Impact of the pneumococcal conjugate vaccine on serotype distribution and susceptibility trends of pediatric non-invasive Streptococcus pneumoniae isolates in Tokai, Japan over a 5-year period

Okade, Hayato; Funatsu, Tori; Eto, Maki; Furuya, Yuri; Mizunaga, Shingo; Nomura, Nobuhiko; Mitsuyama, Junichi; Yamagishi, Yuka; Mikamo, Hiroshige

doi:10.1016/j.jiac.2014.03.010

Cited by 21 publications

(18 citation statements)

References 19 publications

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“…This finding was in contrast to adult IPD data from the UK and paediatric IPD data from France during the post-PCV13 period [19,26]. Although the Bio-Plex assay used in this study was unable to differentiate between serotypes 7F and 7A, it is likely that the majority of implicated serotypes were 7F, as previous studies of both IPD and non-invasive pneumococcal disease have shown that serotype 7A is rarely implicated [6,7,27], Differences in serotypes implicated in contemporary cohorts of IPD and non-bacteraemic pneumococcal disease have been demonstrated previously [28]. Further, unvaccinated adults are likely to have a residual burden of pneumococcal disease due to serotypes included in PCVs, and herd protection effects are likely to manifest slower, in comparison to the vaccinated paediatric population [6,7].…”

Section: Discussioncontrasting

confidence: 87%

Impact of infant 13-valent pneumococcal conjugate vaccine on serotypes in adult pneumonia

et al. 2015

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Infant 13-valent pneumococcal conjugate vaccination (PCV13) was introduced to the UK in 2010. Its impact on serotypes implicated in adult non-bacteraemic pneumococcal pneumonia is not known.Beginning in 2008, a 5-year prospective cohort study of adults admitted to hospital with communityacquired pneumonia (CAP) was conducted. Pneumococcal serotype was established using a validated multiplex immunoassay (Bio-Plex; Bio-Rad, Hercules, CA, USA).The overall incidence for hospitalised CAP and pneumococcal CAP was 79.9 (95% CI 76.6-83.3) and 23.4 (95% CI 21.6-25.3) per 100 000 population, respectively. A decline in CAP (incidence rate ratio (IRR) per year 0.96, 95% CI 0.94-0.99; p=0.016) and pneumococcal CAP (IRR per year 0.84, 95% CI 0.80-0.89; p<0.001) was observed over the 5-year period of the study. Between the pre-and post-PCV13 periods of the study, the incidence of CAP due to serotypes included in the PCV7 declined by 88% (IRR 0.12, 95% CI 0.08-0.20; p<0.001), and CAP due to the additional 6 serotypes in PCV13 declined by 30% (IRR 0.70, 95% CI 0.51-0.96; p=0.024).Incidence of adult pneumococcal pneumonia declined over the last 5 years, with serotypes included in PCV13 declining post-PCV13 introduction, indicating early herd protection effects from PCV13 infant vaccination on adult non-bacteraemic disease. These effects may accrue over the coming years with implications for national pneumococcal vaccination policies in adults. @ERSpublications This is the first study to indicate herd protection from infant PCV13 on adult non-bacteraemic pneumococcal pneumonia

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Section: Discussioncontrasting

confidence: 87%

Impact of infant 13-valent pneumococcal conjugate vaccine on serotypes in adult pneumonia

et al. 2015

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“…An increased prevalence of serotype 3 S. pneumoniae among children was reported in one region of Japan after introduction of the 7-valent pneumococcal conjugate vaccine (PCV7) [6]. National surveillance of pediatric patients after the 13-valent pneumococcal conjugate vaccine (PCV13) introduction in Japan showed that the prevalence rates of serotype 3 were 0.8% and 8.5% in IPD and non-IPD patients, respectively, in 2014 [7].…”

Section: Discussionmentioning

confidence: 99%

Invasive pneumococcal disease caused by mucoid serotype 3 Streptococcus pneumoniae: a case report and literature review

et al. 2017

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BackgroundAmong the different serotypes of Streptococcus pneumoniae, serotype 3 has received global attention. We report the fatal case of a 76-year-old Japanese man who had an invasive pneumococcal disease associated with pneumonia caused by serotype 3 S. pneumoniae.Case presentationThe patient had a history of hypertension, laryngeal cancer, chronic obstructive pulmonary disease, and type 2 diabetes mellitus. Following a cerebral arteriovenous malformation hemorrhage, he underwent surgery to remove the hematoma and began rehabilitation. On day 66 of hospitalization, he suddenly developed a fever, and coarse crackles and wheezes were heard in his right lung. A diagnosis of hospital-acquired aspiration pneumonia was made, and initial treatment with piperacillin/tazobactam was started. Teicoplanin was added after S. pneumoniae was isolated from the blood culture, however, the patient died 5 days later. The S. pneumoniae detected in the sputum smear was serotype 3, showed mucoid colonies and susceptibility to penicillins, cephalosporins, carbapenems, and levofloxacin, but resistance to erythromycin.ConclusionWe experienced a fatal case of pneumonia caused by mucoid serotype 3 S. pneumoniae with a thick capsule. Serotype 3-associated pneumonia may develop a wider pulmonary infiltrative shadow, a prolonged therapeutic or hospitalization course, and a poor outcome. Careful observation and intervention are required, and the use of additional antibiotics or intravenous immunoglobulins should be considered in such cases. Pneumococcal immunization is also an important public health measure to minimize the development of severe infections caused by serotype 3 strains.

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“…However, at the same time, concomitant increases in the colonization of NESp and pneumococcal infections with NESp have been reported. [38][39][40][41] Increased colonization of NESp in the nasopharynx is thought to be a major risk factor for AOM, adenoiditis, pneumonia, and bacteremia. Although NESp does not produce polysaccharide capsule, novel protein PspK, which is expressed by NESp, enhances the adherence of NESp to respiratory epithelial cells and may facilitate nasopharyngeal colonization of NESp.…”

Section: Discussionmentioning

confidence: 99%

Molecular characterization of pneumococcal surface protein K, a potential pneumococcal vaccine antigen

et al. 2017

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The pneumococcal capsule is indispensable for pathogenesis in systemic infections; however, many pneumococcal diseases, including conjunctivitis, otitis media, and some systemic infections in immunocompromised patients, are caused by nonencapsulated Streptococcus pneumoniae (NESp). Null capsule clade 1 (NCC1), found in group 2 NESp, expresses pneumococcal surface protein K (PspK) and is becoming prevalent among pneumococcal organisms owing to the widespread use of pneumococcal conjugate vaccines. Despite its clinical importance, the molecular mechanisms underlying the prevalence of NCC1 have not been fully elucidated. Here, we investigated the role of the R3 domain of PspK in the epithelial cell adherence of NCC1. We found that the R3 domain of PspK mediated NCC1 adherence via its direct interaction with the epithelial surface protein annexin A2. Additionally, neutralization with purified recombinant PspK-R3 or rabbit anti-UD:R3 IgG inhibited binding of NESp to lung epithelial cells in vitro. Immunization with the 'repeat' domain of PspK-R3 or PspK-UD:R3 effectively elicited mucosal and systemic immune responses against PspK-R3 and provided protection against nasopharyngeal, lung, and middle ear colonization of NESp in mice. Additionally, we found that rabbit anti-UD:R3 IgG bound to PspC-R1 of the encapsulated TIGR4 strain and that UD:R3 immunization provided protection against nasopharyngeal and lung colonization of TIGR4 and deaths by TIGR4 and D39 in mice. Further studies using 68 pneumococcal clinical isolates showed that 79% of clinical isolates showed cross-reactivity to rabbit anti-UD:R3 IgG. About 87% of serotypes in the 13-valent pneumococcal conjugate vaccine (PCV) and 68% of nonvaccine serotypes were positive for cross-reactivity with rabbit anti-UD:R3 IgG. Thus, the R3 domain of PspK may be an effective vaccine candidate for both NESp and encapsulated Sp.

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Impact of the pneumococcal conjugate vaccine on serotype distribution and susceptibility trends of pediatric non-invasive Streptococcus pneumoniae isolates in Tokai, Japan over a 5-year period

Cited by 21 publications

References 19 publications

Impact of infant 13-valent pneumococcal conjugate vaccine on serotypes in adult pneumonia

Impact of infant 13-valent pneumococcal conjugate vaccine on serotypes in adult pneumonia

Invasive pneumococcal disease caused by mucoid serotype 3 Streptococcus pneumoniae: a case report and literature review

Molecular characterization of pneumococcal surface protein K, a potential pneumococcal vaccine antigen

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