotype 15 was detected after the implementation of PVC13.…”

Section: Discussionmentioning

confidence: 99%

“…1 IPD in children has been significantly decreased by widespread implementation of the pneumococcal conjugate vaccines (PCVs) in the world. 2 However IPD continues to occur with the serotype replacement due to circulation of new pneumococcal serotypes not included in the PCVvaccines in recent years. 3 With this report we attemped to share the first two pediatric cases of IPD due to non-vaccine serotype 15A in Turkey.…”

Section: Introductionmentioning

confidence: 99%

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Invasive pneumococcal infection due to serotype 15A after the pneumococcal conjugate vaccine implementation in Turkey

Büyükçam

Güdücüoğlu

Karaman

et al. 2017

Human Vaccines & Immunotherapeutics

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Invasive pneumococcal infections among children are a serious public health problem in many countries, including Turkey. Pneumococcal conjugate vaccine has been included in Turkey's National Immunization Programme since 2009. We report the first two pediatric cases of invasive pneumococcal infection due to non-vaccine serotype 15A after pneumococcal conjugate vaccine implementation in Turkey. It is essential to monitor the countries' own local seroepidemiologic data for detecting selective pressure of non-vaccine serotypes of S. pneumonia.

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Population-based estimates of the burden of pneumonia hospitalizations in Hong Kong, 2011–2015

Blais

Wong

et al. 2019

Eur J Clin Microbiol Infect Dis

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Up-to-date data on the burden of disease are important to identify patients with unmet needs and to optimize healthcare resources. We aimed to characterize the burden of pneumonia hospitalizations in Hong Kong and inform targeted healthcare policies for pneumonia control in the era of global ageing. Methods: This was a population-based study using a territory-wide administrative electronic health record system that covers all public hospitals of Hong Kong. Patients admitted to public hospitals, from 2011 to 2015, with a diagnosis of pneumonia at discharge were identified based on the International Classification of Diseases-Ninth Revision-Clinical Modification codes (480-486 and 487.0). Incidence, inpatient case-fatality, all-cause fatality, 28-days readmission, hospital length of stay, and healthcare costs were assessed for seven age strata. Results: We identified 323,992 patients (median age 80 years, 44.4% female) with hospitalized

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Pneumococcal carriage in young children after introduction of PCV13 in Hong Kong

Cited by 37 publications

References 38 publications

Influence of the pneumococcal conjugate vaccines on the temporal variation of pneumococcal carriage and the nasal microbiota in healthy infants: a longitudinal analysis of a case–control study

Influence of the pneumococcal conjugate vaccines on the temporal variation of pneumococcal carriage and the nasal microbiota in healthy infants: a longitudinal analysis of a case–control study

Invasive pneumococcal infection due to serotype 15A after the pneumococcal conjugate vaccine implementation in Turkey

Population-based estimates of the burden of pneumonia hospitalizations in Hong Kong, 2011–2015

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