Clinical Implications of Pneumococcal Serotypes: Invasive Disease Potential, Clinical Presentations, and Antibiotic Resistance

Abstract

Streptococcus pneumoniae can asymptomatically colonize the nasopharynx and cause a diverse range of illnesses. This clinical spectrum from colonization to invasive pneumococcal disease (IPD) appears to depend on the pneumococcal capsular serotype rather than the genetic background. According to a literature review, serotypes 1, 4, 5, 7F, 8, 12F, 14, 18C, and 19A are more likely to cause IPD. Although serotypes 1 and 19A are the predominant causes of invasive pneumococcal pneumonia, serotype 14 remains one of the most common etiologic agents of non-bacteremic pneumonia in adults, even after 7-valent pneumococcal conjugate vaccine (PCV7) introduction. Serotypes 1, 3, and 19A pneumococci are likely to cause empyema and hemolytic uremic syndrome. Serotype 1 pneumococcal meningitis is prevalent in the African meningitis belt, with a high fatality rate. In contrast to the capsule type, genotype is more closely associated with antibiotic resistance. CC320/271 strains expressing serotype 19A are multidrug-resistant (MDR) and prevalent worldwide in the era of PCV7. Several clones of MDR serotype 6C pneumococci emerged, and a MDR 6D clone (ST282) has been identified in Korea. Since the pneumococcal epidemiology of capsule types varies geographically and temporally, a nationwide serosurveillance system is vital to establishing appropriate vaccination strategies for each country.

Lung Abscess Due to Streptococcus pneumoniae: A Case Series and Brief Review of the Literature

“…They were admitted to intensive care. Also, the serotypes found in our cases were extremely rare compared to most cases of pneumonia and/or pulmonary abscess [4,24,25]. The same is true in the patient with spinal meningitis [24,25].…”

“…Also, the serotypes found in our cases were extremely rare compared to most cases of pneumonia and/or pulmonary abscess [4,24,25]. The same is true in the patient with spinal meningitis [24,25]. To our knowledge, this is the first time that 12F Streptococcus p. has been reported as the cause of pulmonary abscess.…”

Impact of 10- and 13-valent pneumococcal conjugate vaccines on incidence of invasive pneumococcal disease in children aged under 16 years in Germany, 2009 to 2012

“…A similar pattern was observed after the introduction of PCV in 2007 (data not shown). A literature review published in 2013, with observations from other countries, addressed the issue of tropism of different pneumococcal serotypes: serotypes 1, 19A and 3 were identified as predominant for pneumococcal pneumonia but not for meningitis IPD during the post-PCV7 period [14]. A recent paper from India, not included in the review, reported that serotypes 1, 5 and 7F (three of the six additional serotypes in PCV13) caused more pneumonia than meningitis [15].…”

Investigation of Bacterial Meningitis Agents from Patients with Suspicion of Non-Neonatal Meningitis by Conventional and Molecular Methods

“…pneumoniae'nın beş yaş altı çocuklarda akut bakteriyel menenjite neden olan en yaygın etken olduğu bildirilmektedir (25) . Yedi valanlı konjuge pnömokok aşısının kullanımından önce beş yaş altı çocuklarda serotip 6A, 6B, 19F ve 23F, eriş-kinlerde serotip 3 ve 23F en sık invaziv hastalık nedeni olarak bildirilirken, aşılama sonrası ise bunların yerini serotip 19A, 6C, 11A, 15A ve 15B/C almış ve menenjitli hastalarda özellikler 19A ve 22F'de artış saptanmıştır (26) . Yıldırım ve ark.…”