| Institution: | 1. Instituto Biomédico, Universidade Federal Fluminense, Alameda Barros Terra, s/n. São Domingos, Niterói, RJ 24020-150, Brazil;2. Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro. Av. Carlos Chagas Filho, 373 - bloco I, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ 21941-902, Brazil;1. College of Chemistry and Material Sciences, School of Life Sciences, Heilongjiang University, Harbin, Heilongjiang 150080, China;2. Institute of Nanobiomaterials and Immunology, Zhejiang Provincial Key Laboratory of Plant Evolutionary Ecology and Conservation, School of Life Sciences, Taizhou University, Taizhou 318000, China;1. Division of Diagnostic & Applied Medicine, Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, AB, Canada;2. Alberta Precision Laboratories – Public Health, AB, Canada;3. Li Ka Shing Institute of Virology, Edmonton, AB, Canada;4. Women and Children’s Health Research Institute, Edmonton, AB, Canada;5. Division of Infectious Diseases, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada;6. Section of Medical Microbiology, Department of Pathology & Laboratory Medicine, Cumming School of Medicine, Calgary, AB, Canada;1. George Washington University Hospital, Department of Obstetrics and Gynecology, 900 23rd ST NW, Washington, DC 20037, United States;2. George Washington University, School of Medicine and Health Sciences, 2300 I St NW, Washington, DC 20052, United States;3. Sarasota Memorial Hospital, 1700 S Tamiami Trail, Sarasota, FL 34239, United States;1. Jerusalem District Health Office, Ministry of Health, Israel;2. The Hebrew University of Jerusalem, Faculty of Medicine, The Hebrew University and Hadassah Braun School of Public and Community Medicine, Jerusalem, Israel |
| Abstract: | BackgroundThe 10-valent pneumococcal conjugate vaccine (PCV10) was introduced for childhood vaccination in Brazil’s National Immunization Program in 2010. After nine years of PCV10 use, we investigated the carriage prevalence, capsular types, antimicrobial resistance and risk factors among children living in Niterói city, RJ, Brazil.MethodsBetween September and December 2019, we conducted a cross-sectional study and recruited children under 6 years of age. Antimicrobial susceptibility was evaluated by the disk-diffusion method and MICs to beta-lactams and macrolides were determined by E-test®. Capsular types were deduced by multiplex PCR. Logistic regression was used to predict risk factors for pneumococcal carriage.ResultsSeventy-five (17.4%) of the 430 children were pneumococcal carriers. The most frequent capsular types were 6C/D (14.7%), 11A/D (13.3%), and 23B (9.3%). PCV10 serotypes represented 5.3%. All isolates were susceptible to levofloxacin, linezolid, rifampicin, and vancomycin. Penicillin non-susceptible pneumococci (PNSP) made up 37.3%, with penicillin and ceftriaxone MICs ranging from 0.12 to 4.0 μg/ml and 0.064–4.0 μg/ml, respectively. Of the 19 (25.3%) erythromycin-resistant (ERY-R) isolates (macrolide MICs of 6 to >256 μg/ml), most had the cMLSB phenotype (84.2%) and carried the erm(B) gene (73.7%). We detected 17 (22.6%) multidrug-resistant (MDR) isolates, strongly associated with serotype 6C/D. Presence of any symptoms, chronic diseases, childcare center attendance, living with young siblings, slum residence, and unstable income were predictors of pneumococcal carriage.ConclusionsLong-term universal childhood use of PCV10 has nearly eliminated carriage with PCV10 serotypes, but the high frequency of MDR isolates, especially associated with serotype 6C/D, remains a concern. Replacing PCV10 with PCV13 should reduce the proportion of ERY-R isolates and PNSP by at least 14% and 18%, respectively. |
