TY - JOUR
T1 - Colonization with 19F and other pneumococcal conjugate vaccine serotypes in children in St. Louis, Missouri, USA
AU - McFarland, Michelle
AU - Szasz, Taylor P.
AU - Zhou, Julie Y.
AU - Motley, Kara
AU - Sivapalan, Janardan S.
AU - Isaacson-Schmid, Megan
AU - Todd, Elizabeth M.
AU - Hogan, Patrick G.
AU - Fritz, Stephanie A.
AU - Burnham, Carey Ann D.
AU - Hoffmann, Steen
AU - Morley, Sharon Celeste
N1 - Funding Information:
Funding for the study was provided by the St. Louis Children’s Hospital Foundation and the Children’s Discovery Institute (Grant Nos. PD-II-2013-295 and PD-II-2014-366 ). SCM is also supported by NIH grant AI104732 . SAF is supported by AHRQ grants HS021736 and HS024269 . Institutional support of REDCap software is provided through grants CTSA Grant [UL1 TR000448 ] and Siteman Comprehensive Cancer Center and NCI Cancer Center Support Grant P30 CA091842 .
Funding Information:
Funding for the study was provided by the St. Louis Children's Hospital Foundation and the Children's Discovery Institute (Grant Nos. PD-II-2013-295 and PD-II-2014-366). SCM is also supported by NIH grant AI104732. SAF is supported by AHRQ grants HS021736 and HS024269. Institutional support of REDCap software is provided through grants CTSA Grant [UL1 TR000448] and Siteman Comprehensive Cancer Center and NCI Cancer Center Support Grant P30 CA091842.
Publisher Copyright:
© 2017 Elsevier Ltd
PY - 2017/8/3
Y1 - 2017/8/3
N2 - Background The epidemiology of nasopharyngeal (NP) pneumococcal carriage varies with geography and has changed in response to pneumococcal conjugate vaccine (PCV): a low prevalence (3% or less of colonizing isolates) of colonization by vaccine-type (VT) pneumococcal serotypes after PCV introduction has been reported. The primary goal of this study was to determine the VT serotype prevalence of NP pneumococcal colonization of children residing in the St. Louis, MO, USA metropolitan area following introduction of the 13-valent PCV in 2010. The secondary goal of this study was to identify characteristics associated with NP pneumococcal carriage of any serotype. Methods Between July 2013 and April 2016, we enrolled 397 healthy children, aged 0–17 years, who required sedation for procedures or minor surgeries at St. Louis Children's Hospital. NP swabs were collected after sedation or anesthesia and cultured for pneumococcus. Vaccine records were obtained from primary care providers or from state immunization databases. Parents/guardians completed a questionnaire to provide demographics, past medical history and household characteristics. Results Of the 88 pneumococcal isolates recovered from 84 colonized subjects (21.2% of all enrolled subjects; 95% CI 17.2–25.2%), 16 were VT. Eleven isolates were serotype 19F (12.5%), four (4.5%) were 6A and one (1.1%) was 19A. Prevalence of VT among colonizing isolates was thus 18.2% (CI 10.1–26.1%) in our cohort, despite complete PCV vaccination in 87% of colonized children. Factors associated with pneumococcal colonization by any serotype included younger age and daycare attendance. Conclusion Children in St. Louis exhibit a higher prevalence of VT serotypes among pneumococcal carriage isolates than has been reported in other areas in the US, demonstrating the necessity of ongoing surveillance of local epidemiology and providing evidence that serotype 19F can remain prevalent in a pediatric population despite high vaccine uptake.
AB - Background The epidemiology of nasopharyngeal (NP) pneumococcal carriage varies with geography and has changed in response to pneumococcal conjugate vaccine (PCV): a low prevalence (3% or less of colonizing isolates) of colonization by vaccine-type (VT) pneumococcal serotypes after PCV introduction has been reported. The primary goal of this study was to determine the VT serotype prevalence of NP pneumococcal colonization of children residing in the St. Louis, MO, USA metropolitan area following introduction of the 13-valent PCV in 2010. The secondary goal of this study was to identify characteristics associated with NP pneumococcal carriage of any serotype. Methods Between July 2013 and April 2016, we enrolled 397 healthy children, aged 0–17 years, who required sedation for procedures or minor surgeries at St. Louis Children's Hospital. NP swabs were collected after sedation or anesthesia and cultured for pneumococcus. Vaccine records were obtained from primary care providers or from state immunization databases. Parents/guardians completed a questionnaire to provide demographics, past medical history and household characteristics. Results Of the 88 pneumococcal isolates recovered from 84 colonized subjects (21.2% of all enrolled subjects; 95% CI 17.2–25.2%), 16 were VT. Eleven isolates were serotype 19F (12.5%), four (4.5%) were 6A and one (1.1%) was 19A. Prevalence of VT among colonizing isolates was thus 18.2% (CI 10.1–26.1%) in our cohort, despite complete PCV vaccination in 87% of colonized children. Factors associated with pneumococcal colonization by any serotype included younger age and daycare attendance. Conclusion Children in St. Louis exhibit a higher prevalence of VT serotypes among pneumococcal carriage isolates than has been reported in other areas in the US, demonstrating the necessity of ongoing surveillance of local epidemiology and providing evidence that serotype 19F can remain prevalent in a pediatric population despite high vaccine uptake.
KW - Epidemiology of pneumococcal carriage
KW - Pneumococcal conjugate vaccine
KW - Pneumococcal nasopharyngeal carriage
UR - http://www.scopus.com/inward/record.url?scp=85021714015&partnerID=8YFLogxK
U2 - 10.1016/j.vaccine.2017.06.047
DO - 10.1016/j.vaccine.2017.06.047
M3 - Article
C2 - 28687405
AN - SCOPUS:85021714015
SN - 0264-410X
VL - 35
SP - 4389
EP - 4395
JO - Vaccine
JF - Vaccine
IS - 34
ER -