title: Nasopharyngeal carriage of individual Streptococcus pneumoniae serotypes during pediatric radiologically confirmed community acquired pneumonia following PCV7 introduction in Switzerland.
abstract: BACKGROUND
  Community-acquired pneumonia (CAP) is a serious cause of morbidity among children in developed countries. The real impact of 7-valent pneumococcal conjugate vaccine (PCV7) on pneumococcal pneumonia is difficult to assess accurately.
  
  
  METHODS
  Children aged ≤16 years with clinical and radiological pneumonia were enrolled in a multicenter prospective study. Children aged ≤16 years admitted for a minor elective surgery was recruited as controls. Nasopharyngeal samples for PCR serotyping of S. pneumoniae were obtained in both groups. Informations on age, gender, PCV7 vaccination status, day care/school attendance, siblings, tobacco exposure were collected.
  
  
  RESULTS
  In children with CAP (n=236), 54% of the nasopharyngeal swabs were PCR-positive for S. pneumoniae compared to 32% in controls (n=105) (p=0.003). Serotype 19A was the most common pneumococcal serotype carried in children with CAP (13%) and in controls (15%). Most common serotypes were non-vaccine types (39.4% for CAP and 47.1% for controls) and serotypes included only in PCV13 (32.3% for CAP and 23.5% for controls). There was no significant difference in vaccine serotype distribution between the two groups. In fully vaccinated children with CAP, the proportion of serotypes carried only in PCV13 was higher (51.4%) than in partially vaccinated or non vaccinated children (27.6% and 28.6% respectively, p=0.037).
  
  
  CONCLUSIONS
  Two to 4 years following introduction of PCV7, predominant S. pneumoniae serotypes carried in children with CAP were non PCV7 serotypes, and the 6 new serotypes included in PCV13 accounted for 51.4% of carried serotypes in fully vaccinated children.
authors.affiliation: Child and Adolescent Department, University Hospital of Geneva, Geneva, Switzerland. helene.chappuy@nck.aphp.fr
authors.forename: Hélène
authors.initials: H
authors.lastname: Chappuy
authors.forename: Kristina
authors.initials: K
authors.lastname: Keitel
authors.forename: Mario
authors.initials: M
authors.lastname: Gehri
authors.forename: René
authors.initials: R
authors.lastname: Tabin
authors.forename: Lynda
authors.initials: L
authors.lastname: Robitaille
authors.forename: Frederic
authors.initials: F
authors.lastname: Raymond
authors.forename: Jacques
authors.initials: J
authors.lastname: Corbeil
authors.forename: Veronica
authors.initials: V
authors.lastname: Maspoli
authors.forename: Naim
authors.initials: N
authors.lastname: Bouazza
authors.forename: Gabriel
authors.initials: G
authors.lastname: Alcoba
authors.forename: Laurence
authors.initials: L
authors.lastname: Lacroix
authors.forename: Sergio
authors.initials: S
authors.lastname: Manzano
authors.forename: Annick
authors.initials: A
authors.lastname: Galetto-Lacour
authors.forename: Alain
authors.initials: A
authors.lastname: Gervaix
mesh_terms: D000293:Adolescent; D002353:Carrier State / Q000276:immunology / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000000981:diagnostic imaging / Q000276:immunology / Q000382:microbiology*; D005260:Female; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D006801:Humans; D007223:Infant; D008297:Male; D009305:Nasopharynx / Q000382:microbiology*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D011018:Pneumonia, Pneumococcal / Q000000981:diagnostic imaging / Q000276:immunology / Q000382:microbiology*; D011446:Prospective Studies; D011859:Radiography; D018709:Statistics, Nonparametric; D013296:Streptococcus pneumoniae / Q000145:classification / Q000302:isolation & purification*
chemical_list: D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022242:Pneumococcal Vaccines
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