Nasopharyngeal carriage of Streptococcus pneumoniae in healthy Turkish infants.

Objectives: The aims of this study were to determine nasopharyngeal carriage rates, serotype distribution and antimicrobial resistance patterns of Streptococcus pneumoniae in healthy 0 to 2 year-old infants who live within a rural or urban locale and not attending daycare centers. In order to evaluate the possible impact of pneumococcal conjugate vaccine in this population, coverage of the isolated serotypes by the vaccine was also calculated.

Methods: The study was conducted on 564 healthy infants attending 2 different well child clinics, one of which is located in an urban region and the other in a rural region. Specimens were collected with nasopharyngeal swabs. Serotyping was performed with standard antisera. Penicillin susceptibility was determined with E-test. Chi-square tests and logistic regression were used for data analysis.

Results: The pneumococcal carriage rate was 22.5%. Age (>2 months age) [2.98 (1.41-6.29) p=0.004] and presence of another child within the house who attends school [1.72 (1.13-2.62) p=0.01] increased the carriage rate. The most frequently isolated serotypes were 11 (11.8%), 23 (7.9%), 19F (7.1%), 22 (6.3%), 9 (5.5%), 19 (5.5%) and 23B (5.5%). The total coverage of vaccine and vaccine-related serotypes by 7, 11 and 13 valent pneumococcal conjugate vaccines were 51.2, 59.0 and 59.0%, respectively. Of the isolated pneumococci, 10 (8.5%) were intermediately resistant and 8 (6.8%) were highly resistant to penicillin.

Conclusion: This study provides data about the local carriage rate and serotype distribution of S. pneumoniae strains in Turkish children, which is important in predicting the possible effects of different valent pneumococcal conjugate vaccines in this population.