BACKGROUND. Pneumococcal carriage studies provide a baseline for measuring the impact of pneumococcal conjugate vaccines (PCVs). The
advent of conjugate vaccines has led to reductions in vaccine serotypes (VTs) in pneumococcal carriage. However, increasing non-vaccine
serotypes (NVTs) remain a significant concern, necessitating continued surveillance of serotypes in the 13-valent PCV vaccine (PCV13) era.
OJECTIVES. To investigate pneumococcal carriage, serotype distribution and risk factors for pneumococcal colonisation among children
presenting for routine immunisation at two clinics in Gauteng Province, South Africa (SA), 10 years after PCV introduction into the SA
Expanded Programme on Immunisation (EPI-SA).
METHODS. Nasopharyngeal swabs were collected from 322 healthy children aged between 6 weeks and 5 years at two clinic centres in 2014
and 2016. Demographic data, risk factors for colonisation and vaccination details were recorded. The pneumococcal isolates were serotyped
and tested for antimicrobial susceptibility.
RESULTS. Pneumococci were isolated from 138/316 healthy children (43.7%) presenting for routine immunisation at two clinics. The
median age was 8.3 months and the age range 1.4 months - 5 years. Carriage varied across the age groups: 6 - 14 weeks 35.5%, 9 months
27.5%, 18 months 21.7%, and 5 years 15.2%. Risk factors significantly associated with pneumococcal colonisation included young age (9 -
18 months (odds ratio OR 3.5; 95% confidence interval (CI) 1.9 - 5.9), type of dwelling (single room (OR 8.1; 95% CI 1.3 - 52.3) or informal
dwelling (OR 2.4; 95% CI 1.2 - 4.5)) and Haemophilus influenzae carriage (OR 5.6; 95% CI 0.6 - 2.5). Of the 26 serotypes detected, 19F
(10/121; 8.3%) was the most frequent. The most frequent NVTs were 23B (16/121; 13.2%), 15B/C (14/121; 11.6 %) and 35B (11/121; 8.2%).
Children aged 9 months carried the highest proportion of NVTs (33/101; 32.7%). Penicillin non-susceptibility was observed in 20 NVT
isolates (20/36; 55.6%) and 2 VT isolates (2/36; 5.6%).
CONCLUSIONS. The pneumococcal carriage prevalence described in our study varied across the age groups and was lower compared with
other African studies that looked at pneumococcal carriage post PCV. The study gave insight into the common NVTs encountered at two
immunisation clinics in Gauteng. Given that pneumococcal carriage precedes disease, common colonisers such as 15B/C and 35B may be
sufficiently prevalent in carriage for expansion to result in significant disease replacement.
Kleynhans, Jackie; Cohen, Cheryl; McMorrow, Meredith L.; Tempia, Stefano; Crowther-Gibson, Penny; Quan, Vanessa C.; De Gouveia, Linda D.; Von Gottberg, Anne(Elsevier, 2019-09)
INTRODUCTION : South Africa introduced seven-valent pneumococcal conjugate vaccine (PCV7) in 2009 and PCV13 in 2011. We aimed to compare the estimated impact of PCV on pneumococcal meningitis (PM) to impact of PCV on total ...
Tempia, Stefano; Wolter, Nicole; Cohen, Cheryl; Walaza, Sibongile; Von Mollendorf, Claire; Cohen, Adam L.; Moyes, Jocelyn; De Gouveia, Linda; Nzenze, Susan; Treurnicht, Florette; Venter, Marietjie; Groome, Michelle J.; Madhi, Shabir A.; Von Gottberg, Anne(BioMed Central, 2015-10-26)
BACKGROUND : The use of molecular diagnostic techniques for the evaluation of the impact of pneumococcal
conjugate vaccines (PCVs) has not been documented. We aimed to evaluate the impact of PCVs on invasive
Musher, Daniel M.; Anderson, Ronald; Feldman, Charles(BMC, 2022)
Although it varies with age and geographical distribution, the global burden of infection with Streptococcus pneumoniae (pneumococcus) remains considerable. The elderly, and younger adults with comorbid conditions, are ...