Two multi-fragment recombination events resulted in the β-lactam-resistant serotype 11A-ST6521 related to Spain9V-ST156 pneumococcal clone spreading in south-western Europe, 2008 to 2016

González-Díaz, Aida; Machado, Miguel P.; Càmara, Jordi; Yuste, José; Varon, Emmanuelle; Domenech, Mirian; Grosso, María Del; Marimón, José María; Cercenado, Emilia; Larrosa, Nieves; Quesada, María Dolores; Fontanals, Dionísia; El-Mniai, Assiya; Cubero, Meritxell; Carriço, João André; Martí, Sara; Ramírez, Mario; Ardanuy, Carmen

doi:10.2807/1560-7917.es.2020.25.16.1900457

Cited by 16 publications

(11 citation statements)

References 45 publications

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“…A previous study from our group ( 28 ) reported persistence of serotype 14 related to CC156; however, in the present study, a significant decrease of serotype 14, mainly in the <5-year-old children and ≥65-year-old adults, was observed. Interestingly, while serotype 14 decreased, serotype 11A related to ST6521, a double locus variant included in CC156, experienced a modest increase that could be associated with capsular switching ( 33 ). Monitoring of the evolution of these serotypes related to CC156 seems relevant for future vaccines.…”

Section: Discussionmentioning

confidence: 99%

Serotypes and Clonal Composition of Streptococcus pneumoniae Isolates Causing IPD in Children and Adults in Catalonia before 2013 to 2015 and after 2017 to 2019 Systematic Introduction of PCV13

et al. 2021

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Section: Discussionmentioning

confidence: 99%

Serotypes and Clonal Composition of Streptococcus pneumoniae Isolates Causing IPD in Children and Adults in Catalonia before 2013 to 2015 and after 2017 to 2019 Systematic Introduction of PCV13

et al. 2021

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“…We also found a significantly high frequency of serotype 11A isolates causing non-BPP episodes. Studies on IPD show a low frequency of episodes caused by this serotype [33] but this is not the case when we look at other pneumococcal diseases. For instance, serotype 11A is a frequent serotype causing acute exacerbations and pneumonia in patients with chronic obstructive pulmonary disease (COPD) [34,35].…”

Section: Discussionmentioning

confidence: 80%

“…In fact, serotype 11A is also frequent in carriage suggesting a low invasive disease potential [36,37]. An increase in serotype 11A isolates has been reported in Europe after the introduction of PCVs [33] due to the emergence of a new lineage related to the Spain 9V -156 clone (PMEN3). As this clone shows characteristically β-lactam resistance with high amoxicillin MICs (4-8 mg/L) [38], its significant frequency among non-BPP episodes should be taken into account when choosing empirical oral therapy.…”

Section: Discussionmentioning

confidence: 99%

Serotypes in Adult Pneumococcal Pneumonia in Spain in the Era of Conjugate Vaccines

et al. 2021

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We studied changes in serotype distribution and antimicrobial susceptibility in adult pneumococcal pneumonia in Spain (2011–2019). Among 895 pneumococci collected (433 bacteremic [BPP] and 462 non-bacteremic [non-BPP]), serotypes 3 (17%), 19A (10%), 8 (6.7%) and 11A (6.7%) were the most frequent. Serotypes 16F, 19A and 24F were associated with old people (≥65) and serotypes 4, 7F, 8, 12F and 19F to young adults. Serotypes 12F, 24F and 1 were significantly more frequent in BPP and serotypes 11A, 23A and 19F in non-BPP. Amoxicillin resistance was higher in non-BPP (17% vs. 11%) while penicillin non-susceptibility (37% vs. 24%) and macrolide resistance (29% vs. 14%) were higher in older adults. In the period 2017–2019, the vaccine coverages were: 32% (PCV13), 39% (PCV15), 65% (PCV20) and 69% (PPV23). Differences were found in serotype composition and antimicrobial resistance by age and type of infection. The maintenance of serotype 3 as a leading cause of adult pneumococcal pneumonia and the increase in highly invasive (serotype 8) or antimicrobial-resistant (serotype 11A) serotypes is worrisome. Further studies will be required to analyse the impact of the upcoming broader conjugate vaccines.

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“…Thus, the emergence of penicillin-resistant strains of serotype 11A is concerning from a pathogenesis perspective [34]. The invasive disease potential of this serotype is highly related to the rise of genotype ST6521 11A that has spread across Europe in the last years, becoming one of the most prevalent within serotype 11A [35]. This genotype of serotype 11A is associated with high levels of antibiotic resistance, shows a greater ability to form biofilms and avoids very efficiently the host immune response [34].…”

Section: Discussionmentioning

confidence: 99%

Evolution of Antimicrobial Susceptibility to Penicillin in Invasive Strains of Streptococcus pneumoniae during 2007–2021 in Madrid, Spain

et al. 2023

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The use of pneumococcal conjugate vaccines has affected the epidemiology and distribution of Streptococcus pneumoniae serotypes causing Invasive Pneumococcal Disease (IPD). The aim of this study was to analyze the evolution of the phenotypical profiles of antimicrobial susceptibility to penicillin (PEN) in all IPD strains isolated in Madrid, Spain, during 2007–2021. In total, 7133 invasive clinical isolates were characterized between 2007 and 2021. Levels of PENR and PNSSDR were 2.0% and 24.2%, respectively. In addition, 94.4% of all the PENR belonged to four serotypes, including 11A (33.6%), 19A (30.8%), 14 (20.3%) and 9V (9.8%). All the strains of serotype 11A, which is a non-PCV13 serotype, were detected after the year 2011. Serotypes 6C, 15A, 23B, 24F, 35B, 19F, 16F, 6B, 23F, 24B, 24A, 15F and a limited number of strains of serogroups 16 and 24 (non-typed at serotype level) were associated with PNSSDR (p < 0.05). PNSSDR strains of non-PCV13 serotypes 11A, 24F, 23B, 24B, 23A and 16F were more frequent from 2014 to 2021. The changes in S. pneumoniae serotype distribution associated with the use of conjugate vaccines had caused in our region the emergence of non-PCV13 pneumococcal strains with different PENR or PNSSDR patterns. The emergence of serotype 11A resistant to penicillin as the most important non-PCV13 serotype is a worrisome event with marked relevance from the clinical and epidemiological perspective.

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Two multi-fragment recombination events resulted in the β-lactam-resistant serotype 11A-ST6521 related to Spain9V-ST156 pneumococcal clone spreading in south-western Europe, 2008 to 2016

Abstract: Two multi-fragment recombination events resulted in the β-lactam-resistant serotype 11A-ST6521 related to Spain9V-ST156 pneumococcal clone spreading

Cited by 16 publications

References 45 publications

Serotypes and Clonal Composition of Streptococcus pneumoniae Isolates Causing IPD in Children and Adults in Catalonia before 2013 to 2015 and after 2017 to 2019 Systematic Introduction of PCV13

Serotypes and Clonal Composition of Streptococcus pneumoniae Isolates Causing IPD in Children and Adults in Catalonia before 2013 to 2015 and after 2017 to 2019 Systematic Introduction of PCV13

Serotypes in Adult Pneumococcal Pneumonia in Spain in the Era of Conjugate Vaccines

Evolution of Antimicrobial Susceptibility to Penicillin in Invasive Strains of Streptococcus pneumoniae during 2007–2021 in Madrid, Spain

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