Changes in Streptococcus pneumoniae Serotype 19A Invasive Infections in Children from 1993 to 2011

Hultén, Kristina G.; Kaplan, Sheldon L.; Lamberth, Linda B.; Barson, William J.; Romero, José R.; Lin, Philana Ling; Bradley, John S.; Givner, Laurence B.; Tan, Tina Q.; Hoffman, Jill A.; Mason, Edward O.

doi:10.1128/jcm.00058-13

Cited by 28 publications

(15 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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“…The initial increase in the prevalence of serotype 19A in the years following the introduction of PCV7 through 2005 was secondary to the clonal expansion of ST199, an ST previously associated with serotype 19A (32). In the period from 2006 to 2010, a clonal shift occurred toward MDR CC320, which became the major CC among serotype 19A isolates in the late 2000s and contributed to the dramatic expansion of serotype 19A among children (17,19). Even though serotype 35B has become one of the most common serotypes causing disease in pediatric patients, the number of cases has not yet reached the magnitude of serotype 19A in the late 2000s.…”

Section: Fig 4 Eburst Analysis Of Penicillin Mic Distribution and Mulmentioning

confidence: 99%

“…Horizontal genetic exchange plays a critical role in the evolution of S. pneumoniae and provides an extraordinary ability to evade environmental stressors like vaccines (14)(15)(16). Sequence type (ST) analysis of pneumococcal isolates in the 7-valent pneumococcal conjugate vaccine (PCV7) era suggested that expansion of preexisting STs, the appearance of new STs, and capsular switching are some of the evolutionary pneumococcal responses observed in previous emergent serotypes (17)(18)(19)(20)(21). Capsular switching occurs when a strain of S. pneumoniae takes the capsular type of another strain by the transfer of the capsular locus (cps) genes (22).…”

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confidence: 99%

Emergence of Multidrug-Resistant Pneumococcal Serotype 35B among Children in the United States

et al. 2017

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Streptococcus pneumoniae serotype 35B is a nonvaccine serotype associated with high rates of penicillin nonsusceptibility. An increase in the proportion of multidrug-resistant (MDR) 35B isolates has recently been reported. The genetic events contributing to the emergence of MDR serotype 35B are unknown. The sequence type (ST) composition of 78 serotype 35B isolates obtained from pediatric patients with invasive pneumococcal disease from 1994 to 2014 and 48 isolates from pediatric patients with otitis media (noninvasive) from 2011 to 2014 was characterized by multilocus sequence typing (MLST). The most common STs were ST558 (69.2%), ST156 (10.3%), and ST452 (3.8%). Two major clonal complexes (CC), CC558 and CC156, were identified by eBURST analysis. Overall, 91% (71/78) of isolates were penicillin nonsusceptible and 16.7% (13/78) were MDR. Among all invasive serotype 35B isolates, MDR isolates increased significantly, from 2.9% (1/35) to 27.9% (12/43) (P ϭ 0.004), after the 13-valent pneumococcal conjugate vaccine (PCV13) was introduced. All CC156 isolates were identified after the introduction of PCV13 (0/35 [0%] before versus 9/43 [20.9%] after; P ϭ 0.003) and were MDR. All CC156 isolates had similar antimicrobial susceptibility patterns; in contrast, high variability in antimicrobial susceptibility was observed among CC558 isolates. The distributions of CC558 and CC156 among invasive and noninvasive isolates were not different. The increased prevalence of MDR serotype 35B after the introduction of PCV13 was directly associated with the emergence of ST156. Genotyping suggests that capsular switching has occurred between MDR vaccine serotypes belonging to ST156 (e.g., 9V, 14, and 19A) and serotype 35B.

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“…The prevalence of serotype 19A increased in the United States during the post-PCV7 era (2004)(2005)(2006)(2007)(2008)(2009) (4,5,15,16), but recent investigations have reported that this serotype has decreased since the introduction of PCV13 (6,17) or possibly prior to its introduction (18). Although serotype 19A has become less prevalent, studies indicated that the nonsusceptibility rates for 19A have increased even further (7,18), likely due to antimicrobial pressure and consequent expansion of multidrug-resistant (MDR) populations within 19A isolates (i.e., clonal complex 320) (18). PCV7 successfully decreased the prevalence of targeted serotypes and also decreased the nonsusceptibility rates of these serotypes (19).…”

mentioning

confidence: 99%

Decreased Ceftriaxone Susceptibility in Emerging (35B and 6C) and Persisting (19A) Streptococcus pneumoniae Serotypes in the United States, 2011-2012: Ceftaroline Remains Active In Vitro among β-Lactam Agents

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Biek²,

Critchley³

et al. 2014

Antimicrob Agents Chemother

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Changes in Streptococcus pneumoniae Serotype 19A Invasive Infections in Children from 1993 to 2011

Cited by 28 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

Emergence of Multidrug-Resistant Pneumococcal Serotype 35B among Children in the United States

Decreased Ceftriaxone Susceptibility in Emerging (35B and 6C) and Persisting (19A) Streptococcus pneumoniae Serotypes in the United States, 2011-2012: Ceftaroline Remains Active In Vitro among β-Lactam Agents

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