Epidemiological and molecular characterization of Streptococcus pneumoniae carriage strains in pre-school children in Arkhangelsk, northern European Russia, prior to the introduction of conjugate pneumococcal vaccines

Abstract

Background The 13-valent Pneumococcal Conjugate Vaccine (PCV-13) was introduced in the National Immunization Programme (NIP) schedule in Russia in March 2014. Previously, the 7-valent Pneumococcal Conjugate Vaccine (PCV-7) was marketed in Russia in 2009 but has never been offered for mass vaccination. A carriage study was performed among children in Arkhangelsk in 2006. The objective was to determine the prevalence of carriage, serotype distribution, antimicrobial susceptibility and the molecular structure of Streptococcus pneumoniae strains before marketing and introduction of PCV-13. Methods A cross-sectional study was conducted on a cluster-randomized sample of children and a self-administrated questionnaire for parents/guardians. Nasopharyngeal samples were collected from 438 children younger than 7 years attending nurseries and kindergartens in the Arkhangelsk region, Russia. Detailed demographic data, as well as information about the child’s health, traveling, exposure to antimicrobials within the last 3 months and anthropometric measurements were collected for all study subjects. Variables extracted from the questionnaire were analysed using statistic regression models to estimate the risk of carriage. All pneumococcal isolates were examined with susceptibility testing, serotyping and multilocus sequence typing. Results The overall prevalence of asymptomatic carriage was high and peaking at 36 months with a rate of 57%. PCV-13 covered 67.3% of the detected strains. High rates of non-susceptibility to penicillin, macrolides and multidrug resistance were associated with specific vaccine serotypes, pandemic clones, and local sequence types. Nine percent of isolates represented three globally disseminated disease-associated pandemic clones; penicillin- and macrolide-resistant clones NorwayNT-42 and Poland6B-20, as well as penicillin- and macrolide-susceptible clone Netherlands3-31. A high level of antimicrobial consumption was noted by the study. According to the parent’s reports, 89.5% of the children used at least one antimicrobial regime since birth. None of the hypothesised predictors of S. pneumoniae carriage were statistically significant in univariable and multivariable logistic models. Conclusions The study identified a high coverage of the PCV-13-vaccine, but serotype replacement and expansion of globally disseminated disease-associated clones with non-vaccine serotypes may be expected. Further surveillance of antimicrobial resistance and serotype distribution is therefore required.

Molecular Characterization Based on Whole-Genome Sequencing of Streptococcus pneumoniae in Children Living in Southwest China During 2017-2019

“…However, the prevalence of pneumococcal serotypes in our region was slightly different from those in developing countries and regions e.g. Thailand (6B, 23F, 14) ( Hocknell et al, 2019 ), Malaysia (14, 6B, 19A, 6A) ( Arushothy et al, 2019 ), Mexico (19A, 3, 15B, 19F) ( Echaniz-Aviles et al, 2019 ) and northern Russia (19F, 23F, 6A) ( Vorobieva S Jensen et al, 2020 ), and were totally different from those in developed countries e.g. the USA (35B, 3, 11A/D) ( Suaya et al, 2020 ), the UK and Ireland (3, 8, 15A) ( Pick et al, 2020 ), and Japan (12F, 3, 23A) ( Yanagihara et al, 2021 ).…”

“…These results suggest that S. pneumoniae may have multiple origins in China. In addition, the prevalent STs in China were different from those in other countries, such as Japan ( Nakano et al, 2016 ), northern Russia ( Vorobieva S Jensen et al, 2020 ), Iran ( Talebi et al, 2016 ) and Latin America ( Moreno et al, 2020 ), strongly suggesting the diversity of S. pneumoniae on a global scale.…”

Antimicrobial susceptibility, serotype distribution, virulence profile and molecular typing of piliated clinical isolates of pneumococci from east coast, Peninsular Malaysia

“…A previous study reported that serotype 15B/C emerged as the predominant non-vaccine serotype and was widely disseminated 16 . Additionally, serotype predominance in relation to age group was observed in a previous study that revealed serotype 14 as the most common serotype in children less than 48 months of age in Russia 17 . This was in agreement with our finding that serotype 14 and 6A/B was predominant among ≤ 5 year-old group.…”

Key features of pneumococcal isolates recovered in Central and Northwestern Russia in 2011–2018 determined through whole-genome sequencing

“…There is currently no national surveillance system for pneumococcal disease in Russia [17,18]. However, a number of studies have reported data on pneumococcal infection incidence and distribution of circulating pneumococcal serotypes [18][19][20][21][22][23]. S. pneumoniae was responsible for 2-20 % of bacterial meningitis cases in children under 5 years of age in [2005][2006], and the incidence of pneumococcal meningitis in the same age group was 4-8 cases per 100 000 [17,19].…”