Prevalence and serotype distribution of nasopharyngeal carriage of Streptococcus pneumoniae among healthy children under 5 years of age in Hainan Province, China

Background The thirteen-valent pneumococcal conjugate vaccine(PCV13)is not included in the national immu-nization program and is administered voluntarily with informed consent in China.In preparation for assessing the impact of pilot introduction in Hainan Province,we conducted a carriage study among children under 5 years of age from four locations in Hainan Province,China.Methods From March to June 2022,nasopharyngeal(NP)swabs,collected from healthy children aged younger than 59 months who lived in the 4 different locations(Haikou,Wanning,Baisha and Qiongzhong)in Hainan Province,were tested for pneumococcus using conventional culture.Pneumococcal isolates were serotyped using the Quel-lung reaction.Risk factors associated with pneumococcal colonization were assessed using univariate analysis and multivariable logistic regression adjusting for age,daycare attendance and other factors.Results Pneumococcus was isolated in 710(30.4%)of the 2333 children enrolled.Of 737 pneumococci,29 serotypes were identifed;60.9%were PCV13 serotypes;the most common vaccine serotypes were 6B(20.4%),19F(13.0%),6A(11.9%)and 23F(6.1%);and the most common nonvaccine serotypes were 23A(12.9%),34(6.1%)and nontypeable(NT)pneumococci(5.6%).Children vaccinated with PCV13 had lower carriage(17.7%vs 32.5%;P=0.0001)and fewer PCV13 serotypes(41.9%vs 62.7%;P=0.0017)compared to unimmunized children.After adjustment,NP carriage Was higher among children attending daycare(aOR=2.3,95%CI:1.7-3.2),living in rural areas(aOR=1.4,95%CI:1.1-1.8),living with siblings(aOR=1.3,95%CI:1.0-1.6)and whose mothers had completed senior high/technical sec-ondary school(aOR=1.5,95%CI:1.1-2.0).In contrast,completion of 3-4 doses of PCV13 were associated with a lower carriage rate(aOR=0.6,95%CI:0.4-0.9).Conclusions We established the baseline of pneumococcal carriage,serotype distribution and PCV13 immuni-zation rates among healthy children under 5 years of age in Hainan Province,prior to the introduction of PCV13 into the national immunization program.The high proportion of PCV13 serotypes suggests that PCV13 introduction will likely have a substantial impact on pneumococcal carriage in Hainan Province.

Experimental study on distribution of serotypes and antimicrobial patterns of Group B streptococcus strains

Objective To obtain information on the distribution of serotypes and antimicrobial agent susceptibilities to group B streptococcus (GBS) strains isolated in Beijing area from 1991 to 1996. Methods Bacterial isolates of GBS were obtained from vaginal and cervical tract of pregnant and nonpregnant women in Beijing Tian Tan Hospital by culture. A total of 76 GBS strains were identified finally by coagglutination. Serotyping was determined by Standard Lancefield method. Susceptibility to test agents was assessed by determining the minimal inhibitory concentrations (MICs) with agar dilution method that was established by the National Committee for Clinical Laboratory Standards (NCCLS). Results Seven serotypes were identified among 76 GBS strains isolates. Types Ⅱ (33%), Ⅲ (23%) and Ⅰa (16%) were the predominant serotypes in pregnant and nonpregnant women. MICs of penicillin G and ampicillin were ≤0.06 μg/ml. MICs of cephazolin, cefuroxime and cefoperozone were 0.003 μg/ml 0.06 μg/ml. MICs of erythromycin were 0.003 μg/ml 0.03 μg/ml. MICs of gentamycin were 1 μg/ml 32 μg/ml. MICs of amikacin were 4 μg/ml ≥64 μg/ml, nearly 12.8% and 40.4% of the strains were resistant to gentamycin and amikacin, respectively. Conclusions Our study provides useful epidemiologic data for preparation of GBS type specific vaccines which can prevent GBS infections and antimicrobial agents susceptibility patterns in China. Routine reports on GBS susceptibilities by clinical laboratories and continuous surveillance for changes in the susceptibility are of considerable clinical importance.