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Open Access Highly Accessed Research article

Nasopharyngeal carriage of individual Streptococcus pneumoniae serotypes during pediatric radiologically confirmed community acquired pneumonia following PCV7 introduction in Switzerland

Hélène Chappuy16*, Kristina Keitel1, Mario Gehri2, René Tabin3, Lynda Robitaille4, Frederic Raymond4, Jacques Corbeil4, Veronica Maspoli1, Naim Bouazza5, Gabriel Alcoba1, Laurence Lacroix1, Sergio Manzano1, Annick Galetto-Lacour1 and Alain Gervaix1

Author Affiliations

1 Child and Adolescent Department, University Hospital of Geneva, Geneva, Switzerland

2 Hôpital de l’Enfance, CHUV, Lausanne, Switzerland

3 Hôpital du Valais, Centre Hospitalier du Centre Valais, Sion, Switzerland

4 Department of Molecular Medicine, Infectious Disease Research Center, CHUL Research Center and Laval University, Québec, Canada

5 Unité de recherche clinique Necker Cochin, APHP, Paris, France

6 Hôpital Necker Enfants Malades, 149 rue de Sèvres 75743, Paris, Cedex 15, France

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BMC Infectious Diseases 2013, 13:357  doi:10.1186/1471-2334-13-357

Published: 31 July 2013

Abstract

Background

Community-acquired pneumonia (CAP) is a serious cause of morbidity among children in developed countries. The real impact of 7-valent pneumococcal conjugate vaccine (PCV7) on pneumococcal pneumonia is difficult to assess accurately.

Methods

Children aged ≤16 years with clinical and radiological pneumonia were enrolled in a multicenter prospective study. Children aged ≤16 years admitted for a minor elective surgery was recruited as controls. Nasopharyngeal samples for PCR serotyping of S. pneumoniae were obtained in both groups. Informations on age, gender, PCV7 vaccination status, day care/school attendance, siblings, tobacco exposure were collected.

Results

In children with CAP (n=236), 54% of the nasopharyngeal swabs were PCR-positive for S. pneumoniae compared to 32% in controls (n=105) (p=0.003). Serotype 19A was the most common pneumococcal serotype carried in children with CAP (13%) and in controls (15%). Most common serotypes were non-vaccine types (39.4% for CAP and 47.1% for controls) and serotypes included only in PCV13 (32.3% for CAP and 23.5% for controls). There was no significant difference in vaccine serotype distribution between the two groups. In fully vaccinated children with CAP, the proportion of serotypes carried only in PCV13 was higher (51.4%) than in partially vaccinated or non vaccinated children (27.6% and 28.6% respectively, p=0.037).

Conclusions

Two to 4 years following introduction of PCV7, predominant S. pneumoniae serotypes carried in children with CAP were non PCV7 serotypes, and the 6 new serotypes included in PCV13 accounted for 51.4% of carried serotypes in fully vaccinated children.

Keywords:
Streptococcus pneumoniae; Serotypes; Pneumonia; Children; Vaccination