Pneumococcal Nasopharyngeal Carriage in Young Healthy Children After Pneumococcal Conjugate Vaccine in Turkey

Arvas, Ahmet; Çokuğraş, Haluk; Gür, Emel; Gönüllü, Nevriye; Taner, Zeynep; Tokman, Hrisi Bahar

doi:10.4274/balkanmedj.2016.1256

Cited by 10 publications

(14 citation statements)

References 19 publications

(31 reference statements)

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“…Erythromycin and clindamycin resistance were 43% and 31%, respectively (12). Correlatively with these results, a study by Arvas et al (2017) also determined that, vaccine type serotypes were detected in 12.6% of children who received full-dose PCV13 vaccine and those strains were found penicillin susceptible with the rates of 85.7% (13). In our study, similar to other studies from Turkey, serogroup 19 and 6 were detected frequently.…”

Section: Resultssupporting

confidence: 78%

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Serotype Distribution and Antibiotic Susceptibilities of Clinical Streptococcus pneumoniae Strains

Kurt

Gönüllü

2018

J Basic Clin Health Sci

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Purpose: Streptococcus pneumoniae is a pathogen that cause significant mortality and morbidity in humans. In particular, bacteremia, pneumonia, meningitis and middle ear inflammation. S.pneumoniae can cause many diseases in children and adults. Recently, S.pneumoniae is the most important cause of acute respiratory tract diseases in developing countries. Increasing antibiotic resistance in S.pneumoniae strains has recently gained importance. The aim of our study was to investigate the antimicrobial susceptibility and distribution of pneumococcal serotypes of S.pneumoniae strains isolated in our University Hospital. Methods:In this study we evaluated 80 S.pneumoniae strains isolated from adults and children between September 2012 and September 2013. The isolates were obtained from sputum (n=56), nasal secretions (n=4), throat swabs (n=1), blood (n=9), tracheal aspirat (n=2), conjunctival smear (n=1), bronchoalveolar lavage (n=6), and biopsy (n=1). Seventy-six isolates were from adults and four were from children. Antibiotic susceptibility testing to penicillin were performed on Mueller-Hinton agar supplemented with 5% sheep blood by the E-test method (bioMerieux, France); erythromycin, clindamycin, vancomycin, chloramphenicol, tetracycline, ofloxacine, levofloxacin, trimethoprim/ sulfamethoxazole, rifampin, linezolid, and oxacillin susceptibilities performed by disc diffusion method and 7-10-13-valent Pneumotest-Latex (Statens Serum Institude, Denmark) kit was used for serotyping.Results: A total of 39/80 isolates (48.75%) were intermediate, and 5/80 (6.25%) were resistant to penicillin according to Clinical & Laboratory Standards Institude (CLSI) guidelines for oral penicillin. Penicillin resistance was not found for parenteral penicillin. Resistance rates of erythromycin, clindamycin, vancomycin, chloramphenicol, tetracycline, ofloxacine, levofloxacin, trimethoprim/sulfamethoxazole, rifampin, and linezolid were as 31.25%, 21.25%, 0%, 5%, 28.75%, 15%, 2.5%, 45%, 0%, and 0% respectively. The most common S.pneumoniae serotypes were determined as serotypes 19, 6, and 23. Serotyping showed serotype 19 to be the leading serotype among the macrolide-resistant isolates, and serotype coverage of 7-10-13-valent pneumococcal vaccine was 68.75%. Conclusion:The increase in intermediate penicillin resistance in S.pneumoniae in our hospital should be monitored carefully and the distribution of pneumococcal serotypes is similar to countries where the Pneumococcal Conjugate Vaccine (PCV) has been introduced.

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Section: Resultssupporting

confidence: 78%

“…vaccine type serotypes were detected in 12.6% of children who received full-dose PCV13 vaccine and those strains were found penicillin susceptible with the rates of 85.7%(13). In our study, similar to other studies from Turkey, serogroup 19 and 6 were detected frequently.…”

supporting

confidence: 89%

Serotype Distribution and Antibiotic Susceptibilities of Clinical Streptococcus pneumoniae Strains

Kurt

Gönüllü

2018

J Basic Clin Health Sci

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“…Current and prior antibiotic use was protective against pneumococcal carriage in some low, upper-middle, and high-income country studies [14, 15, 46, 63, 66, 74-81, 84, 92, 101, 107, 109, 113, 115]. However other studies reported no association between prior antibiotic use and pneumococcal carriage [36,37,40,41,45,47,52,60,70,78,82,93,97,104]. Further, one study reported that antibiotic use in the month preceding the survey was positively associated with carriage, but not at the time of the study [107].…”

Section: Demographicmentioning

confidence: 99%

Factors associated with pneumococcal nasopharyngeal carriage: A systematic review

Neal

Chan

Nguyen

et al. 2022

PLOS Glob Public Health

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Pneumococcal disease is a major contributor to global childhood morbidity and mortality and is more common in low- and middle-income countries (LMICs) than in high-income countries. Pneumococcal carriage is a prerequisite for pneumococcal disease. Pneumococcal conjugate vaccine reduces vaccine-type carriage and disease. However, pneumococcal carriage and disease persist, and it is important to identify other potentially modifiable factors associated with pneumococcal carriage and determine if risk factors differ between low, middle, and high-income countries. This information may help inform pneumococcal disease prevention programs. This systematic literature review describes factors associated with pneumococcal carriage stratified by country income status and summarises pneumococcal carriage rates for included studies. We undertook a systematic search of English-language pneumococcal nasopharyngeal carriage studies up to 30th June 2021. Peer-reviewed studies reporting factors associated with overall pneumococcal nasopharyngeal carriage in healthy, community-based study populations were eligible for inclusion. Two researchers independently reviewed studies to determine eligibility. Results are presented as narrative summaries. This review is registered with PROSPERO, CRD42020186914. Eighty-two studies were included, and 46 (56%) were conducted in LMICs. There was heterogeneity in the factors assessed in each study. Factors positively associated with pneumococcal carriage in all income classification were young age, ethnicity, symptoms of respiratory tract infection, childcare attendance, living with young children, poverty, exposure to smoke, season, and co-colonisation with other pathogens. Breastfeeding and antibiotic use were protective against carriage in all income classifications. Median (interquartile range) pneumococcal carriage rates differed by income classification, ranging from 51% (19.3–70.2%), 38.5% (19.3–51.6%), 31.5% (19.0–51.0%), 28.5% (16.8–35.4%), (P = 0.005) in low-, lower-middle, upper-middle, and high-income classifications, respectively. Our findings suggest that where measured, factors associated with pneumococcal nasopharyngeal carriage are similar across income classifications, despite the highest pneumococcal carriage rates being in low-income classifications. Reducing viral transmission through vaccination and public health interventions to address social determinants of health would play an important role.

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“…Immunization with the pneumococcal conjugate vaccine (PCV) has substantially reduced NP carriage and invasive pneumococcal disease caused by serotypes represented in the vaccine (12,13). In addition, the introduction of PCV has resulted in a reduction in antimicrobial resistant pneumococci amongst circulating strains due to the inclusion of serotypes associated with high antibiotic resistance in the conjugate vaccine (14).…”

Section: Introductionmentioning

confidence: 99%

Characterization of Pneumococcal Colonization Dynamics and Antimicrobial Resistance Using Shotgun Metagenomic Sequencing in Intensively Sampled South African Infants

Manenzhe

Dube

Wright

et al. 2020

Front. Public Health

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Background: There remains a significant proportion of deaths due to pneumococcal pneumonia in infants from low-and middle-income countries despite the marginal global declines recorded in the past decade. Monitoring changes in pneumococcal carriage is key to understanding vaccination-induced shifts in the ecology of carriage, patterns of antimicrobial resistance, and impact on health. We longitudinally investigated pneumococcal carriage dynamics in PCV-13 vaccinated infants by collecting nasopharyngeal (NP) samples at 2-weekly intervals from birth through the first year of life from 137 infants. As a proof of concept, 196 NP samples were retrieved from a subset of 23 infants to explore strain-level pneumococcal colonization patterns and associated antimicrobial-resistance determinants. These were selected on the basis of changes in serotype and antibiogram over time. NP samples underwent short-term enrichment for streptococci prior to total nucleic acid extraction and whole metagenome shotgun sequencing (WMGS). Reads were assembled and aligned to pneumococcal reference genomes for the extraction of pneumococcal and non-pneumococcal bacterial reads. Pneumococcal contigs were aligned to the Antibiotic Resistance Gene-ANNOTation database of acquired AMR genes. In silico pneumococcal capsular and multilocus sequence typing were performed. Results: Of the 196 samples sequenced, 174 had corresponding positive cultures for pneumococci, of which, 152 were assigned an in silico serotype. Metagenomic sequencing detected a single pneumococcal serotype in 85% (129/152), and co-colonization in 15% (23/152) of the samples. Twenty-two different pneumococcal Manenzhe et al. Pneumococcal Colonization Dynamics in a Birth Cohort serotypes were identified, with 15B/15C and 16F being the most common non-PCV13 serotypes, while 23F and 19A were the most common PCV13 serotypes. Twenty-six different sequence types (STs), including four novel STs were identified in silico. Mutations in the folA and folP genes, associated with cotrimoxazole resistance, were detected in 89% (87/98) of cotrimoxazole-non-susceptible pneumococci, as well as in the pbp1a and pbp2x genes, in penicillin non-susceptible ST7052 15B/15C isolates. Conclusions: Metagenomic sequencing of NP samples is a valuable culture-independent technique for a detailed evaluation of the pneumococcal component and resistome of the NP microbiome. This method allowed for the detection of novel STs, as well as co-colonization, with a predominance of non-PCV13 serotypes in this cohort. Forty-eight resistance genes, as well as mutations associated with resistance were detected, but the correlation with phenotypic non-susceptibility was lower than expected.

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Pneumococcal Nasopharyngeal Carriage in Young Healthy Children After Pneumococcal Conjugate Vaccine in Turkey

Cited by 10 publications

References 19 publications

Serotype Distribution and Antibiotic Susceptibilities of Clinical Streptococcus pneumoniae Strains

Serotype Distribution and Antibiotic Susceptibilities of Clinical Streptococcus pneumoniae Strains

Factors associated with pneumococcal nasopharyngeal carriage: A systematic review

Characterization of Pneumococcal Colonization Dynamics and Antimicrobial Resistance Using Shotgun Metagenomic Sequencing in Intensively Sampled South African Infants

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