Impact of Pneumococcal Conjugate Vaccine and of Reduction of Antibiotic Use on Nasopharyngeal Carriage of Nonsusceptible Pneumococci in Children With Acute Otitis Media
BACKGROUND:Penicillin resistance among pneumococci has increased in the past 15 years. The implementation of widespread vaccination with the heptavalent pneumococcal conjugate vaccine (PCV7) and the reduction of inappropriate antibiotic use could help reduce antibiotic resistance. METHODS:Between Se...
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| Veröffentlicht in: | The Pediatric infectious disease journal 2006-11, Vol.25 (11), p.1001-1007 |
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| creator | Cohen, Robert Levy, Corinne de La Rocque, France Gelbert, Nathalie Wollner, Alain Fritzell, Bernard Bonnet, Eric Tetelboum, Robert Varon, Emmanuelle |
| description | BACKGROUND:Penicillin resistance among pneumococci has increased in the past 15 years. The implementation of widespread vaccination with the heptavalent pneumococcal conjugate vaccine (PCV7) and the reduction of inappropriate antibiotic use could help reduce antibiotic resistance.
METHODS:Between September 2001 and June 2004, 89 pediatricians distributed throughout France took part in this prospective study. We obtained 1906 nasopharyngeal swabs for culture from children aged 6 to 24 months with acute otitis media (AOM). At the same time as PCV7 was introduced into the routine immunization schedule, a plan to promote judicious antibiotic use was established. We recorded the frequency of antibiotic use, as well as the dates of immunization with PCV7.
RESULTS:The proportion of PCV7-vaccinated children (≥1 dose) increased from 8.2% (year 1) to 61.4% (year 3). The proportion of children who received antibiotics within 3 months before enrollment decreased from 51.8% in year 1 to 40.9% in year 3 (P < 0.001). Overall pneumococcal carriage and carriage of PCV7 serotypes decreased during the 3-year period by 16% (P < 0.001) and 35% (P < 0.001), respectively. Rates of highly penicillin resistant strains (PRP) decreased yearly15.4%, 10.6%, 6.7% (P < 0.001), respectively. Risks for PRP carriage were 4.2% for immunized children who had not received antibiotics, 8.6% for those vaccinated who also had received antibiotics, 10.3% for unimmunized children who had not received antibiotics, and 16.2% for unimmunized children who had received antibiotics (P < 0.001).
CONCLUSION:Implementation of PCV7, combined with a reduction in antibiotic use, in a country with a high prevalence of antibiotic-resistant pneumococci appears to have a strong impact on the carriage of penicillin nonsusceptible pneumococci in children with AOM. |
| doi_str_mv | 10.1097/01.inf.0000243163.85163.a8 |
| format | Article |
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METHODS:Between September 2001 and June 2004, 89 pediatricians distributed throughout France took part in this prospective study. We obtained 1906 nasopharyngeal swabs for culture from children aged 6 to 24 months with acute otitis media (AOM). At the same time as PCV7 was introduced into the routine immunization schedule, a plan to promote judicious antibiotic use was established. We recorded the frequency of antibiotic use, as well as the dates of immunization with PCV7.
RESULTS:The proportion of PCV7-vaccinated children (≥1 dose) increased from 8.2% (year 1) to 61.4% (year 3). The proportion of children who received antibiotics within 3 months before enrollment decreased from 51.8% in year 1 to 40.9% in year 3 (P < 0.001). Overall pneumococcal carriage and carriage of PCV7 serotypes decreased during the 3-year period by 16% (P < 0.001) and 35% (P < 0.001), respectively. Rates of highly penicillin resistant strains (PRP) decreased yearly15.4%, 10.6%, 6.7% (P < 0.001), respectively. Risks for PRP carriage were 4.2% for immunized children who had not received antibiotics, 8.6% for those vaccinated who also had received antibiotics, 10.3% for unimmunized children who had not received antibiotics, and 16.2% for unimmunized children who had received antibiotics (P < 0.001).
CONCLUSION:Implementation of PCV7, combined with a reduction in antibiotic use, in a country with a high prevalence of antibiotic-resistant pneumococci appears to have a strong impact on the carriage of penicillin nonsusceptible pneumococci in children with AOM.</description><identifier>ISSN: 0891-3668</identifier><identifier>EISSN: 1532-0987</identifier><identifier>DOI: 10.1097/01.inf.0000243163.85163.a8</identifier><identifier>PMID: 17072121</identifier><identifier>CODEN: PIDJEV</identifier><language>eng</language><publisher>Baltimore, MD: Lippincott Williams & Wilkins, Inc</publisher><subject><![CDATA[Acute Disease ; Anti-Bacterial Agents - pharmacology ; Anti-Bacterial Agents - therapeutic use ; Antibacterial agents ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Bacterial diseases ; Biological and medical sciences ; Carrier State - drug therapy ; Carrier State - epidemiology ; Carrier State - microbiology ; Carrier State - prevention & control ; Child, Preschool ; Ent and stomatologic bacterial diseases ; Female ; Heptavalent Pneumococcal Conjugate Vaccine ; Human bacterial diseases ; Humans ; Infant ; Infectious diseases ; Male ; Medical sciences ; Meningococcal Vaccines - administration & dosage ; Nasopharynx - microbiology ; Otitis Media - drug therapy ; Otitis Media - epidemiology ; Otitis Media - microbiology ; Otitis Media - prevention & control ; Penicillin Resistance ; Penicillins - pharmacology ; Penicillins - therapeutic use ; Pharmacology. Drug treatments ; Pneumococcal Infections - drug therapy ; Pneumococcal Infections - epidemiology ; Pneumococcal Infections - microbiology ; Pneumococcal Infections - prevention & control ; Pneumococcal Vaccines - administration & dosage ; Risk Factors ; Serotyping ; Staphylococcal infections, streptococcal infections, pneumococcal infections ; Streptococcus pneumoniae - classification ; Streptococcus pneumoniae - drug effects ; Streptococcus pneumoniae - isolation & purification ; Vaccination]]></subject><ispartof>The Pediatric infectious disease journal, 2006-11, Vol.25 (11), p.1001-1007</ispartof><rights>2006 Lippincott Williams & Wilkins, Inc.</rights><rights>2006 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4174-abd00bc034ab2f2bcdd16561690902adab569da9d6eda7ec3bea94eba04b2e133</citedby><cites>FETCH-LOGICAL-c4174-abd00bc034ab2f2bcdd16561690902adab569da9d6eda7ec3bea94eba04b2e133</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18263241$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17072121$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cohen, Robert</creatorcontrib><creatorcontrib>Levy, Corinne</creatorcontrib><creatorcontrib>de La Rocque, France</creatorcontrib><creatorcontrib>Gelbert, Nathalie</creatorcontrib><creatorcontrib>Wollner, Alain</creatorcontrib><creatorcontrib>Fritzell, Bernard</creatorcontrib><creatorcontrib>Bonnet, Eric</creatorcontrib><creatorcontrib>Tetelboum, Robert</creatorcontrib><creatorcontrib>Varon, Emmanuelle</creatorcontrib><title>Impact of Pneumococcal Conjugate Vaccine and of Reduction of Antibiotic Use on Nasopharyngeal Carriage of Nonsusceptible Pneumococci in Children With Acute Otitis Media</title><title>The Pediatric infectious disease journal</title><addtitle>Pediatr Infect Dis J</addtitle><description>BACKGROUND:Penicillin resistance among pneumococci has increased in the past 15 years. The implementation of widespread vaccination with the heptavalent pneumococcal conjugate vaccine (PCV7) and the reduction of inappropriate antibiotic use could help reduce antibiotic resistance.
METHODS:Between September 2001 and June 2004, 89 pediatricians distributed throughout France took part in this prospective study. We obtained 1906 nasopharyngeal swabs for culture from children aged 6 to 24 months with acute otitis media (AOM). At the same time as PCV7 was introduced into the routine immunization schedule, a plan to promote judicious antibiotic use was established. We recorded the frequency of antibiotic use, as well as the dates of immunization with PCV7.
RESULTS:The proportion of PCV7-vaccinated children (≥1 dose) increased from 8.2% (year 1) to 61.4% (year 3). The proportion of children who received antibiotics within 3 months before enrollment decreased from 51.8% in year 1 to 40.9% in year 3 (P < 0.001). Overall pneumococcal carriage and carriage of PCV7 serotypes decreased during the 3-year period by 16% (P < 0.001) and 35% (P < 0.001), respectively. Rates of highly penicillin resistant strains (PRP) decreased yearly15.4%, 10.6%, 6.7% (P < 0.001), respectively. Risks for PRP carriage were 4.2% for immunized children who had not received antibiotics, 8.6% for those vaccinated who also had received antibiotics, 10.3% for unimmunized children who had not received antibiotics, and 16.2% for unimmunized children who had received antibiotics (P < 0.001).
CONCLUSION:Implementation of PCV7, combined with a reduction in antibiotic use, in a country with a high prevalence of antibiotic-resistant pneumococci appears to have a strong impact on the carriage of penicillin nonsusceptible pneumococci in children with AOM.</description><subject>Acute Disease</subject><subject>Anti-Bacterial Agents - pharmacology</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibacterial agents</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Bacterial diseases</subject><subject>Biological and medical sciences</subject><subject>Carrier State - drug therapy</subject><subject>Carrier State - epidemiology</subject><subject>Carrier State - microbiology</subject><subject>Carrier State - prevention & control</subject><subject>Child, Preschool</subject><subject>Ent and stomatologic bacterial diseases</subject><subject>Female</subject><subject>Heptavalent Pneumococcal Conjugate Vaccine</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>Infant</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Meningococcal Vaccines - administration & dosage</subject><subject>Nasopharynx - microbiology</subject><subject>Otitis Media - drug therapy</subject><subject>Otitis Media - epidemiology</subject><subject>Otitis Media - microbiology</subject><subject>Otitis Media - prevention & control</subject><subject>Penicillin Resistance</subject><subject>Penicillins - pharmacology</subject><subject>Penicillins - therapeutic use</subject><subject>Pharmacology. Drug treatments</subject><subject>Pneumococcal Infections - drug therapy</subject><subject>Pneumococcal Infections - epidemiology</subject><subject>Pneumococcal Infections - microbiology</subject><subject>Pneumococcal Infections - prevention & control</subject><subject>Pneumococcal Vaccines - administration & dosage</subject><subject>Risk Factors</subject><subject>Serotyping</subject><subject>Staphylococcal infections, streptococcal infections, pneumococcal infections</subject><subject>Streptococcus pneumoniae - classification</subject><subject>Streptococcus pneumoniae - drug effects</subject><subject>Streptococcus pneumoniae - isolation & purification</subject><subject>Vaccination</subject><issn>0891-3668</issn><issn>1532-0987</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkd1u1DAQhSMEotvCKyALCe6y2I7zx91qBaVSaRGicGlN7MmuS2KntqOKN-IxcborLb7waEbfzPH4ZNlbRteMtvUHytbG9muaDhcFq4p1Uy43NM-yFSsLntO2qZ9nK9q0LC-qqjnLzkO4T3whGH2ZnbGa1pxxtsr-Xo0TqEhcT75ZnEennFIwkK2z9_MOIpKfoJSxSMDqhfqOelbROLskGxtNZ1w0itwFJKl4A8FNe_B_7A6XMeC9gR0u8I2zYQ4Kp9Qz4H9yhhhLtnszaI-W_DJxTzZqTtK30UQTyFfUBl5lL3oYAr4-xovs7vOnH9sv-fXt5dV2c50rwWqRQ6cp7VRaFDre805pzaqyYlVLW8pBQ1dWrYZWV6ihRlV0CK3ADqjoOLKiuMjeH-ZO3j3MGKIcTXr0MIBFNweZBnFatnUCPx5A5V0IHns5eTOmzSWjcvFJUiaTT_Lkk3zySUKTmt8cVeZuRH1qPRqTgHdHAELyo_dglQknruFVwcXCiQP36IaIPvwe5kf0cp8-P-6fpCtRipynyFjK8qUkin9JZ6_r</recordid><startdate>200611</startdate><enddate>200611</enddate><creator>Cohen, Robert</creator><creator>Levy, Corinne</creator><creator>de La Rocque, France</creator><creator>Gelbert, Nathalie</creator><creator>Wollner, Alain</creator><creator>Fritzell, Bernard</creator><creator>Bonnet, Eric</creator><creator>Tetelboum, Robert</creator><creator>Varon, Emmanuelle</creator><general>Lippincott Williams & Wilkins, Inc</general><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200611</creationdate><title>Impact of Pneumococcal Conjugate Vaccine and of Reduction of Antibiotic Use on Nasopharyngeal Carriage of Nonsusceptible Pneumococci in Children With Acute Otitis Media</title><author>Cohen, Robert ; Levy, Corinne ; de La Rocque, France ; Gelbert, Nathalie ; Wollner, Alain ; Fritzell, Bernard ; Bonnet, Eric ; Tetelboum, Robert ; Varon, Emmanuelle</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4174-abd00bc034ab2f2bcdd16561690902adab569da9d6eda7ec3bea94eba04b2e133</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Acute Disease</topic><topic>Anti-Bacterial Agents - pharmacology</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antibacterial agents</topic><topic>Antibiotics. Antiinfectious agents. Antiparasitic agents</topic><topic>Bacterial diseases</topic><topic>Biological and medical sciences</topic><topic>Carrier State - drug therapy</topic><topic>Carrier State - epidemiology</topic><topic>Carrier State - microbiology</topic><topic>Carrier State - prevention & control</topic><topic>Child, Preschool</topic><topic>Ent and stomatologic bacterial diseases</topic><topic>Female</topic><topic>Heptavalent Pneumococcal Conjugate Vaccine</topic><topic>Human bacterial diseases</topic><topic>Humans</topic><topic>Infant</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Meningococcal Vaccines - administration & dosage</topic><topic>Nasopharynx - microbiology</topic><topic>Otitis Media - drug therapy</topic><topic>Otitis Media - epidemiology</topic><topic>Otitis Media - microbiology</topic><topic>Otitis Media - prevention & control</topic><topic>Penicillin Resistance</topic><topic>Penicillins - pharmacology</topic><topic>Penicillins - therapeutic use</topic><topic>Pharmacology. Drug treatments</topic><topic>Pneumococcal Infections - drug therapy</topic><topic>Pneumococcal Infections - epidemiology</topic><topic>Pneumococcal Infections - microbiology</topic><topic>Pneumococcal Infections - prevention & control</topic><topic>Pneumococcal Vaccines - administration & dosage</topic><topic>Risk Factors</topic><topic>Serotyping</topic><topic>Staphylococcal infections, streptococcal infections, pneumococcal infections</topic><topic>Streptococcus pneumoniae - classification</topic><topic>Streptococcus pneumoniae - drug effects</topic><topic>Streptococcus pneumoniae - isolation & purification</topic><topic>Vaccination</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cohen, Robert</creatorcontrib><creatorcontrib>Levy, Corinne</creatorcontrib><creatorcontrib>de La Rocque, France</creatorcontrib><creatorcontrib>Gelbert, Nathalie</creatorcontrib><creatorcontrib>Wollner, Alain</creatorcontrib><creatorcontrib>Fritzell, Bernard</creatorcontrib><creatorcontrib>Bonnet, Eric</creatorcontrib><creatorcontrib>Tetelboum, Robert</creatorcontrib><creatorcontrib>Varon, Emmanuelle</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Pediatric infectious disease journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cohen, Robert</au><au>Levy, Corinne</au><au>de La Rocque, France</au><au>Gelbert, Nathalie</au><au>Wollner, Alain</au><au>Fritzell, Bernard</au><au>Bonnet, Eric</au><au>Tetelboum, Robert</au><au>Varon, Emmanuelle</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of Pneumococcal Conjugate Vaccine and of Reduction of Antibiotic Use on Nasopharyngeal Carriage of Nonsusceptible Pneumococci in Children With Acute Otitis Media</atitle><jtitle>The Pediatric infectious disease journal</jtitle><addtitle>Pediatr Infect Dis J</addtitle><date>2006-11</date><risdate>2006</risdate><volume>25</volume><issue>11</issue><spage>1001</spage><epage>1007</epage><pages>1001-1007</pages><issn>0891-3668</issn><eissn>1532-0987</eissn><coden>PIDJEV</coden><abstract>BACKGROUND:Penicillin resistance among pneumococci has increased in the past 15 years. The implementation of widespread vaccination with the heptavalent pneumococcal conjugate vaccine (PCV7) and the reduction of inappropriate antibiotic use could help reduce antibiotic resistance.
METHODS:Between September 2001 and June 2004, 89 pediatricians distributed throughout France took part in this prospective study. We obtained 1906 nasopharyngeal swabs for culture from children aged 6 to 24 months with acute otitis media (AOM). At the same time as PCV7 was introduced into the routine immunization schedule, a plan to promote judicious antibiotic use was established. We recorded the frequency of antibiotic use, as well as the dates of immunization with PCV7.
RESULTS:The proportion of PCV7-vaccinated children (≥1 dose) increased from 8.2% (year 1) to 61.4% (year 3). The proportion of children who received antibiotics within 3 months before enrollment decreased from 51.8% in year 1 to 40.9% in year 3 (P < 0.001). Overall pneumococcal carriage and carriage of PCV7 serotypes decreased during the 3-year period by 16% (P < 0.001) and 35% (P < 0.001), respectively. Rates of highly penicillin resistant strains (PRP) decreased yearly15.4%, 10.6%, 6.7% (P < 0.001), respectively. Risks for PRP carriage were 4.2% for immunized children who had not received antibiotics, 8.6% for those vaccinated who also had received antibiotics, 10.3% for unimmunized children who had not received antibiotics, and 16.2% for unimmunized children who had received antibiotics (P < 0.001).
CONCLUSION:Implementation of PCV7, combined with a reduction in antibiotic use, in a country with a high prevalence of antibiotic-resistant pneumococci appears to have a strong impact on the carriage of penicillin nonsusceptible pneumococci in children with AOM.</abstract><cop>Baltimore, MD</cop><cop>Philadelphia, PA</cop><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>17072121</pmid><doi>10.1097/01.inf.0000243163.85163.a8</doi><tpages>7</tpages></addata></record> |
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| ispartof | The Pediatric infectious disease journal, 2006-11, Vol.25 (11), p.1001-1007 |
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| subjects | Acute Disease Anti-Bacterial Agents - pharmacology Anti-Bacterial Agents - therapeutic use Antibacterial agents Antibiotics. Antiinfectious agents. Antiparasitic agents Bacterial diseases Biological and medical sciences Carrier State - drug therapy Carrier State - epidemiology Carrier State - microbiology Carrier State - prevention & control Child, Preschool Ent and stomatologic bacterial diseases Female Heptavalent Pneumococcal Conjugate Vaccine Human bacterial diseases Humans Infant Infectious diseases Male Medical sciences Meningococcal Vaccines - administration & dosage Nasopharynx - microbiology Otitis Media - drug therapy Otitis Media - epidemiology Otitis Media - microbiology Otitis Media - prevention & control Penicillin Resistance Penicillins - pharmacology Penicillins - therapeutic use Pharmacology. Drug treatments Pneumococcal Infections - drug therapy Pneumococcal Infections - epidemiology Pneumococcal Infections - microbiology Pneumococcal Infections - prevention & control Pneumococcal Vaccines - administration & dosage Risk Factors Serotyping Staphylococcal infections, streptococcal infections, pneumococcal infections Streptococcus pneumoniae - classification Streptococcus pneumoniae - drug effects Streptococcus pneumoniae - isolation & purification Vaccination |
| title | Impact of Pneumococcal Conjugate Vaccine and of Reduction of Antibiotic Use on Nasopharyngeal Carriage of Nonsusceptible Pneumococci in Children With Acute Otitis Media |
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