Details:

Alternative Title:
Pediatr Infect Dis J
Publisher's site:
http://dx.doi.org/10.1097/INF.0000000000000856
Personal Author:
Gounder, Prabhu P. ; Brewster, Melissa ; Bruce, Michael G. ; Bruden, Dana JT. ; Rudolph, Karen ; ... More +
Gounder, Prabhu P. ; Brewster, Melissa ; Bruce, Michael G. ; Bruden, Dana JT. ; Rudolph, Karen ; Hurlburt, Debby A. ; Hennessy, Thomas W. Less -
Description:
Background

We describe the relative impact of the heptavalent pneumococcal conjugate vaccine (PCV7, introduced 2001) and antibiotic use on colonization by antibiotic resistant pneumococci in urban Alaskan children during 2000–2010.

Methods

We obtained nasopharyngeal swab specimens from a convenience sample of children aged <5 years at clinics annually during 2000–2004 and 2008–2010. PCV7 status and antibiotic use <90 days before enrollment was determined by interview/medical records review. Pneumococci were characterized by serotype and susceptibility to penicillin (PCN). Isolates with full PCN resistance (PCN-R) or intermediate PCN resistance (PCN-I) were classified as PCN-NS.

Results

We recruited 3,496 children (median: 452/year). During 2000–2010, a range of 18–29%/year of children used PCN/amoxicillin (p-value for trend [p] = 0.09); the proportion age-appropriately vaccinated with PCV7 increased (0%–90%; p <0.01). Among pneumococcal isolates, the PCV7-serotype proportion decreased (53%–<1%; p <0.01) and non-PCV7–serotype proportion increased (43%–95%; p <0.01). PCN-R pneumococcal colonization prevalence decreased (23%–9%, p <0.01) and PCN-I pneumococcal colonization prevalence increased (13%–24%, p <0.01); overall PCN-NS pneumococcal colonization prevalence was unchanged. PCN-NS among colonizing PCV7-type and non-PCV7-type pneumococci remained unchanged; a mean of 31%/year of PCV7-type and 10%/year of non-PCV7-type isolates were PCN-R, and 10%/year of PCV7 and 20%/year of non-PCV7-type isolates were PCN-I.

Conclusions

Overall PCN-NS pneumococcal colonization remained unchanged during 2000–2010 because increased colonization by predominantly PCN-I non-PCV7 serotypes offset decreased colonization by predominantly PCN-R PCV7 serotypes. Proportion PCN-NS did not increase within colonizing pneumococcal serotype-groups (PCV7 versus non-PCV7) despite stable penicillin use in our population.


Subject:
[+]
Article
Carrier State
Child, Preschool
Cross-Sectional Studies
Drug Resistance, Bacterial
Female
Humans
Infant
Infant, Newborn
Male
Nasopharynx
Penicillins
Pneumococcal Infections
Pneumococcal Vaccines
Streptococcus Pneumoniae
Vaccination
Vaccines, Conjugate

Source:
Pediatr Infect Dis J. 34(11):1223-1229.
Pubmed ID:
26226443
Pubmed Central ID:
PMC4604058
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHS/United States
Place as Subject:
Alaska
Collection(s):
Arctic Investigations Program
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:f4c60887fc4728a08a600255b18110e659e5b85b50125087e0457a5150265e36
File Type:

Supporting Files

• 	NIHMS719620-supplement-supplement_1.pdf	pdf
  	nihms719620.nxml	txt
  	nihms719620f1.gif	gif
  	nihms719620f1.jpg	jpeg
  	nihms719620f2.gif	gif
  	nihms719620f2.jpg	jpeg

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