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

D. Bogaert; R. H. Veenhoven; M. Sluijter; W. J. W. Wannet; G. T. Rijkers; T. J. Mitchell; S. C. Clarke; W. H. F. Goessens; A. G. Schilder; E. A. M. Sanders; R. de Groot; P. W. M. Hermans

doi:10.1128/JCM.43.1.74-83.2005

DOI: 10.1128/JCM.43.1.74-83.2005

Article Figures & Data

Figures

Tables

Open in new tab
Download powerpoint
FIG. 1.
Population RFEL structure of the 180 and 186 pneumococcal isolates retrieved before vaccination (T = 0 months) and after pneumococcal conjugate vaccination (T = 14 months), respectively. Levels of genetic relatedness are depicted as percentages. The serotypes and numbers of isolates per genotype are shown in bars for the two periods separately. The contributions of PV children and CV children are shown in grey and black, respectively. I to IV, predominant clusters at the initial phase of the study; A to E, emerging clusters after conjugate vaccination. Clusters consisting of two or more RFEL genotypes are in parentheses. x, clusters of one RFEL genotype.
Open in new tab
Download powerpoint
FIG. 2.
RFEL dendrogram of the 34 MLST sequence types observed within the 29 largest RFEL clusters.

Tables

Figures

TABLE 1.

Pneumococcal isolates with regard to study group and study phase

Phase	Total no. of isolates	PV group		CV group
Phase	Total no. of isolates	No. of isolates	% Vaccine-type strains	No. of isolates	% Vaccine-type strains
All	921	451		470
0 mo	180	96	46	84	58
7 mo	176	81	41	95	46
14 mo	186	84	26	102	40
20 mo	163	81	25	82	49
26 mo	119	64	26	55	54
First AOM^a	97	45	24	52	44

↵ a AOM, acute otitis media.

TABLE 2.

Pneumococcal colonization dynamics of the 351 children according to study and age groupa

Group, age range, and patient no.	Type of pneumococci carried at:
Group, age range, and patient no.		Mo 0	Mo 7	Mo 14	Mo 20	Mo 26	First AOM^b event
PV
12-24 mo
1	1	1	1		0
2	1		1	1	1	1
3				1	1
4			1	1
5	1	1		1	1
6		1	1		1
7	1	0
8	0	0	0	0	1
9			1
10					1
11	0	1		0
12		0		0
13		1	0		1
14		1			1	0
15	1		1		0
16	1
17	0	0	1
18	0
19	1	0	1	1
20			0	1
21	0			1
22	0	0		1		0
23	0			1		1
24	0	0
25	1	1	0
26	0		1
27		1	1
28	1		1	1		1
29		1	0	1	1
30		0			0	1
31					0	1
32				1
33		1	1	1	1
34	0	0	1	0	1
35	0			1
36	0	0		0
37	0	1	1	1		1
38	0	0	1	1	1	1
39	1				1	1
40		1
41	1			1	1
42			1
43	1
44			0
45		0	0	1	1
46	1	1				1
47					1
48		1			1
49				1	1
50			1		1
51	1	0	1	0
52	0	0
53	1		0	1	0
54						0
55		1	1	1	1
56		0		1
57	0		1
58		1		1	1
59						0
60	0	1		1
61	1		0
62		1	1
63		1	1
64	0
65				1
66	1	1				1
67	0	1	1
68		0				0
69			0
70			1
71	0					1
72	0	1	1			1
73	1	0
74	1	0
2-7 yr
75	0		1	0	0	1
76	1	1
77	0
78	0		1
79			1
80	0	0	0	0	1
81	1	0		1
82			1		0	1
83	1	0
84		1	1	1
85				1	0
86	1		1	1		1
87			1		0	1
88		1	1	1	1	1
89			1	1		1
90						1
91	1					1
92	0
93	0	1		1	1
94				1
95	1		1		1
96				1
97				1	1
98				0
99	1	1	1			1
100	0		1	1	0
101	0	0	0
102	1	0		1	1
103	1	0
104	0
105	0	0				0
106		1	1	1
107	1	0
108	0		0
109	1				1
110	1			1	1
111			0			1
112			1		1
113	0	1	1		1	0
114					1
115		1		0
116	1		1	1
117		1	0	0	0
118	1	1	1	1
119	1			1	1
120		1	1	0
121		1		1	1
122	0				0
123		1	1	1	1	1
124	1	0	1	1	1
125					0	1
126	0	0	0			1
127				1	1
128	0		1	1	1	1
129		1	1
130	0		1	0	1	1
131	1
132	1		1	0	0
133		1	1
134	1	1	1	0	1
135	0			1
136	1			1	1
137	1	1		0	0
138	0			1
139	0				1
140	1		1	1
141		1		1	0
142		1	1	1	1	1
143	1	1		1		0
144	1		0
145		1	1		1
146			1		1
147	0				1	1
148	0					0
149		0		1
150		1		1	1
151						1
152			0	1
153			0	1
154			1	0
155		1
156				1		0
157	1		1
158				1
159	1		1		1
160	1	0	0	1
161	1	1		1
162	0	0	1	0		1
163	1			0		0
164	0	1
165			0
166	1	0	1
167	0		0
168		1				1
169		1	0
170	1
171		1	0
CV
12-24 mo
1	0	0	0	0
2	0	0		0	1
3	0
4			1	1		1
5		0	0	0	1
6		0			0
7	0			1	0
8	0	1		1	0
9			1	0
10			1	0
11		1		1
12	1	0		0		0
13		1	1	0	0
14					0
15		0		0
16	0		1	0	1	1
17	0		1		0
18		1	1		0
19	1	1	1	1	0
20			1		0
21	0		1		1
22			0
23			0		0
24	1		0	1
25			1
26	1	1
27				1	0
28	1	1	1	0	1	1
29		1	0		1	0/1
30			0	1		1
31		1	0		0
32		1	0	1	0	1
33					0
34			1			1
35			0
36		0			0
37	0	1		0
38	0	0	1	0	0	1
39			1
40		0		0		0/1
41	0	1	0	1	0
42		1	0	0		1
43	1	1		0	1
44				0	0	0
45				0	1	0
46	0	0	1	0	0	0
47		0	0	0	0	0
48	1	1	0		0
49			1
50	0			0
51	0					1
52			1
53			0
54	0	1		0
55			1	0		0/1
56	0	0	0	0		0
57	0
58	0
59			1
60	0		1
61	0	0		1
62			0
63	1		0	0		0
64	1
65	0			1
66		1	0			1
67		0
68	0		1
69	1					1
70	1	1	1
71	0	0				0
72	1	1
73	0	0	0			0
74	1
75		1	0
76	1	0
2-7 yr
77	0			1	0	1
78			1
79		0
80		1
81				1
82	1	0	0
83	1		0
84	0	0		0	1	1
85		0		0	1
86		1				0
87		1	0	1		1
88			0		1
89	1	0	0
90		1		0	1
91	1		1	1
92	1	0
93			1	1	0
94					1
95	1		1	0	1
96	0	1		0		1
97	0	1		1
98	1	1	1
99	0	1	1	1
100				1	0
101				0
102		0	0	0		0
103		1
104			1	0	1	0
105			1
106	1	0	1
107			0			1/0
108	1	1	0/1	0/0
109			1	1
110	0	0
111	0
112	1
113		0
114			0	1
115		0
116	0	0	0	0
117		1	0	1
118				1	0
119	0	1	1		0
120		1
121						0
122	1		1
123		0		0
124	0	0	1	1		1
125	0	1		0	1
126		0	1	0
127	1		0
128	1	0	0	0
129			1	1	1
130			1	1
131	0			1		1
132		1	1	1		1
133		0	1	1	1
134	0	0	0
135		0	0	0
136	0		1
137	1	0		0
138				0
139		1		1	1	1
140	0	1	1	1	1	0
141			0	1	1
142	1	1			0	0
143		0
144	1	1		1		1
145	0
146	0	0		1	1
147		1	1
148			1		0	1
149			0
150	1		1		1
151					0
152			0
153	0		1		0
154	1				1
155		0			1
156			1	1
157			1
158	0	1	1			0
159	0	1	0			1
160	0
161			1	0
162		1	1			0
163		0
164		0	1
165	0	1	1
166	0	0	0	1
167	1		1	1
168		0				1
169		1				1
170			1
171		1	1	1
172			1
173	0	0	1
174	1					0
175		1
176		1				0
177	0
178	1	1	1

a Boldface indicates persistent carriage. 1, vaccine-type pneumococci; 0, nonvaccine-type pneumococci. Values separated by shills indicate the results for two different isolates cultured.
↵ b AOM, acute otitis media.

TABLE 3.

Antibiotic resistance rates for the S. pneumoniae collection

Drug	No. of resistant strains	% Of total	No. of intermediately resistant strains	% Of total
Penicillin	2	0.2	8	0.9
Cotrimoxazole	37	4.0	61	6.6
Tetracycline	28	3.0	5	0.5
Erythromycin	29	3.2	1	0.1
Ciprofloxacin	2	0.2	0
Cefotaxime	0		2	0.2

TABLE 4.

S. pneumoniae antibiotic resistance profiles, profile rates, and numbers of genotypes and their serotype distribution

Resistance profile^a	No. of strains (%)	No. of genotypes	Serotype(s)
Co(I)	53 (5.7)	29	3/7/8/10/11/12/14/18C/18F/6A/6B/9A/9V/19A/19F/23F/31/33D/NT^b
Co	25 (2.7)	16	6A/6B/9V/18C/21/23F/NT/34
T	7 (0.8)	6	3/19C/19F
T(I)	4 (0.4)	4	23F/18C/11/38
T(I)E	1 (0.1)	1	33
Tci	1 (0.1)	1	19F
TE	7 (0.8)	6	9N/19F
E	8 (0.9)	6	11/14/15/33
E(I)	1 (0.1)	1	23B
Co(I)E	2 (0.2)	2	6A/8
Co(I)T	1 (0.1)	1	6B
Co(I)TE	1 (0.1)	1	6B
CoT	2 (0.2)	2	23A/19F
CoTE	5 (0.5)	4	6A/6B
P(I)	1 (0.1)	1	11
P(I)CoCf(I)	1 (0.1)	1	14
P(I)Co(I)ECf(I)	1 (0.1)	1	6B
P(I)CoTE	3 (0.3)	3	19F/6B/14
PCo(I)	1 (0.1)	1	15
P(I)Co(I)	2 (0.2)	2	14/23F
PCoTE	1 (0.1)	1	6B
PE	1 (0.1)	1	6A
Total	128 (13.8)

↵ a Co, cotrimoxazole; P, penicillin; T, tetracycline; E, erythromycin; Cf, cefotaxime; Ci, ciprofloxacin; (I), intermediate resistance.
↵ b NT, nontypeable.