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. 2020 Feb;25(5):1900303.
doi: 10.2807/1560-7917.ES.2020.25.5.1900303.

How nasopharyngeal pneumococcal carriage evolved during and after a PCV13-to-PCV10 vaccination programme switch in Belgium, 2016 to 2018

Ine Wouters  1 , Stefanie Desmet  2 , Liesbet Van Heirstraeten  3 , Sereina A Herzog  4 , Philippe Beutels  4 , Jan Verhaegen  2 , Herman Goossens  3 , Pierre Van Damme  1 , Surbhi Malhotra-Kumar  3 , Heidi Theeten  1 ; NPcarriage Study Group  5
Affiliations

How nasopharyngeal pneumococcal carriage evolved during and after a PCV13-to-PCV10 vaccination programme switch in Belgium, 2016 to 2018

Ine Wouters et al. Euro Surveill. 2020 Feb.

Abstract

BackgroundThe current carriage study was set up to reinforce surveillance during/after the PCV13-to-PCVC10 switch in Belgium.AimThis observational study monitored carriage of Streptococcus pneumoniae (Sp) serotypes, particularly those no longer covered (3, 6A, 19A), as well as Haemophilus influenzae (Hi), because PCV10 contains the non-typeable Hi protein D.MethodsA total of 2,615 nasopharyngeal swabs from children (6-30 months old) attending day care were collected in three periods over 2016-2018. Children's demographic and clinical characteristics and vaccination status were obtained through a questionnaire. Sp and Hi were identified by culture and PCR. Pneumococcal strains were tested for antimicrobial (non-)susceptibility by disc diffusion and serotyped by Quellung-reaction (Quellung-reaction and PCR for serotypes 3, 6A, 19A).ResultsThe carriage prevalence of Sp (> 75%) remained stable over the successive periods but that of Hi increased (87.4%, 664 Hi-carriers/760 in 2016 vs 93.9%, 895/953 in 2017-2018). The proportion of non-PCV13 vaccine serotypes decreased (94.6%, 438 isolates/463 in 2016 vs 89.7%, 599/668 in 2017-2018) while that of PCV13-non-PCV10 vaccine serotypes (3 + 6A + 19A) increased (0.9%, 4 isolates/463 in 2016 vs 7.8%, 52/668 in 2017-2018), with serotype 19A most frequently identified (87.9%, 58/66 isolates). Non-susceptibility of pneumococci against any of the tested antibiotics was stable over the study period (> 44%).ConclusionsDuring and after the PCV13-to-PCV10 vaccine switch, the proportion of non-PCV13 serotypes decreased, mainly due to a serotype 19A carriage prevalence increase. These results complement invasive pneumococcal disease surveillance data, providing further basis for pneumococcal vaccination programme policy making.

Keywords: Children; Day-care centres; Haemophilus influenzae; Nasopharyngeal carriage; Pneumococcal conjugate vaccines; Streptococcus pneumoniae.

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Conflict of interest statement

Conflict of interest: Investigator-initiated research grant from Pfizer.

Figures

Figure 1
Figure 1
(A) Vaccination status of healthy children in day care (n = 760 in 2016, 902 in 2016–2017, 952a in 2017–2018) and (B) proportions of vaccine and non-vaccine serotypesb among Streptococcus pneumoniae carriers (n = 463 carriers in 2016, 613 in 2016–2017, 668 in 2017–2018), Belgium, 2016–2018
Figure 2
Figure 2
Carriage prevalencea of Streptococcus pneumoniae and Haemophilus influenzae among healthy children in day care, Belgium, 2016–2018 (n = 760 children in 2016, 902 in 2016–2017, 953 in 2017–2018)
Figure 3
Figure 3
Carriage prevalence of PCV13-non-PCV10 vaccine serotypes 3, 6A, 19Aa, Belgium, 2016–2018 (n = 761 in 2016, 904 in 2016–2017, 956 in 2017–2018)
Figure 4
Figure 4
Non-susceptibility against at least one (n = 463 isolates in 2016, 607 in 2016–2017, 662 in 2017–2018) or more than one (n = 462 isolates in 2016, 609 in 2016–2017, 666 in 2017–2018) of the tested antibioticsa and the dominating serotypes among strains of Streptococcus pneumoniae non-susceptible to at least one antibioticb, Belgium, 2016–2018
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