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- Title
Persistence of Nasopharyngeal Pneumococcal Vaccine Serotypes and Increase of Nonvaccine Serotypes Among Vaccinated Infants and Their Mothers 5 Years After Introduction of Pneumococcal Conjugate Vaccine 13 in The Gambia.
- Authors
Usuf, Effua; Bottomley, Christian; Bojang, Ebrima; Cox, Isatou; Bojang, Abdoulie; Gladstone, Rebecca; Kampmann, Beate; Hill, Philip C; Roca, Anna
- Abstract
Background The widespread use of pneumococcal conjugate vaccine (PCV) has brought about a dramatic decrease in pneumococci of vaccine serotypes (VTs) but nonvaccine serotypes (NVTs) have emerged. Methods We conducted a cross-sectional survey (CSS) among infants who received 3 doses of 13-valent PCV (PCV13) and their mothers 5 years (CSS3) after PCV13 introduction. Nasopharyngeal swab samples were collected and cultured for isolation of Streptococcus pneumoniae. Whole-genome sequencing of the nontypeable strains was performed. Data were compared with those from 2 previous surveys conducted before PCV13 introduction (CSS1) and 1 year later (CSS2). Results Among infants, VT carriage decreased from 33.3% (113/339) in CSS1 to 11.4% (40/351) in CSS3 (P =.001) while NVTs increased from 53.1% (180/339) in CSS1 to 74.4% (261/351) in CSS3 (P <.001). Among mothers, there was a significant decrease in VTs between CSS2 8.4% (29/347) and CSS3 5.6% (19/342) (P =.006). NVTs increased from 16.6% (55/331) in CSS1 to 32.2% (110/342) in CSS3 (P <.001). In CSS3, the most prevalent VTs were 7F in infants and 3 in mothers, and the most prevalent NVTs were serogroup 16 and nontypeables, respectively. Genomic analysis showed that VTs were more likely than NVTs to lose their ability to express the capsule. Conclusions Five years after PCV13 introduction, we show both direct (infants) and indirect effects (mothers) of the vaccine, while NVT replacement has occurred in both groups. Ongoing circulation of VTs warrants further study of their relevance in any consideration of a reduced dose schedule.
- Subjects
STREPTOCOCCAL diseases; CARRIER state (Communicable diseases); CELL culture; COMPARATIVE studies; HUMAN genome; MOTHERS; PNEUMOCOCCAL vaccines; STREPTOCOCCUS; SURVEYS; DISEASE relapse; CROSS-sectional method; SEROTYPES; DESCRIPTIVE statistics; SEQUENCE analysis; ADULTS; CHILDREN; DISEASE risk factors
- Publication
Clinical Infectious Diseases, 2019, Vol 68, Issue 9, p1512
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciy726