title: A decade-long surveillance of nasopharyngeal colonisation with Streptococcus pneumoniae among children attending day-care centres in south-eastern France: 1999-2008.
abstract: The antimicrobial resistance and serotype distribution of Streptococcus pneumoniae (SP) among children attending day-care centres in south-eastern France were monitored from 1999 to 2008, before and after interventions promoting prudent antibiotic use initiated in 2000 and the availability of pneumococcal conjugate vaccine in 2003. Antibiotic susceptibility and serotypes of SP isolates were determined on nasopharyngeal samples of children aged 3-40 months attending day-care centres, from January to March 1999, 2002, 2004, 2006 and 2008. SP carriage fell from 54% to 45%, and SP with diminished susceptibility to penicillin (PDSP) fell from 34% to 19%. Antibiotic prescriptions dropped from 63% to 38% of children, but third-generation cephalosporins were increasingly prescribed. The overall antibiotic susceptibility increased. Over 90% of the children had received at least one vaccine dose in 2008. Vaccine serotypes 6B, 9V, 19F and 23F (76%) in 1999 were replaced by non-vaccine types (95%) in 2008, among which were 15 (20%), 19A (15%), 23A/B (10%) and 6A (9%). Serotypes 6A, 19A and 15 accounted for over 50% of PDSP strains in 2008 versus 6% in 1999. Children now mostly harbour non-vaccine types; however, PDSP isolates are mainly recruited among these. Vaccine-related benefits may be threatened by combined vaccine- and antibiotic-driven selective pressure.
authors: Public Health Department, Hôpital de l'Archet, CHU de Nice, BP 3079, 06202, Nice cedex 3, France. dunais.b@chu-nice.fr
authors: B
authors: B
authors: Dunais
authors: P
authors: P
authors: Bruno-Bazureault
authors: H
authors: H
authors: Carsenti-Dellamonica
authors: P
authors: P
authors: Touboul
authors: C
authors: C
authors: Pradier
references: Lancet. 2001 Jun 9;357(9271):1851-3
references: 11410197
references: PLoS Med. 2009 Jun 2;6(6):e1000080
references: 19492081
references: Pediatr Infect Dis J. 2008 Jun;27(6):519-25
references: 18469733
references: Euro Surveill. 2008 Aug 28;13(35):
references: 18761883
references: Vaccine. 2010 Aug 23;28(37):6114-21
references: 19490958
references: J Antimicrob Chemother. 1998 Feb;41(2):253-8
references: 9533468
references: Clin Infect Dis. 2005 May 1;40(9):1215-22
references: 15825020
references: Diagn Microbiol Infect Dis. 2009 Sep;65(1):49-57
references: 19679235
references: Pediatr Infect Dis J. 2008 Nov;27(11):1033-5
references: 18955896
references: Presse Med. 2006 May;35(5 Pt 1):749-54
references: 16710140
references: Diagn Microbiol Infect Dis. 2010 Mar;66(3):332-5
references: 20159378
references: Euro Surveill. 2008 Nov 13;13(46):
references: 19021955
references: Infect Control Hosp Epidemiol. 2010 Apr;31(4):408-11
references: 20175686
references: Pediatr Infect Dis J. 2006 Oct;25(10):981-6
references: 17006311
references: PLoS Med. 2009 Jun 2;6(6):e1000084
references: 19492093
references: J Clin Microbiol. 2008 Jan;46(1):225-34
references: 18003797
references: Acta Paediatr. 2010 Nov;99(11):1686-90
references: 20626365
references: Pediatrics. 2009 Jul;124(1):e1-11
references: 19564254
references: Clin Microbiol Infect. 1997 Feb;3(6):705-708
references: 11864222
references: PLoS Pathog. 2007 Nov;3(11):e168
references: 18020702