Pneumococcal meningitis before the introduction of 10-valent pneumococcal conjugate vaccine into the National Childhood Immunization Program in Poland

Polkowska, Aleksandra; Skoczyńska, Anna; Paradowska-Stankiewicz, Iwona; Stefanoff, Paweł; Hryniewicz, Waleria; Kuch, Alicja; Lyytikäinen, Outi; Nuorti, J. Pekka

doi:10.1016/j.vaccine.2018.12.028

Cited by 5 publications

(5 citation statements)

References 41 publications

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“…In Lithuania, serotypes 6B, 19F and 23F were most commonly isolated from children under 6 years of age with acute upper respiratory tract infection in 2012-2013 [47,48]. In Poland, 91 % of pneumococcal meningitis cases in children <5 years were caused due to PCV13 serotypes in 2008-2011 [49]; subsequently, the number of cases dropped to 64 % in 2012-2015, which might be linked to vaccination of children <5 years with risk factors and local vaccination programmes [49].…”

Section: Discussionmentioning

confidence: 99%

Key features of pneumococcal isolates recovered in Central and Northwestern Russia in 2011–2018 determined through whole-genome sequencing

et al. 2022

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Invasive pneumococcal disease remains one of the leading causes of morbidity and mortality worldwide. In Russia, 13-valent pneumococcal conjugate vaccine (PCV13) was introduced into the childhood immunization programme nationwide in 2014. As part of the Global Pneumococcal Sequencing Project (GPS), we used genome data to characterize 179 pneumococcal isolates collected from Russia in 2011-2018 to investigate the circulating pneumococcal strains using a standardized genomic definition of pneumococcal lineages (global pneumococcal sequence clusters, GPSCs), prevalent serotypes and antimicrobial resistance profiles.We observed high serotype and lineage diversity among the 179 isolates recovered from cerebrospinal fluid (n=77), nasopharyngeal swabs (n=99) and other non-sterile site swabs (n=3). Overall, 60 GPSCs were identified, including 48 clonal complexes (CCs) and 14 singletons, and expressed 42 serotypes (including non-typable). Among PCV13 serotypes, 19F, 6B and 23F were the top three serotypes while 11A, 15B/C and 8 were the top three among non-PCV13 serotypes in the collection. Two lineages (GPSC6 and GPSC47) expressed both PCV13 and non-PCV13 serotypes that caused invasive disease, and were penicillin-and multidrug-resistant (MDR), highlighting their potential to adapt and continue to cause infections under vaccine and antibiotic selective pressure. PCV13 serotypes comprised 92 % (11/12) of the CSF isolates from the children aged below 5 years; however, the prevalence of PCV13 serotype isolates dropped to 53 % (31/58) among the nasopharyngeal isolates. Our analysis showed that 59 % (105/179) of the isolates were predicted to be non-susceptible to at least one class of antibiotics and 26 % (46/179) were MDR. Four MDR lineages (GPSC1, GPSC6, GPSC10 and GPSC47) accounted for 65 % (30/46) of the MDR isolates and expressed PCV13 serotypes (93 %, 28/30).This study provides evidence of high genetic and serotype diversity contributed by a mix of globally spreading and regionally circulating lineages in Russia. The observations suggest that the PCV13 vaccine could be important in reducing both invasive disease and antimicrobial resistance. We also identify potential lineages (GPSC6 and GPSC47) that may evade the vaccine.

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Section: Discussionmentioning

confidence: 99%

Key features of pneumococcal isolates recovered in Central and Northwestern Russia in 2011–2018 determined through whole-genome sequencing

et al. 2022

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“…Serotype 8 associated with lower OR for death [ 47 , 72 ] and/or lower CFR [ 38 , 75 ], and so did serotype 12F [ 38 , 75 ]. Serotypes 10A and 22F showed a high case fatality proportion in meningitis [ 77 ].…”

Section: Resultsmentioning

confidence: 99%

Pneumococcal Serotype Evolution and Burden in European Adults in the Last Decade: A Systematic Review

Teixeira¹,

Kossyvaki²,

Gálvez

et al. 2023

Microorganisms

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Pneumococcal disease is a major cause of morbidity/mortality worldwide, and vaccination is an important measure in its prevention. Despite European children being vaccinated with pneumococcal conjugate vaccines (PCVs), pneumococcal infections are still a major cause of morbidity/mortality in adults with risk conditions and their vaccination might be an important prevention strategy. New PCVs have been approved, but information is lacking on their potential impact in European adults. In our review, we searched PubMed, MEDLINE, and Embase for studies on the additional PCV20 serotypes (concerning incidence, prevalence, disease severity, lethality, and antimicrobial resistance) in European adults, between January 2010 and April 2022, having included 118 articles and data from 33 countries. We found that these serotypes have become more prevalent in both invasive and non-invasive pneumococcal disease (IPD and NIPD), representing a significant proportion of cases (serotypes 8, 12F, 22F) and more serious disease and/or lethality (10A, 11A, 15B, 22F), showing antimicrobial resistance (11A, 15B, 33F), and/or affecting more vulnerable individuals such as the elderly, immunocompromised patients, and those with comorbidities (8, 10A, 11A, 15B, 22F). The relevance of pneumococcal adult carriers (11A, 15B, 22F, and 8) was also identified. Altogether, our data showed an increase in the additional PCV20 serotypes’ prevalence, accounting for a proportion of approximately 60% of all pneumococcal isolates in IPD in European adults since 2018/2019. Data suggest that adults, as older and/or more vulnerable patients, would benefit from vaccination with higher-coverage PCVs, and that PCV20 may address an unmet medical need.

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“…In our research, we took into account the two commonest etiological factors: Streptococcus pneumoniae and Neisseria meningitidis [12,13]. After the introduc-tion of population-based immunization against Haemophilus influenzae in Poland, an invasive bacterial infection caused by Haemophilus influenzae is no longer a problem [14].…”

Section: Discussionmentioning

confidence: 99%

Acute bacterial meningitis in Polish children – assessment of risk factors of neurological complications

Kadziszewska,

Gowin,

Kadziszewski

2023

polp

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Introduction: Bacterial meningitis remains a potential problem for contemporary pediatrics, as regards both treatment and further care of patients with long-term complications. The aim of this study is to identify the most common neurological complications of acute bacterial meningitis among children and their main risk factors of occurrence. Material and methods: We analyzed data on cases of children with bacterial meningitis hospitalized in The Infectious Diseases Department in St. Joseph Children's Hospital in Poznan, between 2010 and 2020. We considered Streptococcus pneumoniae and Neisseria meningitidis as etiological factors. Data on neurological complications were obtained during follow-up visits and as a result of telephone surveys. Results: We identified 75 patients (1 month up to 17 years of age) with acute bacterial meningitidis with the etiological factors Streptococcus pneumoniae and Neisseria meningitidis; 2 of them died as a result of infection (2.66%). Data on short and long-term complications were obtained from 59 patients. We observed complications among 42 children; the most frequent complications were cognitive impairment (31.37%), subdural effusion (17.19%), focal neurological deficits (15.6%), and hearing disorders (14.0%). Patients with neurological complications showed a higher frequency of lower count of neutrophils < 13.8 × 10³/μl (p < 0.01), a lower hemoglobin level < 12.0 g/dl (p < 0.00), and platelet levels above 340 × 10³/μl (p < 0.02). Risks factors of neurological complications occurrence were irritability at admission (p < 0.04) , age of patients under 34 months (95 CI%: 0.58-0.86), and length of hospitalization over 14 days (95 CI%: 0.70-0.92). Conclusions: Despite the introduction of protective vaccination, bacterial meningitis is still a life-threatening disease that leads to significant neurological consequences. It is important to recognize patients with risk factors of neurological complications to provide them with multidisciplinary medical care later in life.

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Pneumococcal meningitis before the introduction of 10-valent pneumococcal conjugate vaccine into the National Childhood Immunization Program in Poland

Cited by 5 publications

References 41 publications

Key features of pneumococcal isolates recovered in Central and Northwestern Russia in 2011–2018 determined through whole-genome sequencing

Key features of pneumococcal isolates recovered in Central and Northwestern Russia in 2011–2018 determined through whole-genome sequencing

Pneumococcal Serotype Evolution and Burden in European Adults in the Last Decade: A Systematic Review

Acute bacterial meningitis in Polish children – assessment of risk factors of neurological complications

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