Seven-Valent Pneumococcal Conjugate Vaccine and Nasopharyngeal Microbiota in Healthy Children

Emerging Infectious Diseases (Impact Factor: 6.75). 02/2014; 20(2):201-10. DOI: 10.3201/eid2002.131220
Source: PubMed


Seven-valent pneumococcal conjugate vaccine (PCV-7) is effective against vaccine serotype disease and carriage. Nevertheless, shifts in colonization and disease toward nonvaccine serotypes and other potential pathogens have been described. To understand the extent of these shifts, we analyzed nasopharyngeal microbial profiles of 97 PCV-7-vaccinated infants and 103 control infants participating in a randomized controlled trial in the Netherlands. PCV-7 immunization resulted in a temporary shift in microbial community composition and increased bacterial diversity. Immunization also resulted in decreased presence of the pneumococcal vaccine serotype and an increase in the relative abundance and presence of nonpneumococcal streptococci and anaerobic bacteria. Furthermore, the abundance of Haemophilus and Staphylococcus bacteria in vaccinees was increased over that in controls. This study illustrates the much broader effect of vaccination with PCV-7 on the microbial community than currently assumed, and highlights the need for careful monitoring when implementing vaccines directed against common colonizers.

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Available from: Krzysztof Trzciński, Feb 11, 2014
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    • "The authors, however, question the role of PCV10 as a causative agents since there was an overall reduction in H. influenzae carriage and no association between vaccination status and carriage of H. influenzae [32]. No consistent changes in carriage of M. catarrhalis overtime were found [45], also not on microbiota level both PCV7 [41] and PCV10-vaccinated children [48]. Strengths of our study are the consistency of data collection in repeated large, identically designed, well-defined studies conducted overtime by the same study group in an open population of children and their parents. "
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    ABSTRACT: After introduction of the 7-valent pneumococcal conjugate vaccine (PCV7) in the infant national immunization program (NIP) in the Netherlands in 2006, Streptococcus pneumoniae strains of the non-vaccine serotype 19A emerged and became the dominant serotype in carriage in children and their parents. Similar patterns were observed in other European countries and the United States. Increases in carriage rates of Staphylococcus aureus and non-typeable (NT) Haemophilus influenzae were also observed. After switching of PCV7 to 10-valent vaccine (PCV10) in 2011, a new carriage surveillance study was performed in the winter of 2012/2013. Nasopharyngeal carriage of S. pneumoniae, H. influenzae, S. aureus, and Moraxella catarrhalis was determined by conventional culture in 330 PCV10-vaccinated 11-month-old children, 330 PCV7-vaccinated 24-month-old children, and their parents. Carriage prevalence was compared with similar carriage studies conducted in 2005, 2009, and 2010/2011. Although serotype 19A remained the most frequently carried pneumococcal serotype in children, prevalence of 19A significantly declined in PCV7-vaccinated 24-month-old children (14% to 8%, p = 0.01), but less in PCV10-vaccinated 11-month-old children (12% to 9%, p = 0.31). Carriage of H. influenzae remained stable at an elevated level (65% in 11-month-olds and 69% in 24-month-olds), while the carriage of S. aureus returned to pre-PCV7 levels in 11-month-old children (14% in 2010/2011 to 7% in 2012/2013), but not in 24-month-olds (remained at 7%). Our results might indicate a new balance between replacing non-vaccine pneumococcal serotypes and other potential pathogenic bacteria in nasopharyngeal carriage. Carriage studies are valuable tools in assessing vaccine effects on pathogens circulating in the population, for evaluation of PCV impact, and in predicting changes in respiratory and invasive disease.
    Full-text · Article · Dec 2015 · Vaccine
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    • "Understanding the relationships between microbes of the upper respiratory tract (URT) during perturbations is anticipated to provide insights into the pathogenesis of URT infections. Studies of the nasopharyngeal microbiota in children have observed changes due to season (winter/fall versus spring) [4] and treatment with antimicrobials or the heptavalent conjugated pneumococcal polysaccharide vaccine [6,7]. Specific commensal taxa have been negatively associated with colonization of known pathogenic bacteria and with acute otitis media in children, and these relationships changed depending on antibiotic usage [8]. "
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    ABSTRACT: Background The bacterial communities of the nasopharynx play an important role in upper respiratory tract infections (URTIs). Our study represents the first survey of the nasopharynx during a known, controlled viral challenge. We aimed to gain a better understanding of the composition and dynamics of the nasopharyngeal microbiome during viral infection. Methods Rhinovirus illnesses were induced by self-inoculation using the finger to nose or eye natural transmission route in ten otherwise healthy young adults. Nasal lavage fluid samples (NLF) samples were collected at specific time points before, during, and following experimental rhinovirus inoculation. Bacterial DNA from each sample (N = 97 from 10 subjects) was subjected to 16S rRNA sequencing by amplifying the V1-V2 hypervariable region followed by sequencing using the 454-FLX platform. Results This survey of the nasopharyngeal microbiota revealed a highly complex microbial ecosystem. Taxonomic composition varied widely between subjects and between time points of the same subject. We also observed significantly higher diversity in not infected individuals compared to infected individuals. Two genera – Neisseria and Propionibacterium – differed significantly between infected and not infected individuals. Certain phyla, including Firmicutes, Actinobacteria, and Proteobacteria, were detected in all samples. Conclusions Our results reveal the complex and diverse nature of the nasopharyngeal microbiota in both healthy and viral-challenged adults. Although some phyla were common to all samples, differences in levels of diversity and selected phyla were detected between infected and uninfected participants. Deeper, species-level metagenomic sequencing in a larger sample is warranted.
    Full-text · Article · Jun 2014
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    ABSTRACT: The widespread use of the 7-valent pneumococcal conjugate vaccine has been associated with epidemiological changes of mucosal and invasive pneumococcal disease. No study describes the impact of 13-valent pneumococcal conjugate vaccine (PCV13) on chronic sinusitis in children. We describe changes in epidemiology of S. pneumoniae chronic sinusitis after the introduction of PCV13 at Texas Children's Hospital (TCH). We identified patients <18 years with positive sinus culture for S. pneumoniae who underwent endoscopic sinus surgery due to chronic sinusitis from August 2008 to December 2013 at TCH. Isolates were serotyped by the capsular swelling method. Demographic and clinical information was collected retrospectively. The χ2 test and Fisher's exact test were used to analyze dichotomous variables. We identified 91 cases of chronic sinusitis with positive sinus culture for S. pneumoniae. Sixty-one (67%) isolates were non-PCV13 serotypes. PCV13 cases decreased 31% in the post-PCV13 period (p=0.003). Serotype 19A decreased 27% in the post-PCV13 period (p=0.007), but accounted for all the isolates with penicillin MIC ≥ 4µg/ml and ceftriaxone MIC ≥2 µg/ml. Serotypes 19A (38%) and 15C (17%) were the most common in the pre- and post-PCV13 periods, respectively. The most common organism co-isolated was Haemophilus influenzae (52%). Isolation of Prevotella spp. increased in the post-PCV13 period (p=0.02). S. pneumoniae continues to represent an important pathogen in chronic sinusitis in children < 5 years. After the introduction of PCV13, S. pneumoniae isolation declined in children with chronic sinusitis at TCH. We also observed a substantial reduction of PCV13 serotypes, predominantly serotype 19A.
    No preview · Article · Apr 2014 · The Pediatric Infectious Disease Journal
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