Streptococcus pneumoniaeSerotype 19A in Children, South Korea

Abstract

A single, multidrug-resistant strain was responsible for increased incidence of this serotype before introduction of the pneumococcal 7-valent conjugate vaccine.

Changing trends in serotype distribution and antimicrobial susceptibility ofStreptococcus pneumoniaecausing invasive diseases in Central Thailand, 2009–2012

“…28 We found a similarly increase of serotype 19A in children <5 y of age (5. sales in Bangkok indicate PCV uptake of 14.0% in 2009 and 25.9% in 2012 for infants born in Bangkok. This finding was similar to reports from Korea 12 and China 29 that found an increase of 19A before the introduction of PCV7 in the routine childhood immunization program. A study from Singapore 10 also showed an increase of serotype 19A among children aged <5 y with IPD before PCV7 was available, and this became more pronounced following the introduction of PCV7 (26.7% in 2010) These data suggested that other factors were more important than the effect of local use of PCV7 to influence changes in serotypes.…”

“…However, emergence of non-vaccine serotypes, particularly serotype 19A, has been noted in many parts of the world including North America, 1,2 Europe, [3][4][5][6][7] Oceania, 8 Latin America, 9 and Asia. [10][11][12] The emergent serotype 19A was associated with a higher rate of penicillin nonsusceptibity. [13][14][15] Other non-vaccine serotype have been identified to increase penicillin nonsusceptibility of invasive pneumococci in the post PCV7 era.…”

Meningitis neumocóccica por serotipo 19 A, de curso fatal: ¿Un caso prevenible?

“…En el análisis realizado destacó un cambio en los genotipos prevalentes en el período 1993-2007 a lo observado con posterioridad al año 2007, lo que refleja probablemente la presión del uso de antimicrobianos sumado al fenómeno post vacuna PCV-7 14 . Otros estudios han mostrado un cambio en los patrones de resistencia antimicrobiana del serotipo 19 A, incluso antes de la introducción de PCV-7, lo cual probablemente esté representando sólo el mecanismo de presión selectiva del uso de antimicrobianos 15 . Un ejemplo de ello queda demostrado en un estudio realizado en Canadá, donde a partir de los datos clínicos y microbiológicos de registros de ENI, se evidenció una mayor asociación de serotipo 19 A con meningitis en niños bajo 5 años de edad y una tasa de resistencia a múltiples antimicrobianos para el serotipo 19 A cercana a 20%, en tanto que para otros serotipos esta tasa era menor a 1% 16 .…”

Pneumococcal vaccination: time to move on?

“…Although the PCV7 vaccine holds an inherent risk for serotype replacement, it would be an oversimplification to point to PCV-7 vaccine as the one and only cause of the worrying serotype replacement. Some serotypes including 1 and 19A were already on the rise before the vaccine was introduced as has been documented in Korea and Israel [4,6]. A Belgian survey also documented a rise in 19A before the introduction of vaccination with a further increase post-vaccination (unpublished data, manuscript in preparation).…”