Continued Vaccine Breakthrough Cases of Serotype 3 Complicated Pneumonia in Vaccinated Children, Portugal (2016–2019)

Silva-Costa, Catarina; Gomes-Silva, Joana; Pinho, Marcos D.; Friães, Ana; Ramírez, Mario; Melo‐Cristino, José

doi:10.1128/spectrum.01077-22

Cited by 14 publications

(6 citation statements)

References 15 publications

(74 reference statements)

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“…Moreover, concentrations were by far the lowest of the tested serotypes. Since serotype 3 is a main driver of IPD in Germany, these results corroborate the well-known lack of vaccine-protection [37][38][39]. However, for a more accurate assessment of this problem, a longer follow-up of recipients and larger group of participants are necessary.…”

Section: Discussionsupporting

confidence: 74%

Antibody responses after sequential vaccination with PCV13 and PPSV23 in kidney transplant recipients

et al. 2023

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Purpose Vaccination against Streptococcus pneumoniae is recommended in transplant recipients to reduce the morbidity and mortality from invasive pneumococcal disease. Previous studies indicate that transplant recipients can produce specific antibodies after vaccination with the 13-valent pneumococcal conjugate vaccine Prevenar 13 (PCV13) or the pneumococcal polysaccharide vaccine Pneumovax 23 (PPSV23). National guidelines recommend sequential vaccination with PCV13 followed by PPSV23 in kidney transplant patients. However, there are currently no data on the serological response in kidney transplant recipients, who received a sequential vaccination with PCV13 and PPSV23. Methods In the current study, we sequentially vaccinated 46 kidney transplant recipients with PCV13 and PPSV23 and determined global and serotype-specific anti-pneumococcal antibody responses in the year following vaccination. Results Serotype-specific and global anti-pneumococcal antibody concentrations were significantly higher compared to baseline. We observed that serotype-specific antibody responses varied by serotype (between 2.2- and 2.9-fold increase after 12 months). The strongest responses after 12 months were detected against the serotypes 9N (2.9-fold increase) and 14 (2.8-fold increase). Global antibody responses also varied with respect to immunoglobulin class. IgG2 revealed the highest increase (2.7-fold), IgM the lowest (1.7-fold). Sequential vaccination with both vaccines achieved higher antibody levels in comparison with a historical cohort studied at our institute, that was vaccinated with PCV13 alone. During the 12-months follow-up period, none of the patients developed pneumococcal-associated pneumonia or vaccination-related allograft rejection. Conclusion In conclusion, we strongly recommend sequential vaccination over single immunization in kidney transplant recipients.

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Section: Discussionsupporting

confidence: 74%

Antibody responses after sequential vaccination with PCV13 and PPSV23 in kidney transplant recipients

et al. 2023

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“…Similarly, Silva-Costa et al showed 87/98 (89%) of S . pneumoniae cases were only identified using PCR [ 23 ]. Reliance on culture-based methods for empyema diagnostics may therefore substantially underestimate S .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a multiplex-qPCR for paediatric pleural empyema—An observational study in hospitalised children

Jacobson,

Fabri,

Osowicki

et al. 2024

PLoS ONE

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Pleural empyema is a serious complication of pneumonia in children. Negative bacterial cultures commonly impede optimal antibiotic therapy. To improve bacterial identification, we developed a molecular assay and evaluated its performance compared with bacterial culture. Our multiplex-quantitative PCR to detect Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus and Haemophilus influenzae was assessed using bacterial genomic DNA and laboratory-prepared samples (n = 267). To evaluate clinical performance, we conducted the Molecular Assessment of Thoracic Empyema (MATE) observational study, enrolling children hospitalised with empyema. Pleural fluids were tested by bacterial culture and multiplex-qPCR, and performance determined using a study gold standard. We determined clinical sensitivity and time-to-organism-identification to assess the potential of the multiplex-qPCR to reduce the duration of empiric untargeted antibiotic therapy. Using spiked samples, the multiplex-qPCR demonstrated 213/215 (99.1%) sensitivity and 52/52 (100%) specificity for all organisms. During May 2019–March 2023, 100 children were enrolled in the MATE study; median age was 3.9 years (IQR 2–5.6). A bacterial pathogen was identified in 90/100 (90%) specimens by multiplex-qPCR, and 24/100 (24%) by bacterial culture (P <0.001). Multiplex-qPCR identified a bacterial cause in 68/76 (90%) culture-negative specimens. S. pneumoniae was the most common pathogen, identified in 67/100 (67%) specimens. We estimate our multiplex-qPCR would have reduced the duration of untargeted antibiotic therapy in 61% of cases by a median 20 days (IQR 17.5–23, range 1–55). Multiplex-qPCR significantly increased pathogen detection compared with culture and may allow for reducing the duration of untargeted antibiotic therapy.

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“…However, IPDs and AOMs replaced by non-vaccine serotypes including those associated to antibiotic resistance have emerged and now predominate in high-income countries (de Miguel et al 2021 ; Sempere et al 2022 ; Pichichero et al 2023 ). To date, S. pneumoniae still remains a major cause of serious human disease not only in the elderly (de Miguel et al 2021 ), but also in the pediatric population where it associates with complicated pneumonia cases, often with empyema or pleural effusion (Silva-Costa et al 2022 ). Moreover, recent results have demonstrated that serotype 3 pneumococci may cause adverse cardiovascular events during IPD (Africano et al 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Two putative glutamate decarboxylases of Streptococcus pneumoniae as possible antigens for the production of anti-GAD65 antibodies leading to type 1 diabetes mellitus

Garcı́a

2023

Int Microbiol

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Type 1 diabetes mellitus (T1DM) has been increasing in prevalence in the last decades and has become a global burden. Autoantibodies against human glutamate decarboxylase (GAD65) are among the first to be detected at the onset of T1DM. Diverse viruses have been proposed to be involved in the triggering of T1DM because of molecular mimicry, i.e., similarity between parts of some viral proteins and one or more epitopes of GAD65. However, the possibility that bacterial proteins might also be responsible for GAD65 mimicry has been seldom investigated. To date, many genomes of Streptococcus pneumoniae (the pneumococcus), a prominent human pathogen particularly prevalent among children and the elderly, have been sequenced. A dataset of more than 9000 pneumococcal genomes was mined and two different (albeit related) genes (gadA and gadB), presumably encoding two glutamate decarboxylases similar to GAD65, were found. The various gadASpn alleles were present only in serotype 3 pneumococci belonging to the global lineage GPSC83, although some homologs have also been discovered in two subspecies of Streptococcus constellatus (pharyngis and viborgensis), an isolate of the group B streptococci, and several strains of Lactobacillus delbrueckii. Besides, gadBSpn alleles are present in > 10% of the isolates in our dataset and represent 16 GPSCs with 123 sequence types and 20 different serotypes. Sequence analyses indicated that gadA- and gadB-like genes have been mobilized among different bacteria either by prophage(s) or by integrative and conjugative element(s), respectively. Substantial similarities appear to exist between the putative pneumococcal glutamate decarboxylases and well-known epitopes of GAD65. In this sense, the use of broader pneumococcal conjugate vaccines such as PCV20 would prevent the majority of serotypes expressing those genes that might potentially contribute to T1DM. These results deserve upcoming studies on the possible involvement of S. pneumoniae in the etiopathogenesis and clinical onset of T1DM.

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Continued Vaccine Breakthrough Cases of Serotype 3 Complicated Pneumonia in Vaccinated Children, Portugal (2016–2019)

Cited by 14 publications

References 15 publications

Antibody responses after sequential vaccination with PCV13 and PPSV23 in kidney transplant recipients

Antibody responses after sequential vaccination with PCV13 and PPSV23 in kidney transplant recipients

Evaluation of a multiplex-qPCR for paediatric pleural empyema—An observational study in hospitalised children

Two putative glutamate decarboxylases of Streptococcus pneumoniae as possible antigens for the production of anti-GAD65 antibodies leading to type 1 diabetes mellitus

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