Carriage of Streptoccoccus pneumoniae 7 years after implementation of vaccination program in a population with very high and long-lasting coverage, Italy

Filippo Ansaldi, Daniela de Florentiis, Paola Canepa, Marta Zancolli, Mariano Martini, Andrea Orsi, Paolo Durando, Giancarlo Icardi

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

To evaluate how the 7-valent pneumococcal vaccine (PCV7) programme and the very high vaccination coverage reached for over 4 years affected the prevalence of Streptoccoccus pneumoniae serotypes in the paediatric population and to evaluate demographic, behavioural and risk factors for carriage in the post-vaccination era, a cross-sectional study on nasopharyngeal carriage was performed. Six hundred sixty-nine children under the age of 5, representative of the open population, were enrolled by cluster sampling. High sensitive techniques for detection of multi-serotype carriage, i.e. broth enrichment and real-time PCR and sequential PCRs for detection and typing, respectively, were used. Of the 669 enrolled children, 97.8% were compliant with the recommended PCV7 vaccination schedule. Post-stratification adjustment for age was applied considering the Ligurian population as standard population. Age-weighted carriage rate was 50.1% and 78% of carriers were colonized by more than one serotype. The prevalence of carriage increased with age from 22% in the first year of life, to 48.6% in the second year of life and to 60% in the 25-59 month age group.Age-weighted prevalence of any of the PCV7, PCV10 or PCV13 serotypes was 10.3%, 20.3% and 27.5%, respectively. PCV7 serotypes were mainly represented by serotype 4 that was carried since the 3rd year of life and was responsible for invasive pneumococcal disease (IPD) and non-IPD in adults, but not in children confirming the high vaccine effectiveness. Among the serotypes included in recently available vaccines, serotypes 5 and 19A showed a higher prevalence, being carried by 15.2% and 8.8% of the population, respectively.A multivariate analysis showed that age, the presence of child siblings at home and day care attendance covariates were strongly associated with S. pneumoniae carriage.In conclusion, over 7 years of vaccination with PCV7 and very high coverage in the last 4 years has led to low carriage prevalence in the first year of life rapidly increasing in the following years and high prevalence of non-PCV7 serotypes carriage.

Original languageEnglish
Pages (from-to)2288-2294
Number of pages7
JournalVaccine
Volume30
Issue number13
DOIs
Publication statusPublished - Mar 16 2012

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Italy
pneumonia
Pneumonia
serotypes
Vaccination
vaccination
Population
vaccines
Vaccines
Serogroup
Pneumococcal Vaccines
Home Care Services
cross-sectional studies
multivariate analysis
Siblings
Real-Time Polymerase Chain Reaction
Appointments and Schedules
quantitative polymerase chain reaction
risk factors
demographic statistics

Keywords

  • Carriage
  • PCV7
  • Replacement
  • S. pneumoniae

ASJC Scopus subject areas

  • Immunology and Microbiology(all)
  • Infectious Diseases
  • Public Health, Environmental and Occupational Health
  • veterinary(all)
  • Molecular Medicine

Cite this

Carriage of Streptoccoccus pneumoniae 7 years after implementation of vaccination program in a population with very high and long-lasting coverage, Italy. / Ansaldi, Filippo; de Florentiis, Daniela; Canepa, Paola; Zancolli, Marta; Martini, Mariano; Orsi, Andrea; Durando, Paolo; Icardi, Giancarlo.

In: Vaccine, Vol. 30, No. 13, 16.03.2012, p. 2288-2294.

Research output: Contribution to journalArticle

Ansaldi, F, de Florentiis, D, Canepa, P, Zancolli, M, Martini, M, Orsi, A, Durando, P & Icardi, G 2012, 'Carriage of Streptoccoccus pneumoniae 7 years after implementation of vaccination program in a population with very high and long-lasting coverage, Italy', Vaccine, vol. 30, no. 13, pp. 2288-2294. https://doi.org/10.1016/j.vaccine.2012.01.067
Ansaldi, Filippo ; de Florentiis, Daniela ; Canepa, Paola ; Zancolli, Marta ; Martini, Mariano ; Orsi, Andrea ; Durando, Paolo ; Icardi, Giancarlo. / Carriage of Streptoccoccus pneumoniae 7 years after implementation of vaccination program in a population with very high and long-lasting coverage, Italy. In: Vaccine. 2012 ; Vol. 30, No. 13. pp. 2288-2294.
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abstract = "To evaluate how the 7-valent pneumococcal vaccine (PCV7) programme and the very high vaccination coverage reached for over 4 years affected the prevalence of Streptoccoccus pneumoniae serotypes in the paediatric population and to evaluate demographic, behavioural and risk factors for carriage in the post-vaccination era, a cross-sectional study on nasopharyngeal carriage was performed. Six hundred sixty-nine children under the age of 5, representative of the open population, were enrolled by cluster sampling. High sensitive techniques for detection of multi-serotype carriage, i.e. broth enrichment and real-time PCR and sequential PCRs for detection and typing, respectively, were used. Of the 669 enrolled children, 97.8{\%} were compliant with the recommended PCV7 vaccination schedule. Post-stratification adjustment for age was applied considering the Ligurian population as standard population. Age-weighted carriage rate was 50.1{\%} and 78{\%} of carriers were colonized by more than one serotype. The prevalence of carriage increased with age from 22{\%} in the first year of life, to 48.6{\%} in the second year of life and to 60{\%} in the 25-59 month age group.Age-weighted prevalence of any of the PCV7, PCV10 or PCV13 serotypes was 10.3{\%}, 20.3{\%} and 27.5{\%}, respectively. PCV7 serotypes were mainly represented by serotype 4 that was carried since the 3rd year of life and was responsible for invasive pneumococcal disease (IPD) and non-IPD in adults, but not in children confirming the high vaccine effectiveness. Among the serotypes included in recently available vaccines, serotypes 5 and 19A showed a higher prevalence, being carried by 15.2{\%} and 8.8{\%} of the population, respectively.A multivariate analysis showed that age, the presence of child siblings at home and day care attendance covariates were strongly associated with S. pneumoniae carriage.In conclusion, over 7 years of vaccination with PCV7 and very high coverage in the last 4 years has led to low carriage prevalence in the first year of life rapidly increasing in the following years and high prevalence of non-PCV7 serotypes carriage.",
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