Association of serotype with respiratory presentations of pneumococcal infection, Ontario, Canada, 2003–2011

Rudnick, Wallis; Green, Karen; Tyrrell, Gregory J.; Demczuk, Walter; Gold, Wayne L.; Gubbay, Jonathan B.; Plevneshi, Agron; Pong-Porter, Sylvia; Richardson, Susan E.; McGeer, Allison

doi:10.1016/j.vaccine.2015.11.021

Cited by 13 publications

(15 citation statements)

References 48 publications

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“…5–7 Few recent experiences showed an increase of serotype 35F among children carriers, especially after the extensive use of pneumococcal conjugate vaccine (PCV7) and adult patients with both IPD and non-IPD, even if it was more likely to be associated with colonization than disease. 14,15 According to our results, we might speculate that PCV13 could potentially be protective in about 50% of available serotype cases in CAP patients, a finding partly consistent with previous studies showing a potential coverage from PCV13 between 34% and 80% of cases. 5–7 Moreover, our interesting finding of a lower rate of antibiotic resistances of S. pneumoniae , and particularly macrolide resistance, is slightly different from previous studies.…”

Section: Discussionsupporting

confidence: 92%

Serotypes and antibiotic susceptibility of Streptococcus pneumoniae isolated from hospitalized patients with community-acquired pneumonia in Italy

et al. 2017

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Background:Pneumonia remain an important public health problem. The primary objective was to determine the proportion of community-acquired pneumonia that is attributable to Streptococcus pneumoniae infection; secondary objectives were the description of community-acquired pneumonia attributable to Streptococcus pneumoniae according to socio-demographic and clinical variables, the clinical evolution of community-acquired pneumonia and the description of the serotype distribution of vaccine-preventable disease and antibiotic resistance rate of pneumococcal infections.Methods:An observational, prospective study was conducted on consecutive patients coming from the community, who were hospitalized with pneumonia. Data on admission, at discharge and 30 days after discharge were collected. Logistic regression models were used to evaluate the risk factors independently associated with pneumococcal pneumonia.Results:Among the 193 patients enrolled in the study, the etiology of community-acquired pneumonia was identified in 60 patients (33%) and 35 (18%) of evaluable patients had community-acquired pneumonia due to Streptococcus pneumoniae. Of all clinical characteristics, if no previous antibiotic treatment was performed, there was a 13-fold higher risk of presenting community-acquired pneumonia due to Streptococcus pneumoniae (odds ratio, 12.9; 95% confidence interval, 1.42–117.9). Moreover, the most frequent isolated serotypes were 35F, 3 and 24 (29%, 23% and 16%, respectively).Conclusion:The most frequent serotypes in pneumococcal community-acquired pneumonia are 35F, 3, 24, 6 and 7A, and thus almost 50% of Streptococcus pneumoniae strains could be covered by pneumococcal conjugate vaccine 13 in adult patients with risk factors for pneumococcal infections.

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Section: Discussionsupporting

confidence: 92%

Serotypes and antibiotic susceptibility of Streptococcus pneumoniae isolated from hospitalized patients with community-acquired pneumonia in Italy

et al. 2017

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“…Notwithstanding serotype 3, there appears to be a persistence of PCV13 serotypes causing CAP. Serotypes 3, 5 and 6A were relatively more common in CAP compared with IPD, possibly indicating a predilection for pneumonia (rather than IPD) with these serotypes, as also observed by others 24 25…”

Section: Discussionsupporting

confidence: 72%

“…This large prospective population-based cohort study describes trends in pneumococcal serotypes implicated in adult pneumococcal pneumonia over the last 5 years, during which PCV13 replaced PCV7 in the national childhood immunisation programme. Unlike laboratory-based studies, our study population is not over-represented by patients with chronic lung disease or those requiring invasive respiratory procedures 25. Use of the novel Bio-plex24 assay enabled identification of PCV13 and PPV23 serotypes in patients presenting with non-invasive disease, which is the vast majority of adults with CAP, compared with previous studies which have been unable to identify PPV23-non13-serotype disease from non-invasive samples and have classified these cases as non-vaccine-type infection only.…”

Section: Discussionmentioning

confidence: 99%

Pneumococcal serotype trends, surveillance and risk factors in UK adult pneumonia, 2013–18

Pick

Daniel

Rodrigo

et al. 2019

Thorax

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BackgroundChanges over the last 5 years (2013–18) in the serotypes implicated in adult pneumococcal pneumonia and the patient groups associated with vaccine-type disease are largely unknown.MethodsWe conducted a population-based prospective cohort study of adults admitted to two large university hospitals with community-acquired pneumonia (CAP) between September 2013 and August 2018. Pneumococcal serotypes were identified using a novel 24-valent urinary monoclonal antibody assay and from blood cultures. Trends in incidence rates were compared against national invasive pneumococcal disease (IPD) data. Persons at risk of vaccine-type pneumonia (pneumococcal conjugate vaccine (PCV)13 and pneumococcal polysaccharide vaccine (PPV)23) were determined from multivariate analyses.FindingsOf 2934 adults hospitalised with CAP, 1075 (36.6%) had pneumococcal pneumonia. The annual incidence of pneumococcal pneumonia increased from 32.2 to 48.2 per 100 000 population (2013–18), predominantly due to increases in PCV13non7-serotype and non-vaccine type (NVT)-serotype pneumonia (annual incidence rate ratio 1.12, 95% CI 1.04 to 1.21 and 1.19, 95% CI 1.10 to 1.28, respectively). Incidence trends were broadly similar to IPD data. PCV13non7 (56.9% serotype 3) and PPV23non13 (44.1% serotype 8) serotypes were identified in 349 (32.5%) and 431 (40.1%) patients with pneumococcal pneumonia, respectively. PCV13-serotype pneumonia (dominated by serotype 3) was more likely in patients in the UK pneumococcal vaccination clinical risk group (adjusted OR (aOR) 1.73, 95% CI 1.31 to 2.28) while PPV23-serotype pneumonia was more likely in patients outside the clinical risk group (aOR 1.54, 95% CI 1.13 to 2.10).InterpretationThe incidence of pneumococcal CAP is increasing, predominantly due to NVT serotypes and serotype 3. PPV23-serotype pneumonia is more likely in adults outside currently identified clinical risk groups.

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“…In addition, all isolates submitted for confirmatory testing to the Public Health Ontario Laboratory (PHOL), Canada’s National Microbiology Laboratory (NML), and the Canadian Nosocomial Infection Surveillance Program were identified. During active surveillance, each newly identified case in TIBDN laboratories was reported to the central study office, with annual audits of participating and reference laboratories conducted to ensure complete case identification ( 17 ). Patient information was reviewed for each isolate to ensure that patients were counted only once.…”

Section: Methodsmentioning

confidence: 99%

Emergence of Carbapenemase-ProducingEnterobacteriaceae, South-Central Ontario, Canada1

Köhler¹,

Melano²,

Patel³

et al. 2018

Emerg. Infect. Dis.

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We analyzed population-based surveillance data from the Toronto Invasive Bacterial Diseases Network to describe carbapenemase-producing Enterobacteriaceae (CPE) infections during 2007–2015 in south-central Ontario, Canada. We reviewed patients’ medical records and travel histories, analyzed microbiologic and clinical characteristics of CPE infections, and calculated incidence. Among 291 cases identified, New Delhi metallo-β-lactamase was the predominant carbapenemase (51%). The proportion of CPE-positive patients with prior admission to a hospital in Canada who had not received healthcare abroad or traveled to high-risk areas was 13% for patients with oxacillinase-48, 24% for patients with New Delhi metallo-β-lactamase, 55% for patients with Klebsiella pneumoniae carbapenemase, and 67% for patients with Verona integron-encoded metallo-β-lactamase. Incidence of CPE infection increased, reaching 0.33 cases/100,000 population in 2015. For a substantial proportion of patients, no healthcare abroad or high-risk travel could be established, suggesting CPE acquisition in Canada. Policy and practice changes are needed to mitigate nosocomial CPE transmission in hospitals in Canada.

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Association of serotype with respiratory presentations of pneumococcal infection, Ontario, Canada, 2003–2011

Cited by 13 publications

References 48 publications

Serotypes and antibiotic susceptibility of Streptococcus pneumoniae isolated from hospitalized patients with community-acquired pneumonia in Italy

Serotypes and antibiotic susceptibility of Streptococcus pneumoniae isolated from hospitalized patients with community-acquired pneumonia in Italy

Pneumococcal serotype trends, surveillance and risk factors in UK adult pneumonia, 2013–18

Emergence of Carbapenemase-ProducingEnterobacteriaceae, South-Central Ontario, Canada1

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