Reduction of antimicrobial resistant pneumococci seven years after introduction of pneumococcal vaccine in Iceland.
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AuthorsHjálmarsdóttir, Martha Á
Quirk, Sigríður Júlía
Kristinsson, Karl G
MetadataShow full item record
CitationHjálmarsdóttir MÁ, Haraldsson G, Quirk SJ, Haraldsson Á, Erlendsdóttir H, Kristinsson KG. Reduction of antimicrobial resistant pneumococci seven years after introduction of pneumococcal vaccine in Iceland. PLoS One. 2020;15(3):e0230332. Published 2020 Mar 17. doi:10.1371/journal.pone.0230332
AbstractBackground: Penicillin non-susceptible (PNSP) and multi-resistant pneumococci have been prevalent in Iceland since early nineties, mainly causing problems in treatment of acute otitis media. The 10-valent protein conjugated pneumococcal vaccine (PHiD-CV) was introduced into the childhood vaccination program in 2011. The aim of the study was to investigate the changes in antimicrobial susceptibility and serotype distribution of penicillin non-susceptible pneumococci (PNSP) in Iceland 2011-2017. Methods and findings: All pneumococcal isolates identified at the Landspítali University Hospital in 2011-2017, excluding isolates from the nasopharynx and throat were studied. Susceptibility testing was done according to the EUCAST guidelines using disk diffusion with chloramphenicol, erythromycin, clindamycin, tetracycline, trimethoprim/sulfamethoxazole and oxacillin for PNSP screening. Penicillin and ceftriaxone minimum inhibitory concentrations (MIC) were measured for oxacillin resistant isolates using the E-test. Serotyping was done using latex agglutination and/or multiplex PCR. The total number of pneumococcal isolates that met the study criteria was 1,706, of which 516 (30.2%) were PNSP, and declining with time. PNSP isolates of PHiD-CV vaccine serotypes (VT) were 362/516 (70.2%) declining with time, 132/143 (92.3%) in 2011 and 17/54 (31.5%) in 2017. PNSP were most commonly of serotype 19F, 317/516 isolates declining with time, 124/143 in 2011 and 15/54 in 2017. Their number decreased in all age groups, but mainly in the youngest children. PNSP isolates of non PHiD-CV vaccine serotypes (NVT) were 154/516, increasing with time, 11/14, in 2011 and 37/54 in 2017. The most common emerging NVTs in 2011 and 2017 were 6C, 1/143 and 10/54 respectively. Conclusions: PNSP of VTs have virtually disappeared from children with pneumococcal diseases after the initiation of pneumococcal vaccination in Iceland and a clear herd effect was observed. This was mainly driven by a decrease of PNSP isolates belonging to a serotype 19F multi-resistant lineage. However, emerging multi-resistant NVT isolates are of concern.
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- Effect of Vaccination on Pneumococci Isolated from the Nasopharynx of Healthy Children and the Middle Ear of Children with Otitis Media in Iceland.
- Authors: Quirk SJ, Haraldsson G, Erlendsdóttir H, Hjálmarsdóttir MÁ, van Tonder AJ, Hrafnkelsson B, Sigurdsson S, Bentley SD, Haraldsson Á, Brueggemann AB, Kristinsson KG
- Issue date: 2018 Dec
- Comparison of Serotype Prevalence of Pneumococci Isolated from Middle Ear, Lower Respiratory Tract and Invasive Disease Prior to Vaccination in Iceland.
- Authors: Hjálmarsdóttir MÁ, Quirk SJ, Haraldsson G, Erlendsdóttir H, Haraldsson Á, Kristinsson KG
- Issue date: 2017
- Nasopharyngeal carriage, serotype distribution and antimicrobial resistance of Streptococcus pneumoniae among children from Brazil before the introduction of the 10-valent conjugate vaccine.
- Authors: Neves FP, Pinto TC, Corrêa MA, dos Anjos Barreto R, de Souza Gouveia Moreira L, Rodrigues HG, Cardoso CA, Barros RR, Teixeira LM
- Issue date: 2013 Jul 13
- Epidemiology of penicillin-non-susceptible pneumococci in Iceland, 1995-2010.
- Authors: Hjálmarsdóttir MÁ, Kristinsson KG
- Issue date: 2014 Apr
- Pneumococcal carriage among children after four years of routine 10-valent pneumococcal conjugate vaccine use in Brazil: The emergence of multidrug resistant serotype 6C.
- Authors: Neves FPG, Cardoso NT, Snyder RE, Marlow MA, Cardoso CAA, Teixeira LM, Riley LW
- Issue date: 2017 May 15