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. 2024 Feb 9;10(4):e25741.
doi: 10.1016/j.heliyon.2024.e25741. eCollection 2024 Feb 29.

Changes in pneumococcal serotypes distribution and penicillin resistance in healthy children five years after generalization of PCV10

Karima Warda  1 , Sara Amari  1 , Majda Boureddane  1 , Youssef Elkamouni  1   2 , Lamiae Arsalane  1   2 , Said Zouhair  1   2 , Mohammed Bouskraoui  1   3
Affiliations

Changes in pneumococcal serotypes distribution and penicillin resistance in healthy children five years after generalization of PCV10

Karima Warda et al. Heliyon. .

Abstract

Objective: Streptococcus pneumoniae (S. pneumoniae) nasopharyngeal carriage has significantly decreased after the generalization of pneumococcal vaccination worldwide. This study sought to investigate changes in S. pneumoniae carriage rates, serotype distribution and penicillin non-susceptibility following the generalization of 10-valent pneumococcal conjugate vaccine.

Methods: A prospective study was conducted in Marrakesh, Morocco, between 2017 and 2018, among healthy children attending vaccination centers. We collected nasopharyngeal swabs and questionnaire data for each child. Using univariate logistic regression, we analyzed the association between S. pneumoniae carriage and various risk factors. Comparisons of serotype diversity and penicillin resistance between 2017 and 2018 and the period before introduction of vaccination (2008-2009, n = 660) were performed using Simpson index and the chi-squared test, respectively.

Results: During 2017-2018, 515 children aged between 6 and 36 months participated. The S. pneumoniae carriage rate was 43.3%. Looking at the distribution serotypes, the rate of PCV10 serotypes rate was only 9.6%. Among non-vaccine serotypes, an increase in serotypes 6C/6D (22; 14%), 19B/19C (17; 10.8%), and 15B/15C (11; 7%) was observed. A particular increase in serotype diversity was also observed after the generalization of PCV10 (p < 0.001). S. pneumoniae non-susceptible to penicillin decreased, reaching a rate of 26.6% in 2017-2018.

Conclusion: The significant change in S. pneumoniae carriage, serotype distribution, and penicillin resistance highlights the effectiveness of the pneumococcal conjugate vaccine among children in Marrakesh, Morocco.

Keywords: Carriage; Nasopharyngeal; PCV10; Penicillin resistance; S. pneumoniae.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Serotype distribution of S. pneumoniae strains isolated from nasopharyngeal carriage in healthy children after the introduction of PCV10 in Marrakesh, Morocco. *NVS: non-vaccine serotypes, excluding serotypes 2, 3, 6A, 6C/6D, 8, 10, 11A/11D, 15A/15F, 15B/15C, 19B/19C, 20, 23A, 23B, 33A/33F/37.
Fig. 2
Fig. 2
S. pneumoniae serotypes rate (PCV10, PCV13, and NVSs) before (2008–2009) and after (2017–2018) the generalization of PCV10 in Marrakesh, Morocco.
Fig. 3
Fig. 3
Antibiotic resistance of 64 S. pneumoniae strains isolated among healthy children five years after the introduction of PCV10. *Resistant: Intermediate + Resistant.
Fig. 4
Fig. 4
Distribution of S. pneumoniae serotypes according topenicillin resistance.
See this image and copyright information in PMC

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