Kaya Gursoy Basak, Beyazova Ufuk, Oguz Melahat Melek, Demirel Filiz, Ozkan Secil, Sultan Nedim, Nar Otgun Selin
Department of Pediatrics, Faculty of Medicine, Gazi University Ankara, Turkey.
Department of Pediatrics, Dr. Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, Ankara, Turkey.
J Infect Dev Ctries. 2019 Mar 31;13(3):227-232. doi: 10.3855/jidc.10833.
We aimed to evaluate the effects of 7-valent pneumococcal conjugate vaccine on nasopharyngeal carriage of Streptococcus pneumoniae and antibiotic resistance in children in a well-child clinic in a tertiary children's hospital in Turkey.
We collected nasopharyngeal (NP) specimens from 557 two-month-old babies before vaccination. After the study population had received PCV7, NP samples were obtained from 135 babies. Antimicrobial susceptibility testing and serotyping were performed.
S. pneumoniae colonized in 48 (8.6%) of the 557 two-month-old babies before vaccination. The follow-up cohort consisted of 135 subjects. The prevalence of PCV7 strain decreased from 33.3% to 19.3% after vaccination. However, non-PCV7 types increased from 66.6% to 80.6% (p = 0.02). Of PCV7 serotypes, 19F was the most frequent serotype before and after vaccination. There was an increase in 6A and 15 of non-PCV7 serotypes after vaccination. Penicillin non-susceptible increased from 56.3% to 80.6% after vaccination (p =0.03). Serotypes 14, 18C, 9V and 6B, which were identified before vaccination, never colonized afterwards. Number of siblings and having sibling with older age of five were determined to be significant effective factors for SP colonization presence after vaccination and antibiotic use was negatively associated with pneumococcal carriage but associated with penicillin non-susceptibility.
Nasopharyngeal carriage rate of S. pneumoniae dropped after PCV7 vaccination, and replacement by NVT pneumococci were also observed. Risk factors for nasopharyngeal carriage included household crowding and having a sibling age five years or older. Penicillin non-susceptibility increased in both VT and NVT strains.
我们旨在评估7价肺炎球菌结合疫苗对土耳其一家三级儿童医院健康儿童门诊中儿童肺炎链球菌鼻咽部携带情况及抗生素耐药性的影响。
我们在接种疫苗前从557名两个月大的婴儿中采集鼻咽（NP）标本。研究人群接种PCV7后，从135名婴儿中获取NP样本。进行了抗菌药物敏感性测试和血清分型。
接种疫苗前，557名两个月大的婴儿中有48名（8.6%）定植有肺炎链球菌。随访队列包括135名受试者。接种疫苗后，PCV7菌株的流行率从33.3%降至19.3%。然而，非PCV7型从66.6%增至80.6%（p = 0.02）。在PCV7血清型中，19F是接种疫苗前后最常见的血清型。接种疫苗后，非PCV7血清型的6A和15型有所增加。接种疫苗后，青霉素不敏感率从56.3%增至80.6%（p = 0.03）。接种疫苗前鉴定出的14、18C、9V和6B血清型之后未再定植。确定兄弟姐妹数量以及有5岁以上的兄弟姐妹是接种疫苗后肺炎链球菌定植存在的显著有效因素，抗生素使用与肺炎球菌携带呈负相关，但与青霉素不敏感性相关。
接种PCV7疫苗后肺炎链球菌的鼻咽部携带率下降，同时也观察到非疫苗型肺炎球菌的替代情况。鼻咽部携带的危险因素包括家庭拥挤以及有5岁或以上的兄弟姐妹。疫苗型和非疫苗型菌株的青霉素不敏感性均增加。
