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Volume 17, Number 4—April 2011

Research

Carriage of Streptococcus pneumoniae 3 Years after Start of Vaccination Program, the Netherlands

Judith Spijkerman, Elske J.M. van Gils, Reinier H. Veenhoven, Eelko Hak, F. Yzerman, Arie van der Ende, Alienke J. Wijmenga-Monsuur, Germie P.J.M. van den Dobbelsteen, and Elisabeth A.M. SandersComments to Author 
Author affiliations: Author affiliations: University Medical Center, Utrecht, the Netherlands (J. Spijkerman, E.J.M. van Gils, E.A.M. Sanders); Spaarne Hospital, Hoofddorp, the Netherlands (J. Spijkerman, E.J.M. van Gils, R.H. Veenhoven); University Medical Center, Groningen, the Netherlands (E. Hak); Regional Laboratory of Public Health, Haarlem, the Netherlands (E.P.F. Yzerman); Academic Medical Center, Amsterdam, the Netherlands (A. van der Ende); Netherlands Vaccine Institute, Bilthoven, the Netherlands (A.J. Wijmenga-Monsuur, G.P.J.M. van den Dobbelsteen)

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Table 3

Frequencies of nasopharyngeal carriage of individual Streptococcus pneumoniae serotypes in children and their parents before and 3 years after implementation of PCV7 vaccination program, the Netherlands*

Serotype 11-mo-old children
24-mo-old children
Parents
Pre-PCV7, n = 319 Post-PCV7, n = 329† p value‡ Pre-PCV7, n = 321 Post-PCV7, n = 330 p value‡ Controls, n = 296 Vaccinees, n = 324 p value‡
PCV7
19F 36 (11) 5 (2) <0.001 24 (8) 4 (1) <0.001 9 (3) 2 (1) 0.02
23F 34 (11) 6 (2) <0.001 28 (9) 0 (0) <0.001 2 (1) 0 (0) 0.14
6B 26 (8) 12 (4) 0.02 43 (13) 7 (2) <0.001 5 (2) 0 (0) 0.02
14 10 (3) 0 (0) 0.001 8 (3) 0 (0) 0.003 6 (2) 0 (0) 0.01
9V 9 (3) 1 (0) 0.01 6 (2) 1 (0) 0.07 1 (0) 0 (0) 0.30
18C 6 (2) 1 (0) 0.07 4 (1) 2 (1) 0.45 0 (0) 0 (0) NA
4
1(0)
0 (0)
0.49

1 (0)
0 (0)
0.49

2 (1)
0 (0)
0.14
Non-PCV7§
19A 5 (2) 32 (10) <0.001 9 (3) 21 (6) 0.03 4 (1)¶ 6 (2) 0.62
11A 11 (3) 12 (4) 0.89 10 (3) 22 (7) 0.04 3 (1) 8 (2) 0.17
6A# 19 (6) 11 (3) 0.11 17 (5) 9 (3) 0.09 2 (1) 2 (1) 0.93
15B 3 (1) 10 (3) 0.06 8 (3) 6 (2) 0.55 1 (0) 2 (1) 0.62
15C 4 (1) 4 (1) 0.97 2 (1) 8 (2) 0.06 1 (0) 2 (1) 0.62
6C 5 (2) 8 (2) 0.43 5 (2) 10 (3) 0.21 1 (0) 1 (0)? 0.95
22F 4 (1) 7 (2) 0.39 2 (1) 5 (2) 0.45 0 (0) 2 (1) 0.18
10A 1 (0) 6 (2) 0.12 1 (0) 8 (2) 0.04 1 (0) 2 (1) 0.62
16F 1 (0) 6 (2) 0.12 4 (1) 6 (2) 0.75 3 (1) 1 (0) 0.27
23B 5 (2) 5 (2) 1,00 12 (4) 11 (3) 0.78 0 (0) 4 (1) 0.06
35F 2 (1) 5 (2) 0.45 0 (0) 9 (3) 0.004 0 (0) 3 (1) 0.10
NT 1 (0) 6 (2) 0.12 3 (1) 5 (2) 0.73 1 (0) 4 (1) 0.21
Other 31 (10) 17 (6) NA 21 (7) 26 (8) NA 8 (3) 12 (4) NA

*Values are no. (%) except as indicated. PCV7, all serotypes included in the 7-valent conjugate vaccine; NA, not applicable; non-PCV7, all other serotypes not included in the 7-valent conjugate vaccine; NT, nontypeable.
†325/329 (99%) swabs were taken just before the booster vaccination at 11 mo of age, and 4/329 (1%) children had received a booster vaccination within 1 wk before the sample was obtained.
‡All p values are for comparison with control group and calculated with χ2 or 2-tailed Fisher exact test where appropriate.
§Only non-PCV7 serotypes with >5 isolates in 11- or 24-mo-old children or in parents are included in this table.
¶In only 1 parent, pneumococci were present in both samples but with detection of a different serotype; serotype 19A was found in the transnasal swab and serotype 3 was found in the transoral swab. Serotype 19A is included in this table.
#After discrimination between 6A and 6C by PCR, different serotypes were found by PCR compared with Quellung: 3 isolates (serotypes 6B [n = 1] and 14 [n = 2]) in 24-mo-old controls and 2 isolates (serotypes 11 and 15) in 24-mo-old vaccinees. These serotypes were not included in this table.

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