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Warda K, Amari S, Boureddane M, Elkamouni Y, Arsalane L, Zouhair S, Bouskraoui M. Changes in pneumococcal serotypes distribution and penicillin resistance in healthy children five years after generalization of PCV10. Heliyon 2024; 10:e25741. [PMID: 38380016 PMCID: PMC10877248 DOI: 10.1016/j.heliyon.2024.e25741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/11/2024] [Accepted: 02/01/2024] [Indexed: 02/22/2024] Open
Abstract
Objective Streptococcus pneumoniae (S. pneumoniae) nasopharyngeal carriage has significantly decreased after the generalization of pneumococcal vaccination worldwide. This study sought to investigate changes in S. pneumoniae carriage rates, serotype distribution and penicillin non-susceptibility following the generalization of 10-valent pneumococcal conjugate vaccine. Methods A prospective study was conducted in Marrakesh, Morocco, between 2017 and 2018, among healthy children attending vaccination centers. We collected nasopharyngeal swabs and questionnaire data for each child. Using univariate logistic regression, we analyzed the association between S. pneumoniae carriage and various risk factors. Comparisons of serotype diversity and penicillin resistance between 2017 and 2018 and the period before introduction of vaccination (2008-2009, n = 660) were performed using Simpson index and the chi-squared test, respectively. Results During 2017-2018, 515 children aged between 6 and 36 months participated. The S. pneumoniae carriage rate was 43.3%. Looking at the distribution serotypes, the rate of PCV10 serotypes rate was only 9.6%. Among non-vaccine serotypes, an increase in serotypes 6C/6D (22; 14%), 19B/19C (17; 10.8%), and 15B/15C (11; 7%) was observed. A particular increase in serotype diversity was also observed after the generalization of PCV10 (p < 0.001). S. pneumoniae non-susceptible to penicillin decreased, reaching a rate of 26.6% in 2017-2018. Conclusion The significant change in S. pneumoniae carriage, serotype distribution, and penicillin resistance highlights the effectiveness of the pneumococcal conjugate vaccine among children in Marrakesh, Morocco.
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Affiliation(s)
- Karima Warda
- Laboratory of Microbiology and Virology, Cadi Ayad University, Marrakesh, Morocco
| | - Sara Amari
- Laboratory of Microbiology and Virology, Cadi Ayad University, Marrakesh, Morocco
| | - Majda Boureddane
- Laboratory of Microbiology and Virology, Cadi Ayad University, Marrakesh, Morocco
| | - Youssef Elkamouni
- Laboratory of Microbiology and Virology, Cadi Ayad University, Marrakesh, Morocco
- Laboratory of Microbiology-Virology and Molecular Biology, Avicenna Military Hospital, Marrakesh, Morocco
| | - Lamiae Arsalane
- Laboratory of Microbiology and Virology, Cadi Ayad University, Marrakesh, Morocco
- Laboratory of Microbiology-Virology and Molecular Biology, Avicenna Military Hospital, Marrakesh, Morocco
| | - Said Zouhair
- Laboratory of Microbiology and Virology, Cadi Ayad University, Marrakesh, Morocco
- Laboratory of Microbiology-Virology and Molecular Biology, Avicenna Military Hospital, Marrakesh, Morocco
| | - Mohammed Bouskraoui
- Laboratory of Microbiology and Virology, Cadi Ayad University, Marrakesh, Morocco
- Department of Pediatrics, Mohamed VI University Hospital Center, Marrakesh, Morocco
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Malchrzak W, Babicki M, Mastalerz-Migas A. Vaccination against Streptococcus pneumoniae in Children Born between 2015 and 2018 in Poland-How Has the Introduction of Free Compulsory Pneumococcal Vaccination Affected Its Uptake? Vaccines (Basel) 2023; 11:1654. [PMID: 38005986 PMCID: PMC10675499 DOI: 10.3390/vaccines11111654] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 10/26/2023] [Indexed: 11/26/2023] Open
Abstract
Starting from 2017, pneumococcal vaccination was added to the Polish vaccination calendar as mandatory for all children born after 2016. The 10-valent conjugate vaccine was selected as mandatory and therefore free of charge. This paper aims to examine the impact of introducing mandatory vaccination on vaccine uptake. For this purpose, an analysis was conducted for 1595 vaccination record sheets from outpatient clinics in Wrocław and surrounding villages for children born 2015-2018. After the introduction of compulsory vaccination, the percentage of children fully vaccinated against pneumococcus increased (60.4% vs. 84.8%, p < 0.001). A significant decrease in the number of children who did not receive any dose of the vaccine was observed (27.8% to 3.3%, p < 0.001). The introduction of compulsory vaccination did not affect the completion of the pneumococcal schedule (11.8% vs. 11.9%). Compulsory PCV10 vaccination resulted in the less frequent choice of the 13-valent vaccine (72.3% vs. 19.9%, p < 0.001). More children in rural outpatient clinics were vaccinated against pneumococcus compared to urban outpatient clinics (84.8% vs. 70.8%, p < 0.001). The introduction of free pneumococcal vaccination increased the proportion of children vaccinated, although it did not affect the rate of discontinuation of the initiated schedule. In Poland, the increased popularity of the 10-valent vaccine at the expense of the 13-valent one translated into a change in the proportion of pneumococcal serotypes causing invasive pneumococcal disease.
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Affiliation(s)
- Wojciech Malchrzak
- Department of Family Medicine, Faculty of Medicine, Wroclaw Medical University, 50-367 Wrocław, Poland; (M.B.); (A.M.-M.)
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Schellenberg JJ, Adam HJ, Baxter MR, Karlowsky JA, Golden AR, Martin I, Demczuk W, Mulvey MR, Zhanel GG. Comparison of PCV10, PCV13, PCV15, PCV20 and PPSV23 vaccine coverage of invasive Streptococcus pneumoniae isolate serotypes in Canada: the SAVE study, 2011-20. J Antimicrob Chemother 2023; 78:i37-i47. [PMID: 37130588 DOI: 10.1093/jac/dkad068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND As pneumococci evolve under vaccine, antimicrobial and other selective pressures, it is important to track isolates covered by established (PCV10, PCV13 and PPSV23) and new (PCV15 and PCV20) vaccine formulations. OBJECTIVES To compare invasive pneumococcal disease (IPD) isolates from serotypes covered by PCV10, PCV13, PCV15, PCV20 and PPSV23, collected in Canada from 2011 to 2020, by demographic category and antimicrobial resistance phenotype. METHODS IPD isolates from the SAVE study were initially collected by members of the Canadian Public Health Laboratory Network (CPHLN) as part of a collaboration between the Canadian Antimicrobial Resistance Alliance (CARA) and the Public Health Agency of Canada (PHAC). Serotypes were determined by quellung reaction, and antimicrobial susceptibility testing was performed using the CLSI broth microdilution method. RESULTS A total of 14 138 invasive isolates were collected from 2011 to 2020, with 30.7% of isolates covered by the PCV13 vaccine, 43.6% of isolates covered by the PCV15 vaccine (including 12.9% non-PCV13 serotypes 22F and 33F), and 62.6% of isolates covered by the PCV20 vaccine (including 19.0% non-PCV15 serotypes 8, 10A, 11A, 12F and 15B/C). Non-PCV20 serotypes 2, 9N, 17F and 20, but not 6A (present in PPSV23) represented 8.8% of all IPD isolates. Higher-valency vaccine formulations covered significantly more isolates by age, sex, region and resistance phenotype including MDR isolates. Coverage of XDR isolates did not significantly differ between vaccine formulations. CONCLUSIONS When compared with PCV13 and PCV15, PCV20 covered significantly more IPD isolates stratified by patient age, region, sex, individual antimicrobial resistance phenotypes and MDR phenotype.
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Affiliation(s)
- John J Schellenberg
- Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, Room 543-745 Bannatyne Avenue, Winnipeg, Manitoba R3E 0J9, Canada
| | - Heather J Adam
- Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, Room 543-745 Bannatyne Avenue, Winnipeg, Manitoba R3E 0J9, Canada
- Clinical Microbiology, Shared Health, MS673-820 Sherbrook Street, Winnipeg, Manitoba R3A 1R9, Canada
| | - Melanie R Baxter
- Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, Room 543-745 Bannatyne Avenue, Winnipeg, Manitoba R3E 0J9, Canada
| | - James A Karlowsky
- Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, Room 543-745 Bannatyne Avenue, Winnipeg, Manitoba R3E 0J9, Canada
- Clinical Microbiology, Shared Health, MS673-820 Sherbrook Street, Winnipeg, Manitoba R3A 1R9, Canada
| | - Alyssa R Golden
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba R3E 3R2, Canada
| | - Irene Martin
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba R3E 3R2, Canada
| | - Walter Demczuk
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba R3E 3R2, Canada
| | - Michael R Mulvey
- Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, Room 543-745 Bannatyne Avenue, Winnipeg, Manitoba R3E 0J9, Canada
- National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba R3E 3R2, Canada
| | - George G Zhanel
- Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, Room 543-745 Bannatyne Avenue, Winnipeg, Manitoba R3E 0J9, Canada
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Li L, Ma J, Yu Z, Li M, Zhang W, Sun H. Epidemiological characteristics and antibiotic resistance mechanisms of Streptococcus pneumoniae: An updated review. Microbiol Res 2023; 266:127221. [DOI: 10.1016/j.micres.2022.127221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/13/2022] [Accepted: 10/03/2022] [Indexed: 11/27/2022]
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Kim GR, Kim EY, Kim SH, Lee HK, Lee J, Shin JH, Kim YR, Song SA, Jeong J, Uh Y, Kim YK, Yong D, Kim HS, Kim S, Kim YA, Shin KS, Jeong SH, Ryoo N, Shin JH. Serotype Distribution and Antimicrobial Resistance of Streptococcus pneumoniae Causing Invasive Pneumococcal Disease in Korea Between 2017 and 2019 After Introduction of the 13-Valent Pneumococcal Conjugate Vaccine. Ann Lab Med 2023; 43:45-54. [PMID: 36045056 PMCID: PMC9467834 DOI: 10.3343/alm.2023.43.1.45] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/02/2022] [Accepted: 08/20/2022] [Indexed: 01/14/2023] Open
Abstract
Background Streptococcus pneumoniae is a serious pathogen causing various infections in humans. We evaluated the serotype distribution and antimicrobial resistance of S. pneumoniae causing invasive pneumococcal disease (IPD) after introduction of pneumococcal conjugate vaccine (PCV)13 in Korea and investigated the epidemiological characteristics of multidrug-resistant (MDR) isolates. Methods S. pneumoniae isolates causing IPD were collected from 16 hospitals in Korea between 2017 and 2019. Serotyping was performed using modified sequential multiplex PCR and the Quellung reaction. Antimicrobial susceptibility tests were performed using the broth microdilution method. Multilocus sequence typing was performed on MDR isolates for epidemiological investigations. Results Among the 411 S. pneumoniae isolates analyzed, the most prevalent serotype was 3 (12.2%), followed by 10A (9.5%), 34 (7.3%), 19A (6.8%), 23A (6.3%), 22F (6.1%), 35B (5.8%), 11A (5.1%), and others (40.9%). The coverage rates of PCV7, PCV10, PCV13, and pneumococcal polysaccharide vaccine (PPSV)23 were 7.8%, 7.8%, 28.7%, and 59.4%, respectively. Resistance rates to penicillin, ceftriaxone, erythromycin, and levofloxacin were 13.1%, 9.2%, 80.3%, and 4.1%, respectively. MDR isolates accounted for 23.4% of all isolates. Serotypes 23A, 11A, 19A, and 15B accounted for the highest proportions of total isolates at 18.8%, 16.7%, 14.6%, and 8.3%, respectively. Sequence type (ST)166 (43.8%) and ST320 (12.5%) were common among MDR isolates. Conclusions Non-PCV13 serotypes are increasing among invasive S. pneumoniae strains causing IPD. Differences in antimicrobial resistance were found according to the specific serotype. Continuous monitoring of serotypes and antimicrobial resistance is necessary for the appropriate management of S. pneumoniae infections.
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Affiliation(s)
- Gyu Ri Kim
- Department of Laboratory Medicine, Inje University College of Medicine, Busan, Korea
| | - Eun-Young Kim
- Department of Laboratory Medicine, Inje University College of Medicine, Busan, Korea.,Paik Institute for Clinical Research, Inje University College of Medicine, Busan, Korea
| | - Si Hyun Kim
- Department of Clinical Laboratory Science, Semyung University, Jecheon, Korea
| | - Hae Kyung Lee
- Department of Laboratory Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jaehyeon Lee
- Department of Laboratory Medicine, Jeonbuk National University Medical School and Hospital, Jeonju, Korea
| | - Jong Hee Shin
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Young Ree Kim
- Department of Laboratory Medicine, College of Medicine, Jeju National University, Jeju, Korea
| | - Sae Am Song
- Department of Laboratory Medicine, Inje University College of Medicine, Busan, Korea
| | - Joseph Jeong
- Department of Laboratory Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Young Uh
- Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Yu Kyung Kim
- Department of Laboratory Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Dongeun Yong
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Soo Kim
- Department of Laboratory Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Sunjoo Kim
- Department of Laboratory Medicine, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Young Ah Kim
- Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Kyeong Seob Shin
- Department of Laboratory Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Seok Hoon Jeong
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea
| | - Namhee Ryoo
- Department of Laboratory Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Jeong Hwan Shin
- Department of Laboratory Medicine, Inje University College of Medicine, Busan, Korea.,Paik Institute for Clinical Research, Inje University College of Medicine, Busan, Korea
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Recalibrated estimates of non-bacteremic and bacteremic pneumococcal community acquired pneumonia in hospitalized Canadian adults from 2010 to 2017 with addition of an extended spectrum serotype-specific urine antigen detection assay. Vaccine 2022; 40:2635-2646. [DOI: 10.1016/j.vaccine.2022.02.081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/10/2022] [Accepted: 02/24/2022] [Indexed: 12/26/2022]
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Abstract
Intravenous cefiderocol (Fetroja®; Fetcroja®) is the first siderophore cephalosporin approved for the treatment of adults with serious Gram-negative bacterial infections. Cefiderocol is stable against all four Ambler classes of β-lactamases (including metallo-β-lactamases) and exhibits excellent in vitro activity against many clinically relevant Gram-negative pathogens, including multidrug resistant strains. In randomized, double-blind clinical trials, cefiderocol was noninferior to imipenem/cilastatin for the treatment of complicated urinary tract infections (cUTI) and to meropenem for nosocomial pneumonia. Furthermore, in a pathogen-focused clinical trial in patients with carbapenem-resistant (CR) infections, cefiderocol showed comparable efficacy to best available therapy (BAT), albeit all-cause mortality rate was higher in the cefiderocol arm, the cause of which has not been established. Cefiderocol had a good tolerability and safety profile in clinical trials. Thus cefiderocol is a novel, emerging, useful addition to the current treatment options for adults with susceptible Gram-negative bacterial infections (including cUTI and nosocomial pneumonia) for whom there are limited treatment options.
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Affiliation(s)
- Yahiya Y Syed
- Springer Nature, Private Bag 65901, Mairangi Bay, Auckland, 0754, New Zealand.
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