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Prevention of antibiotic-nonsusceptible Streptococcus pneumoniae with conjugate vaccines

Lee M Hampton1, Monica M Farley, William Schaffner

  • 1Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia 30329, USA. lhampton@cdc.gov

The Journal of Infectious Diseases
|December 14, 2011
PubMed
Abstract

Insights

Antibiotic-resistant invasive pneumococcal disease (IPD) rates have declined significantly in young children and older adults following vaccine introduction. The 13-valent pneumococcal conjugate vaccine (PCV13) shows promise for further reducing resistance.

Area of Science:

  • Epidemiology
  • Infectious Diseases
  • Vaccinology

Background:

  • Invasive pneumococcal disease (IPD) remains a significant public health concern, with antibiotic nonsusceptibility complicating treatment.
  • The introduction of pneumococcal conjugate vaccines (PCV7 and PCV13) aimed to reduce the burden of IPD.

Purpose of the Study:

  • To evaluate trends in antibiotic-nonsusceptible IPD in the US from 1998-2008.
  • To assess the impact of PCV7 and PCV13 introductions on these trends.

Main Methods:

  • Analysis of IPD cases reported to the Active Bacterial Core surveillance (ABCs) system (1998-2008).
  • Serotyping and antibiotic susceptibility testing (broth microdilution) of isolated pneumococci.
  • Evaluation of trends using penicillin susceptibility breakpoints adopted in 2008.

Main Results:

  • Penicillin-nonsusceptible strains accounted for 6%-14% of IPD cases.
  • Significant declines in penicillin-nonsusceptible IPD rates observed: 64% in children <5 years and 45% in adults ≥65 years.
  • Serotypes targeted by PCV13, but not PCV7, were responsible for the majority of penicillin-nonsusceptible IPD in 2007-2008.

Conclusions:

  • Antibiotic-nonsusceptible IPD rates are currently below pre-PCV7 levels for key age groups.
  • PCV13 vaccination is a promising strategy for further reducing antibiotic nonsusceptibility in IPD.
  • Continued surveillance is crucial to monitor evolving resistance patterns.

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