title: Nasopharyngeal Pneumococcal Carriage among Healthy Children in Cyprus Post Widespread Simultaneous Implementation of PCV10 and PCV13 Vaccines.
abstract: The objective of the study was to describe the incidence of pneumococcal nasopharyngeal carriage, serotype distribution and antibiotic resistance profile of pneumococcal nasopharyngeal isolates in healthy children aged 6 to 36 months following the implementation of conjugate vaccines. A nasopharyngeal swab was collected from 1105 healthy children following a stratified random sampling between September 2013 and April 2014. Demographics, vaccination status and data on possible risk factors were recorded. Isolates were serotyped and tested for antibiotic susceptibility. The nasopharyngeal carriage rate was 25.3%. Among 1105 children enrolled, 393 had received PCV13 and 685 PCV10. The prevailing isolated serotypes were: 23A (14.3%), 15A (8.9%), 6C (8.6%), 23B (7.5%), 19A (5.4%) and 15B (5%). The proportion of non-vaccine serotypes, PCV10 serotypes, PCV13 additional serotypes (3, 6A, 19A) was 76.8%, 2.1% and 10.4% respectively. Although children, who were fully or partially vaccinated with PCV13, were 63% less likely to be colonized with additional PCV13 serotypes compared to those vaccinated with PCV10, the difference is not significant (95%Cl = 0.14-1.02, p = 0.053). The highest antibiotic non-susceptible rates were found for erythromycin (28.2%) and penicillin (27.9%). The overall multidrug resistance rate was 13.2%, with serotypes 24F (4/6), 15A (14/25) and 19A (6/15) being the main contributors. Carriage rate was similar between children vaccinated with PCV10 or PCV13. The high incidence of 15A serotype which is also multidrug resistant should be underlined. Ongoing surveillance is needed to monitor the dynamics on nasopharyngeal carriage.
authors.affiliation: Paediatric Department, Larnaca General Hospital, Larnaca, Cyprus.|European University Medical School, 6, Diogenis Street, Engomi, 1516 Nicosia, Cyprus.
authors.forename: Adamos
authors.initials: A
authors.lastname: Hadjipanayis
authors.affiliation: Paediatric Department, Larnaca General Hospital, Larnaca, Cyprus.
authors.forename: Elisavet
authors.initials: E
authors.lastname: Efstathiou
authors.affiliation: Microbiology Laboratory, Larnaca General Hospital, Larnaca, Cyprus.
authors.forename: Maria
authors.initials: M
authors.lastname: Alexandrou
authors.affiliation: Microbiology Laboratory, Larnaca General Hospital, Larnaca, Cyprus.
authors.forename: Loukia
authors.initials: L
authors.lastname: Panayiotou
authors.affiliation: Microbiology Laboratory, Larnaca General Hospital, Larnaca, Cyprus.
authors.forename: Chrystalla
authors.initials: C
authors.lastname: Zachariadou
authors.affiliation: Microbiology Laboratory, Larnaca General Hospital, Larnaca, Cyprus.
authors.forename: Panayiotis
authors.initials: P
authors.lastname: Petrou
authors.affiliation: Third Department of Paediatrics, National and Kapodistrian University of Athens, General University Hospital "ATTIKON", Athens, Greece.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Papaevangelou
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002353:Carrier State / Q000453:epidemiology; D002675:Child, Preschool; D003535:Cyprus / Q000453:epidemiology; D024881:Drug Resistance, Bacterial / Q000187:drug effects; D004917:Erythromycin / Q000494:pharmacology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D009305:Nasopharynx / Q000382:microbiology*; D010406:Penicillins / Q000494:pharmacology; D011008:Pneumococcal Infections / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000276:immunology*; D012307:Risk Factors; D065288:Serogroup; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000302:isolation & purification*; D014611:Vaccination; D018074:Vaccines, Conjugate
chemical_list: C586648:10-valent pneumococcal conjugate vaccine; C538862:13-valent pneumococcal vaccine; D000900:Anti-Bacterial Agents; D010406:Penicillins; D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate; D004917:Erythromycin