Effect of Seven-Valent Pneumococcal Conjugate Vaccine on Staphylococcus aureus Colonisation in a Randomised Controlled TrialReport as inadecuate




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Background

Heptavalent pneumococcal conjugate vaccine PCV7 shifts nasopharyngeal colonisation with vaccine serotype pneumococci towards nonvaccine serotypes. Because of the reported negative association of vaccine serotype pneumococci and Staphylococcus aureus in the nasopharynx, we explored the effect of PCV7 on nasopharyngeal colonisation with S. aureus in children and parents.

Methodology-Principal Findings

This study was part of a randomised controlled trial on the effect of PCV7 on pneumococcal carriage, enrolling healthy newborns who were randomly assigned 1∶1∶1 to receive PCV7 1 at 2 and 4 months of age 2 at 2, 4 and 11 months or 3 no PCV7 controls. Nasopharyngeal colonisation of S. aureus was a planned secondary outcome. Nasopharyngeal swabs were obtained from all children over a 2-year period with 6-months interval and from one parent at the child-s age of 12 and 24 months and cultured for Streptococcus pneumoniae and S. aureus. Between July 2005 and February 2006, 1005 children were enrolled and received either 2-doses of PCV7 n = 336, 2+1-doses 336 or no dose n = 333 before PCV7 implementation in the Dutch national immunization program. S. aureus colonisation had doubled in children in the 2+1-dose group at 12 months of age compared with unvaccinated controls 10.1% versus 5.0%; p = 0.019. A negative association for co-colonisation of S. pneumoniae and S. aureus was observed for both vaccine serotype adjusted odds ratio aOR 0.53, 95% confidence interval CI 0.38–0.74 and nonvaccine serotype pneumococci aOR 0.67, 95% CI 0.52–0.88.

Conclusions-Significance

PCV7 induces a temporary increase in S. aureus colonisation in children around 12 months of age after a 2+1-dose PCV7 schedule. The potential clinical consequences are unknown and monitoring is warranted.

Trial Registration

ClinicalTrials.gov NCT00189020



Author: Elske J. M. van Gils , Eelko Hak, Reinier H. Veenhoven, Gerwin D. Rodenburg, Debby Bogaert, Jacob P. Bruin, Loek van Alphen, Elis

Source: http://plos.srce.hr/



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