BACKGROUND: The 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in the United States in February 2000. The PROTEKT US study evaluated serotype distribution, PCV7 coverage and antimicrobial susceptibility among @entity328 isolates collected from @entity1 aged 0 to 14 years in 2000 through 2001 (year 1; n = 2033), 2002 through 2003 (year 3; n = 1740) and 2003 through 2004 (year 4; n = 1591). METHODS: Serotyping was performed by Neufeld Quellung reaction. Antimicrobial susceptibilities were determined centrally according to Clinical Laboratory Standards Institute methodology and interpretive breakpoints. RESULTS: The proportion of isolates covered by PCV7 (vaccine serotypes) decreased from 65.5% (year 1) to 34.7% (year 3) and to 27.0% (year 4) (P < 0.0001) with similar changes seen at regional and state levels. The most common serotypes in year 4 were nonvaccine serotypes (NVS) 19A (19.0% of all isolates), 6A (7.8%), 3 (7.6%), 15 (6.3%) and 35B (5.8%) and vaccine serotype 19F (12.7%). NVS 19A increased relative to vaccine serotype 19F among isolates expressing the erm(B) + mef(A) @entity7646 -resistant genotype (P < 0.0001) between year 1 (7.8% [19A] versus 86.7% [19F]) and year 4 (45.5% [19A] versus 51.7% @entity25279 ). Antimicrobial resistance rates (year 1 versus year 4) among NVS from nonblood (respiratory tract) sources increased for @entity114 (resistant: 12.7-16.1% [P = 0.0857]; intermediate susceptibility: 20.1-31.5% [P < 0.0001]), @entity2929 (21.2-31.6% [P < 0.0001]), @entity115 - @entity798 (1.4-5.8% [P < 0.0001]) and multidrug resistance (resistance to > or =2 antimicrobial classes) (24.6-31.6% [P = 0.0034]). CONCLUSIONS: The proportion of @entity2260 isolates from U.S. pediatric @entity1 covered by PCV7 decreased substantially in the 4 years after vaccine introduction. However, resistance to commonly used antimicrobials, including @entity7660 and macrolides, as well as multidrug-resistant strains increased significantly among respiratory tract isolates of NVS.

Increased antimicrobial resistance among nonvaccine serotypes of XXXX in the pediatric population after the introduction of 7-valent pneumococcal vaccine in the United States.

@entity1 :: ('9606', 'Species') :: ['children', 'patients'] @entity115 :: ('MESH:D000658', 'Chemical') :: ['amoxicillin'] @entity7646 :: ('CHEBI:25106', 'Chemical') :: ['macrolide'] @entity114 :: ('MESH:D010406', 'Chemical') :: ['penicillin'] @entity2260 :: ('2104', 'Species') :: ['S. pneumoniae'] @entity2929 :: ('MESH:D004917', 'Chemical') :: ['erythromycin'] @entity7660 :: ('MESH:D047090', 'Chemical') :: ['beta-lactams'] @entity798 :: ('MESH:D019818', 'Chemical') :: ['clavulanate'] @entity25279 :: ('CHEBI:36940', 'Chemical') :: ['[19F]'] @entity328 :: ('1313', 'Species') :: ['Streptococcus pneumoniae']
@entity328 :: (1313,Species) :: ['Streptococcus pneumoniae']
