Streptococcus pneumoniae Serotype 3 in Mexico (1994 to 2017): Decrease of the Unusual Clonal Complex 4909 Lineage following PCV13 Introduction

Abstract

Streptococcus pneumoniae expressing serotype 3 has a high virulence and a high case fatality ratio. Most studies of serotype 3 pneumococci have focused on a single lineage, the widespread sequence type 180 (ST180). To evaluate the serotype 3 lineages causing infections in Mexico, we characterized 196 isolates recovered from 1994 to 2017. The isolates were mostly susceptible to all antimicrobials tested. A single meningitis isolate was resistant to penicillin, and the resistance to erythromycin was 5.2%. The isolates represented the widely disseminated clonal complex 180 (CC180; n = 140), the unusual CC4909 (n = 42), CC260 (n = 11), and a few singletons (n = 3). CC260 was less frequent among pneumococcal invasive disease isolates than CC180 and CC4909 (P = 0.015). There was a decrease of CC4909 (P < 0.001) following PCV13 introduction (2012 to 2017). The CC4909 isolates were represented mostly by ST1119 (n = 40), seemingly having a restricted geographic origin, with isolates in the PubMLST database having been recovered only in Mexico, the United States, and Germany. A genomic analysis of publicly available genomes showed that ST1119 isolates have less than 32% similarity with ST180 isolates, indicating that these lineages are more separated than revealed by traditional multilocus sequence typing. Considering the suggestions of a lower efficacy of the 13-valent pneumococcal conjugate vaccine against serotype 3, the different dynamics of the two major serotype 3 lineages in Mexico following the introduction of PCV13 should be closely monitored.

Serotype Distribution, Antimicrobial Susceptibility, Multilocus Sequencing Type and Virulence of Invasive Streptococcus pneumoniae in China: A Six-Year Multicenter Study

“…As previously mentioned, high levels of resistance in serotypes 23F, 19F, 19A, and 14 may be associated with the widespread international spread of ST81, ST271, ST320, and ST876, respectively. As for serotype 3, a similar resistance pattern was observed in Mexico, where 196 S. pneumoniae strains were susceptible to almost all the antibiotics tested, the predominant clonal complex group being CC180 (71.4%) (Echániz-Aviles et al, 2019). In our study, serotype 3 had a highly clonal diversity, dominated by ST505 (19.4%) and ST180 (19.4%).…”

PspA Diversity, Serotype Distribution and Antimicrobial Resistance of Invasive Pneumococcal Isolates from Paediatric Patients in Shenzhen, China

“…MLST data of S. pneumoniae serotype 3 from 13 foreign countries were collected from PubMLST (https://pubmlst.org/) and previous publications. 27,28 The Eburst algorithm was used to estimate the relationship among isolates. STs that share six identical alleles of the seven MLST loci were grouped as a clone complex (CC).…”

Streptococcus pneumoniae serotype 3 genotypes in invasive isolates from Colombia

“…ST-180 is the most frequent typing for serotype 3 and is characterized by its susceptibility to antibiotics for clinical use and its wide geographical distribution (8,10,11,20). Although ST-180 is still the most common, other clonal groups such as ST-458 have also been reported for this capsular type, which is the predominant lineage in the serotype 3 isolates recovered in South Africa (12), as well as ST-4909, which is the second most frequent sequence type in Mexican isolates (38), and ST-260, which was found in 41.9% of serotype 3 isolates in Spain (39). Additionally, as a result of possible capsular switching events, the presence of capsular type 3 has been reported in other clones of worldwide distribution including Spain 23F -1-3, Taiwan 23F -15-3, Poland 6B -20-3, Portugal 19F -21-3, Spain 23F -1-3, Netherlands 14 -35-3, Netherlands 15 -37-3, and Netherlands 7F -39-3 (https://pubmlst.org/spneumoniae/).…”