Streptococcus pneumoniae serotype 3 is masking PCV13-mediated herd immunity in Canadian adults hospitalized with community acquired pneumonia: A study from the Serious Outcomes Surveillance (SOS) Network of the Canadian immunization research Network (CIRN)

LeBlanc, Jason J.; ElSherif, May; Ye, Lingyun; MacKinnon‐Cameron, Donna; Ambrose, Ardith; Hatchette, Todd F.; Lang, Amanda; Gillis, Hayley D; Martín, Irene; Demczuk, Walter; Andrew, Melissa K.; Boivin, Guy; Bowie, William; Green, Karen; Johnstone, Jennie; Loeb, Mark; McCarthy, Anne; McGeer, Allison; Semret, Makeda; Trottier, Sylvie; Valiquette, Louis; Webster, Duncan; McNeil, Shelly

doi:10.1016/j.vaccine.2019.05.003

Cited by 32 publications

(41 citation statements)

References 43 publications

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“…63 As recently reported in a study originating from Canada, other potential mechanisms of PCV vaccine-related antibiotic resistance include differential induction of herd protection by vaccine serotypes. 64 In this context, herd protection conferred by the highly-invasive serotype 3 of the pneumococcus (represented in PCV13, but not PCV7) has been disappointing, possibly due to poor, postimmunization opsonophagocytic activity of antibodies produced in response to the capsular polysaccharides of this strain. 65 Poor immunogenicity appears to be associated with the emergence of the predominant global clonal complex of serotype 3 of the pneumococcus, CC180, within which the emerging Clade II exhibits increased virulence and possibly antibiotic resistance.…”

Section: Causes and Mechanisms Of Antibiotic Resistancementioning

confidence: 99%

The Role of Streptococcus pneumoniae in Community-Acquired Pneumonia

Feldman

Anderson

2020

Semin Respir Crit Care Med

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AbstractWith the notable exceptions of the United States and Canada in particular, the global burden of disease in adults due to invasive infection with the dangerous respiratory, bacterial pathogen, Streptococcus pneumoniae (pneumococcus) remains. This situation prevails despite the major successes of inclusion of polysaccharide conjugate vaccines (PCVs) in many national childhood immunization programs and associated herd protection in adults, as well as the availability of effective antimicrobial agents. Accurate assessment of the geographic variations in the prevalence of invasive pneumococcal disease (IPD) has, however, been somewhat impeded by the limitations imposed on the acquisition of reliable epidemiological data due to reliance on often insensitive, laboratory-based, pathogen identification procedures. This, in turn, may result in underestimation of the true burden of IPD and represents a primary focus of this review. Other priority topics include the role of PCVs in the changing epidemiology of IPD in adults worldwide, smoking as a risk factor not only in respect of increasing susceptibility for development of IPD, but also in promoting pneumococcal antibiotic resistance. The theme of pneumococcal antibiotic resistance has been expanded to include mechanisms of resistance to commonly used classes of antibiotics, specifically β-lactams, macrolides and fluoroquinolones, and, perhaps somewhat contentiously, the impact of resistance on treatment outcome. Finally, but no less importantly, the role of persistent antigenemia as a driver of a chronic, subclinical, systemic proinflammatory/procoagulant phenotype that may underpin the long-term sequelae and premature mortality of those adults who have recovered from an episode of IPD, is considered.

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Section: Causes and Mechanisms Of Antibiotic Resistancementioning

confidence: 99%

The Role of Streptococcus pneumoniae in Community-Acquired Pneumonia

Feldman

Anderson

2020

Semin Respir Crit Care Med

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“…Streptococcus pneumoniae (or pneumococcus) infections cause high morbidity and mortality worldwide, with significant impact on public health and healthcare resources 2–5. Individuals at risk include children aged ≤5 years, adults aged ≥65 years and individuals of any age with underlying medical conditions 1 5–12. The most serious manifestations of pneumococcal infection include invasive pneumococcal diseases (IPDs) and community-acquired pneumonia (CAP).…”

Section: Introductionmentioning

confidence: 99%

“…The most serious manifestations of pneumococcal infection include invasive pneumococcal diseases (IPDs) and community-acquired pneumonia (CAP). S. pneumoniae is the most frequently identified bacterial pathogen in CAP, and CAP is the most common presentation of pneumococcal disease in older adults 7–12. Recent studies in hospitalised Canadian adults demonstrated that 14%–23% of CAP cases were attributable to S. pneumoniae , but these data were likely underestimated 7.…”

Section: Introductionmentioning

confidence: 99%

“…Recent studies in hospitalised Canadian adults demonstrated that 14%–23% of CAP cases were attributable to S. pneumoniae , but these data were likely underestimated 7. Pneumococcal community-acquired pneumonia (pCAP) cases were more likely than CAP cases testing negative for S. pneumoniae (non-pCAP) to be admitted to the intensive care unit (ICU), to require mechanical ventilation, and had high mortality 7 8. Vaccine-preventable serotypes of S. pneumoniae remain predominant in adults hospitalised with pCAP, despite efforts to confer adult protection indirectly through childhood immunisation 8 13–15…”

Section: Introductionmentioning

confidence: 99%

“…Indirect protection of adults against pneumococcal disease can occur through herd immunity, where childhood immunisation reduces colonisation and subsequent transmission to adults 13–15. Following childhood immunisation with a 7-valent conjugate vaccine (PCV7) in Canada, IPD caused by PCV7 serotypes declined significantly in vaccinated children, unvaccinated children and adults 1 8 13–15. A few years later, non-PCV7 serotypes emerged, and PCV7 was replaced by PCV10 in 2009 in some provinces, and by 2010, PCV13 was implemented in all Canadian provinces 1 8 13–15.…”

Section: Introductionmentioning

confidence: 99%

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Age-stratified burden of pneumococcal community acquired pneumonia in hospitalised Canadian adults from 2010 to 2015

LeBlanc

ElSherif

et al. 2020

BMJ Open Resp Res

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BackgroundIn Canada, 13-valent pneumococcal conjugate vaccine (PCV13) is recommended in childhood, in individuals at high risk of invasive pneumococcal disease (IPD) and in healthy adults aged ≥65 years for protection against vaccine-type IPD and pneumococcal community-acquired pneumonia (pCAP). Since vaccine recommendations in Canada include both age-based and risk-based guidance, this study aimed to describe the burden of vaccine-preventable pCAP in hospitalised adults by age.MethodsSurveillance for community-acquired pneumonia (CAP) in hospitalised adults was performed prospectively from 2010 to 2015. CAP was radiologically confirmed, and pCAP was identified using blood and sputum culture and urine antigen testing. Patient demographics and outcomes were stratified by age (16–49, 50–64, ≥65 and ≥50 years).ResultsOf 6666/8802 CAP cases tested, 830 (12.5%) had pCAP, and 418 (6.3%) were attributed to a PCV13 serotype. Of PCV13 pCAP, 41% and 74% were in adults aged ≥65 and ≥50 years, respectively. Compared with non-pCAP controls, pCAP cases aged ≥50 years were more likely to be admitted to intensive care units (ICUs) and to require mechanical ventilation. Older adults with pCAP were less likely to be admitted to ICU or required mechanical ventilation, given their higher mortality and goals of care. Of pCAP deaths, 67% and 90% were in the ≥65 and ≥50 age cohorts, respectively.ConclusionsAdults hospitalised with pCAP in the age cohort of 50–64 years contribute significantly to the burden of illness, suggesting that an age-based recommendation for adults aged ≥50 years should be considered in order to optimise the impact of pneumococcal vaccination programmes in Canada.

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Updated information on new coronavirus disease 2019 occurrence, drugs, and prediction of a potential receptor

Khodaei

Ahsan

Chamanifard

et al. 2020

J Biochem & Molecular Tox

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The new coronavirus (COVID‐19) was first reported in Wuhan in China, on 31 December 2019. COVID‐19 is a new virus from the family of coronaviruses that can cause symptoms ranging from a simple cold to pneumonia. The virus is thought to bind to the angiotensin‐converting enzyme 2, as a well‐known mechanism to enter the cell. It then transfers its DNA to the host in which the virus replicates the DNA. The viral infection leads to severe lack of oxygen, lung oxidative stress because of reactive oxygen species generation, and overactivation of the immune system by activating immune mediators. The purpose of this review is to elaborate on the more precise mechanism(s) to manage the treatment of the disease. Regarding the mechanisms of the virus action, the suggested pharmacological and nutritional regimens have been described.

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Streptococcus pneumoniae serotype 3 is masking PCV13-mediated herd immunity in Canadian adults hospitalized with community acquired pneumonia: A study from the Serious Outcomes Surveillance (SOS) Network of the Canadian immunization research Network (CIRN)

Cited by 32 publications

References 43 publications

The Role of Streptococcus pneumoniae in Community-Acquired Pneumonia

The Role of Streptococcus pneumoniae in Community-Acquired Pneumonia

Age-stratified burden of pneumococcal community acquired pneumonia in hospitalised Canadian adults from 2010 to 2015

Updated information on new coronavirus disease 2019 occurrence, drugs, and prediction of a potential receptor

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