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Journal of Clinical Microbiology, January 2005, p. 74-83, Vol. 43, No. 1
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.1.74-83.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Molecular Epidemiology of Pneumococcal Colonization in Response to Pneumococcal Conjugate Vaccination in Children with Recurrent Acute Otitis Media

D. Bogaert,1 R. H. Veenhoven,2 M. Sluijter,1 W. J. W. Wannet,3 G. T. Rijkers,4 T. J. Mitchell,5 S. C. Clarke,6 W. H. F. Goessens,7 A. G. Schilder,8 E. A. M. Sanders,4 R. de Groot,1 and P. W. M. Hermans1*

Department of Pediatrics, Erasmus MC-Sophia,1 Department of Medical Microbiology and Infectious Diseases, Erasmus MC, Rotterdam,7 Department of Pediatrics, Spaarne Hospital, Haarlem,2 National Institute for Public Health and the Environment, Bilthoven,3 Department of Immunology,4 Department of Otorhinolaryngology, University Medical Center, Wilhelmina Children's Hospital, Utrecht, The Netherlands,8 Division of Infection and Immunity, IBLS, University of Glasgow,5 Division Scottish Meningococcus and Pneumococcus Reference Laboratory, Stobhill Hospital, Glasgow, United Kingdom6

Received 29 September 2003/ Returned for modification 19 November 2003/ Accepted 3 September 2004

A randomized double-blind trial with a 7-valent pneumococcal conjugate vaccine was conducted in The Netherlands among 383 children, aged 1 to 7 years, with a history of recurrent acute otitis media. No effect of vaccination on the pneumococcal colonization rate was found. However, a shift in serotype distribution was clearly observed (R. Veenhoven et al., Lancet 361:2189-2195, 2003). We investigated the molecular epidemiology of 921 pneumococcal isolates retrieved from both the pneumococcal vaccine (PV) and control vaccine (CV) groups during the vaccination study. Within individuals a high turnover rate of pneumococcal restriction fragment end labeling genotypes, which was unaffected by vaccination, was observed. Comparison of the genetic structures before and after completion of the vaccination scheme revealed that, despite a shift in serotypes, there was clustering of 70% of the pneumococcal populations. The remaining isolates (30%) were equally observed in the PV and CV groups. In addition, the degree of genetic clustering was unaffected by vaccination. However, within the population genetic structure, nonvaccine serotype clusters with the serotypes 11, 15, and 23B became predominant over vaccine-type clusters after vaccination. Finally, overall pneumococcal resistance was low (14%), and, albeit not significant, a reduction in pneumococcal resistance as a result of pneumococcal vaccination was observed. Molecular surveillance of colonization in Dutch children shows no effect of pneumococcal conjugate vaccination on the degree of genetic clustering and the genetic structure of the pneumococcal population. However, within the genetic pneumococcal population structure, a clear shift toward nonvaccine serotype clusters was observed.

* Corresponding author. Mailing address: Erasmus MC-Sophia Rotterdam, Laboratory of Pediatrics, Room Ee 1500, Dr. Molewaterplein 50, 3015 GE Rotterdam, The Netherlands. Phone: 31-10-4088224. Fax: 31-10-4089486. E-mail: p.hermans{at}erasmusmc.nl.

Journal of Clinical Microbiology, January 2005, p. 74-83, Vol. 43, No. 1
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.1.74-83.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.



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  • Bogaert, D., Sluijter, M., Toom, N. L.-d., Mitchell, T. J., Goessens, W. H. F., Clarke, S. C., de Groot, R., Hermans, P. W. M. (2006). Dynamics of pneumococcal colonization in healthy Dutch children. Microbiology 152: 377-385 [Abstract] [Full Text]  


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