Adult invasive pneumococcal disease pre- and peri-pneumococcal conjugate vaccine introduction in a tertiary hospital in Singapore

Hsu, Li Yang; Lui, See Weng; Lee, Jia Ling; Hedzlyn, Hazwany Md Mahrom; Kong, Debra Han-Lin; Shameen, Suku; Siti, Nur Puteri Mohammad; Tan, Wei Yu; Toh, Xin Yi.; Koh, Tse-Yuen; Koh, Tse-Hsien

doi:10.1099/jmm.0.003764-0

Cited by 18 publications

(20 citation statements)

References 11 publications

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“…We found male predominate, similar to that found in other studies, although the reason for this is unclear. 7,9,10 We previously reported the PCV13 serotype prevalence of pneumococcal invasive isolates of 61% in 2006-2009 in elderly >65 y; the most common serotypes were 6B, 19A, 23F, and 9V. 11 In comparison, the 58.3% serotype coverage found in this study was not different (P value 0.792), as well as the most common serotypes.…”

Section: Discussionmentioning

confidence: 47%

“…10 In Singapore, the most frequent serotypes among IPD in adult patients (median age 64 y) were serotypes 14, 3 and 6B. 7 In Laos, the most common serotypes were serotypes 1, 5, 6A/B/C, 14, 23F. 16 In our study, the most common serotypes were different from those countries.…”

Section: Discussionmentioning

confidence: 73%

“…6 Most isolates of IPD in adults were from blood, and rarely from CSF or other sterile sites. 7,8 This implied pathogenesis of IPD that affected specific organs were from hematogenous spread. We found male predominate, similar to that found in other studies, although the reason for this is unclear.…”

Section: Discussionmentioning

confidence: 98%

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Serotype distribution and antibiotic susceptibility of invasiveStreptococcus pneumoniaeisolates in patients aged 50 years or older in Thailand

Srifeungfung

Phongsamart

Tribuddharat

et al. 2013

Human Vaccines & Immunotherapeutics

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As the 13-valent pneumococcal conjugate vaccine (PCV13) has been approved for use in adults aged 50 y and older, we evaluated vaccine-serotype coverage rate in Thai adult patients with invasive pneumococcal infections before the vaccine was widely used. Of the 157 S. pneumoniae isolates from normal sterile sites during January 2005 to September 2012, 150 (95%) from blood, mean patients' age 69.6 (range 50-89) years, the overall serotype coverage by PCV13 was 58%. The vaccine covered 50%, 56%, 59%, and 68% of the invasive isolates from patients aged 50-59, 60-69, 70-79, and ≥80 y, respectively. The most common vaccine serotypes were 6B (17%), 19A (9%), 18C (5%), and 23F (4%). The susceptibility rates of penicillin and ceftriaxone were 95% and 96% for nonmeningitis criteria; and 46% and 92% for meningitis criteria, respectively. The susceptibilities to other antibiotics were: chloramphenicol 76%, clindamycin 80%, erythromycin 57%, levofloxacin 100%, ofloxacin 94%, tetracycline 39%, trimethoprim/sulfamethoxazole 37%, linezolid 99%, and vancomycin 100%, respectively. These data served as a reference for monitoring of vaccine serotype coverage with future increased vaccine utilization.

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Section: Discussionmentioning

confidence: 47%

Section: Discussionmentioning

confidence: 73%

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Serotype distribution and antibiotic susceptibility of invasiveStreptococcus pneumoniaeisolates in patients aged 50 years or older in Thailand

Srifeungfung

Phongsamart

Tribuddharat

et al. 2013

Human Vaccines & Immunotherapeutics

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“…However, protection is restricted to only the limited number of serotypes included in the vaccine formulation (26), and the expensive production costs limit its use in developing countries. Moreover, serotype replacement has been observed in vaccinated populations and an increase in infections by pneumococcal serotypes not included in the 7-valent conjugated polysaccharide vaccine has been described recently (29,56). In some countries, as many as 66% of childhood strains would not be covered (26,45).…”

mentioning

confidence: 99%

PspA Family Fusion Proteins Delivered by AttenuatedSalmonella entericaSerovar Typhimurium Extend and Enhance Protection againstStreptococcus pneumoniae

Wei

et al. 2009

Infect Immun

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Pneumococcal surface protein A (PspA) is highly immunogenic and can induce a protective immune response against pneumococcal infection. PspA is divided into two major families based on serological variability: family 1 and family 2. To provide broad protection, PspA proteins from pneumococcal strains Rx1 (family 1) and EF5668 (family 2) were combined to form two PspA fusion proteins, PspA/Rx1-EF5668 and PspA/EF5668-Rx1. Each protein was fused to a type II secretion signal and delivered by a recombinant attenuated Salmonella vaccine (RASV). Both PspA/Rx1-EF5668 and PspA/EF5668-Rx1 were synthesized in the RASV and secreted into the periplasm and supernatant. The fusion proteins reacted strongly with both anti-PspA/Rx1 and anti-PspA/EF5668 antisera. Oral immunization of BALB/c mice with RASV synthesizing either PspA fusion protein elicited serum immunoglobulin G (IgG) and mucosal IgA responses against both families of PspA. Analysis of IgG isotypes (IgG2a and IgG1) indicated a strong Th1 bias to the immune responses to both proteins. Sera from mice immunized with RASV synthesizing PspA/Rx1-EF5668 bound to the surface and directed C3 complement deposition on representative strains from all five PspA clades. Immunization with RASV synthesizing either protein protected mice against intraperitoneal challenge with Streptococcus pneumoniae WU2 strain (family 1), intravenous challenge with S. pneumoniae 3JYP2670 strain (family 2), and intranasal challenge with S. pneumoniae A66.1 (family 1). The PspA/Rx1-EF5668 protein elicited significantly greater protection than PspA/EF5668-Rx1, PspA/Rx1, or PspA/EF5668. These results indicate an RASV synthesizing a PspA fusion protein representing both PspA families constitutes an effective antipneumococcal vaccine, extending and enhancing protection against multiple strains of S. pneumoniae.

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“…4,5,6,7,8,9,10 The seven-valent pneumococcal conjugate vaccine (PCV7)—Prevnar (Pfizer, New York, USA) covers serotypes 4, 6B, 9V, 14, 18C, 19F and 23F, and has been available on demand in Singapore since its approval in 2005 11 and was added to the childhood immunization programme in October 2009. 11,12,13 Other available pneumococcal vaccines are PCV10—Synflorix (GlaxoSmithKline, Bentford, UK) that includes PCV7 serotypes and serotypes 1, 5 and 7F; and pneumococcal polysaccharide vaccine (PPV-23)—Pneumovax 23 (Merck, New Jersey, USA) which consists of pure polysaccharides of 23 pneumococcal serotypes (1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19A, 19F, 20, 22F, 23F, 33F).…”

Section: Introductionmentioning

confidence: 99%

Genetic diversity of Streptococcus pneumoniae causing meningitis and sepsis in Singapore during the first year of PCV7 implementation

Jauneikaite

Jefferies

Churton

et al. 2014

Emerging Microbes & Infections

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Streptococcus pneumoniae is a major cause of sepsis, meningitis and respiratory disease worldwide. Pneumococcal conjugate vaccines (PCVs) have now been implemented in many countries worldwide, including Singapore. To evaluate the effectiveness of these vaccines, pneumococcal surveillance studies are required. Detailed and unified pneumococcal epidemiology data are currently scarce in South East Asia. Thus, we present data on invasive pneumococcal (IPD) isolates from Singapore that could assist in evaluating the effectiveness of pneumococcal vaccine in Singapore. One hundred and fifty-nine invasive pneumococcal disease isolates were received by the National Public Health Laboratory in Singapore between June 2009 and August 2010. Isolates were characterized using serotyping and multilocus sequence typing. Twenty-four different serotypes were found, the most common of which were 19A, 3, 7F, 23F, 6B, 14, 8 and 19F (in rank order). One hundred and two sequence types were observed, of which 38 were novel due to new alleles or new combinations of already existing alleles. Based on the Simpson's Index of Diversity, serotypes 3, 6B and 19A were the most genetically diverse. Novel sequence types were more prevalent among conjugate vaccine serotypes 3, 19F and 23F and non-conjugate vaccine serotype 8, serogroup 15 and in non-typable isolates. We have demonstrated considerable genetic diversity among invasive pneumococci before and during the widespread use of conjugate vaccines in Singapore. Approximately half of all novel IPD clones identified in this study were non-conjugate vaccine serotypes. Although PCVs would target the most common serotypes, the high genetic diversity in non-vaccine serotypes would require further surveillance studies.

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Adult invasive pneumococcal disease pre- and peri-pneumococcal conjugate vaccine introduction in a tertiary hospital in Singapore

Cited by 18 publications

References 11 publications

Serotype distribution and antibiotic susceptibility of invasiveStreptococcus pneumoniaeisolates in patients aged 50 years or older in Thailand

Serotype distribution and antibiotic susceptibility of invasiveStreptococcus pneumoniaeisolates in patients aged 50 years or older in Thailand

PspA Family Fusion Proteins Delivered by AttenuatedSalmonella entericaSerovar Typhimurium Extend and Enhance Protection againstStreptococcus pneumoniae

Genetic diversity of Streptococcus pneumoniae causing meningitis and sepsis in Singapore during the first year of PCV7 implementation

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