Serotype distribution ofStreptococcus pneumoniaein children with invasive diseases in Turkey: 2008–2014

Abstract

Successful vaccination policies for protection from invasive pneumococcal diseases (IPD) dependent on determination of the exact serotype distribution in each country. We aimed to identify serotypes of pneumococcal strains causing IPD in children in Turkey and emphasize the change in the serotypes before and after vaccination with 7-valent pneumococcal conjugate vaccine (PCV-7) was included and PCV-13 was newly changed in Turkish National Immunization Program. Streptococcus pneumoniae strains were isolated at 22 different hospitals of Turkey, which provide healthcare services to approximately 65% of the Turkish population. Of the 335 diagnosed cases with S. pneumoniae over the whole period of 2008-2014, the most common vaccine serotypes were 19F (15.8%), 6B (5.9%), 14 (5.9%), and 3 (5.9%). During the first 5 y of age, which is the target population for vaccination, the potential serotype coverage ranged from 57.5 % to 36.8%, from 65.0% to 44.7%, and from 77.4% to 60.5% for PCV-7, PCV-10, and PCV-13 in 2008-2014, respectively. The ratio of non-vaccine serotypes was 27.2% in 2008-2010 whereas was 37.6% in 2011-2014 (p=0.045). S. penumoniae serotypes was less non-susceptible to penicillin as compared to our previous results (33.7 vs 16.5 %, p=0.001). The reduction of those serotype coverage in years may be attributed to increasing vaccinated children in Turkey and the increasing non-vaccine serotype may be explained by serotype replacement. Our ongoing IPD surveillance is a significant source of information for the decision-making processes on pneumococcal vaccination.

Invasive pneumococcal disease: From a tertiary care hospital in the post-vaccine era

“…9 Ceyhan et al cited a vaccine breakthrough figure of 25% in Turkey from 2008-2014. 7 These study findings support those found in 2 of our cases.…”

“…3 In the Turkish pneumococcal disease surveillance system, the proportion of non-vaccine serotypes was stated to be 27% in the 2008-2011 period and 38% in 2011-2014 period. There was a significant reduction (20%) in the number of isolates in the latter period, possibly owing to the impact of the national pediatric vaccination program which included PCVs, 6,7 Two of the patients in the current study who had completed the age-appropriate PCV13 vaccine series acquired serotype 19F, indicative of a vaccine breakthrough. Underlying neurological diseases were present in both of these patients who died during treatment.…”

The effects of pneumococcal conjugate vaccine (PCV7 and PCV13) on Turkish children with invasive pneumococcal disease: a single center experience

“…Also, they found that the percentage of non-PCV13 serotypes was 37.6 in PCV13 era and in our study the non-PCV13 serotypes rate was 44% in PCV13 era. 28 Although serotype 19A was the most responsible serotype in children with IPD in USA and in European countries in post PCV7-era, as a surprising result, there was only 1 serotype 19A in our patients in post PCV7 and PCV13-era. Also, serotype 19A was rare in Turkish children with IPD as 1.8% to 5.6%.…”

“…Also, serotype 19A was rare in Turkish children with IPD as 1.8% to 5.6%. [24][25][26]28 On the other hand, serotype 19F was identified in 3 fully vaccinated children with PCV7 or PCV13.…”

Necrotizing pneumonia caused by Streptococcus pneumoniae serotype 3 despite PCV13

“…1 Conjugated pneumococcal Necrotizing pneumonia caused by Streptococcus pneumoniae serotype 3 despite PCV13 vaccine 7 (PCV7) which include 4, 6B, 9V, 14, 18C, 19F, 23F serotypes, was introduced to Turkish national immunization program in 2009 and then was replaced by PCV13 which includes 1, 3, 5, 6A, 7F and 19A serotypes. 2 In a multicenter study from Turkey, the potential serotype coverages of PCV-7, PCV-10 and, PCV-13 were 16.3 %, 45.4 %, and 60 %, respectively, for pediatric parapneumonic empyema. 3 By the end of 2015, the vaccination rate for PCV13 was reported as 97 % in Turkey.…”