The Changing Epidemiology of Streptococcus pneumoniae Serotype 19A Clonal Complexes

Tyrrell, Gregory J.

doi:10.1093/infdis/jir056

Cited by 17 publications

(10 citation statements)

References 16 publications

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“…These results are in agreement with those published in the USA from the late PCV7 period and the early PCV13 [5,7, 33–35] but, as data of molecular epidemiology after PCV13 introduction in Europe is scarce, we could not compare the occurrence of this phenomenon in other countries. Moreover, a reduction of isolates belonging to ST320 19A has also been detected in a pediatric population from the USA [35] after the PCV13 introduction, even though this reduction was lower than that observed for the susceptible clones.…”

Section: Discussionsupporting

confidence: 88%

Decrease of invasive pneumococcal disease (IPD) in adults after introduction of pneumococcal 13-valent conjugate vaccine in Spain

et al. 2017

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A prospective laboratory-based multicenter study that collected all adult invasive pneumococcal disease (IPD) episodes from 6 Spanish hospitals before (2008–2009) and after (2012–2013). The 13-valent pneumococcal conjugate vaccine (PCV13) licensure was conducted in order to analyze the impact of PCV13 introduction for children on adult IPD. A total of 1558 IPD episodes were detected. The incidence of IPD decreased significantly in the second period by -33.9% (95% CI, -40.3% to -26.8%). IPD due to PCV7 serotypes (-52.7%; 95% CI, -64.2% to -37.5%) and to PCV13 additional serotypes (-55.0% 95% CI, -62.0% to -46.7%) significantly decreased whereas IPD due to non-PCV13 serotypes remained stable (1.0% 95% CI, -12.9% to 17.2%). IPD due to all PCV13 additional serotypes significantly declined with the exception of serotype 3 (-11.3%; 95%CI -35.0% to 21.1%). IPD due to two non-PCV13 serotypes varied: serotype 6C that rose (301.6%; 95%CI, 92.7% to 733.3%, p<0.001), related to the expansion of ST3866C, and serotype 8 that decreased (-34.9%, 95%CI, -57.1 to -1.2, p = 0.049), related to a decline of the ST638. The recombinant clone ST652111A (variant of ST1569V) increased in frequency. The decrease of serotype 19A IPD was linked to a fall in those antibiotic susceptible clones. In the last period, rates of penicillin- and cefotaxime-resistance remained under 10% and 4%, respectively. Adult IPD decreased after the PCV13 introduction in Spain due to herd protection. The spread of multidrug resistant clones (ST3866C, ST652111A) related to non-PCV13 serotypes needs further surveillance.

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Section: Discussionsupporting

confidence: 88%

Decrease of invasive pneumococcal disease (IPD) in adults after introduction of pneumococcal 13-valent conjugate vaccine in Spain

et al. 2017

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“…These 3 clonal complexes collectively comprised approximately 87% of the serotype 19A isolates collected from 2005–2007 [53]. CC 199 was the most prevalent clonal complex of serotype 19A before the PCV7 vaccine, and the IPD caused by serotype 19A of CC 199 declined gradually from 72% (in 2003–2004) to 40% (in 2007) in the USA, indicating changes in the epidemiology of serotype 19A [54]. Simultaneously, IPDs caused by serotype 19A with increased penicillin MIC values belonging to CC 320/271 and CC 695 increased in USA.…”

Section: Discussionmentioning

confidence: 99%

“…Both serotypes are covered by PCV7, and their prevalence was strongly reduced between 1998/1999 and 2006/2007 from 11.1% to 1.2% (data for serotype 19F) and 6.8% to 0.2% (data for serotype 4). Because penicillin resistance in pneumococci is often associated with multi-drug resistant phenotype, it was suggested that the observed serotype switches of those clonal complexes to 19A were driven by selective antimicrobial pressure [54]. A transmission and recombination of the pbp2x - cps locus- pbp1a from CC 199 19A (donor) to CC695 4 (recipient) was proposed to result in CC695 19A [36].…”

Section: Discussionmentioning

confidence: 99%

Whole Genome Sequencing of 39 Invasive Streptococcus pneumoniae Sequence Type 199 Isolates Revealed Switches from Serotype 19A to 15B

Makarewicz¹,

Lucas²,

Brandt³

et al. 2017

PLoS ONE

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Streptococcus pneumoniae is a major pathogen that causes different invasive pneumococcal diseases (IPD). The pneumococcal polysaccharide capsule is a main virulence factor. More than 94 capsule types have been described, but only a limited number of capsule types accounted for the majority of IPD cases before the introduction of pneumococcal vaccines. After the introduction of the conjugated pneumococcal vaccine PCV7, which covered the seven most frequent serotypes in IPD in the USA, an increase in IPD caused by non-vaccine serotypes was observed, and serotype 19A, which belongs to sequence type (ST) 199, was among the most prevalent STs. After the introduction of the extended vaccine PCV13, which includes serotype 19A, serogroup 15B/C increased in IPD. Therefore, whole genome sequences of 39 isolates of ST199 from Germany (collected between 1998 and 2011) with serotype 19A (n = 24) and serogroup 15B/C (n = 15) were obtained using an Illumina platform and were analysed to identify capsular switches within ST199. Two 19A to 15B/C serotype switch events were identified. Both events occurred before the introduction of PCV7, which indicates that a capsular switch from 19A to 15B among ST199 isolates is not unusual and is not directly linked to the vaccination. The observed serotype replacement appears to be the result of a vacant niche due to the displacement of vaccine serotypes that is now successfully occupied by ST199 clones.

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“…34 It is likely that the implementation of PCV7 program throughout the world, high antimicrobial nonsusceptibility and so on have driven the appearance and spread of the serotype 19A ST320 clone. 35 Recently, Hu et al 36 used a decision-analytic model to estimate the public health impact of nationwide vaccination of infants with PCV7 in China. They predicted that more than 16.2 million cases of pneumococcal disease and 70,9411 deaths could be prevented in China over the initial 10-year period following the introduction of the PCV7.…”

Section: Discussionmentioning

confidence: 99%

Etiology and Epidemiology of Children With Acute Otitis Media and Spontaneous Otorrhea in Suzhou, China

Ding

Geng

Tao

et al. 2015

Pediatric Infectious Disease Journal

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The Changing Epidemiology of Streptococcus pneumoniae Serotype 19A Clonal Complexes

Cited by 17 publications

References 16 publications

Decrease of invasive pneumococcal disease (IPD) in adults after introduction of pneumococcal 13-valent conjugate vaccine in Spain

Decrease of invasive pneumococcal disease (IPD) in adults after introduction of pneumococcal 13-valent conjugate vaccine in Spain

Whole Genome Sequencing of 39 Invasive Streptococcus pneumoniae Sequence Type 199 Isolates Revealed Switches from Serotype 19A to 15B

Etiology and Epidemiology of Children With Acute Otitis Media and Spontaneous Otorrhea in Suzhou, China

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