title: Age-specific cluster of cases of serotype 1 Streptococcus pneumoniae carriage in remote indigenous communities in Australia.
abstract: Seven-valent pneumococcal conjugate vaccination commenced in 2001 for Australian indigenous infants. Pneumococcal carriage surveillance detected substantial replacement with nonvaccine serotypes and a cluster of serotype 1 carriage. Our aim was to review Streptococcus pneumoniae serotype 1 carriage and invasive pneumococcal disease (IPD) data for this population and to analyze serotype 1 isolates. Carriage data were collected between 1992 and 2004 in the Darwin region, one of the five regions in the Northern Territory. Carriage data were also collected in 2003 and 2005 from four regions in the Northern Territory. Twenty-six cases of serotype 1 IPD were reported from 1994 to 2007 in the Northern Territory. Forty-four isolates were analyzed by BOX typing and 11 by multilocus sequence typing. In the Darwin region, 26 children were reported carrying serotype 1 (ST227) in 2002 but not during later surveillance. Scattered cases of serotype 1 carriage were noted in two other regions. Cocolonization of serotype 1 with other pneumococcal serotypes was common (34% serotype 1-positive swabs). In conclusion, pneumococcal carriage studies detected intermittent serotype 1 carriage and an ST227 cluster in children in indigenous communities in the Northern Territory of Australia. There was no apparent increase in serotype 1 IPD during this time. The rate of serotype 1 cocolonization with other pneumococcal serotypes suggests that carriage of this serotype may be underestimated.
authors.affiliation: Menzies School of Health Research, Darwin, Australia. heidi@menzies.edu.au
authors.forename: H
authors.initials: H
authors.lastname: Smith-Vaughan
authors.forename: R
authors.initials: R
authors.lastname: Marsh
authors.forename: G
authors.initials: G
authors.lastname: Mackenzie
authors.forename: J
authors.initials: J
authors.lastname: Fisher
authors.forename: P S
authors.initials: PS
authors.lastname: Morris
authors.forename: K
authors.initials: K
authors.lastname: Hare
authors.forename: G
authors.initials: G
authors.lastname: McCallum
authors.forename: M
authors.initials: M
authors.lastname: Binks
authors.forename: D
authors.initials: D
authors.lastname: Murphy
authors.forename: G
authors.initials: G
authors.lastname: Lum
authors.forename: H
authors.initials: H
authors.lastname: Cook
authors.forename: V
authors.initials: V
authors.lastname: Krause
authors.forename: S
authors.initials: S
authors.lastname: Jacups
authors.forename: A J
authors.initials: AJ
authors.lastname: Leach
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001315:Australia / Q000453:epidemiology; D015373:Bacterial Typing Techniques; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D016172:DNA Fingerprinting; D004269:DNA, Bacterial / Q000235:genetics; D005838:Genotype; D006801:Humans; D007223:Infant; D011008:Pneumococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D044382:Population Groups; D017422:Sequence Analysis, DNA; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000145:classification / Q000302:isolation & purification*; D055815:Young Adult; D000095283:Australian Aboriginal and Torres Strait Islander Peoples
chemical_list: D004269:DNA, Bacterial