title: Efficacy of 13-valent pneumococcal conjugate vaccine (PCV13) versus that of 7-valent PCV (PCV7) against nasopharyngeal colonization of antibiotic-nonsusceptible Streptococcus pneumoniae.
abstract: BACKGROUND
  Pediatric respiratory infections caused by antibiotic-nonsusceptible Streptococcus pneumoniae (ANSP) continue to present an important challenge, even after introduction of 7-valent pneumococcal conjugate vaccine (PCV7). This randomized double-blind trial assessed the potential additional impact of PCV13 over PCV7 on reducing ANSP carriage.
  
  
  METHODS
  Healthy infants were randomly assigned to receive PCV13 (n = 932) or PCV7 (n = 934) at ages 2, 4, 6, or 12 months. Eight nasopharyngeal specimens were collected by swabbing between ages 2 and 24 months. S. pneumoniae isolates were serotyped and tested for antimicrobial susceptibility by the disk-diffusion method and the Etest. Nasopharyngeal acquisition and prevalence of ANSP during ages 7-24 months were compared between the 2 vaccine groups.
  
  
  RESULTS
  In general, new acquisition of pneumococci nonsusceptible to penicillin, erythromycin, clindamycin, penicillin plus erythromycin, and multiple drugs (≥3 antibiotics) was significantly lower in the PCV13 group compared with the PCV7 group; the main serotypes contributing to this significant decrease were serotype 19F, present in PCV13 and PCV7, and serotypes 6A and 19A, present in PCV13 only.
  
  
  CONCLUSIONS
  PCV13 has a significant added benefit over PCV7 in reducing carriage of ANSP. Because carriage determines transmission, these results suggest that PCV13 will provide protection against ANSP disease that exceeds protection provided by PCV7.
  
  
  BACKGROUND
  NCT00508742.
authors.affiliation: Pediatric Infectious Disease Unit, Soroka University Medical Center Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Ron
authors.initials: R
authors.lastname: Dagan
authors.affiliation: Pfizer Pharma, Berlin, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Juergens
authors.affiliation: InVentiv Health Clinical, Princeton, New Jersey.
authors.forename: James
authors.initials: J
authors.lastname: Trammel
authors.affiliation: Pfizer, Pearl River, New York.
authors.forename: Scott
authors.initials: S
authors.lastname: Patterson
authors.affiliation: Pediatric Infectious Disease Unit, Soroka University Medical Center Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Greenberg
authors.affiliation: Pediatric Infectious Disease Unit, Soroka University Medical Center Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Noga
authors.initials: N
authors.lastname: Givon-Lavi
authors.affiliation: Pediatric Infectious Disease Unit, Soroka University Medical Center Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Nurith
authors.initials: N
authors.lastname: Porat
authors.affiliation: Pfizer, Pearl River, New York.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Gurtman
authors.affiliation: Pfizer, Pearl River, New York.
authors.forename: William C
authors.initials: WC
authors.lastname: Gruber
authors.affiliation: Pfizer, Pearl River, New York.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Scott
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002675:Child, Preschool; D004311:Double-Blind Method; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D006801:Humans; D007223:Infant; D008297:Male; D009305:Nasopharynx / Q000382:microbiology*; D011008:Pneumococcal Infections / Q000382:microbiology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000276:immunology / Q000592:standards*; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000382:microbiology / Q000517:prevention & control*; D012703:Serotyping; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000276:immunology*; D018074:Vaccines, Conjugate
chemical_list: C538862:13-valent pneumococcal vaccine; D000900:Anti-Bacterial Agents; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate
keywords: Streptococcus pneumoniae; antibiotic-nonsusceptibility; nasopharyngeal colonization; pneumococcal conjugate vaccine