Increased Penicillin Nonsusceptibility of Nonvaccine-Serotype Invasive Pneumococci Other than Serotypes 19A and 6A in Post-7-Valent Conjugate Vaccine Era

Gertz, Robert E.; Li, Zhongya; Pimenta, Fabiana Cristina; Jackson, Delois; Juni, Billie A.; Lynfield, Ruth; Jorgensen, James H.; Carvalho, Maria da Glória; Beall, Bernard

doi:10.1086/650496

Cited by 111 publications

(99 citation statements)

References 14 publications

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“…The strong association of ST156 with vaccine serotypes like 9V and 14 in the pre-PCV13 era suggests that ST156 has exchanged its cps encoding a vaccine serotype capsule with genes encoding a 35B capsule. In the United States, no evidence of capsular switching among serotype 35B isolates was reported before 2009 (8,26,27). Continuous surveillance will determine whether this vaccine escape recombinant (serotype 35B ST156 ) will successfully spread.…”

Section: Fig 4 Eburst Analysis Of Penicillin Mic Distribution and Mulmentioning

confidence: 99%

Emergence of Multidrug-Resistant Pneumococcal Serotype 35B among Children in the United States

et al. 2017

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Streptococcus pneumoniae serotype 35B is a nonvaccine serotype associated with high rates of penicillin nonsusceptibility. An increase in the proportion of multidrug-resistant (MDR) 35B isolates has recently been reported. The genetic events contributing to the emergence of MDR serotype 35B are unknown. The sequence type (ST) composition of 78 serotype 35B isolates obtained from pediatric patients with invasive pneumococcal disease from 1994 to 2014 and 48 isolates from pediatric patients with otitis media (noninvasive) from 2011 to 2014 was characterized by multilocus sequence typing (MLST). The most common STs were ST558 (69.2%), ST156 (10.3%), and ST452 (3.8%). Two major clonal complexes (CC), CC558 and CC156, were identified by eBURST analysis. Overall, 91% (71/78) of isolates were penicillin nonsusceptible and 16.7% (13/78) were MDR. Among all invasive serotype 35B isolates, MDR isolates increased significantly, from 2.9% (1/35) to 27.9% (12/43) (P ϭ 0.004), after the 13-valent pneumococcal conjugate vaccine (PCV13) was introduced. All CC156 isolates were identified after the introduction of PCV13 (0/35 [0%] before versus 9/43 [20.9%] after; P ϭ 0.003) and were MDR. All CC156 isolates had similar antimicrobial susceptibility patterns; in contrast, high variability in antimicrobial susceptibility was observed among CC558 isolates. The distributions of CC558 and CC156 among invasive and noninvasive isolates were not different. The increased prevalence of MDR serotype 35B after the introduction of PCV13 was directly associated with the emergence of ST156. Genotyping suggests that capsular switching has occurred between MDR vaccine serotypes belonging to ST156 (e.g., 9V, 14, and 19A) and serotype 35B.

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Section: Fig 4 Eburst Analysis Of Penicillin Mic Distribution and Mulmentioning

confidence: 99%

Emergence of Multidrug-Resistant Pneumococcal Serotype 35B among Children in the United States

et al. 2017

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“…These reductions have been undermined by the rapid evolution of resistance in non-vaccine strains causing invasive disease such that the proportion of such strains resistant to antibiotics has now reached prevaccine levels [44,45], even if the absolute number of cases of disease has decreased. In particular, there has been a rapid expansion of antimicrobialresistant serotype 19A, leading to the speculation that the resistance alone may be sufficient to explain the ascent in the prevalence of this serotype.…”

Section: Role Of Antimicrobial Resistance In the Persistence And Seromentioning

confidence: 99%

Contribution of vaccines to our understanding of pneumococcal disease

Klugman

2011

Phil. Trans. R. Soc. B

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Pneumonia is the leading cause of mortality in children in developing countries and is also the leading infectious cause of death in adults. The most important cause of pneumonia is the Gram-positive bacterial pathogen, Streptococcus pneumoniae, also known as the pneumococcus. It has thus become the leading vaccine-preventable cause of death and is a successful and diverse human pathogen. The development of conjugate pneumococcal vaccines has made possible the prevention of pneumococcal disease in infants, but has also elucidated aspects of pneumococcal biology in a number of ways. Use of the vaccine as a probe has increased our understanding of the burden of pneumococcal disease in children globally. Vaccination has also elucidated the clinical spectrum of vaccine-preventable pneumococcal infections; the identification of a biological niche for multiple pneumococcal serotypes in carriage and the differential invasiveness of pneumococcal serotypes; the impact of pneumococcal transmission among children on disease burden in adults; the role of carriage as a precursor to pneumonia; the plasticity of a naturally transformable pathogen to respond to selective pressure through capsular switching and the accumulation of antibioticresistance determinants; and the role of pneumococcal infections in hospitalization and mortality associated with respiratory viral infections, including both seasonal and pandemic influenza. Finally, there has been a recent demonstration that pneumococcal pneumonia in children may be an important cause of hospitalization for those with underlying tuberculosis.

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“…Of these serotypes, 15A, 23A, 35B, and 6C were the most common among penicillin-nonsusceptible isolates from population-based invasive pneumococcal surveillance in the United States during 2007. 16 The emergence of non-PCV7 serotypes led to the development and introduction of broader PCVs: a 10-valent vaccine (PCV10)-PCV7 with serotypes 1, 5, and 7F added 17,18 ; and a 13-valent vaccine (PCV13)-PCV10 with serotypes 3, 6A, and 19A added. 19 Recently, the 15-valent vaccine (PCV15) with serotypes 22F and 33F added to PCV13, has been tested in clinical trials.…”

Section: Introductionmentioning

confidence: 99%

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

Phongsamart

Srifeungfung

Chatsuwan

et al. 2014

Human Vaccines & Immunotherapeutics

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Increased Penicillin Nonsusceptibility of Nonvaccine-Serotype Invasive Pneumococci Other than Serotypes 19A and 6A in Post-7-Valent Conjugate Vaccine Era

Cited by 111 publications

References 14 publications

Emergence of Multidrug-Resistant Pneumococcal Serotype 35B among Children in the United States

Emergence of Multidrug-Resistant Pneumococcal Serotype 35B among Children in the United States

Contribution of vaccines to our understanding of pneumococcal disease

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

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