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Clinical and Vaccine Immunology, February 2009, p. 218-221, Vol. 16, No. 2
1071-412X/09/$08.00+0     doi:10.1128/CVI.00283-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Age-Specific Cluster of Cases of Serotype 1 Streptococcus pneumoniae Carriage in Remote Indigenous Communities in Australia {triangledown}

H. Smith-Vaughan,1,2,{dagger}* R. Marsh,1,2,{dagger} G. Mackenzie,1,2,3,{dagger},{ddagger} J. Fisher,1,2,{dagger} P. S. Morris,1,2,3 K. Hare,1,2 G. McCallum,1,2 M. Binks,1,2 D. Murphy,4 G. Lum,5,§ H. Cook,6 V. Krause,6 S. Jacups,1,2 and A. J. Leach1,2

Menzies School of Health Research, Darwin, Australia,1 Institute of Advanced Studies, Charles Darwin University, Darwin, Australia,2 Northern Territory Clinical School, Flinders University, Darwin, Australia,3 Queensland Health, Brisbane, Australia,4 Northern Territory Government Pathology Service, Darwin, Australia,5 Centre for Disease Control, Department of Health and Families, Darwin, Australia6

Received 22 July 2008/ Returned for modification 24 August 2008/ Accepted 20 November 2008

Seven-valent pneumococcal conjugate vaccination commenced in 2001 for Australian indigenous infants. Pneumococcal carriage surveillance detected substantial replacement with nonvaccine serotypes and a cluster of serotype 1 carriage. Our aim was to review Streptococcus pneumoniae serotype 1 carriage and invasive pneumococcal disease (IPD) data for this population and to analyze serotype 1 isolates. Carriage data were collected between 1992 and 2004 in the Darwin region, one of the five regions in the Northern Territory. Carriage data were also collected in 2003 and 2005 from four regions in the Northern Territory. Twenty-six cases of serotype 1 IPD were reported from 1994 to 2007 in the Northern Territory. Forty-four isolates were analyzed by BOX typing and 11 by multilocus sequence typing. In the Darwin region, 26 children were reported carrying serotype 1 (ST227) in 2002 but not during later surveillance. Scattered cases of serotype 1 carriage were noted in two other regions. Cocolonization of serotype 1 with other pneumococcal serotypes was common (34% serotype 1-positive swabs). In conclusion, pneumococcal carriage studies detected intermittent serotype 1 carriage and an ST227 cluster in children in indigenous communities in the Northern Territory of Australia. There was no apparent increase in serotype 1 IPD during this time. The rate of serotype 1 cocolonization with other pneumococcal serotypes suggests that carriage of this serotype may be underestimated.

* Corresponding author. Mailing address: Menzies School of Health Research, P.O. Box 41096, Casuarina, NT 0811, Australia. Phone: 61 889228871. Fax: 61 889275187. E-mail: heidi{at}menzies.edu.au

{triangledown} Published ahead of print on 17 December 2008.

{dagger} These authors provided equal contributions to the study.

{ddagger} Present address: MRC Laboratories, Fajara, The Gambia.

§ Present address: Department of Health and Ageing, Canberra, Australia.

Clinical and Vaccine Immunology, February 2009, p. 218-221, Vol. 16, No. 2
1071-412X/09/$08.00+0     doi:10.1128/CVI.00283-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





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