Serotypes of carriage and invasive isolates of Streptococcus pneumoniae in Brazilian children in the era of pneumococcal vaccines.
Nasopharyngeal carriage of Streptococcus pneumoniae is a key factor in the development of invasive disease and the spread of resistant strains within the community. A single nasopharyngeal swab was obtained from 648 unvaccinated children aged <5 years, either healthy or with acute respiratory tract infection or meningitis, during the winters of 2000 and 2001. The overall pneumococcal carriage rate was 35.8% (95% CI 32.1-39.6). The pneumococcal serotypes found most frequently in the nasopharynx were 14, 6B, 6A, 19F, 10A, 23F and 18C, which included five of the seven serotypes in the currently licensed seven-valent conjugate vaccine (PCV7); serotypes 4 and 9V were less common. Serotypes 1 and 5 were isolated rarely from the nasopharynx. A comparison of 222 nasopharyngeal isolates with 125 invasive isolates, matched for age and time to the carrier isolates, showed a similar prevalence of penicillin non-susceptible pneumococci (PNSp) (19.8% and 19.2%, respectively). PNSp serotypes were similar (6B, 14, 19F, 19 A, 23B and 23F) for carriage and invasive disease isolates. The coverage of PCV7 for carriage isolates (52.2%) and invasive isolates (62.4%) did not differ significantly (p 0.06); similarly, there was no significant difference in PCV7 coverage for carriage isolates (34.5%) and invasive isolates (28.2%) of PNSp. These data suggest that PCV7 has the potential to reduce pneumococcal carriage and the number of carriers of PNSp belonging to vaccine serotypes.
Laval
C B
CB
Communicable Disease Surveillance, Secretariat of Health of the Municipality of Goiânia, Brazil.
de Andrade
A L S S
AL
Pimenta
F C
FC
de Andrade
J G
JG
de Oliveira
R M
RM
Silva
S A
SA
de Lima
E C
EC
Fabio
J L
JL
Casagrande
S T
ST
Brandileone
M C C
MC
D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001938:Brazil / Q000453:epidemiology; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009305:Nasopharynx / Q000382:microbiology; D010403:Penicillin Resistance; D010406:Penicillins / Q000494:pharmacology; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000382:microbiology; D022242:Pneumococcal Vaccines / Q000008:administration & dosage; D015995:Prevalence; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification* / Q000187:drug effects / Q000302:isolation & purification / Q000472:pathogenicity; D014611:Vaccination; D018074:Vaccines, Conjugate / Q000008:administration & dosage
D000900:Anti-Bacterial Agents; D010406:Penicillins; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate