title: Nasopharyngeal carriage of Streptococcus pneumoniae in healthy children: implications for the use of heptavalent pneumococcal conjugate vaccine.
abstract: We assessed the prevalence of Streptococcus pneumoniae serotypes in the nasopharynx of healthy children, antimicrobial susceptibility patterns, risk factors for carriage, and the coverage of heptavalent pneumococcal conjugate vaccine. In 2,799 healthy infants and children, the S. pneumoniae carrier rate was 8.6% (serotypes 3, 19F, 23F, 19A, 6B, and 14 were most common). Most pneumococci (69.4%) were resistant to one or more antimicrobial classes. The rate of penicillin resistance was low (9.1%); macrolide resistance was high (52.1%). Overall, 63.2% of the isolates belonged to strains covered by the heptavalent pneumococcal vaccine. This percentage was higher in children <2 years old (73.1%) and in those ages 2-5 years (68.9%). Sinusitis in the previous 3 months was the only risk factor for carrier status; acute otitis media was the only risk factor for the carriage of penicillin-resistant S. pneumoniae. Most isolated strains are covered by the heptavalent conjugate vaccine, especially in the first years of life, suggesting that its use could reduce the incidence of pneumococcal disease.
authors: University of Milan, Via Commenda 9, 20122 Milan, Italy.
authors: Paola
authors: P
authors: Marchisio
authors: Susanna
authors: S
authors: Esposito
authors: Gian Carlo
authors: GC
authors: Schito
authors: Anna
authors: A
authors: Marchese
authors: Roberta
authors: R
authors: Cavagna
authors: Nicola
authors: N
authors: Principi
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D006801:Humans; D007223:Infant; D007769:Lactams; D018942:Macrolides; D009666:Nose / Q000382:microbiology*; D010614:Pharynx / Q000382:microbiology*; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000276:immunology / Q000627:therapeutic use*; D015995:Prevalence; D012307:Risk Factors; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents; D007769:Lactams; D018942:Macrolides; D022242:Pneumococcal Vaccines