Serotypes and antibacterial susceptibility of pneumococci isolated from children with infections in Ankara in relation to proposed pneumococcal vaccine coverage.
BACKGROUND
Streptococcus pneumoniae is an important pathogen for both children and adults. Although there is an effective vaccine, it is not protective under 2 years of age and common serotypes differ from one location to another.


METHODS
A total of 44 Streptococcus pneumoniae isolates were recovered from clinical specimens of children in various hospitals in Ankara, Turkey. All isolates were serotyped and evaluated for vaccine coverage and tested for antibacterial susceptibility.


RESULTS
There were 23 different serotypes with a predominance of serotypes 6A, 14, 19F and 23F. The nine-valent conjugate vaccine, which has been proposed for use in young children, covers 90.4% of isolations in children < 2 years of age. This coverage decreases to 43.4% after 2 years of age. The coverage of 23-valent vaccine is better than that of the conjugate vaccine (60.8% vs 43.4%, P < 0.05). Two relatively common and resistant types in our isolates (10A and 21) are not included in either vaccines and adding these serotypes into the 23-valent vaccine was suggested. Although the rate of intermediately penicillin resistant strains was 31.8%, highly penicillin resistant strains were not found in the present study.


CONCLUSIONS
The usefulness of conjugate vaccine before 2 years of age and appropriate choice of vaccine strains to include all resistant serotypes for older children in our region, is discussed. It is shown that conjugated vaccine is protective in children less than 2 years of age, but a booster with 23-valent vaccine will be needed once they are older than 2.
Kanra
G
G
Department of Pediatric Infectious Diseases, Hacettepe University, School of Medicine, Ankara, Turkey. gkania@gen.hun.edu.tr
Erdem
G
G
Ceyhan
M
M
Klugman
K P
KP
Vasas
A
A
D001428:Bacterial Vaccines / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D004352:Drug Resistance, Microbial; D006801:Humans; D007223:Infant; D008826:Microbial Sensitivity Tests; D011008:Pneumococcal Infections / Q000382:microbiology* / Q000517:prevention & control; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification* / Q000187:drug effects / Q000276:immunology; D014421:Turkey; D018074:Vaccines, Conjugate / Q000276:immunology*
D001428:Bacterial Vaccines; D018074:Vaccines, Conjugate