Decrease in pneumococcal co-colonization following vaccination with the seven-valent pneumococcal conjugate vaccine

PLoS One. 2012;7(1):e30235. doi: 10.1371/journal.pone.0030235. Epub 2012 Jan 12.

Abstract

Understanding the epidemiology of pneumococcal co-colonization is important for monitoring vaccine effectiveness and the occurrence of horizontal gene transfer between pneumococcal strains. In this study we aimed to evaluate the impact of the seven-valent pneumococcal conjugate vaccine (PCV7) on pneumococcal co-colonization among Portuguese children. Nasopharyngeal samples from children up to 6 years old yielding a pneumococcal culture were clustered into three groups: pre-vaccine era (n = 173), unvaccinated children of the vaccine era (n = 169), and fully vaccinated children (4 doses; n = 150). Co-colonization, serotype identification, and relative serotype abundance were detected by analysis of DNA of the total bacterial growth of the primary culture plate using the plyNCR-RFLP method and a molecular serotyping microarray-based strategy. The plyNCR-RFLP method detected an overall co-colonization rate of 20.1%. Microarray analysis confirmed the plyNCR-RFLP results. Vaccination status was the only factor found to be significantly associated with co-colonization: co-colonization rates were significantly lower (p = 0.004; Fisher's exact test) among fully vaccinated children (8.0%) than among children from the pre-PCV7 era (17.3%) or unvaccinated children of the PCV7 era (18.3%). In the PCV7 era there were significantly less non-vaccine type (NVT) co-colonization events than would be expected based on the NVT distribution observed in the pre-PCV7 era (p = 0.024). In conclusion, vaccination with PCV7 resulted in a lower co-colonization rate due to an asymmetric distribution between NVTs found in single and co-colonized samples. We propose that some NVTs prevalent in the PCV7 era are more competitive than others, hampering their co-existence in the same niche. This result may have important implications since a decrease in co-colonization events is expected to translate in decreased opportunities for horizontal gene transfer, hindering pneumococcal evolution events such as acquisition of antibiotic resistance determinants or capsular switch. This might represent a novel potential benefit of conjugate vaccines.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Child, Preschool
  • Colony Count, Microbial
  • Heptavalent Pneumococcal Conjugate Vaccine
  • Humans
  • Infant
  • Multivariate Analysis
  • Oligonucleotide Array Sequence Analysis
  • Pneumococcal Vaccines / immunology*
  • Polymorphism, Restriction Fragment Length
  • Reproducibility of Results
  • Risk Factors
  • Serotyping
  • Streptococcus pneumoniae / classification
  • Streptococcus pneumoniae / growth & development*
  • Streptococcus pneumoniae / immunology*
  • Streptococcus pneumoniae / isolation & purification
  • Vaccination*

Substances

  • Heptavalent Pneumococcal Conjugate Vaccine
  • Pneumococcal Vaccines