Dose-response relationship between age and Streptococcus pneumoniae vaccination coverage in kindergarten children

LI Ting; DENG Wen-Jun; ZHANG Jing-Feng; LI Ping-Yuan; ZHOU Jun-Li; YAO Zhen-Jiang; YE Xiao-Hua

doi:10.7499/j.issn.1008-8830.2305003

PDF(681 KB)

Chinese Journal of Contemporary Pediatrics ›› 2023, Vol. 25 ›› Issue (10) : 1059-1065. DOI: 10.7499/j.issn.1008-8830.2305003

CLINICAL RESEARCH

Dose-response relationship between age and Streptococcus pneumoniae vaccination coverage in kindergarten children

LI Ting, DENG Wen-Jun, ZHANG Jing-Feng, LI Ping-Yuan, ZHOU Jun-Li, YAO Zhen-Jiang, YE Xiao-Hua

Author information +

History +

Abstract

Objective To investigate the potential relationship between age and Streptococcus pneumoniae vaccination coverage in kindergarten children, and to provide a basis for guiding vaccination and developing new protein vaccines. Methods The stratified cluster random sampling method was used to select 1 830 healthy children from six kindergartens in Shunde District, Foshan City, China, and nasopharyngeal swabs were collected for the isolation and identification of Streptococcus pneumoniae. The logistic regression model based on restricted cubic spline was used to analyze the dose-response relationship between age and Streptococcus pneumoniae vaccination coverage. Results The rate of nasal Streptococcus pneumoniae carriage was 22.46% (411/1 830) among the kindergarten children, with the predominant serotypes of 6B, 19F, 15A, 23A, 34, and 23F. The coverage rates of 10-valent pneumococcal conjugate vaccine (PCV10) and 13-valent pneumococcal conjugate vaccine (PCV13) were 53.0% and 57.9%, respectively, and there was a significant non-linear dose-response relationship between age and the coverage rates of PCV10 and PCV13 (P<0.05), with a higher coverage rate of PCV10 (88.0%) and PCV13 (91.1%) in the children aged 2 years. There was a significant non-linear dose-response relationship between age and the coverage rates of pilus islet 1 (PI-1) and pilus islet 2 (PI-2) (P<0.05), with a lower vaccination coverage rate for PI-1 (37.7%) and PI-2 (16.1%). The coverage rates of PI-1 (13.0%-58.5%) and PI-2 (6.0%-29.4%) were lower in all age groups. The virulence genes lytA (99.5%) and ply (99.0%) associated with candidate protein vaccines showed higher vaccination coverage rates. Conclusions There is a significant non-linear dose-response relationship between the age of kindergarten children and the coverage rates of PCV10 and PCV13 serotypes, and kindergarten children aged 2 years have a relatively high coverage rate of PCV. The high prevalence of the virulence genes lytA and ply shows that they are expected to become candidate virulence factors for the development of a new generation of recombinant protein vaccines.

Key words

Streptococcus pneumoniae / Serotype / Pneumococcal conjugate vaccine / Protein vaccine / Child

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

LI Ting, DENG Wen-Jun, ZHANG Jing-Feng, LI Ping-Yuan, ZHOU Jun-Li, YAO Zhen-Jiang, YE Xiao-Hua. Dose-response relationship between age and Streptococcus pneumoniae vaccination coverage in kindergarten children[J]. Chinese Journal of Contemporary Pediatrics. 2023, 25(10): 1059-1065 https://doi.org/10.7499/j.issn.1008-8830.2305003

References

1 周梦兰, 于淑颖, 杨启文, 等. 肺炎链球菌鼻咽部定植及胞内感染的致病机制研究进展[J]. 中国新药杂志, 2020, 29(5): 530-533. DOI: 10.3969/j.issn.1003-3734.2020.05.009.
2 中华预防医学会, 中华预防医学会疫苗与免疫分会. 肺炎球菌性疾病免疫预防专家共识（2020版）[J]. 中华流行病学杂志, 2020, 41(12): 1945-1979. PMID: 33261246. DOI: 10.3760/cma.j.cn112338-20201111-01322.
3 Tan TQ. Pediatric invasive pneumococcal disease in the United States in the era of pneumococcal conjugate vaccines[J]. Clin Microbiol Rev, 2012, 25(3): 409-419. PMID: 22763632. PMCID: PMC3416489. DOI: 10.1128/CMR.00018-12.
4 Dhoubhadel BG, Morimoto K. Prevention of pneumococcal diseases: the challenge remains[J]. Lancet Glob Health, 2022, 10(10): e1375-e1376. PMID: 36113515. DOI: 10.1016/S2214-109X(22)00374-6.
5 Golden AR, Adam HJ, Karlowsky JA, et al. Molecular characterization of predominant Streptococcus pneumoniae serotypes causing invasive infections in Canada: the SAVE study, 2011-15[J]. J Antimicrob Chemother, 2018, 73(suppl_7): vii20-vii31. PMID: 29982573. DOI: 10.1093/jac/dky157.
6 World Health Organization. Pneumococcal conjugate vaccines in infants and children under 5 years of age: WHO position paper-February 2019[J]. Wkly Epidemiol Rec, 2019, 94(8): 85-103.
7 Liu Y, Li W, Dong Q, et al. Non-linear relationships between children age and pneumococcal vaccine coverage: important implications for vaccine prevention strategies[J]. Vaccine, 2021, 39(9): 1392-1401. PMID: 33531198. DOI: 10.1016/j.vaccine.2021.01.056.
8 McDaniel LS, Swiatlo E. If not now, when? Nonserotype pneumococcal protein vaccines[J]. Open Forum Infect Dis, 2021, 8(12): ofab576. PMID: 34934775. PMCID: PMC8684483. DOI: 10.1093/ofid/ofab576.
9 Zangari T, Zafar MA, Lees JA, et al. Pneumococcal capsule blocks protection by immunization with conserved surface proteins[J]. NPJ Vaccines, 2021, 6(1): 155. PMID: 34930916. PMCID: PMC8688510. DOI: 10.1038/s41541-021-00413-5.
10 Ganaie F, Maruhn K, Li C, et al. Structural, genetic, and serological elucidation of Streptococcus pneumoniae serogroup 24 serotypes: discovery of a new serotype, 24C, with a variable capsule structure[J]. J Clin Microbiol, 2021, 59(7): e0054021. PMID: 33883183. PMCID: PMC8218768. DOI: 10.1128/JCM.00540-21.
11 Chen H, Liu C. Molecular epidemiology of Streptococcus pneumoniae isosslated from children with community-acquired pneumonia under 5 years in Chengdu, China[J]. Epidemiol Infect, 2022, 151: e2. PMID: 36515066. PMCID: PMC9990402. DOI: 10.1017/S0950268822001881.
12 Yu YY, Xie XH, Ren L, et al. Epidemiological characteristics of nasopharyngeal Streptococcus pneumoniae strains among children with pneumonia in Chongqing, China[J]. Sci Rep, 2019, 9(1): 3324. PMID: 30824811. PMCID: PMC6397308. DOI: 10.1038/s41598-019-40088-6.
13 Hocknell RE, Cleary DW, Srifeungfung S, et al. Serotype distribution of disease-causing Streptococcus pneumoniae in Thailand: a systematic review[J]. Vaccine, 2019, 37(24): 3159-3166. PMID: 31060951. DOI: 10.1016/j.vaccine.2019.04.085.
14 Olarte L, Barson WJ, Barson RM, et al. Pneumococcal pneumonia requiring hospitalization in US children in the 13-valent pneumococcal conjugate vaccine era[J]. Clin Infect Dis, 2017, 64(12): 1699-1704. PMID: 28199482. DOI: 10.1093/cid/cix115.
15 Sidorenko S, Rennert W, Lobzin Y, et al. Multicenter study of serotype distribution of Streptococcus pneumoniae nasopharyngeal isolates from healthy children in the Russian Federation after introduction of PCV13 into the national vaccination calendar[J]. Diagn Microbiol Infect Dis, 2020, 96(1): 114914. PMID: 31704066. DOI: 10.1016/j.diagmicrobio.2019.114914.
16 余海峰, 邓文君, 李平原, 等. 佛山市学龄前儿童肺炎链球菌的传播模式及影响因素[J]. 中华疾病控制杂志, 2023, 27(2): 184-190. DOI: 10.16462/j.cnki.zhjbkz.2023.02.010.
17 Zhang X, Tian J, Shan W, et al. Characteristics of pediatric invasive pneumococcal diseases and the pneumococcal isolates in Suzhou, China before introduction of PCV13[J]. Vaccine, 2017, 35(33): 4119-4125. PMID: 28668572. DOI: 10.1016/j.vaccine.2017.06.046.
18 Yan Z, Cui Y, Zhou W, et al. Molecular characterization of Streptococcus pneumoniae in children living in southwest China and assessment of a potential protein vaccine, rPfbA[J]. Vaccine, 2019, 37(5): 721-731. PMID: 30611601. DOI: 10.1016/j.vaccine.2018.12.021.
19 Zhao W, Pan F, Wang B, et al. Epidemiology characteristics of Streptococcus pneumoniae from children with pneumonia in Shanghai: a retrospective study[J]. Front Cell Infect Microbiol, 2019, 9: 258. PMID: 31380301. PMCID: PMC6657011. DOI: 10.3389/fcimb.2019.00258.
20 Chen K, Zhang X, Shan W, et al. Serotype distribution of Streptococcus pneumoniae and potential impact of pneumococcal conjugate vaccines in China: a systematic review and meta-analysis[J]. Hum Vaccin Immunother, 2018, 14(6): 1453-1463. PMID: 29451838. PMCID: PMC6037451. DOI: 10.1080/21645515.2018.1435224.
21 Savulescu C, Krizova P, Valentiner-Branth P, et al. Effectiveness of 10 and 13-valent pneumococcal conjugate vaccines against invasive pneumococcal disease in European children: SpIDnet observational multicentre study[J]. Vaccine, 2022, 40(29): 3963-3974. PMID: 35637067. DOI: 10.1016/j.vaccine.2022.05.011.
22 Guo MY, Shi XH, Gao W, et al. The dynamic change of serotype distribution and antimicrobial resistance of pneumococcal isolates since PCV13 administration and COVID-19 control in Urumqi, China[J]. Front Cell Infect Microbiol, 2023, 13: 1110652. PMID: 36844410. PMCID: PMC9951612. DOI: 10.3389/fcimb.2023.1110652.
23 Mokaddas E, Syed S, Albert MJ. The 13-valent pneumococcal conjugate vaccine (PCV13) does not appear to provide much protection on combined invasive disease due to the six PCV13 non-PCV7 serotypes 1, 3, 5, 6A, 7F, and 19A in Kuwait during 2010-2019[J]. Hum Vaccin Immunother, 2021, 17(11): 4661-4666. PMID: 34435932. PMCID: PMC8828145. DOI: 10.1080/21645515.2021.1968216.
24 Feldman C, Anderson R. Review: current and new generation pneumococcal vaccines[J]. J Infect, 2014, 69(4): 309-325. PMID: 24968238. DOI: 10.1016/j.jinf.2014.06.006.
25 Azarian T, Grant LR, Georgieva M, et al. Association of pneumococcal protein antigen serology with age and antigenic profile of colonizing isolates[J]. J Infect Dis, 2017, 215(5): 713-722. PMID: 28035010. PMCID: PMC6005115. DOI: 10.1093/infdis/jiw628.
26 Yan Z, Cui Y, Huang X, et al. Molecular characterization based on whole-genome sequencing of Streptococcus pneumoniae in children living in southwest China during 2017-2019[J]. Front Cell Infect Microbiol, 2021, 11: 726740. PMID: 34796125. PMCID: PMC8593041. DOI: 10.3389/fcimb.2021.726740.