scholarly journals How nasopharyngeal pneumococcal carriage evolved during and after a PCV13-to-PCV10 vaccination programme switch in Belgium, 2016 to 2018

2020 ◽  
Vol 25 (5) ◽  
Author(s):  
Ine Wouters ◽  
Stefanie Desmet ◽  
Liesbet Van Heirstraeten ◽  
Sereina A Herzog ◽  
Philippe Beutels ◽  
...  
Keyword(s):  
Vaccination Programme ◽  
Disease Surveillance ◽  
Pneumococcal Disease ◽  
Pneumococcal Vaccination ◽  
Disc Diffusion ◽  
Vaccine Serotypes ◽  
Pneumococcal Carriage ◽  
Set Up ◽  
Quellung Reaction ◽  
Carriage Prevalence

Background The current carriage study was set up to reinforce surveillance during/after the PCV13-to-PCVC10 switch in Belgium. Aim This observational study monitored carriage of Streptococcus pneumoniae (Sp) serotypes, particularly those no longer covered (3, 6A, 19A), as well as Haemophilus influenzae (Hi), because PCV10 contains the non-typeable Hi protein D. Methods A total of 2,615 nasopharyngeal swabs from children (6–30 months old) attending day care were collected in three periods over 2016–2018. Children’s demographic and clinical characteristics and vaccination status were obtained through a questionnaire. Sp and Hi were identified by culture and PCR. Pneumococcal strains were tested for antimicrobial (non-)susceptibility by disc diffusion and serotyped by Quellung-reaction (Quellung-reaction and PCR for serotypes 3, 6A, 19A). Results The carriage prevalence of Sp (> 75%) remained stable over the successive periods but that of Hi increased (87.4%, 664 Hi-carriers/760 in 2016 vs 93.9%, 895/953 in 2017–2018). The proportion of non-PCV13 vaccine serotypes decreased (94.6%, 438 isolates/463 in 2016 vs 89.7%, 599/668 in 2017–2018) while that of PCV13-non-PCV10 vaccine serotypes (3 + 6A + 19A) increased (0.9%, 4 isolates/463 in 2016 vs 7.8%, 52/668 in 2017–2018), with serotype 19A most frequently identified (87.9%, 58/66 isolates). Non-susceptibility of pneumococci against any of the tested antibiotics was stable over the study period (> 44%). Conclusions During and after the PCV13-to-PCV10 vaccine switch, the proportion of non-PCV13 serotypes decreased, mainly due to a serotype 19A carriage prevalence increase. These results complement invasive pneumococcal disease surveillance data, providing further basis for pneumococcal vaccination programme policy making.

Incidence of Invasive Pneumococcal Disease Higher Among People Notified With Markers of Hepatitis C Virus Infection: Population-based Surveillance in Victoria, Australia, 2001–2017

2020 ◽  
Author(s):  
Katherine B Gibney ◽  
Jennifer MacLachlan ◽  
Rachel Coutts ◽  
Nasra Higgins ◽  
Janet Strachan
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
General Population ◽  
Virus Infection ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Pneumococcal Vaccination ◽  
Hepatitis C Virus Infection ◽  
Hepatitis C Infection ◽  
Vaccine Serotypes

Abstract Background Worse outcomes from invasive pneumococcal disease (IPD) have been reported among those coinfected with hepatitis C. We aimed to establish if IPD notification rates are higher among people notified with markers of hepatitis C virus infection than the general population. Methods IPD cases notified in Victoria, Australia, from July 2001–December 2017 were linked with hepatitis C cases (diagnosed by serology or PCR testing) notified from January 1991–December 2017. IPD incidence was calculated using population data and the estimated number of Victorians with hepatitis C. Results From July 2001–December 2017, 6407 IPD cases were notified. Hepatitis C infection was notified in 342 (5.3%) of IPD cases overall, and 24.4% among IPD cases aged 45–49 years. Among IPD cases also notified with hepatitis C, 55.3% were infected with 13-valent pneumococcal conjugate vaccine serotypes and 82.8% with 23-valent pneumococcal polysaccharide vaccine serotypes. Compared with IPD cases without hepatitis C, IPD cases also notified with hepatitis C were younger (mean age, 45.7 vs 49.4 years; P = .011) and more often male (65.5% vs 55.5%, P < .001). Annual IPD notification incidence was 6.8/100 000 among people without hepatitis C and 39.4/100 000 among people with hepatitis C (IRR, 5.8; 95% CI, 5.2–6.4; P < .001). Conclusions IPD notification incidence was 5 times higher among people notified with markers of hepatitis C than the general population. Pneumococcal vaccination should be offered to people with markers of hepatitis C virus infection. To facilitate appropriate treatment, young and middle-aged adults with IPD should be tested for hepatitis C.

scholarly journals 89Factors associated with pneumococcal nasopharyngeal carriage: a systematic review

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Eleanor Neal ◽  
Jocelyn Chan ◽  
Fiona M. Russell ◽  
Cattram. D Nguyen
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Low Income ◽  
Pneumococcal Disease ◽  
High Income ◽  
Study Quality ◽  
Nasopharyngeal Carriage ◽  
Factors Associated ◽  
Pneumococcal Carriage ◽  
Carriage Prevalence

Abstract Background Pneumococcal disease is a major contributor to global childhood morbidity and mortality. Pneumococcal carriage is a prerequisite for pneumococcal disease. Identifying factors associated with pneumococcal carriage can aid public health intervention programs. It is unknown if risk factors for pneumococcal carriage differ between low, middle, and high-income countries. We present preliminary findings of our systematic review of factors associated with pneumococcal carriage in community settings, in all ages. Methods A systematic search for pneumococcal nasopharyngeal carriage studies, published in English before July 2019. Two researchers independently reviewed studies that described factors associated with pneumococcal nasopharyngeal carriage. Study quality was assessed using the NIH Study Quality Assessment Tools. Results are presented as narrative summaries due to heterogeneity amongst factor definitions. Results Preliminary results are shown. Sixty-seven studies were included. 49% were conducted in high-income countries. Pneumococcal prevalence ranged from 0.3%-97%, 2.6%-89.6%, 14%-73%, 1.6%-82.4% in low-, lower-middle, upper-middle, and high-income classifications. Age, respiratory tract infection symptoms, living with young children, poverty, exposure to smoke, and season were positively associated with pneumococcal carriage in all income classifications. Conclusions Pneumococcal carriage prevalence was highest in low-income classifications. Pneumococcal carriage is associated with similar factors across income classifications. Differences in prevalence of risk factors associated with pneumococcal carriage by income classification may contribute to differences in carriage prevalence by income classifications. Key messages Pneumococcal carriage is considered a prerequisite for pneumococcal disease. Pneumococcal carriage prevalence is highest in low-income countries, however preliminary results suggest risk factors for carriage may be similar across income classifications.

scholarly journals Serotype patterns of pneumococcal disease in adults are correlated with carriage patterns in older children

2019 ◽  
Author(s):  
Anne L. Wyllie ◽  
Joshua L. Warren ◽  
Gili Regev-Yochay ◽  
Noga Givon-Lavi ◽  
Ron Dagan ◽  
...  
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Age Groups ◽  
Deviance Information Criterion ◽  
Information Criterion ◽  
Older Children ◽  
Disease Patterns ◽  
Pneumococcal Carriage ◽  
Age Related ◽  
Carriage Prevalence

ABSTRACTBackgroundThe importance of specific serotypes causing invasive pneumococcal disease (IPD) differs by age. Data on pneumococcal carriage in different age groups, along with data on serotype-specific invasiveness, could help to explain these age-related patterns and their implications for vaccination.MethodsUsing pneumococcal carriage and disease data from Israel, we evaluated the association between serotype-specific IPD in adults and serotype-specific carriage prevalence among children in different age categories, while adjusting for serotype-specific invasiveness. We used a sliding window approach to estimate carriage prevalence using different age groupings. Deviance Information Criterion was used to determine which age groupings of carriage data best fit the adult IPD data. Serotype-specific disease patterns were further evaluated by stratifying IPD data by comorbidity status.ResultsThe relative frequency of serotypes causing IPD differed between adults and children, and also differed between older and younger adults and between adults with and without comorbidities. Serotypes over-represented as causes of IPD in adults were more commonly carried in older children as compared to younger children. In line with this, the serotype-specific frequency of carriage in older children (aged 36-59 months), rather than infants, best correlated with serotype-specific IPD in adults.ConclusionsThese analyses suggest that older children, rather than infants, are the main drivers of disease patterns in adults. These insights could help in optimizing vaccination strategies to reduce disease burden across all ages.40-word summary of the article’s main pointSerotype-specific rates of invasive pneumococcal disease in adults are better correlated with serotype-specific carriage patterns in older children (36-59 months of age) than those in infants.

scholarly journals Carriage burden, multiple colonization and antibiotic pressure promote emergence of resistant vaccine escape pneumococci

2015 ◽  
Vol 370 (1670) ◽  
pp. 20140342 ◽  
Author(s):  
Patrick K. Mitchell ◽  
Marc Lipsitch ◽  
William P. Hanage
Keyword(s):  
Antibiotic Resistance ◽  
Streptococcus Pneumoniae ◽  
Dynamic Model ◽  
Pneumococcal Disease ◽  
Pneumococcal Vaccination ◽  
Stochastic Dynamic ◽  
Conjugate Vaccines ◽  
High Burden ◽  
Pneumococcal Carriage ◽  
Low Levels

Pneumococcal conjugate vaccines target the limited subset of the more than 90 known serotypes of Streptococcus pneumoniae responsible for the greatest burden of pneumococcal disease and antibiotic resistance. Following the introduction of these vaccines, serotypes not targeted were able to expand and resistance became more common within these types. Here we use a stochastic dynamic model of pediatric pneumococcal carriage to evaluate potential influences on the emergence of new resistant lineages following the introduction of a vaccine targeting more common resistant types. Antibiotic pressure was the strongest driver, with no emergence at low levels and universal emergence at high levels. At intermediate levels of antibiotic pressure, higher carriage burden and a greater degree of dual carriage promoted emergence. This may have implications for current plans to introduce childhood pneumococcal vaccination in several high-burden countries.

scholarly journals Serotype Patterns of Pneumococcal Disease in Adults Are Correlated With Carriage Patterns in Older Children

2020 ◽  
Author(s):  
Anne L Wyllie ◽  
Joshua L Warren ◽  
Gili Regev-Yochay ◽  
Noga Givon-Lavi ◽  
Ron Dagan ◽  
...  
Keyword(s):  
Pneumococcal Disease ◽  
A Priori ◽  
Age Groups ◽  
Deviance Information Criterion ◽  
Information Criterion ◽  
Older Children ◽  
Disease Patterns ◽  
Pneumococcal Carriage ◽  
Age Related ◽  
Carriage Prevalence

Abstract Background The importance of specific serotypes causing invasive pneumococcal disease (IPD) differs by age. Data on pneumococcal carriage in different age groups, along with data on serotype-specific invasiveness, could help explain these age-related patterns and their implications for vaccination. Methods Using pneumococcal carriage and disease data from Israel, we evaluated the association between serotype-specific IPD in adults and serotype-specific carriage prevalence among children in different age categories, while adjusting for serotype-specific invasiveness. We estimated carriage prevalence using different age groupings that were selected a priori. The Deviance Information Criterion was used to determine which age groupings of carriage data best fit the adult IPD data. Serotype-specific disease patterns were further evaluated by stratifying IPD data by comorbidity status. Results The relative frequency of serotypes causing IPD differed between adults and children, and also differed between older and younger adults and between adults with and without comorbidities. Serotypes overrepresented as causes of IPD in adults were more commonly carried in older children compared with younger children. In line with this, the serotype-specific frequency of carriage in older children, rather than infants, best correlated with serotype-specific IPD in adults. Conclusions These analyses demonstrate that the serotype patterns in carriage in older children, rather than infants, are best correlated with disease patterns in adults. This might suggest these older children are more influential for disease patterns in adults. These insights could help in optimizing vaccination strategies to reduce disease burden across all ages.

scholarly journals Pneumococcal vaccination for HIV-infected individuals in Singapore

2018 ◽  
Vol 28 (1) ◽  
pp. 55-60 ◽  
Author(s):  
Paul V Licciardi ◽  
Eng Lee Tan ◽  
Peng Li ◽  
Oon Tek Ng
Keyword(s):  
High Risk ◽  
Pneumococcal Disease ◽  
Healthcare Professionals ◽  
Pneumococcal Vaccination ◽  
High Risk Group ◽  
Pneumococcal Carriage ◽  
Immunodeficiency Virus ◽  
Significant Burden ◽  
High Risk Populations ◽  
Key Issues

Susceptibility to infections with pneumococcal bacteria ( Streptococcus pneumoniae) is substantially higher among human immunodeficiency virus (HIV)-infected individuals, and accounts for a significant burden of morbidity and healthcare costs. Pneumococcal vaccination is recommended in most countries for HIV-infected adults. Current policy in Singapore and Australia recommends the use of the 23-valent pneumococcal polysaccharide vaccine (PPSV23) as a booster dose following the use of 13-valent pneumococcal conjugate vaccine (PCV13). Despite this, adherence to this policy has been suboptimal in Singapore. This may be related to the fact that PPSV23 has not been shown to have any impact on pneumococcal carriage (the necessary prerequisite for disease development). PPSV23 has also been associated with immune hyporesponsiveness, raising concerns over the use of this vaccine globally and, in particular, in high-risk populations. The lack of data from studies comparing PCV13 and PPSV23 has also contributed to the suboptimal uptake of pneumococcal vaccines by healthcare professionals for HIV-infected individuals. This review article discusses the key issues and importance of rigorous pneumococcal vaccination programmes for HIV-infected individuals. Current recommendations for pneumococcal vaccination of HIV-infected individuals in Singapore should be adopted more readily to reduce the burden of pneumococcal disease in this high-risk group.

scholarly journals Burden of paediatric invasive pneumococcal disease in Europe, 2005

2006 ◽  
Vol 135 (4) ◽  
pp. 644-656 ◽  
Author(s):  
E. D. G. McINTOSH ◽  
B. FRITZELL ◽  
M. A. FLETCHER
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Disease Surveillance ◽  
Pneumococcal Disease ◽  
Disease Incidence ◽  
Pneumococcal Vaccination ◽  
Epidemiological Data ◽  
Antibiotic Prescribing ◽  
The European Union ◽  
Year 2000 ◽  
The Eu

SUMMARYWithin the European Union (EU), documenting the burden of invasive pneumococcal disease (IPD) in infants and children is important for coordinating effective pneumococcal immunization policies. Our objective was to document the burden of IPD in countries of the EU plus Switzerland and Norway. European affiliates of Wyeth Vaccines made available recent epidemiological data on IPD from local disease surveillance programmes, including unpublished sources. Recent literature and websites were also searched to provide as wide a representation as possible. This included OVID and abstracts from a number of international meetings, dating from the year 2000. The reported rates of paediatric IPD per 100 000 (age) ranged from a low of 1·7 (<2 years) to 4·2 (2–15 years) in Sweden to a high of 93·5 to 174 (<2 years) to 56·2 (<5 years) in Spain. The percentage of circulating serotypes causing IPD that are covered by 7-valent pneumococcal conjugate vaccine (PCV) IPD serotype coverage ranged from 60% to 80% for European children aged <2 years. Under reporting, differences in reporting methods, antibiotic prescribing and disparities in blood-culturing practices may explain the differences in reported disease incidence. Because of the excellent clinical efficacy of the PCV against IPD, national pneumococcal vaccination programmes in Europe have the potential to prevent much morbidity and mortality.

scholarly journals Nasopharyngeal carriage of Streptococcus pneumoniae among healthy children in Kassena-Nankana districts of Northern Ghana

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Deborah K. Narwortey ◽  
Alex Owusu-Ofori ◽  
Hans-Christian Slotved ◽  
Eric S. Donkor ◽  
Patrick O. Ansah ◽  
...  
Keyword(s):  
Disease Surveillance ◽  
Cross Sectional Study ◽  
Latex Agglutination ◽  
Northern Ghana ◽  
Healthy Children ◽  
Carriage Rate ◽  
Cross Sectional ◽  
Vaccine Serotypes ◽  
Pneumococcal Carriage ◽  
The Impact

Abstract Background Pneumococcal vaccine immunizations may be responsible for alterations in serotype epidemiology within a region. This study investigated the pneumococcal carriage prevalence and the impact of the 13-valent pneumococcal conjugate vaccine (PCV-13) on circulating serotypes among healthy children in Northern Ghana. Methods This was a cross sectional study conducted in the Kassena-Nankana districts of Northern Ghana from November to December during the dry season of 2018. Nasopharyngeal swabs collected from 193 participants were cultured per standard microbiological protocols and pneumococcal isolates were serotyped using the latex agglutination technique and the capsular Quellung reaction test. We examined for any association between the demographic characteristics of study participants and pneumococcal carriage using chi-square test and logistic regression. Results Of the 193 participants that were enrolled the mean age was 8.6 years and 54.4% were females. The carriage rate among the participants was 32.6% (63/193), and twenty different serotypes were identified. These included both vaccine serotypes (VT), 35% (7/20) and non-vaccine serotypes (NVT), 65% (13/20). The predominant serotypes (34 and 11A), both of which were NVT, accounted for a prevalence of 12.8%. PCV-13 covered only 35% of serotypes identified whiles 40% of serotypes are covered by PPV 23. Conclusion Post-vaccination carriage of S. pneumoniae is high and is dominated by non-vaccine serotypes. There is therefore a need for the conduct of invasive pneumococcal disease surveillance (IPD) to find out if the high non-vaccine serotype carriage translates to disease. And in addition, a review of the currently used PCV-13 vaccine in the country would be considered relevant.

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