Invasive pneumococcal disease in children under 16 years of age: Incomplete rebound in incidence after the maximum effect of PCV13 in 2012/13 in Germany

Weinberger, Raphael; Kries, Rüdiger von; Linden, Mark van der; Rieck, Thorsten; Siedler, Anette; Falkenhorst, Gerhard

doi:10.1016/j.vaccine.2017.11.085

Cited by 52 publications

(36 citation statements)

References 14 publications

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“…Of note, such non-vaccine-type lineages (GPSC19, GPSC38, GPSC48, GPSC9, GPSC7, and GPSC36; appendix 1) were found in several countries and expressed serotypes that were observed to be major non-vaccine serotypes causing invasive pneumococcal disease in multiple countries after PCV13 introduction. 3,6,38,39 The application of GPSCs to isolates from additional countries could allow better understanding of these nonvaccine serotypes importance to disease replacement.…”

Section: Discussionmentioning

confidence: 99%

“…Among the ten most prevalent lineages causing nonvaccine-type invasive pneumococcal disease in the PCV13 period, two (GPSC3 and GPSC26) expressed invasive serotypes 8, 12F, and 33F. Increases in serotype 12F resulting in disease replacement were reported in England and Wales, 6 France, 9,40 and Germany, 39 although the genotypes of those isolates were not reported. Globally, serotype 12F isolates mainly belong to clonal complex (CC) 989 (GPSC26), 41,42 but also to ST218 (GPSC32) in North America 43,44 and CC3524 (GPSC55), a regional lineage, in Israel.…”

Section: Discussionmentioning

confidence: 99%

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Pneumococcal lineages associated with serotype replacement and antibiotic resistance in childhood invasive pneumococcal disease in the post-PCV13 era: an international whole-genome sequencing study

Gladstone

Tonder

et al. 2019

The Lancet Infectious Diseases

201

184

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Background Invasive pneumococcal disease remains an important health priority owing to increasing disease incidence caused by pneumococci expressing non-vaccine serotypes. We previously defined 621 Global Pneumococcal Sequence Clusters (GPSCs) by analysing 20 027 pneumococcal isolates collected worldwide and from previously published genomic data. In this study, we aimed to investigate the pneumococcal lineages behind the predominant serotypes, the mechanism of serotype replacement in disease, as well as the major pneumococcal lineages contributing to invasive pneumococcal disease in the post-vaccine era and their antibiotic resistant traits. Methods We whole-genome sequenced 3233 invasive pneumococcal disease isolates from laboratory-based surveillance programmes in Hong Kong (n=78), Israel (n=701), Malawi (n=226), South Africa (n=1351), The Gambia (n=203), and the USA (n=674). The genomes represented pneumococci from before and after pneumococcal conjugate vaccine (PCV) introductions and were from children younger than 3 years. We identified predominant serotypes by prevalence and their major contributing lineages in each country, and assessed any serotype replacement by comparing the incidence rate between the pre-PCV and PCV periods for Israel, South Africa, and the USA. We defined the status of a lineage as vaccine-type GPSC (≥50% 13-valent PCV [PCV13] serotypes) or non-vaccine-type GPSC (>50% non-PCV13 serotypes) on the basis of its initial serotype composition detected in the earliest vaccine period to measure their individual contribution toward serotype replacement in each country. Major pneumococcal lineages in the PCV period were identified by pooled incidence rate using a random effects model. Findings The five most prevalent serotypes in the PCV13 period varied between countries, with only serotypes 5, 12F, 15B/C, 19A, 33F, and 35B/D common to two or more countries. The five most prevalent serotypes in the PCV13 period varied between countries, with only serotypes 5, 12F, 15B/C, 19A, 33F, and 35B/D common to two or more countries. These serotypes were associated with more than one lineage, except for serotype 5 (GPSC8). Serotype replacement was mainly mediated by expansion of non-vaccine serotypes within vaccine-type GPSCs and, to a lesser extent, by increases in non-vaccine-type GPSCs. A globally spreading lineage, GPSC3, expressing invasive serotypes 8 in South Africa and 33F in the USA and Israel, was the most common lineage causing non-vaccine serotype invasive pneumococcal disease in the PCV13 period. We observed that same prevalent non-vaccine serotypes could be associated with distinctive lineages in different countries, which exhibited dissimilar antibiotic resistance profiles. In non-vaccine serotype isolates, we detected significant increases in the prevalence of resistance to penicillin (52 [21%] of 249 vs 169 [29%] of 575, p=0•0016) and erythromycin (three [1%] of 249 vs 65 [11%] of 575, p=0•0031) in the PCV13 period compared with the pre-PCV period. Interpretation Globally spreading line...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pneumococcal lineages associated with serotype replacement and antibiotic resistance in childhood invasive pneumococcal disease in the post-PCV13 era: an international whole-genome sequencing study

Gladstone

Tonder

et al. 2019

The Lancet Infectious Diseases

201

184

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“…Replacing PCV7 with PCV13 decidedly decreased serotype 19A isolates among causative pathogens, but in several countries, NVTs such as 15A and 35B increased. Gradual increases of NVTs, unfortunately, have blunted the effectiveness of conjugate vaccines ( 42 ).…”

Section: Discussionmentioning

confidence: 99%

Effects of Pneumococcal Conjugate Vaccine on Genotypic Penicillin Resistance and Serotype Changes, Japan, 2010–2017

Ubukata¹,

Takata²,

Morozumi³

et al. 2018

Emerg. Infect. Dis.

105

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To clarify year-to-year changes in capsular serotypes, resistance genotypes, and multilocus sequence types of Streptococcus pneumoniae, we compared isolates collected from patients with invasive pneumococcal disease before and after introductions of 7- and 13-valent pneumococcal conjugate vaccines (PCV7 and PVC13, respectively). From April 2010 through March 2017, we collected 2,856 isolates from children and adults throughout Japan. Proportions of PCV13 serotypes among children decreased from 89.0% in fiscal year 2010 to 12.1% in fiscal year 2016 and among adults from 74.1% to 36.2%. Although nonvaccine serotypes increased after introduction of PCV13, genotypic penicillin resistance decreased from 54.3% in 2010 to 11.2% in 2016 among children and from 32.4% to 15.5% among adults. However, genotypic penicillin resistance emerged in 9 nonvaccine serotypes, but not 15A and 35B. Multilocus sequence typing suggested that resistant strains among nonvaccine serotypes may have evolved from clonal complexes 156 and 81. A more broadly effective vaccine is needed.

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“…Colonization of the lower airways with the non-vaccine serotypes 15B/C, 23B and 35B was noted for the first time. Previous studies have reported post-PCV13 increases in colonization due to non-vaccine serotypes including 23B, 15B/C and 35B [ 9 , 17 , 18 ]. Our data suggest higher numbers of these serotypes in the tracheostomy patients; although the difference is not significant with the available sample size (40.7% vs 21.4%, Fig 1 , P = 0.15).…”

Section: Discussionmentioning

confidence: 99%

Pneumococcal colonization among tracheostomy tube dependent children

et al. 2018

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Streptococcus pneumoniae colonization is a precursor to pneumococcal disease. Although children with a tracheostomy have an increased risk of pneumococcal pneumonia, the pneumococci colonizing their lower airways remain largely uncharacterized. We sought to compare lower respiratory tract isolates colonizing tracheostomy patients and a convenience sample of isolates from individuals intubated for acute conditions. We collected pneumococcal isolates from the lower respiratory tract of 27 patients with a tracheostomy and 42 patients intubated for acute conditions. We compared the penicillin susceptibility, rates of co-colonization, genetic background, and serotype of isolates colonizing these patient populations. Isolates from both groups showed high genetic diversity. Forty multi-locus sequence types and 20 serotypes were identified. There was no significant difference in serotype distribution, co-colonization rates, vaccine coverage, or non-susceptibility to penicillin among pneumococcal isolates from the two groups. Colonization of the lower airways with non-vaccine serotypes 15B/C, 23B and 35B was noted for the first time in patients with tracheostomies and supports recently observed increases in nasopharyngeal colonization and disease due to these serotypes.

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Invasive pneumococcal disease in children under 16 years of age: Incomplete rebound in incidence after the maximum effect of PCV13 in 2012/13 in Germany

Cited by 52 publications

References 14 publications

Pneumococcal lineages associated with serotype replacement and antibiotic resistance in childhood invasive pneumococcal disease in the post-PCV13 era: an international whole-genome sequencing study

Pneumococcal lineages associated with serotype replacement and antibiotic resistance in childhood invasive pneumococcal disease in the post-PCV13 era: an international whole-genome sequencing study

Effects of Pneumococcal Conjugate Vaccine on Genotypic Penicillin Resistance and Serotype Changes, Japan, 2010–2017

Pneumococcal colonization among tracheostomy tube dependent children

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Invasive pneumococcal disease in children under 16 years of age: Incomplete rebound in incidence after the maximum effect of PCV13 in 2012/13 in Germany

Cited by 52 publications

References 14 publications

Pneumococcal lineages associated with serotype replacement and antibiotic resistance in childhood invasive pneumococcal disease in the post-PCV13 era: an international whole-genome sequencing study

Pneumococcal lineages associated with serotype replacement and antibiotic resistance in childhood invasive pneumococcal disease in the post-PCV13 era: an international whole-genome sequencing study

Effects of Pneumococcal Conjugate Vaccine on Genotypic Penicillin Resistance and Serotype Changes, Japan, 2010–2017

Pneumococcal colonization among tracheostomy tube dependent children

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Invasive pneumococcal disease in children under 16 years of age: Incomplete rebound in incidence after the maximum effect of PCV13 in 2012/13 in Germany