Non-vaccine serotype pneumococcal carriage in healthy infants in South Africa following introduction of the 13-valent pneumococcal conjugate vaccine

dc.contributor.authorSkosana, Z.
dc.contributor.authorVon Gottberg, A
dc.contributor.authorOlorunju, S.
dc.contributor.authorMohale, T.
dc.contributor.authorDu Plessis, M.
dc.contributor.authorAdams, T.
dc.contributor.authorMbelle, Nontombi Marylucy
dc.date.accessioned2022-10-18T08:48:14Z
dc.date.available2022-10-18T08:48:14Z
dc.date.issued2021-02
dc.description.abstractBACKGROUND. 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.en_US
dc.description.departmentMedical Microbiologyen_US
dc.description.librariandm2022en_US
dc.description.sponsorshipNHLS Research Trust Development grant.en_US
dc.description.urihttp://www.samj.org.zaen_US
dc.identifier.citationSkosana, Z., Von Gottberg, A., Olorunju, S. et al. Non-vaccine serotype pneumococcal carriage in healthy infants in South Africa following introduction of the 13-valent pneumococcal conjugate vaccine. South African Medical Journal, vol. 111, no. 2, pp. 143-148, feb. 2021. doi:10.7196/SAMJ.2021.v111i2.14626.en_US
dc.identifier.issn2078- 5135 (online)
dc.identifier.issn0256-9574 (print)
dc.identifier.other10.7196/SAMJ.2021.v111i2.14626
dc.identifier.urihttps://repository.up.ac.za/handle/2263/87778
dc.language.isoenen_US
dc.publisherHealth and Medical Publishing Groupen_US
dc.rightsThis open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.en_US
dc.subjectPneumococcal conjugate vaccine (PCV)en_US
dc.subjectConjugate vaccinesen_US
dc.subjectPneumococcal carriageen_US
dc.subjectNon-vaccine serotypes (NVTs)en_US
dc.subject13-valent PCV vaccine (PCV13)en_US
dc.subjectSerotype distributionen_US
dc.subjectRisk factorsen_US
dc.subjectPneumococcal colonisationen_US
dc.subjectChildrenen_US
dc.subjectImmunisationen_US
dc.subjectSouth Africa (SA)en_US
dc.titleNon-vaccine serotype pneumococcal carriage in healthy infants in South Africa following introduction of the 13-valent pneumococcal conjugate vaccineen_US
dc.typeArticleen_US

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