Streptococcus pneumoniae colonization after introduction of 13-valent pneumococcal conjugate vaccine for US adults 65 years of age and older, 2015–2016

for the Adult Pneumococcal Carriage Study Group

Research output: Contribution to journalArticle

Abstract

Background: Vaccination of children with 13-valent pneumococcal conjugate vaccine (PCV13) led to declines in vaccine-type pneumococcal nasopharyngeal carriage among adults through indirect effects. In August 2014, PCV13 immunization of all U.S. adults ≥65 years of age was recommended. This study sought to define prevalence and serotype distribution of pneumococcal carriage among adults ≥65 years of age and to describe risk factors for colonization soon after introduction of PCV13 in adults. Methods: A cross-sectional survey of non-institutionalized U.S. adults ≥65 years of age was conducted in four states in 2015–2016. Demographic information, risk factors for disease, PCV13 vaccination history, and nasopharyngeal (NP) and oropharyngeal (OP) swabs were collected. NP and OP swabs were processed separately and pneumococcal isolates were serotyped by Quellung reaction. Antimicrobial susceptibility of pneumococcal isolates was performed. NP swabs also underwent real-time PCR for pneumococcal detection and serotyping. Results: Of 2989 participants, 45.3% (1354/2989) had been vaccinated with PCV13. Fifty-five (1.8%) carried pneumococcus (45 identified by culture and 10 by real-time PCR only) and PCV13 serotypes were found in eight (0.3%) participants. Almost half (22/45) of pneumococcal isolates were not susceptible to at least one of the antibiotics tested. Vaccine-type carriage among vaccinated and unvaccinated individuals was similar (0.2% vs. 0.1%, respectively). Respiratory symptoms were associated with higher odds of pneumococcal colonization (adjusted OR: 2.1; 95% CI = 1.1–3.8). Conclusions: Pneumococcal carriage among non-institutionalized adults ≥65 years of age was very low. Less than 0.5% of both vaccinated and unvaccinated individuals in our study carried vaccine-type serotypes. Over a decade of PCV vaccination of children likely led to indirect effects in adults. However, given the low vaccine-type carriage rates we observed in an already high PCV13 adult coverage setting, it is difficult to attribute our findings to the direct versus indirect effects of PCV13 on adult carriage.

Original languageEnglish (US)
Pages (from-to)1094-1100
Number of pages7
JournalVaccine
Volume37
Issue number8
DOIs
StatePublished - Feb 14 2019

Fingerprint

Conjugate Vaccines
Streptococcus pneumoniae
Vaccination
Vaccines
vaccines
Real-Time Polymerase Chain Reaction
Serotyping
Pneumococcal Vaccines
Immunization
serotypes
Cross-Sectional Studies
History
vaccination
Demography
Anti-Bacterial Agents
quantitative polymerase chain reaction
risk factors
13-valent pneumococcal vaccine
Serogroup
cross-sectional studies

Keywords

  • Older adults
  • PCV13
  • Pneumococcal carriage
  • Pneumococcal conjugate vaccine
  • Streptococcus pneumoniae

ASJC Scopus subject areas

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

Cite this

Streptococcus pneumoniae colonization after introduction of 13-valent pneumococcal conjugate vaccine for US adults 65 years of age and older, 2015–2016. / for the Adult Pneumococcal Carriage Study Group.

In: Vaccine, Vol. 37, No. 8, 14.02.2019, p. 1094-1100.

Research output: Contribution to journalArticle

@article{48a937682eb0403d8b82959caa6b4102,
title = "Streptococcus pneumoniae colonization after introduction of 13-valent pneumococcal conjugate vaccine for US adults 65 years of age and older, 2015–2016",
abstract = "Background: Vaccination of children with 13-valent pneumococcal conjugate vaccine (PCV13) led to declines in vaccine-type pneumococcal nasopharyngeal carriage among adults through indirect effects. In August 2014, PCV13 immunization of all U.S. adults ≥65 years of age was recommended. This study sought to define prevalence and serotype distribution of pneumococcal carriage among adults ≥65 years of age and to describe risk factors for colonization soon after introduction of PCV13 in adults. Methods: A cross-sectional survey of non-institutionalized U.S. adults ≥65 years of age was conducted in four states in 2015–2016. Demographic information, risk factors for disease, PCV13 vaccination history, and nasopharyngeal (NP) and oropharyngeal (OP) swabs were collected. NP and OP swabs were processed separately and pneumococcal isolates were serotyped by Quellung reaction. Antimicrobial susceptibility of pneumococcal isolates was performed. NP swabs also underwent real-time PCR for pneumococcal detection and serotyping. Results: Of 2989 participants, 45.3{\%} (1354/2989) had been vaccinated with PCV13. Fifty-five (1.8{\%}) carried pneumococcus (45 identified by culture and 10 by real-time PCR only) and PCV13 serotypes were found in eight (0.3{\%}) participants. Almost half (22/45) of pneumococcal isolates were not susceptible to at least one of the antibiotics tested. Vaccine-type carriage among vaccinated and unvaccinated individuals was similar (0.2{\%} vs. 0.1{\%}, respectively). Respiratory symptoms were associated with higher odds of pneumococcal colonization (adjusted OR: 2.1; 95{\%} CI = 1.1–3.8). Conclusions: Pneumococcal carriage among non-institutionalized adults ≥65 years of age was very low. Less than 0.5{\%} of both vaccinated and unvaccinated individuals in our study carried vaccine-type serotypes. Over a decade of PCV vaccination of children likely led to indirect effects in adults. However, given the low vaccine-type carriage rates we observed in an already high PCV13 adult coverage setting, it is difficult to attribute our findings to the direct versus indirect effects of PCV13 on adult carriage.",
keywords = "Older adults, PCV13, Pneumococcal carriage, Pneumococcal conjugate vaccine, Streptococcus pneumoniae",
author = "{for the Adult Pneumococcal Carriage Study Group} and Jennifer Milucky and Carvalho, {Maria de Gloria} and Nadine Rouphael and Bennett, {Nancy M.} and Talbot, {H. Keipp} and Harrison, {Lee H.} and Farley, {Monica M.} and Walston, {Jeremy D} and Fabiana Pimenta and Lessa, {Fernanda C.} and Mary Bower and Nina McNair and Sabrina Williams and Emily Presmanes and Amy Tunali and Stephanie Thomas and Hollick, {Rosemary A} and Jacqueline Langdon and {Salar Sepehri}, Amir and Anna Sharova",
year = "2019",
month = "2",
day = "14",
doi = "10.1016/j.vaccine.2018.12.075",
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volume = "37",
pages = "1094--1100",
journal = "Vaccine",
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TY - JOUR

T1 - Streptococcus pneumoniae colonization after introduction of 13-valent pneumococcal conjugate vaccine for US adults 65 years of age and older, 2015–2016

AU - for the Adult Pneumococcal Carriage Study Group

AU - Milucky, Jennifer

AU - Carvalho, Maria de Gloria

AU - Rouphael, Nadine

AU - Bennett, Nancy M.

AU - Talbot, H. Keipp

AU - Harrison, Lee H.

AU - Farley, Monica M.

AU - Walston, Jeremy D

AU - Pimenta, Fabiana

AU - Lessa, Fernanda C.

AU - Bower, Mary

AU - McNair, Nina

AU - Williams, Sabrina

AU - Presmanes, Emily

AU - Tunali, Amy

AU - Thomas, Stephanie

AU - Hollick, Rosemary A

AU - Langdon, Jacqueline

AU - Salar Sepehri, Amir

AU - Sharova, Anna

PY - 2019/2/14

Y1 - 2019/2/14

N2 - Background: Vaccination of children with 13-valent pneumococcal conjugate vaccine (PCV13) led to declines in vaccine-type pneumococcal nasopharyngeal carriage among adults through indirect effects. In August 2014, PCV13 immunization of all U.S. adults ≥65 years of age was recommended. This study sought to define prevalence and serotype distribution of pneumococcal carriage among adults ≥65 years of age and to describe risk factors for colonization soon after introduction of PCV13 in adults. Methods: A cross-sectional survey of non-institutionalized U.S. adults ≥65 years of age was conducted in four states in 2015–2016. Demographic information, risk factors for disease, PCV13 vaccination history, and nasopharyngeal (NP) and oropharyngeal (OP) swabs were collected. NP and OP swabs were processed separately and pneumococcal isolates were serotyped by Quellung reaction. Antimicrobial susceptibility of pneumococcal isolates was performed. NP swabs also underwent real-time PCR for pneumococcal detection and serotyping. Results: Of 2989 participants, 45.3% (1354/2989) had been vaccinated with PCV13. Fifty-five (1.8%) carried pneumococcus (45 identified by culture and 10 by real-time PCR only) and PCV13 serotypes were found in eight (0.3%) participants. Almost half (22/45) of pneumococcal isolates were not susceptible to at least one of the antibiotics tested. Vaccine-type carriage among vaccinated and unvaccinated individuals was similar (0.2% vs. 0.1%, respectively). Respiratory symptoms were associated with higher odds of pneumococcal colonization (adjusted OR: 2.1; 95% CI = 1.1–3.8). Conclusions: Pneumococcal carriage among non-institutionalized adults ≥65 years of age was very low. Less than 0.5% of both vaccinated and unvaccinated individuals in our study carried vaccine-type serotypes. Over a decade of PCV vaccination of children likely led to indirect effects in adults. However, given the low vaccine-type carriage rates we observed in an already high PCV13 adult coverage setting, it is difficult to attribute our findings to the direct versus indirect effects of PCV13 on adult carriage.

AB - Background: Vaccination of children with 13-valent pneumococcal conjugate vaccine (PCV13) led to declines in vaccine-type pneumococcal nasopharyngeal carriage among adults through indirect effects. In August 2014, PCV13 immunization of all U.S. adults ≥65 years of age was recommended. This study sought to define prevalence and serotype distribution of pneumococcal carriage among adults ≥65 years of age and to describe risk factors for colonization soon after introduction of PCV13 in adults. Methods: A cross-sectional survey of non-institutionalized U.S. adults ≥65 years of age was conducted in four states in 2015–2016. Demographic information, risk factors for disease, PCV13 vaccination history, and nasopharyngeal (NP) and oropharyngeal (OP) swabs were collected. NP and OP swabs were processed separately and pneumococcal isolates were serotyped by Quellung reaction. Antimicrobial susceptibility of pneumococcal isolates was performed. NP swabs also underwent real-time PCR for pneumococcal detection and serotyping. Results: Of 2989 participants, 45.3% (1354/2989) had been vaccinated with PCV13. Fifty-five (1.8%) carried pneumococcus (45 identified by culture and 10 by real-time PCR only) and PCV13 serotypes were found in eight (0.3%) participants. Almost half (22/45) of pneumococcal isolates were not susceptible to at least one of the antibiotics tested. Vaccine-type carriage among vaccinated and unvaccinated individuals was similar (0.2% vs. 0.1%, respectively). Respiratory symptoms were associated with higher odds of pneumococcal colonization (adjusted OR: 2.1; 95% CI = 1.1–3.8). Conclusions: Pneumococcal carriage among non-institutionalized adults ≥65 years of age was very low. Less than 0.5% of both vaccinated and unvaccinated individuals in our study carried vaccine-type serotypes. Over a decade of PCV vaccination of children likely led to indirect effects in adults. However, given the low vaccine-type carriage rates we observed in an already high PCV13 adult coverage setting, it is difficult to attribute our findings to the direct versus indirect effects of PCV13 on adult carriage.

KW - Older adults

KW - PCV13

KW - Pneumococcal carriage

KW - Pneumococcal conjugate vaccine

KW - Streptococcus pneumoniae

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