Evaluating post-vaccine expansion patterns of pneumococcal serotypes

Phillips, Maile T.; Warren, Joshua L.; Givon-Lavi, Noga; Tóthpál, Adrienn; Regev‐Yochay, Gili; Dagan, Ron

doi:10.1016/j.vaccine.2020.10.045

Cited by 15 publications

(11 citation statements)

References 20 publications

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“…The decrease in the number of IPD cases caused by PCV13 is reassuring, as it confirms the success of the PCV13 vaccine. However, attention must be paid now to those serotypes not included in the vaccine, as their incidence is increasing and they are taking the lead as the major serotypes causing IPD ( 41 – 43 ). This serotype replacement phenomenon is more remarkable in adults, where the main leaders are now serotypes 8 and 12F, as observed in Fig.…”

Section: Discussionmentioning

confidence: 99%

Serotypes and Clonal Composition of Streptococcus pneumoniae Isolates Causing IPD in Children and Adults in Catalonia before 2013 to 2015 and after 2017 to 2019 Systematic Introduction of PCV13

et al. 2021

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Section: Discussionmentioning

confidence: 99%

Serotypes and Clonal Composition of Streptococcus pneumoniae Isolates Causing IPD in Children and Adults in Catalonia before 2013 to 2015 and after 2017 to 2019 Systematic Introduction of PCV13

et al. 2021

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“…As this serotype show a multidrug-resistant phenotype, [30], this could favour its persistence among adults with comorbidities. With regard to serotype 24F, it is a serotype whose incidence seems to be increasing [31], it is also associated with high invasive disease potential [32] and in our geographical area is related to the multidrug-resistant Denmark 14 -ST230 clone [23]. Probably this serotype has occupied the ecological niche that other multi-resistant serotypes such as 19A or 23F left in older adults after the introduction of PCVs.…”

Section: Discussionmentioning

confidence: 95%

Serotypes in Adult Pneumococcal Pneumonia in Spain in the Era of Conjugate Vaccines

et al. 2021

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We studied changes in serotype distribution and antimicrobial susceptibility in adult pneumococcal pneumonia in Spain (2011–2019). Among 895 pneumococci collected (433 bacteremic [BPP] and 462 non-bacteremic [non-BPP]), serotypes 3 (17%), 19A (10%), 8 (6.7%) and 11A (6.7%) were the most frequent. Serotypes 16F, 19A and 24F were associated with old people (≥65) and serotypes 4, 7F, 8, 12F and 19F to young adults. Serotypes 12F, 24F and 1 were significantly more frequent in BPP and serotypes 11A, 23A and 19F in non-BPP. Amoxicillin resistance was higher in non-BPP (17% vs. 11%) while penicillin non-susceptibility (37% vs. 24%) and macrolide resistance (29% vs. 14%) were higher in older adults. In the period 2017–2019, the vaccine coverages were: 32% (PCV13), 39% (PCV15), 65% (PCV20) and 69% (PPV23). Differences were found in serotype composition and antimicrobial resistance by age and type of infection. The maintenance of serotype 3 as a leading cause of adult pneumococcal pneumonia and the increase in highly invasive (serotype 8) or antimicrobial-resistant (serotype 11A) serotypes is worrisome. Further studies will be required to analyse the impact of the upcoming broader conjugate vaccines.

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“…Similar carriage data on serotype 8 in children below 5 years of age showing limited carriage have been observed in other countries [ 37 ]. It has furthermore been found that there is a limitation in using carriage data from children to forecast changes in general IPD epidemiology, and that serotype 8 is a possible example of a serotype transmitted directly among older age groups [ 38 ]. This observation is supported by studies from the UK performed on other age groups than children, in which they observed serotype 8 carriage [ 37 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

Molecular characterization and epidemiology of Streptococcus pneumoniae serotype 8 in Denmark

et al. 2021

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Background Streptococcus pneumoniae serotype 8 incidence has increased in Denmark after the introduction of pneumococcal conjugated vaccines (PCV). The mechanism behind the serotype 8 replacement is not well understood. In this study, we aimed to present epidemiological data on invasive pneumococcal disease (IPD) and molecular characterization of 96 serotype 8 clinical isolates. Methods IPD data from 1999 to 2019 were used to calculate the incidence and age distribution. Whole-genome sequencing (WGS) analysis was performed on 96 isolates (6.8% of the total serotype 8 IPD isolates in the period) to characterize the isolates with respect to pneumococcal lineage traits, a range of genes with potential species discrimination, presence of colonization and virulence factors, and molecular resistance pattern. Results The serotype 8 IPD incidence increased significantly (P < 0.05) for the age groups above 15 years after the introduction of PCV13, primarily affecting the elderly (65+). All isolates were phenotypically susceptible to penicillin, erythromycin and clindamycin. Molecular characterization revealed seven different MLST profiles with ST53 as the most prevalent lineage (87.5%) among the analyzed serotype 8 isolates. The genes covering the cell-surface proteins: lytA, rspB, pspA, psaA & Xisco and the pneumococcal toxin pneumolysin = ply were present in all isolates, while genes for the membrane transporter proteins: piaA/piaB/piaC; the capsular genes: cpsA (wzg) & psrP; the metallo-binding proteins zmpB & zmpC; and the neuroamidase proteins: nanA/nanB were variably present. Surprisingly, the putative transcriptional regulator gene SP2020 was not present in all isolates (98%). Susceptibility to penicillin, erythromycin and clindamycin was molecularly confirmed. Conclusion The observed serotype 8 replacement was not significantly reflected with a change in the MLST profile or changes in antibiotic resistance- or virulence determinants.

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Evaluating post-vaccine expansion patterns of pneumococcal serotypes

Cited by 15 publications

References 20 publications

Serotypes and Clonal Composition of Streptococcus pneumoniae Isolates Causing IPD in Children and Adults in Catalonia before 2013 to 2015 and after 2017 to 2019 Systematic Introduction of PCV13

Serotypes and Clonal Composition of Streptococcus pneumoniae Isolates Causing IPD in Children and Adults in Catalonia before 2013 to 2015 and after 2017 to 2019 Systematic Introduction of PCV13

Serotypes in Adult Pneumococcal Pneumonia in Spain in the Era of Conjugate Vaccines

Molecular characterization and epidemiology of Streptococcus pneumoniae serotype 8 in Denmark

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