Twenty year surveillance of invasive pneumococcal disease in Nottingham: serogroups responsible and implications for immunisation

Ispahani, P.; Slack, R. C. B.; Donald, Fiona; Weston, Vivienne; Rutter, N

doi:10.1136/adc.2003.036921

Cited by 78 publications

(55 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a study by Fouda et al (11) from Saudi Arabia, a similar coverage rate of 55.5% was reported for the 7-valent conjugate vaccine against invasive infections. However, other studies (16,18,24,26,27) have reported variable coverage rates, ranging from low (26%) to high (95%), for invasive pneumococcal isolates.…”

Section: Discussionmentioning

confidence: 97%

Implications of Streptococcus pneumoniae Penicillin Resistance and Serotype Distribution in Kuwait for Disease Treatment and Prevention

Mokaddas

Rotimi

Albert

2008

Clin Vaccine Immunol

View full text Add to dashboard Cite

Streptococcus pneumoniae causes serious infections. Treatment is difficult because of the emergence of penicillin resistance in S. pneumoniae. Pneumococcal vaccines offer the promise of control and prevention of pneumococcal infections. Serotype prevalence and penicillin susceptibility data for a country will predict the usefulness of the vaccines in that country. In Kuwait, the 23-valent polysaccharide and the 7-valent conjugate vaccines are being used without knowledge of the prevalent serotypes in the country. To obtain the necessary background information, data on penicillin susceptibility and serogroups were obtained from 397 consecutive clinical isolates collected during 2004 and 2005. Two hundred fifty-three isolates (64%) were penicillin resistant, and resistance was significantly higher in patients <15 years old and among the upper respiratory tract and eye isolates. The most common serotypes were 23F, 19F, 6A, 6B, 14, and 19A. Among the penicillinresistant strains, the most common serotypes were 23F, 19F, 6B, 14, and 9A. Among the invasive strains, the most common serotypes were 14, 23F, 19A, and 9V. The polysaccharide vaccine gave 82% coverage against invasive infections in all age groups >2 years. The coverage of the 7-valent conjugate vaccine against invasive serotypes in children <2 years old was 55%. This moderate coverage by the conjugate vaccine against invasive infections in children necessitates a revised strategy on the use of the present conjugate vaccine and shows the need for formulation of an improved vaccine for superior coverage for Kuwait and possibly other countries of the Arabian Gulf.Successful treatment of Streptococcus pneumoniae infections remains a challenge. S. pneumoniae is a major cause of community-acquired pneumonia, meningitis, and otitis media in adults and children in developed countries (6, 10, 23). Surveillance data continue to reveal increasing resistance of S. pneumoniae to a variety of antimicrobial agents, including penicillins, cephalosporins, macrolides, and quinolones. Currently, in some areas of the world, up to 40% of clinical infections are caused by a pneumococcal strain that is resistant to at least one drug, and 15% are due to strains resistant to three or more drugs (27a). The situation in Kuwait is not different, as indicated by a study in 2001, which revealed that the prevalence of penicillin-resistant S. pneumoniae (PRSP) is 63%; almost half of these strains were multidrug resistant (20). Preventive strategies for pneumococcal infection include targeted use of the 23-valent polysaccharide pneumococcal vaccine in individuals older than 2 years of age and routine immunization of infants and children under 2 years of age with the 7-valent polysaccharide-protein conjugate pneumococcal vaccine. The conjugate vaccine is also recommended for children between 2 and 5 years of age who have not already received the vaccine and are also at high risk of severe pneumococcal disease (2, 3; Centers for Disease Control, unpublished data). Prevention of infection also ...

show abstract

Section: Discussionmentioning

confidence: 97%

Implications of Streptococcus pneumoniae Penicillin Resistance and Serotype Distribution in Kuwait for Disease Treatment and Prevention

Mokaddas

Rotimi

Albert

2008

Clin Vaccine Immunol

View full text Add to dashboard Cite

show abstract

“…Serotypes causing invasive diseases differ from country to country; therefore, it is of utmost importance to identify the most common serotypes causing invasive diseases and to determine which of these are resistant to antimicrobial agents. Serogroup coverage rate for the 7-valent conjugate vaccine for children has been reported as 78% in the United States of America [9], 75.3% in Greece [10], 71% in England [11], 56% in Gambia [12], and 48.4% in Scotland [13]. Serotypes 1 and 5, which are not found in the 7-valent conjugate vaccine, have been reported to be common serotypes, especially in developing countries.…”

Section: Discussionmentioning

confidence: 99%

Ten-year surveillance of invasive Streptococcus pneumoniae isolates in central Turkey prior to the introduction of a conjugate vaccine

Perçin

Altintop

Sümerkan

2010

J Infect Dev Ctries

View full text Add to dashboard Cite

Introduction: The aim of this study was to characterize the serotypes and antimicrobial susceptibility patterns of invasive Streptococcus pneumoniae isolates in central Turkey. Methodology: A total of 332 invasive S. pneumoniae isolates were identified, serotyped and tested for antimicrobial susceptibility by routine microbiological methods. Results: The most common serogroups/serotypes were 1, 19, 3, 18, 6, 14, and 7 in rank order. Serogroup/serotype coverage of the 23-valent polysaccharide vaccine, and the 7-, 10-, and 13-valent conjugate vaccines were 96%, 44%, 78.6%, 96.4%, respectively. Overall, 20 (6%) of the isolates were resistant to penicillin, 1 (0.3%) to cefotaxime, 20 (6%) to erythromycin, 13 (4%) to cloramphenicol, and 120 (36%) to trimethoprim-sulfamethoxasole. Among cerebrospinal fluid (CSF) isolates, 20 (18.5%) were resistant to penicillin (26.3% and 11.5%, respectively, of child and adult meningitis cases; p≥0.05). Conclusions: Although the seven-valent conjugate vaccine is expected to protect less than half of children younger than three years of age, of the incorporation of this vaccine into the routine immunization program of Turkey is advised to continue. However, the 13-valent conjugate vaccine, including serotypes 1, 3, 5, and 7, has the most potential prevent the highest burden of invasive pneumococcal diseases in this age group.

show abstract

“…The hemolytic property of pneumolysin has also been shown to be involved in the initial stages of pneumonia, including invasion of the lung tissue and neutrophil recruitment; however, hemolytic activity is not important in facilitating pneumococcal growth in the alveoli (62,63). As serotype 1 disease is associated with pneumonia rather than meningitis in Europe and the United States (26,30) (Table 1), it may be that hemolytically active pneumolysin is not essential for the pathogenesis of certain serotype 1 sequence types, such as ST306. This may mean that there will be less selective pressure to conserve the nucleotide sequences that encode the hemolytic activity of pneumolysin and may allow the mutations we have identified to arise.…”

Section: Discussionmentioning

confidence: 99%

Identification of Invasive Serotype 1 Pneumococcal Isolates That Express Nonhemolytic Pneumolysin

et al. 2006

View full text Add to dashboard Cite

Recently, there has been an increase in invasive pneumococcal disease (IPD) caused by serotype 1 Streptococcus pneumoniae throughout Europe. Serotype 1 IPD is associated with bacteremia and pneumonia in Europe and North America, especially in neonates, and is ranked among the top five most prevalent pneumococcal serotypes in at least 10 countries. The currently licensed pediatric pneumococcal vaccine does not afford protection to this serotype. Upon screening of 252 clinical isolates of S. pneumoniae, we discovered mutations in the pneumolysin gene of two out of the four serotype 1 strains present in the study group. Analysis of an additional 28 serotype 1 isolates from patients with IPD from various Scottish Health Boards, revealed that >50% had mutations in their pneumolysin genes. This resulted in the expression of nonhemolytic forms of pneumolysin. All of the strains producing nonhemolytic pneumolysin were sequence type 306 (ST306), whereas those producing "wild-type" pneumolysin were ST227. The mutations were in a region of pneumolysin involved in pore formation. These mutations can be made in vitro to give the nonhemolytic phenotype. Pneumolysin is generally conserved throughout all serotypes of S. pneumoniae and is essential for full invasive disease; however, it appears that serotype 1 ST306 does not require hemolytically active pneumolysin to cause IPD.

show abstract

Twenty year surveillance of invasive pneumococcal disease in Nottingham: serogroups responsible and implications for immunisation

Cited by 78 publications

References 33 publications

Implications of Streptococcus pneumoniae Penicillin Resistance and Serotype Distribution in Kuwait for Disease Treatment and Prevention

Implications of Streptococcus pneumoniae Penicillin Resistance and Serotype Distribution in Kuwait for Disease Treatment and Prevention

Ten-year surveillance of invasive Streptococcus pneumoniae isolates in central Turkey prior to the introduction of a conjugate vaccine

Identification of Invasive Serotype 1 Pneumococcal Isolates That Express Nonhemolytic Pneumolysin

Contact Info

Product

Resources

About