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Updated: Mar 14, 2026
Experimental Human Pneumococcal Carriage
Published on: February 15, 2013
Nasopharyngeal Pneumococcal Carriage among Healthy Children in Cyprus Post Widespread Simultaneous Implementation of
Adamos Hadjipanayis1,2, Elisavet Efstathiou1, Maria Alexandrou3
1Paediatric Department, Larnaca General Hospital, Larnaca, Cyprus.
Insights
Pneumococcal nasopharyngeal carriage in children post-vaccine implementation shows a 25.3% rate. Multidrug-resistant serotype 15A is a concern, necessitating ongoing surveillance for pneumococcal conjugate vaccines (PCV10, PCV13).
Area of Science:
- Pediatric Infectious Diseases
- Vaccinology
- Microbiology
Background:
- Pneumococcal nasopharyngeal carriage is a key factor in disease transmission.
- The introduction of pneumococcal conjugate vaccines (PCV10, PCV13) aims to reduce carriage and invasive disease.
- Understanding carriage dynamics, serotype distribution, and antibiotic resistance post-vaccination is crucial for public health.
Purpose of the Study:
- To determine the incidence of pneumococcal nasopharyngeal carriage in children aged 6-36 months.
- To analyze serotype distribution and antibiotic resistance profiles of pneumococcal isolates after conjugate vaccine implementation.
- To compare carriage rates and specific serotype colonization between PCV10 and PCV13 vaccinated children.
Main Methods:
- Stratified random sampling of 1105 healthy children aged 6-36 months.
- Collection of nasopharyngeal swabs for bacterial isolation, serotyping, and antibiotic susceptibility testing.
- Recording of demographics, vaccination status (PCV10, PCV13), and potential risk factors.
Main Results:
- Overall pneumococcal nasopharyngeal carriage rate was 25.3%.
- Predominant serotypes included 23A, 15A, 6C, 23B, 19A, and 15B. Serotype 15A showed high multidrug resistance.
- Carriage rates were similar between PCV10 and PCV13 vaccinated groups; PCV13 vaccination showed a non-significant trend towards reduced colonization by additional vaccine serotypes.
Conclusions:
- Pneumococcal conjugate vaccines have been implemented, but nasopharyngeal carriage persists.
- The high prevalence of multidrug-resistant serotype 15A warrants attention and continued monitoring.
- Ongoing surveillance is essential to track pneumococcal carriage dynamics and antibiotic resistance patterns in the post-vaccine era.
Abstract:
The objective of the study was to describe the incidence of pneumococcal nasopharyngeal carriage, serotype distribution and antibiotic resistance profile of pneumococcal nasopharyngeal isolates in healthy children aged 6 to 36 months following the implementation of conjugate vaccines. A nasopharyngeal swab was collected from 1105 healthy children following a stratified random sampling between September 2013 and April 2014. Demographics, vaccination status and data on possible risk factors were recorded. Isolates were serotyped and tested for antibiotic susceptibility. The nasopharyngeal carriage rate was 25.3%. Among 1105 children enrolled, 393 had received PCV13 and 685 PCV10. The prevailing isolated serotypes were: 23A (14.3%), 15A (8.9%), 6C (8.6%), 23B (7.5%), 19A (5.4%) and 15B (5%). The proportion of non-vaccine serotypes, PCV10 serotypes, PCV13 additional serotypes (3, 6A, 19A) was 76.8%, 2.1% and 10.4% respectively. Although children, who were fully or partially vaccinated with PCV13, were 63% less likely to be colonized with additional PCV13 serotypes compared to those vaccinated with PCV10, the difference is not significant (95%Cl = 0.14-1.02, p = 0.053). The highest antibiotic non-susceptible rates were found for erythromycin (28.2%) and penicillin (27.9%). The overall multidrug resistance rate was 13.2%, with serotypes 24F (4/6), 15A (14/25) and 19A (6/15) being the main contributors. Carriage rate was similar between children vaccinated with PCV10 or PCV13. The high incidence of 15A serotype which is also multidrug resistant should be underlined. Ongoing surveillance is needed to monitor the dynamics on nasopharyngeal carriage.
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