Pneumococcal carriage and changes in serotype distribution post- PCV13 introduction in children in Matiari, Pakistan

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2024-08-20 DOI:10.1016/j.vaccine.2024.126238

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Abstract

Background

In early 2021, the 10-valent Pneumococcal conjugate vaccine (PCV10) was replaced with 13-valent (PCV13) by the federal directorate of immunization (FDI), Pakistan. We assessed the impact of a higher valent vaccine, PCV13, on the serotype distribution of nasopharyngeal carriage in rural Pakistan.

Methods

Children <2 years were randomly selected from two rural union councils of Matiari, Sindh in Pakistan between September–October,2022. Clinical, sociodemographic and vaccination histories were recorded. Nasopharyngeal swabs were collected and processed at Infectious Disease Research Laboratory, Aga Khan University, Karachi. Whole genome sequencing was performed on the culture positive isolates.

Results

Of the 200 children enrolled, pneumococcus was detected in 140(70 %) isolates. Majority of age-eligible children (60.1 %,110/183) received 3 PCV13 doses. PCV10 carriage declined from 13.2 %(78/590) in 2017/18 to 7.2 % (10/140) in 2022, additional PCV13 serotypes (3, 6A/6C and 19A) decreased from 18.5 %(109/590) to 11.4 %(16/140) while non-PCV13 serotypes increased from 68.3 %(403/590) to 81.4 %(114/140). There were 88.5 %(n = 124), 80.7 %(n = 113), 55.0 %(n = 77), and 46.0 %(n = 65) isolates predicted to be resistant to cotrimoxazole, penicillin(meningitis cut-off), tetracycline, and erythromycin respectively.

Conclusion

Replacing PCV10 with PCV13 rapidly decreased prevalence of PCV13 carriage among vaccinated children in Matiari, Pakistan. Vaccine-driven selection pressure may have been responsible for the increase of non-PCV13 serotypes.

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巴基斯坦马蒂亚里儿童肺炎球菌携带情况和 PCV13 引入后血清型分布的变化

背景2021年初，巴基斯坦联邦免疫局（FDI）用13价肺炎球菌结合疫苗（PCV13）取代了10价肺炎球菌结合疫苗（PCV10）。我们评估了高价疫苗 PCV13 对巴基斯坦农村地区鼻咽带菌血清型分布的影响。记录了临床、社会人口学和疫苗接种史。卡拉奇阿迦汗大学传染病研究实验室收集并处理了鼻咽拭子。对培养呈阳性的分离株进行了全基因组测序。大多数适龄儿童（60.1%，110/183 名）接受了 3 次 PCV13 疫苗注射。PCV10 带菌率从 2017/18 年的 13.2 %（78/590）下降到 2022 年的 7.2 %（10/140），其他 PCV13 血清型（3、6A/6C 和 19A）从 18.5 %（109/590）下降到 11.4 %（16/140），而非 PCV13 血清型从 68.3 %（403/590）上升到 81.4 %（114/140）。预测对复方新诺明、青霉素（脑膜炎临界值）、四环素和红霉素耐药的分离株分别为88.5%（124株）、80.7%（113株）、55.0%（77株）和46.0%（65株）。疫苗驱动的选择压力可能是非 PCV13 血清型增加的原因。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

期刊介绍： Vaccine is unique in publishing the highest quality science across all disciplines relevant to the field of vaccinology - all original article submissions across basic and clinical research, vaccine manufacturing, history, public policy, behavioral science and ethics, social sciences, safety, and many other related areas are welcomed. The submission categories as given in the Guide for Authors indicate where we receive the most papers. Papers outside these major areas are also welcome and authors are encouraged to contact us with specific questions.

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