Effect of the seven-valent conjugate pneumococcal vaccine on carriage and drug resistance of Streptococcus pneumoniae in healthy children attending day-care centers in Lisbon
Effect of the seven-valent conjugate pneumococcal vaccine on carriage and drug resistance of Streptococcus pneumoniae in healthy children attending day-care centers in Lisbon
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DOI：
10.1097/01.inf.0000154326.77617.3e
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发表时间：
2005-03-01
影响因子：
3.6
通讯作者：
de Lencastre, H
中科院分区：
文献类型：
--
作者：
Frazao, N;Brito-Avô, A;de Lencastre, H
目的：前瞻性研究，以评估7价肺炎球菌结合疫苗的影响，对鼻咽（NP）携带耐药肺炎链球菌（DRPn），由健康儿童参加日托中心（年龄6个月至6岁）。2001年5月至2003年2月连续6个采样期对肺炎克雷伯氏菌和DRPn进行血清学分型和遗传背景分析。接种组和对照组的Pn总携带率无显著性差异（平均68%）或DRPn携带频率（平均38%），包括青霉素不敏感菌株的频率（平均24%）。相比之下，疫苗血清型DRPn携带率下降，但表达疫苗中不存在的不寻常血清型（6A、10A、15A和15C、19 A、23 A、33 F）的DRPn频率的出现和逐渐增加以及不可分型菌株的增加弥补了这一点。大多数具有不寻常血清型的DRPn显示出不同的脉冲场凝胶电泳模式，表明原始耐药植物群被其他耐药菌克隆类型所取代。抗生素的消费和呼吸道感染的频率之间的vaccines和controls.Conclusions：肺炎球菌疫苗接种并没有改变耐药菌株的携带频率是最初占主导地位的疫苗血清型取代其他表达nonvaccine血清型。减少DRPn的携带可能需要结合疫苗和降低抗生素压力的组合。
Aims: Prospective study to evaluate the impact of the 7-valent pneumococcal conjugate vaccine (Prevenar) on the nasopharyngeal (NP) carriage of drug-resistant Streptococcus pneumoniae (DRPn), by healthy children attending day-care centers (ages 6 months-6 years).Methods: Vaccinees (238 children) who received vaccine and controls (457 children) were followed for carriage of total S. pneumoniae and DRPn and for the serotypes and genetic backgrounds of DRPn during 6 consecutive sampling periods between May 2001 and February 2003.Results: We detected no significant differences between vaccinees and the control group in the total carriage rate of Pn (average, 68%) or in the frequency of carriage of DRPn (average, 38%), including the frequency of penicillin-nonsusceptible strains (average, 24%). In contrast, there was a decline in the carriage of DRPn with vaccine serotypes which was compensated by the appearance and gradual increase in the frequency of DRPn expressing unusual serotypes (6A, 10A, 15A and 15C, 19A, 23A, 33F) which were not present in the vaccine as well as an increase in nontypable strains. The majority of the DRPn with unusual serotypes showed different pulsed field gel electrophoresis patterns indicating replacement of the original resistant flora by other clonal types of drug-resistant bacteria. Antibiotic consumption and the frequency of respiratory tract infections were similar among the vaccinces and controls.Conclusions: Pneumococcal vaccination did not change the frequency of carriage of drug-resistant strains being the initially dominant vaccine serotypes replaced by others expressing nonvaccine serotypes. Reduction in the carriage of DRPn may require a combination of the conjugate vaccine and a decrease in antibiotic pressure.