Vaccination as infection control: a pilot study to determine the impact of Staphylococcus aureus vaccination on nasal carriage.
BACKGROUND
There is a critical need for an effective Staphylococcus aureus vaccine for the prevention of staphylococcal disease. In this study, we investigated the impact of S. aureus conjugate vaccine comprised of capsular polysaccharides 5 and 8 (CP5, CP8) on nasal colonization with S. aureus.


METHODS
Healthy adults recruited from one academic medical center to participate in a lot consistency trial of StaphVAX (S. aureus capsular polysaccharide 5 and 8 conjugate vaccine) were assessed for S. aureus nasal colonization at two weekly points prior to vaccination and again at six weeks post-vaccination. Serum anti-capsular antibody titers to CP5 and CP8 were obtained prior to vaccination and 42 days post-vaccination and measured by ELISA.


RESULTS
Thirty of 88 enrolled subjects (34%) had S. aureus isolated from at least one of the pre-immunization cultures. Of these, 20 were termed persistent carriers due to two positive cultures one week apart; 19 of the 20 were evaluable at Day 42. Baseline anti-CP8 concentrations were higher in persistent carriers of CP8+ S. aureus; however, baseline anti-CP5 levels were not significantly higher in individuals persistently colonized with CP5+ S. aureus. Statistically significant rises in antibody concentrations were noted after vaccination. At Day 42, 14 of 19 persistent carriers remained colonized; 5 subjects did not have evidence of S. aureus colonization. Ten additional subjects were positive for S. aureus at Day 42 who were not persistently colonized at baseline. Serum antibody concentrations were not statistically different between those with persistent carriage vs. those that lost carriage or those with newly acquired carriage.


CONCLUSIONS
Immune responses to vaccine were brisk and comparable in subjects with or without persistent colonization. Despite a substantial rise in anti-CP5 and anti-CP8 antibody concentrations post-vaccination, S. aureus nasal colonization rates did not significantly change.
Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University School of Medicine and the Monroe Carell, Jr. Children's Hospital at Vanderbilt, United States. buddy.creech@vanderbilt.edu
C Buddy
CB
Creech
B Gayle
BG
Johnson
Andrew R
AR
Alsentzer
Matthew
M
Hohenboken
Kathryn M
KM
Edwards
Thomas R
TR
Talbot
D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D016667:Bacterial Capsules / Q000276:immunology*; D002353:Carrier State / Q000276:immunology; D005260:Female; D006801:Humans; D008297:Male; D009297:Nasal Mucosa / Q000382:microbiology; D010865:Pilot Projects; D011786:Quality Control; D013203:Staphylococcal Infections / Q000276:immunology / Q000517:prevention & control*; D013209:Staphylococcal Vaccines / Q000276:immunology*; D018074:Vaccines, Conjugate / Q000276:immunology
D000907:Antibodies, Bacterial; C423263:StaphVax; D013209:Staphylococcal Vaccines; D018074:Vaccines, Conjugate; C054106:capsular polysaccharide, type 5, Staphylococcus aureus; C064836:capsular polysaccharide, type 8, Staphylococcus aureus