Nasopharyngeal carriage of Streptococcus pneumoniae in healthy Turkish children after the addition of PCV7 to the national vaccine schedule

• Published in: European journal of pediatrics Vol. 173; no. 3; pp. 313 - 320
• Main Authors: Özdemir, Halil, Çiftçi, Ergin, Durmaz, Rıza, Güriz, Haluk, Aysev, Ahmet Derya, Karbuz, Adem, Gökdemir, Refik, Acar, Bülent, Nar Ötgün, Selin, Ertek, Mustafa, Köse, Serdal Kenan, İnce, Erdal
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.03.2014; Springer Nature B.V
• Subjects: Adolescent; Anti-Bacterial Agents - pharmacology; Antibiotics; Antimicrobial agents; Ceftriaxone - pharmacology; Child; Child, Preschool; Developing countries; Disease; Drug resistance; Drug Resistance, Bacterial; Female; Health care; Heptavalent Pneumococcal Conjugate Vaccine; Humans; Immunization; Immunization Schedule; Infant; Laboratories; LDCs; Male; Medical schools; Medicine; Medicine & Public Health; Meningitis; Nasopharynx - microbiology; Original Article; Outpatient care facilities; Pediatrics; Penicillin; Penicillins - pharmacology; Pneumococcal Infections - microbiology; Pneumococcal Infections - prevention & control; Pneumococcal Vaccines - administration & dosage; Pneumonia; Serotyping; Streptococcus infections; Streptococcus pneumoniae; Streptococcus pneumoniae - drug effects; Streptococcus pneumoniae - isolation & purification; Turkey; Vaccines; Turkey; Ankara Turkey; United States > US; Pneumococcal conjugate vaccine; Nasopharyngeal carriage; Serotype; Antibiotic susceptibility
• ISSN: 0340-6199; 1432-1076
• DOI: 10.1007/s00431-013-2156-7

The aim of this study was to determine serotype distribution and investigate antimicrobial resistance patterns of Streptococcus pneumoniae in healthy Turkish children in the era of community-wide pneumococcal conjugate vaccine (PCV7). The study was conducted on 1,101 healthy children less than 18 years of age. Specimens were collected with nasopharyngeal swabs between April 2011 and June 2011. Penicillin and ceftriaxone susceptibilities were determined by E-test according to the 2008 Clinical Laboratory Standards Institute, and serotypes of the isolates were determined by Quellung reaction. The nasopharyngeal pneumococcal carriage rate was 21.9 % (241/1,101). Using the meningitis criteria of minimum inhibitory concentration values, 73 % of the isolates were resistant to penicillin and 47.7 % of them were resistant to ceftriaxone. Half of all pneumococcal isolates were serotyped as 19F (15.2 %), 6A (15.2 %), 23F (10.3 %), and 6B (9.3 %) and surprisingly, no serotype 19A was isolated. Serotype coverage rates of PCV7 and non-PCV7 were 46.2 and 53.8 %, respectively. The most common penicillin- and ceftriaxone-resistant serotypes were 6A, 6B, 14, 19F, and 23F. Penicillin- and ceftriaxone-resistant isolates were more prevalent in serotypes covered by PCV7 than the non-PCV7 serotypes. Conclusion: After the community-wide PCV7 vaccination, more non-PCV7 serotypes were isolated from the carriers compared to the time before PCV7 was used especially the serotype 6A, and the antimicrobial resistance of pneumococci was significantly increased.