Kristian Riesbeck, Sweden

Department for Translational Medicine, Lund University,Malmö Clinical Microbiology

Poster Author Of 1 e-Poster

Author Of 2 Presentations

PNEUMOCOCCAL CARRIAGE IN CHILDREN IN ANGOLA (ID 643)

Abstract

Background

Streptococcus pneumoniae is a major cause of childhood morbidity and mortality, especially in low- and middle-income countries. Angola introduced the conjugated pneumococcal vaccine (PCV13) in 2013. Our objective was to study pneumococcal carriage and antibiotic resistance in unvaccinated children in Angola.

Methods

The study enrolled children in Luanda and Lunda Sul in November and December 2017. Nasopharyngeal samples were transported frozen in STGG medium to Sweden where bacteria were identified by optochin susceptibility. Pneumococci were serotyped by a multiplex PCR and the Quellung reaction. Antimicrobial susceptibility testing was done according to EUCAST.

Results

Of 940 children, 443 (47%) were females, and median age was 8 years (range 4-12 years). The carriage of pneumococci was 35% (332/940), and 45% (127/280) of strains exhibited PCV13-serotypes. Reduced sensitivity to penicillin was found in 39%, more commonly in vaccine-type than in non-vaccine-type pneumococci (50% vs 33%, p=0.003). Underweight children (BMI under 5th percentile) carried pneumococci more often than other children (44% vs 34%, p=0.013).

Conclusions

If implemented successfully PCV-13 may have a significant impact on pneumococcal disease in Angola. It may also prevent pneumococcal penicillin resistance. Our data may be used as an estimate of the pre-vaccine situation in Angola.

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PNEUMOCOCCAL SEROTYPE DISTRIBUTION IN ADULTS HOSPITALIZED WITH RADIOLOGICALLY-CONFIRMED COMMUNITY-ACQUIRED PNEUMONIA IN MALMÖ, SWEDEN (ID 904)

Abstract

Background

In Sweden, pneumococcal serotype distribution in adults with community-acquired pneumonia (CAP) and potential coverage of licensed and developmental pneumococcal conjugate vaccines (PCVs) are unknown.

Methods

2016-2018, consecutive patients aged ≥18 years hospitalized with chest x-ray positive (CXR+) CAP were enrolled at Skåne University Hospital. Streptococcus pneumoniae (Spn) blood culture isolates were serotyped by multiprime PCR and Quellung reaction. Urine was tested by the pan-pneumococcal urinary antigen test (BinaxNOW®) and Pfizer’s proprietary serotype-specific urine antigen detection assays (UAD1/UAD2). UAD1 detects serotypes in PCV13, UAD2 detects additional serotypes in PCV15 and PCV20 plus serotypes 2,9N,17F and 20.

Results

Of 567 enrollees, 518 had CXR+CAP and urine sample collected and were included in analysis. Spn serotypes were identified by UAD or blood culture isolates.

Table CXR+CAP by age group and vaccine serotype categories.

Spn detected:

18-64 years
n=169 (32.6%)

≥65 years
n=349 (67.4%)

≥18 years
n=518 (100%)

PCV13-types*

12.4%

10.0%

10.8%

PCV15-types*

13.6%

12.0%

12.5%

PCV20-types*

20.7%

15.2%

17.0%

Any Spn

27.2%

22.9%

24.3%

*PCV13:1,3,4,5,6A/6C,6B,7F,9V,14,18C,19A,19F,23F

PCV15:PCV13+22F,33F

PCV20:PCV15+8,10A,11A,12F,15B/C

Conclusions

In the context of robust pediatric PCV immunization, PCV13 serotypes were relatively common in adult CXR+CAP, emphasizing the limits of relying on indirect protection. PCV20 will further increase the ability of direct vaccination to reduce adult pneumonia morbidity.

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