Carriage of Streptoccoccus pneumoniae in healthy adults aged 60 y or over in a population with very high and long-lasting pneumococcal conjugate vaccine coverage in children Rationale and perspectives for PCV13 implementation

被引:26
作者
Ansaldi, Filippo [1 ,2 ]
de Florentiis, Daniela [2 ]
Canepa, Paola [2 ]
Ceravolo, Antonella [2 ]
Rappazzo, Emanuela [2 ]
Iudici, Rocco [2 ]
Martini, Mariano [2 ]
Botti, Gerardo [2 ]
Orsi, Andrea [2 ]
Icardi, Giancarlo [1 ,2 ]
Durando, Paolo [1 ,2 ]
机构
[1] IRCCS AOU San Martino IST, Genoa, Italy
[2] Univ Genoa, Dept Hlth Sci, Genoa, Italy
关键词
vaccine prevention; conjugate vaccine; S; pneumoniae; carriage; replacement; STREPTOCOCCUS-PNEUMONIAE; DISEASE; IMMUNIZATION; SEROTYPES; PROGRAM; IMPACT;
D O I
10.4161/hv.23253
中图分类号
Q81 [生物工程学(生物技术)]; Q93 [微生物学];
学科分类号
071005 ; 0836 ; 090102 ; 100705 ;
摘要
A serial cross-sectional study of nasopharyngeal carriage among adults aged 60 y or over was conducted in winter-spring 2012 with the aim to describe circulating Streptococcus pneumoniae in an area, Liguria Administrative Region, where the vaccine was implemented for a decade and coverage in pediatric age group reached a value close to 100% for more than 5 y, determining a picture of very high vaccine immunological pressure. The serotype-specific carriage picture in adults was compared with that observed in children by means of a cross-sectional study performed one year before using the same sampling and laboratory methods. Cluster sampling enrolled 283 adults, representative of the open population. Detection of multi-serotype carriage was performed using, real-time PC R and primer specific PCRs. Carriage prevalence of participants with at least one positive sample adjusted for age, i.e., period prevalence, was 18.7%, considering the Ligurian population as standard population, showing that the pneumococcal carriage in the elderly is not a rare event as emerged in other surveys. The long-term use of PCV7 has resulted in strong decrease of vaccine types carriage among adults and children. A multivariate analysis showed that age class and contact with children attending day care covariates were strongly associated with Streptococcus pneumoniae carriage. A strong link between the picture observed in < 5-y-old children and >= 60-y-old adults emerged: a strong correlation of specific-serotype prevalence between adults and children and risk factor analysis supported the role played by inter-age-group transmission.
引用
收藏
页码:614 / 620
页数:7
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