Serotype changes in adult invasive pneumococcal infections in Portugal did not reduce the high fraction of potentially vaccine preventable infections

Horácio, Andreia N.; Diamantino-Miranda, Jorge; Aguiar, Sandra I.; Ramírez, Mario; Melo‐Cristino, José

doi:10.1016/j.vaccine.2011.11.022

Cited by 26 publications

(49 citation statements)

References 29 publications

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“…In previous studies, we showed that immunization of children with PCV7 resulted in the decline of PCV7 serotypes as causes of adult IPD [13], [19]. In the present study, we show that a decline of PCV7 serotypes also occurred among isolates causing NIPP in adults.…”

Section: Discussionsupporting

confidence: 69%

“…Among the differences are the more significant fractions of non-typable isolates among NIPP and of serotype 1 isolates in bacteremic pneumonia in Denmark relative to Portugal. Serotype 1 was always an important serotype among isolates causing IPD in both children and adults in Portugal, but its significance has declined in recent years [13], [15], [19], [28]. This change cannot be attributed entirely to the use of higher valency vaccines, such as PCV13, although vaccination was potentially a contributing factor [19], [28].…”

Section: Discussionmentioning

confidence: 99%

“…Until recently, the only available vaccine for adults was the 23-valent polysaccharide vaccine (PPV23) that, while potentially effective in preventing IPD, may be less efficacious against NIPP [10], [11]. Possibly due to the ongoing debate on the usefulness of PPV23 vaccination, in the majority of the European countries, including Portugal, there has been a low uptake of this vaccine [12], [13]. On the other hand, the 7-valent conjugate vaccine (PCV7) was introduced in many European countries for vaccinating children, rapidly reaching high coverages in the targeted age groups.…”

Section: Introductionmentioning

confidence: 99%

“…PCV7 was available in Portugal for vaccination of children between 2001 and 2009 and, although not part of the national immunization program, its uptake was estimated to have grown continuously, albeit slower that in countries where it was part of the national immunization program [14]. Changes in the serotype distribution of isolates causing IPD, compatible with an effect of PCV7 occurred in both children and adults in Portugal and elsewhere [13]–[17], the latter potentially resulting from a herd effect. The 10-valent (PCV10) and the 13-valent conjugate vaccines (PCV13) became available in Portugal in 2009 and in 2010, respectively.…”

Section: Introductionmentioning

confidence: 99%

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Non-Invasive Pneumococcal Pneumonia in Portugal—Serotype Distribution and Antimicrobial Resistance

et al. 2014

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There is limited information on the serotypes causing non-invasive pneumococcal pneumonia (NIPP). Our aim was to characterize pneumococci causing NIPP in adults to determine recent changes in serotype prevalence, the potential coverage of pneumococcal vaccines and changes in antimicrobial resistance. Serotypes and antimicrobial susceptibility profiles of a sample of 1300 isolates recovered from adult patients (≥18 yrs) between 1999 and 2011 (13 years) were determined. Serotype 3 was the most frequent cause of NIPP accounting for 18% of the isolates. The other most common serotypes were 11A (7%), 19F (7%), 19A (5%), 14 (4%), 22F (4%), 23F (4%) and 9N (4%). Between 1999 and 2011, there were significant changes in the proportion of isolates expressing vaccine serotypes, with a steady decline of the serotypes included in the 7-valent conjugate vaccine from 31% (1999–2003) to 11% (2011) (P<0.001). Taking together the most recent study years (2009–2011), the potential coverage of the 13-valent conjugate vaccine was 44% and of the 23-valent polysaccharide vaccine was 66%. While erythromycin resistance increased from 8% in 1999–2003 to 18% in 2011 (P<0.001), no significant trend was identified for penicillin non-susceptibility, which had an average value of 18.5%. The serotype distribution found in this study for NIPP was very different from the one previously described for IPD, with only two serotypes in common to the ones responsible for half of each presentation in 2009–2011 – serotypes 3 and 19A. In spite of these differences, the overall prevalence of resistant isolates was similar in NIPP and in IPD.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Non-Invasive Pneumococcal Pneumonia in Portugal—Serotype Distribution and Antimicrobial Resistance

et al. 2014

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“…In a systematic review, realized to estimate the global and regional distributions of serotypes causing IPD in children <5 years of age, serotype 14 was the most common serotype accounting for 12%–29% of IPD worldwide [23]. Serotype 1 was a frequent cause of IPD in older children; this serotype has a lower propensity to cause infections in the older age groups [24]. An increase in serotype 3 frequency was observed, which was mainly found in the ≥50 age group.…”

Section: Discussionmentioning

confidence: 99%

Serotype and Genotype Distribution among Invasive Streptococcus pneumoniae Isolates in Colombia, 2005–2010

Parra-Barrera

Ramos²,

Sanabria³

et al. 2014

PLoS ONE

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In Colombia, a laboratory-based surveillance of invasive Streptococcus pneumoniae isolates as part of SIREVA II PAHO has been conducted since 1994. This study describes the serotype distribution, antimicrobial resistance, and genetic relationships of pneumococcal isolates recovered in Colombia from 2005 to 2010. In this study, demographic data of invasive S. pneumoniae isolates were analyzed, and antimicrobial susceptibility patterns were determined. Pulse field gel electrophoresis (n = 629) and multilocus sequence typing (n = 10) were used to determine genetic relationship of isolates with minimal inhibitory concentration to penicillin ≥0.125 µg/mL. A total of 1775 isolates of S. pneumoniae were obtained. Fifteen serotypes accounted for 80.7% of isolates. Serotype 14 (23.1%) was the most frequent in the general population. Penicillin resistance was 30.7% in meningitis and 9.0% in non-meningitis. Clones Spain6BST90, Spain9VST156, Spain23FST81, and Colombia23FST338 were associated to isolates. Additionally, serotype 6A isolates were associated with ST460 and ST473, and 19A isolates with ST276, ST320, and ST1118. In conclusion, the surveillance program provided updated information of trends in serotype distribution, antimicrobial resistance and the circulation of clones in invasive pneumococcal diseases. These results could be helpful to understand the epidemiology of S. pneumoniae in Colombia, and provide a baseline to measure the impact of vaccine introduction.

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Streptococcus pneumoniae

Ramírez

2015

Molecular Medical Microbiology

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Serotype changes in adult invasive pneumococcal infections in Portugal did not reduce the high fraction of potentially vaccine preventable infections

Cited by 26 publications

References 29 publications

Non-Invasive Pneumococcal Pneumonia in Portugal—Serotype Distribution and Antimicrobial Resistance

Non-Invasive Pneumococcal Pneumonia in Portugal—Serotype Distribution and Antimicrobial Resistance

Serotype and Genotype Distribution among Invasive Streptococcus pneumoniae Isolates in Colombia, 2005–2010

Streptococcus pneumoniae

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