title: Nasopharyngeal carriage of Streptococcus pneumoniae in healthy Turkish children after the addition of PCV7 to the national vaccine schedule.
abstract: The aim of this study was to determine serotype distribution and investigate antimicrobial resistance patterns of Streptococcus pneumoniae in healthy Turkish children in the era of community-wide pneumococcal conjugate vaccine (PCV7). The study was conducted on 1,101 healthy children less than 18 years of age. Specimens were collected with nasopharyngeal swabs between April 2011 and June 2011. Penicillin and ceftriaxone susceptibilities were determined by E-test according to the 2008 Clinical Laboratory Standards Institute, and serotypes of the isolates were determined by Quellung reaction. The nasopharyngeal pneumococcal carriage rate was 21.9 % (241/1,101). Using the meningitis criteria of minimum inhibitory concentration values, 73 % of the isolates were resistant to penicillin and 47.7 % of them were resistant to ceftriaxone. Half of all pneumococcal isolates were serotyped as 19F (15.2 %), 6A (15.2 %), 23F (10.3 %), and 6B (9.3 %) and surprisingly, no serotype 19A was isolated. Serotype coverage rates of PCV7 and non-PCV7 were 46.2 and 53.8 %, respectively. The most common penicillin- and ceftriaxone-resistant serotypes were 6A, 6B, 14, 19F, and 23F. Penicillin- and ceftriaxone-resistant isolates were more prevalent in serotypes covered by PCV7 than the non-PCV7 serotypes.
  
  
  CONCLUSIONS
  After the community-wide PCV7 vaccination, more non-PCV7 serotypes were isolated from the carriers compared to the time before PCV7 was used especially the serotype 6A, and the antimicrobial resistance of pneumococci was significantly increased.
authors.affiliation: Department of Pediatric Infectious Disease, Ankara University Medical School, Dikimevi, Ankara, 06100, Turkey, doktorhalil@gmail.com.
authors.forename: Halil
authors.initials: H
authors.lastname: Ozdemir
authors.forename: Ergin
authors.initials: E
authors.lastname: Ciftçi
authors.forename: Rıza
authors.initials: R
authors.lastname: Durmaz
authors.forename: Haluk
authors.initials: H
authors.lastname: Güriz
authors.forename: Ahmet Derya
authors.initials: AD
authors.lastname: Aysev
authors.forename: Adem
authors.initials: A
authors.lastname: Karbuz
authors.forename: Refik
authors.initials: R
authors.lastname: Gökdemir
authors.forename: Bülent
authors.initials: B
authors.lastname: Acar
authors.forename: Selin
authors.initials: S
authors.lastname: Nar Ötgün
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ertek
authors.forename: Serdal Kenan
authors.initials: SK
authors.lastname: Köse
authors.forename: Erdal
authors.initials: E
authors.lastname: Ince
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002443:Ceftriaxone / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D008297:Male; D009305:Nasopharynx / Q000382:microbiology*; D010406:Penicillins / Q000494:pharmacology; D011008:Pneumococcal Infections / Q000382:microbiology* / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000302:isolation & purification*; D014421:Turkey
chemical_list: D000900:Anti-Bacterial Agents; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D010406:Penicillins; D022242:Pneumococcal Vaccines; D002443:Ceftriaxone
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