Assessment of multidrug resistance, clonality and virulence in non-PCV-13 <i>Streptococcus pneumoniae</i> serotypes in Canada, 2011–13

Golden, Alyssa; Adam, Heather J.; Gilmour, Matthew W.; Baxter, Melanie; Martín, Irene; Nichol, Kim; Demczuk, Walter; Hoban, Daryl J.; Zhanel, George G.

doi:10.1093/jac/dkv061

Cited by 33 publications

(26 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A study from Canada also identified a serotype 35B isolate that represented an SLV of ST156 (ST9346) in 2011 (25). The two studies reported 1 or 2 occurrences of ST156 or its SLV in association with serotype 35B (8,25). Thus, ST156 did not contribute to the increased prevalence of serotype 35B in those studies.…”

Section: Fig 4 Eburst Analysis Of Penicillin Mic Distribution and Mulmentioning

confidence: 99%

“…In the United States, a recent study reported 2 capsular switching events that involved a serotype 35B donor strain (35B/ST558) and an ST156 recipient strain; the first occurred in 2009 and the second in 2012 (8). A study from Canada also identified a serotype 35B isolate that represented an SLV of ST156 (ST9346) in 2011 (25). The two studies reported 1 or 2 occurrences of ST156 or its SLV in association with serotype 35B (8,25).…”

Section: Fig 4 Eburst Analysis Of Penicillin Mic Distribution and Mulmentioning

confidence: 99%

“…In vitro studies show that serotype 35B is capable of forming substantial amounts of biofilm, similar to 19F and 19A, which may facilitate nasopharyngeal colonization and mucosal disease (35). Pneumococcal virulence factors such as pili have been found among CC558 and CC156 isolates (25,36,37). These virulence factors facilitate colonization, and they are thought to contribute to invasiveness as well (38).…”

Section: Fig 4 Eburst Analysis Of Penicillin Mic Distribution and Mulmentioning

confidence: 99%

See 2 more Smart Citations

Emergence of Multidrug-Resistant Pneumococcal Serotype 35B among Children in the United States

et al. 2017

View full text Add to dashboard Cite

Streptococcus pneumoniae serotype 35B is a nonvaccine serotype associated with high rates of penicillin nonsusceptibility. An increase in the proportion of multidrug-resistant (MDR) 35B isolates has recently been reported. The genetic events contributing to the emergence of MDR serotype 35B are unknown. The sequence type (ST) composition of 78 serotype 35B isolates obtained from pediatric patients with invasive pneumococcal disease from 1994 to 2014 and 48 isolates from pediatric patients with otitis media (noninvasive) from 2011 to 2014 was characterized by multilocus sequence typing (MLST). The most common STs were ST558 (69.2%), ST156 (10.3%), and ST452 (3.8%). Two major clonal complexes (CC), CC558 and CC156, were identified by eBURST analysis. Overall, 91% (71/78) of isolates were penicillin nonsusceptible and 16.7% (13/78) were MDR. Among all invasive serotype 35B isolates, MDR isolates increased significantly, from 2.9% (1/35) to 27.9% (12/43) (P ϭ 0.004), after the 13-valent pneumococcal conjugate vaccine (PCV13) was introduced. All CC156 isolates were identified after the introduction of PCV13 (0/35 [0%] before versus 9/43 [20.9%] after; P ϭ 0.003) and were MDR. All CC156 isolates had similar antimicrobial susceptibility patterns; in contrast, high variability in antimicrobial susceptibility was observed among CC558 isolates. The distributions of CC558 and CC156 among invasive and noninvasive isolates were not different. The increased prevalence of MDR serotype 35B after the introduction of PCV13 was directly associated with the emergence of ST156. Genotyping suggests that capsular switching has occurred between MDR vaccine serotypes belonging to ST156 (e.g., 9V, 14, and 19A) and serotype 35B.

show abstract

Section: Fig 4 Eburst Analysis Of Penicillin Mic Distribution and Mulmentioning

confidence: 99%

Section: Fig 4 Eburst Analysis Of Penicillin Mic Distribution and Mulmentioning

confidence: 99%

Section: Fig 4 Eburst Analysis Of Penicillin Mic Distribution and Mulmentioning

confidence: 99%

See 1 more Smart Citation

Emergence of Multidrug-Resistant Pneumococcal Serotype 35B among Children in the United States

et al. 2017

View full text Add to dashboard Cite

show abstract

“…The increase of Sweden 15A -25 and Utah 35B -24 and their variants expressing NVT serotypes may lead to continued high antimicrobial resistance rates among noninvasive pneumococci. It is concerning that these nonsusceptible clones associated with NVT pneumococci have occurred in several countries after conjugate vaccine introduction (32,33). However, the absence of the PI-1 in some nonsusceptible NVT clones is encouraging as this may limit their dissemination.…”

Section: Prevalencementioning

confidence: 99%

Noninvasive Pneumococcal Clones Associated with Antimicrobial Nonsusceptibility Isolated from Children in the Era of Conjugate Vaccines

McElligott

Vickers

Meehan

et al. 2015

Antimicrob Agents Chemother

View full text Add to dashboard Cite

Streptococcus pneumoniae causes invasive infections, such as meningitis, or noninvasive infections, including conjunctivitis and otitis media. The organism is frequently carried asymptomatically in the nasopharynx of young children and can be transmitted to adults (1). Antimicrobial-nonsusceptible pneumococci pose a challenge for devising effective empirical antimicrobial treatment strategies.Pneumococci are encapsulated with 95 serotypes described. Nontypeable (NT) pneumococci lack a capsule. Pneumococci of the same serotype may have genetically distinct backgrounds (i.e., clones), and multilocus sequence typing (MLST) characterizes pneumococci into related clonal groups or sequence types (STs) (2). Antimicrobial nonsusceptibility is common among some pneumococcal clones, such as Spain 6B -2, England 14 -9, Sweden 15A -25, and clonal complex 320 (CC320) (3). The presence of a pilus (pilus locus 1 [PI-1]) among some nonsusceptible clones may contribute to their spread (4, 5).The first pneumococcal conjugate vaccine was the 7-valent pneumococcal conjugate vaccine (PCV7), targeting serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F. These serotypes were previously important in carriage and disease (6). Importantly, PCV7 also targeted several serotypes belonging to antimicrobial-nonsusceptible clones (3). Following PCV7 introduction, non-PCV7 serotypes increased, including serotype 19A (7-11). The frequency of serotype 19A is of concern as many 19A-associated clones, such as CC320, are antimicrobial nonsusceptible (3). The 13-valent pneumococcal conjugate vaccine (PCV13) targeting PCV7 serotypes plus serotypes 1, 3, 5, 6A, 7F, and 19A is now used in several countries and should further impact positively on nonsusceptible pneumococci. Surveillance of pneumococcal serotypes/clones following PCV13 introduction will determine if antimicrobial-nonsusceptible clones expressing nonvaccine serotypes (NVT) emerge. This surveillance should encompass pediatric carriage and noninvasive infections, as greater rates of nonsusceptibility are reported in these isolates (12).PCV7 was introduced to the Irish childhood immunization schedule in 2008 and replaced by PCV13 in 2010. Previously, we reported on pneumococcal serotypes associated with nonsusceptibility in an Irish pediatric hospital (9). In the present study, we used MLST to further characterize these nonsusceptible noninvasive pneumococci. We also included nonsusceptible pneumococcal isolates from two other Irish pediatric hospitals collected in 2013 to 2014. We determined the prevalence of PI-1 among these isolates, given its association with some nonsusceptible clones (4, 5). Finally, we compared our results to those from a collection of

show abstract

“…Shortly after implementation of PCV13 in Canada, the number of IPD cases due to vaccine-associated serotypes such as 19A and 7F declined (Deng et al, 2015). However, the concurrent increase of IPD due to non-vaccine serotypes 22F, 15A, 33F, and 35B post-introduction of PCV13 has become a concern to clinicians (Deng et al, 2015; Golden et al, 2015; Duvvuri et al, 2016). In addition to use in children, the PCV13 vaccine was also approved by Canadian health authorities in 2012 for use among adults 50 years and older for the prevention of IPD (An Advisory Committee Statement (ACS), 2013).…”

Section: Introductionmentioning

confidence: 99%

Whole-genome Sequencing for Surveillance of Invasive Pneumococcal Diseases in Ontario, Canada: Rapid Prediction of Genotype, Antibiotic Resistance and Characterization of Emerging Serotype 22F

et al. 2016

View full text Add to dashboard Cite

Background: Molecular typing is essential for inferring genetic relatedness between bacterial pathogens. In this study, we applied whole genome sequencing (WGS) for rapid prediction of sequence type and antibiotic resistance for invasive pneumococcal isolates.Methods: 240 isolates from adults (≥50 years old) in Ontario, Canada during 2009 to 2013 were subjected to WGS. Sequence type, antibiotic susceptibility and resistance were predicted directly from short reads. Emerging non-vaccine serotype 22F was further characterized by WGS.Results: Sequence type was successfully determined for 98.3% of isolates. The overall sensitivity and specificity for antibiotic resistance prediction were 95 and 100% respectively, compared to standard susceptibility testing methods. WGS-based phylogeny divided emerging 22F (ST433) strains into two distinct clades: clade A harboring a 23 kb-prophage and anti-phage PhD/Doc system and clade B with virulence-related proteases. Five isolates in clade A developed macrolide resistance via 5.1 kb mega element recombination (encoding mefE and msrD), while one isolate in clade B displayed quinolone resistance via a gyrA mutation.Conclusions: WGS is valuable for routine surveillance of pneumococcal clinical isolates and facilitates prediction of genotype and antibiotic resistance. The emergence of 22F in Ontario in the post-vaccine era and evidence of evolution and divergence of the 22F population warrants heightened pneumococcal molecular surveillance.

show abstract

Assessment of multidrug resistance, clonality and virulence in non-PCV-13 Streptococcus pneumoniae serotypes in Canada, 2011–13

Abstract: Non-PCV-13 serotype 22F is increasing in Canada through the rapid clonal expansion of ST433. Numerous new STs associated with serotype 33F indicate the potential divergence of the serotype. Serotypes 15A and 35B in Canada are related to international clones of S. pneumoniae.

Cited by 33 publications

References 15 publications

Emergence of Multidrug-Resistant Pneumococcal Serotype 35B among Children in the United States

Emergence of Multidrug-Resistant Pneumococcal Serotype 35B among Children in the United States

Noninvasive Pneumococcal Clones Associated with Antimicrobial Nonsusceptibility Isolated from Children in the Era of Conjugate Vaccines

Whole-genome Sequencing for Surveillance of Invasive Pneumococcal Diseases in Ontario, Canada: Rapid Prediction of Genotype, Antibiotic Resistance and Characterization of Emerging Serotype 22F

Contact Info

Product

Resources

About