Prevention of antibiotic-nonsusceptible Streptococcus pneumoniae with conjugate vaccines.

BACKGROUND Streptococcus pneumoniae (pneumococcus) caused approximately 44000 US invasive pneumococcal disease (IPD) cases in 2008. Antibiotic nonsusceptibility complicates IPD treatment. Using penicillin susceptibility breakpoints adopted in 2008, we evaluated antibiotic-nonsusceptible IPD trends in light of the introductions of a 7-valent pneumococcal conjugate vaccine (PCV7) in 2000 and a 13-valent pneumococcal conjugate vaccine (PCV13) in 2010. METHODS IPD cases were defined by isolation of pneumococcus from a normally sterile site in individuals residing in Active Bacterial Core surveillance (ABCs) areas during 1998-2008. Pneumococci were serotyped and tested for antibiotic susceptibility using broth microdilution. RESULTS During 1998-2008, ABCs identified 43198 IPD cases. Penicillin-nonsusceptible strains caused 6%-14% of IPD cases, depending on age. Between 1998-1999 and 2008, penicillin-nonsusceptible IPD rates declined 64% for children aged <5 years (12.1-4.4 cases per 100000), and 45% for adults aged ≥65 (4.8-2.6 cases per 100000). Rates of IPD nonsusceptible to multiple antibiotics mirrored these trends. During 2007-2008, serotypes in PCV13 but not PCV7 caused 78%-97% of penicillin-nonsusceptible IPD, depending on age. CONCLUSIONS Antibiotic-nonsusceptible IPD rates remain below pre-PCV7 rates for children <5 and adults ≥65 years old. PCV13 vaccines hold promise for further nonsusceptibility reductions.

[1]  R. Duncan,et al.  Diagnosis and Management of Acute Otitis Media , 2019, Jurnal Penelitian Perawat Profesional.

[2]  U. Pennsylvania,et al.  Clinical and Laboratory Standards Institute , 2019, Springer Reference Medizin.

[3]  R. Rosenfeld,et al.  The diagnosis and management of acute otitis media. , 2013, Pediatrics.

[4]  R. Aungst,et al.  Healthy People 2020 , 2013, American Journal of Kidney Diseases.

[5]  João A Carriço,et al.  Analysis of Invasiveness of Pneumococcal Serotypes and Clones Circulating in Portugal before Widespread Use of Conjugate Vaccines Reveals Heterogeneous Behavior of Clones Expressing the Same Serotype , 2011, Journal of Clinical Microbiology.

[6]  R. Veenhoven,et al.  Pneumococcal conjugate vaccination and nasopharyngeal acquisition of pneumococcal serotype 19A strains. , 2010, JAMA.

[7]  Matthew R Moore,et al.  A dynamic model of pneumococcal infection in the United States: implications for prevention through vaccination. , 2010, Vaccine.

[8]  S. Kaplan,et al.  Serotype 19A Is the Most Common Serotype Causing Invasive Pneumococcal Infections in Children , 2010, Pediatrics.

[9]  S. Pelton,et al.  Changing Serotypes Causing Childhood Invasive Pneumococcal Disease: Massachusetts, 2001–2007 , 2009, The Pediatric infectious disease journal.

[10]  W. Schaffner,et al.  Sustained reductions in invasive pneumococcal disease in the era of conjugate vaccine. , 2010, The Journal of infectious diseases.

[11]  Licensure of a 13-valent pneumococcal conjugate vaccine (PCV13) and recommendations for use among children - Advisory Committee on Immunization Practices (ACIP), 2010. , 2010, MMWR. Morbidity and mortality weekly report.

[12]  S. Opal,et al.  Pathogenesis, treatment, and prevention of pneumococcal pneumonia , 2009, The Lancet.

[13]  N. Chiu,et al.  National survey of invasive pneumococcal diseases in Taiwan under partial PCV7 vaccination in 2007: emergence of serotype 19A with high invasive potential. , 2009, Vaccine.

[14]  Carlos G. Grijalva,et al.  Antibiotic prescription rates for acute respiratory tract infections in US ambulatory settings. , 2009, JAMA.

[15]  D. Farrell,et al.  Increase in Pneumococcus Macrolide Resistance, United States , 2009, Emerging infectious diseases.

[16]  Ronald N. Jones,et al.  Rationale for revised penicillin susceptibility breakpoints versus Streptococcus pneumoniae: coping with antimicrobial susceptibility in an era of resistance. , 2009, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[17]  M. Moore.  Rethinking replacement and resistance. , 2009, The Journal of infectious diseases.

[18]  D. Greenberg,et al.  Introduction and proliferation of multidrug-resistant Streptococcus pneumoniae serotype 19A clones that cause acute otitis media in an unvaccinated population. , 2009, The Journal of infectious diseases.

[19]  C. Whitney,et al.  PCR-Based Quantitation and Clonal Diversity of the Current Prevalent Invasive Serogroup 6 Pneumococcal Serotype, 6C, in the United States in 1999 and 2006 to 2007 , 2009, Journal of Clinical Microbiology.

[20]  Godfrey L. Smith,et al.  Effects of new penicillin susceptibility breakpoints for Streptococcus pneumoniae--United States, 2006-2007. , 2008, MMWR. Morbidity and mortality weekly report.

[21]  J. Treanor,et al.  Differential effects of pneumococcal vaccines against serotypes 6A and 6C. , 2008, The Journal of infectious diseases.

[22]  Rosanna Lagos,et al.  Age- and serotype-specific pediatric invasive pneumococcal disease: insights from systematic surveillance in Santiago, Chile, 1994--2007. , 2008, The Journal of infectious diseases.

[23]  R. Dagan,et al.  Impact of conjugate pneumococcal vaccines on antibiotic resistance. , 2008, The Lancet. Infectious diseases.

[24]  Ronald N. Jones,et al.  Serotype replacement and multiple resistance in Streptococcus pneumoniae after the introduction of the conjugate pneumococcal vaccine. , 2008, Microbial drug resistance.

[25]  Marc Lipsitch,et al.  Seasonality of antibiotic-resistant streptococcus pneumoniae that causes acute otitis media: a clue for an antibiotic-restriction policy? , 2008, The Journal of infectious diseases.

[26]  W. Schaffner,et al.  Population snapshot of emergent Streptococcus pneumoniae serotype 19A in the United States, 2005. , 2008, The Journal of infectious diseases.

[27]  Clinical,et al.  Performance Standards for Antimicrobial Susceptibility Testing; Eighteenth Informational Supplement , 2008 .

[28]  W. Schaffner,et al.  Incidence of pneumococcal disease due to non-pneumococcal conjugate vaccine (PCV7) serotypes in the United States during the era of widespread PCV7 vaccination, 1998-2004. , 2007, The Journal of infectious diseases.

[29]  J. Bartlett,et al.  Infectious Diseases Society of America/American Thoracic Society Consensus Guidelines on the Management of Community-Acquired Pneumonia in Adults , 2007, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[30]  M. Pichichero,et al.  Increased Antimicrobial Resistance Among Nonvaccine Serotypes of Streptococcus pneumoniae in the Pediatric Population After the Introduction of 7-Valent Pneumococcal Vaccine in the United States , 2007, The Pediatric infectious disease journal.

[31]  M. Lipsitch,et al.  Diversity and antibiotic resistance among nonvaccine serotypes of Streptococcus pneumoniae carriage isolates in the post-heptavalent conjugate vaccine era. , 2007, The Journal of infectious diseases.

[32]  In Ho Park,et al.  Discovery of a New Capsular Serotype (6C) within Serogroup 6 of Streptococcus pneumoniae , 2007, Journal of Clinical Microbiology.

[33]  J. Burke,et al.  Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America Guidelines for Developing an Institutional Program to Enhance Antimicrobial Stewardship , 2007 .

[34]  T. Peto,et al.  Capsular serotype-specific attack rates and duration of carriage of Streptococcus pneumoniae in a population of children. , 2006, The Journal of infectious diseases.

[35]  W. Schaffner,et al.  Effect of introduction of the pneumococcal conjugate vaccine on drug-resistant Streptococcus pneumoniae. , 2006, The New England journal of medicine.

[36]  古谷 良輔,et al.  Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. , 2008, American journal of respiratory and critical care medicine.

[37]  Claude Carbón,et al.  Reduction of antibiotic use in the community reduces the rate of colonization with penicillin G-nonsusceptible Streptococcus pneumoniae. , 2005, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[38]  D. Greenberg,et al.  Community Prescribing and Resistant Streptococcus pneumoniae , 2005, Emerging infectious diseases.

[39]  K. Auranen,et al.  Invasiveness of Serotypes and Clones of Streptococcus pneumoniae among Children in Finland , 2005, Infection and Immunity.

[40]  A. Schuchat,et al.  Decline in invasive pneumococcal disease after the introduction of protein-polysaccharide conjugate vaccine. , 2003, The New England journal of medicine.

[41]  Joshua Lederberg,et al.  Microbial Threats to Health: Emergence, Detection, and Response , 2003 .

[42]  R. Dagan,et al.  Effect of a conjugate pneumococcal vaccine on the occurrence of respiratory infections and antibiotic use in day-care center attendees , 2001, The Pediatric infectious disease journal.

[43]  A. Schuchat,et al.  Epidemiology of invasive Streptococcus pneumoniae infections in the United States, 1995-1998: Opportunities for prevention in the conjugate vaccine era. , 2001, JAMA.

[44]  L. Harrison,et al.  Active bacterial core surveillance of the emerging infections program network. , 2001, Emerging infectious diseases.

[45]  M. Cetron,et al.  Increasing prevalence of multidrug-resistant Streptococcus pneumoniae in the United States. , 2000, The New England journal of medicine.

[46]  R. Hakenbeck,et al.  Penicillin-Binding Proteins in β-Lactam–Resistant Streptococcus pneumoniae , 1999 .

[47]  M. P. van der Linden,et al.  Penicillin-binding proteins in beta-lactam-resistant streptococcus pneumoniae. , 1999, Microbial drug resistance.

[48]  A. Tomasz.  Antibiotic resistance in Streptococcus pneumoniae. , 1997, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[49]  Henry Nider,et al.  Report of the Committee on Infectious Diseases , 1989 .