The relative invasive disease potential of Streptococcus pneumoniae among children after PCV introduction: A systematic review and meta-analysis

Balsells, Evelyn; Dagan, Ron; Yıldırım, İnci; Gounder, Prabhu; Steens, Anneke; Muñoz-Almagro, Carmen; Mameli, Chiara; Kandasamy, Rama; Givon-Lavi, Noga; Daprai, Laura; Ende, Arie van der; Trzciński, Krzysztof; Nzenze, Susan; Meiring, Susan; Foster, Dona; Bulkow, Lisa; Rudolph, Karen; Valero-Rello, Ana; Ducker, Struan; Vestrheim, Didrik Frimann; Gottberg, Anne von; Pelton, Stephen I.; Zuccotti, Gian Vincenzo; Pollard, Andrew J.; Sanders, Elisabeth A. M.; Campbell, Harry; Madhi, Shabir А.; Nair, Harish; Kyaw, Moe H.

doi:10.1016/j.jinf.2018.06.004

Cited by 103 publications

(88 citation statements)

References 34 publications

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“…However, for serotypes 11A and 24F, cells expressing PSGL-1 did not kill efficiently these particular serotypes suggesting that strains expressing these two CPS, may have an increased ability to produce IPD. This is consistent with the emergence of amoxicillin-resistant variants of serotype 11A with genotype ST6521 that avoid efficiently the phagocytosis process and are good biofilm formers (Aguinagalde et al, 2015) and with the increased severity of infection by isolates of serotype 24F (Balsells et al, 2018).…”

Section: Discussionsupporting

confidence: 81%

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Clinical Relevance and Molecular Pathogenesis of the Emerging Serotypes 22F and 33F of Streptococcus pneumoniae in Spain

et al. 2020

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Section: Discussionsupporting

confidence: 81%

“…in patients with COPD, serotypes 3 and 11A are among the most prevalent (Shoji et al, 2018). In addition, serotype 24F is more prone to cause meningitis, showing an increase in clinical severity (Balsells et al, 2018) which could be associated to the increase resistant pattern to phagocytosis when replicating as a biofilm.…”

Section: Discussionmentioning

confidence: 99%

Clinical Relevance and Molecular Pathogenesis of the Emerging Serotypes 22F and 33F of Streptococcus pneumoniae in Spain

et al. 2020

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“…A high proportion of both penicillin and macrolide non-susceptible isolates in our study was found to be related to NT isolates. The recently published meta-analysis of estimated invasive disease potential for individual pneumococcal serotypes showed a low disease potential for non-serotypeable pneumococci [44]. However, all non-serotypeable isolates in our study were closely related and belonged to the ST344-cluster, the globally disseminated PMEN clone Norway NT -42, vaccination against which is so far unavailable.…”

Section: Effects Of Pcv-13 Vaccinationmentioning

confidence: 44%

“…The seven most common serotypes (14, 6B, 23F, 19F, 6A, 9 V, 18C) from our study were previously described in the group of the ten most common serotypes of IPD cases globally [43], and they are a part of PCV-13. Three other PCV-13associated serotypes 1, 5 and 7F are not frequently detected among pneumococcal carriage isolates in Russia [30][31][32] nor in other geographical areas [40,41] but were generally related to cases of IPD in infants and young children [44][45][46].…”

Section: Distribution Of Serotypesmentioning

confidence: 93%

Epidemiological and molecular characterization of Streptococcus pneumoniae carriage strains in pre-school children in Arkhangelsk, northern European Russia, prior to the introduction of conjugate pneumococcal vaccines

et al. 2020

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Background The 13-valent Pneumococcal Conjugate Vaccine (PCV-13) was introduced in the National Immunization Programme (NIP) schedule in Russia in March 2014. Previously, the 7-valent Pneumococcal Conjugate Vaccine (PCV-7) was marketed in Russia in 2009 but has never been offered for mass vaccination. A carriage study was performed among children in Arkhangelsk in 2006. The objective was to determine the prevalence of carriage, serotype distribution, antimicrobial susceptibility and the molecular structure of Streptococcus pneumoniae strains before marketing and introduction of PCV-13. Methods A cross-sectional study was conducted on a cluster-randomized sample of children and a self-administrated questionnaire for parents/guardians. Nasopharyngeal samples were collected from 438 children younger than 7 years attending nurseries and kindergartens in the Arkhangelsk region, Russia. Detailed demographic data, as well as information about the child’s health, traveling, exposure to antimicrobials within the last 3 months and anthropometric measurements were collected for all study subjects. Variables extracted from the questionnaire were analysed using statistic regression models to estimate the risk of carriage. All pneumococcal isolates were examined with susceptibility testing, serotyping and multilocus sequence typing. Results The overall prevalence of asymptomatic carriage was high and peaking at 36 months with a rate of 57%. PCV-13 covered 67.3% of the detected strains. High rates of non-susceptibility to penicillin, macrolides and multidrug resistance were associated with specific vaccine serotypes, pandemic clones, and local sequence types. Nine percent of isolates represented three globally disseminated disease-associated pandemic clones; penicillin- and macrolide-resistant clones NorwayNT-42 and Poland6B-20, as well as penicillin- and macrolide-susceptible clone Netherlands3-31. A high level of antimicrobial consumption was noted by the study. According to the parent’s reports, 89.5% of the children used at least one antimicrobial regime since birth. None of the hypothesised predictors of S. pneumoniae carriage were statistically significant in univariable and multivariable logistic models. Conclusions The study identified a high coverage of the PCV-13-vaccine, but serotype replacement and expansion of globally disseminated disease-associated clones with non-vaccine serotypes may be expected. Further surveillance of antimicrobial resistance and serotype distribution is therefore required.

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“…The rare occurrence of certain GBS serotypes in maternal carriage and neonatal disease, however, makes it difficult to estimate these quantities with certainty, even in large samples. 20,21 While randomeffects meta-analysis of data from multiple epidemiologic studies may thus present an attractive analysis strategy, 22 investigators remain likely to encounter challenges when generating pooled risk ratios or odds ratios in the presence of zero-valued counts within studies. Common ad-hoc workarounds, such as "continuity corrections" adding a fixed value to cells [23][24][25] and simple summing or averaging of values across studies, 13 risk introducing bias in both point estimates and measures of uncertainty.…”

Section: Introductionmentioning

confidence: 99%

An empirical Bayes method for serotype case-carrier ratios, with an application to Group B streptococcus

2018

Preprint

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Background: Case-carrier ratios quantifying the relative pathogenicity of serotypes can inform vaccine formulations for antigenically-diverse pathogens. However, sparse serotype-specific counts in epidemiologic datasets may undermine such analyses, most notably for rare serotypes that pose emergence risks in vaccinated populations. This challenge is well-illustrated in Group B streptococcus (GBS), where serotype III dominates in both carriage and disease. Methods:We develop an empirical Bayes random-effects model based on conjugate Dirichletmultinomial distributions of serotype frequencies in carriage and disease states. We validate the model using simulated datasets, and apply it to data from 15 paired sets of GBS isolates from intrapartum rectovaginal colonization (n=3403) and neonatal invasive disease (NID; n=1088), 16 from blood (n=2352) and cerebrospinal fluid (n=780) neonatal specimens, and 3 from fatal (n=173) and non-fatal (n=1684) neonatal invasive infections. Results:Our method accurately recovers parameters in simulated datasets. Using this approach, we confirm that GBS serotype III exhibits the greatest invasiveness, followed by serotype Ia with a 75.3% (95%CrI: 43.7-93.8%) lower estimate. Enhanced invasiveness of serotypes III and Ia is most evident in late-onset disease. Non-hexavalent-vaccine serotypes, which are rare in carriage and disease, generally show lower invasiveness; serotype IX/non-typeable GBS, the most prevalent cause of non-vaccinepreventable disease, is 98.7% (81.7-99.9%) and 94.2% (13.9-99.6%) less invasive than serotypes III and Ia, respectively. Conclusions:We present a strategy for measuring associations of serotype with carrier and disease states in the presence of sparse counts, avoiding biases that exist in common ad-hoc approaches. METHODS Outcome definitionWe aimed to measure the association of serotype with the following epidemiologic features of neonatal invasive GBS:

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The relative invasive disease potential of Streptococcus pneumoniae among children after PCV introduction: A systematic review and meta-analysis

Cited by 103 publications

References 34 publications

Clinical Relevance and Molecular Pathogenesis of the Emerging Serotypes 22F and 33F of Streptococcus pneumoniae in Spain

Clinical Relevance and Molecular Pathogenesis of the Emerging Serotypes 22F and 33F of Streptococcus pneumoniae in Spain

Epidemiological and molecular characterization of Streptococcus pneumoniae carriage strains in pre-school children in Arkhangelsk, northern European Russia, prior to the introduction of conjugate pneumococcal vaccines

An empirical Bayes method for serotype case-carrier ratios, with an application to Group B streptococcus

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