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Carriage burden, multiple colonization and antibiotic pressure promote emergence of resistant vaccine escape pneumococci.


ABSTRACT: Pneumococcal conjugate vaccines target the limited subset of the more than 90 known serotypes of Streptococcus pneumoniae responsible for the greatest burden of pneumococcal disease and antibiotic resistance. Following the introduction of these vaccines, serotypes not targeted were able to expand and resistance became more common within these types. Here we use a stochastic dynamic model of pediatric pneumococcal carriage to evaluate potential influences on the emergence of new resistant lineages following the introduction of a vaccine targeting more common resistant types. Antibiotic pressure was the strongest driver, with no emergence at low levels and universal emergence at high levels. At intermediate levels of antibiotic pressure, higher carriage burden and a greater degree of dual carriage promoted emergence. This may have implications for current plans to introduce childhood pneumococcal vaccination in several high-burden countries.

SUBMITTER: Mitchell PK 

PROVIDER: S-EPMC4424439 | biostudies-literature | 2015 Jun

REPOSITORIES: biostudies-literature

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Carriage burden, multiple colonization and antibiotic pressure promote emergence of resistant vaccine escape pneumococci.

Mitchell Patrick K PK   Lipsitch Marc M   Hanage William P WP  

Philosophical transactions of the Royal Society of London. Series B, Biological sciences 20150601 1670


Pneumococcal conjugate vaccines target the limited subset of the more than 90 known serotypes of Streptococcus pneumoniae responsible for the greatest burden of pneumococcal disease and antibiotic resistance. Following the introduction of these vaccines, serotypes not targeted were able to expand and resistance became more common within these types. Here we use a stochastic dynamic model of pediatric pneumococcal carriage to evaluate potential influences on the emergence of new resistant lineage  ...[more]

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