Carriage of Streptoccoccus pneumoniae in healthy adults aged 60 years or over in a population with very high and long-lasting pneumococcal conjugate vaccine coverage in children: rationale and perspectives for PCV13 implementation

Hum Vaccin Immunother. 2013 Mar;9(3):614-20. doi: 10.4161/hv.23253. Epub 2013 Jan 4.

Abstract

A serial cross-sectional study of nasopharyngeal carriage among adults aged 60 y or over was conducted in winter-spring 2012 with the aim to describe circulating Streptococcus pneumoniae in an area, Liguria Administrative Region, where the vaccine was implemented for a decade and coverage in pediatric age group reached a value close to 100% for more than 5 y, determining a picture of very high vaccine immunological pressure. The serotype-specific carriage picture in adults was compared with that observed in children by means of a cross-sectional study performed one year before using the same sampling and laboratory methods. Cluster sampling enrolled 283 adults, representative of the open population. Detection of multi-serotype carriage was performed using, real-time PCR and primer specific PCRs. Carriage prevalence of participants with at least one positive sample adjusted for age, i.e., period prevalence, was 18.7%, considering the Ligurian population as standard population, showing that the pneumococcal carriage in the elderly is not a rare event as emerged in other surveys. The long-term use of PCV7 has resulted in strong decrease of vaccine types carriage among adults and children. A multivariate analysis showed that age class and contact with children attending day care covariates were strongly associated with Streptococcus pneumoniae carriage. A strong link between the picture observed in < 5-y-old children and ≥ 60-y-old adults emerged: a strong correlation of specific-serotype prevalence between adults and children and risk factor analysis supported the role played by inter-age-group transmission.

Keywords: S. pneumoniae; carriage; conjugate vaccine; replacement; vaccine prevention.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carrier State / epidemiology*
  • Carrier State / microbiology*
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Heptavalent Pneumococcal Conjugate Vaccine
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Pneumococcal Infections / epidemiology*
  • Pneumococcal Infections / microbiology*
  • Pneumococcal Vaccines / administration & dosage*
  • Pneumococcal Vaccines / immunology
  • Polymerase Chain Reaction
  • Prevalence
  • Streptococcus pneumoniae / classification*
  • Streptococcus pneumoniae / isolation & purification*

Substances

  • Heptavalent Pneumococcal Conjugate Vaccine
  • Pneumococcal Vaccines