Epidemiologic Characteristics of Streptococcus pneumoniae in Vietnam and Implications for Population Vaccination.

Pneumococcal Colonization;Streptococcus Pneumoniae;Vietnam;Pneumococcal Conjugate Vaccine;Pneumococci;Household;Public Health;Health Sciences;Epidemiological Science

Talarico, Carla A.Marrs, Carl F. ;

University of Michigan

关键词: Pneumococcal Colonization;    Streptococcus Pneumoniae;    Vietnam;    Pneumococcal Conjugate Vaccine;    Pneumococci;    Household;    Public Health;    Health Sciences;    Epidemiological Science;   

Others  :  https://deepblue.lib.umich.edu/bitstream/handle/2027.42/64706/ctalaric_1.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: The Illinois Digital Environment for Access to Learning and Scholarship

【 摘 要 】

Streptococcus pneumoniae is the leading cause of bacterial infections worldwide and causes a range of illness from otitis media to pneumonia and meningitis.Use of the heptavalent pneumococcal conjugate vaccine (PCV7) in the United States led to a reduction in invasive pneumococcal disease caused by vaccine serotypes (VTs), reduced nasopharyngeal (NP) carriage of VTs, and reduced antibiotic-resistant pneumococcal disease.However, an increase in colonization and disease due to non-vaccine serotypes has been observed and may threaten the long-term utility of this vaccine.Other countries now want to introduce a PCV.Vietnam, in particular, would like to introduce a PCV, but the epidemiologic data upon which to base this decision are lacking.In order to provide Vietnamese health policymakers with the data upon which to base a decision about a pneumococcal vaccine and to more broadly advance the understanding of the epidemiology of S. pneumoniae, we conducted a cross-sectional study of NP carriage among 519 healthy individuals of all ages who lived in 115 households in one hamlet of Nha Trang, Vietnam.NP carriage was common among children (40%), and colonization decreased with age to 2% among adults ≥ 50 years.Children ≤5 years were more likely to carry PCV serotypes, while older children and adults were more likely to carry non-PCV serotypes.The prevalence of multidrug resistance was high among PCV and non-PCV serotypes (83%).We also identified an unusually high proportion of nontypeable (NT) pneumococci colonizing children and adults in Vietnam (30% of isolates).These NTs were more likely to be resistant compared to encapsulated pneumococci.Furthermore, we demonstrated that a multiplex PCR assay for capsular typing of invasive isolates can also be used with carriage isolates.Finally, we identified age as the most important predictor of individual- and household-level pneumococcal colonization. Children in Vietnam may greatly benefit from use of a PCV, although a vaccine may not reduce antibiotic resistance in Vietnam in the long-term because of the high prevalence of resistance among non-PCV serotypes and the low probability of decreases in inappropriate antibiotic usage in Vietnam.